LINCOLN, Neb. (KMTV) — Nebraska’s nurses, nursing homes, assisted living centers, behavioral health providers, medical clinics, rural care providers and people serving those with developmental disabilities all are seeking funding boosts, a legislative committee heard Tuesday.
Combined, those seven bills seek to spend $294.5 million in federal American Rescue Plan Act funds if all were approved. The Appropriations Committee, which sets the Legislature’s spending priorities, heard how those funds could help ease staffing and funding challenges facing parts of Nebraska’s health care system.
Legislative Bill 996, proposed by State Sen. Myron Dorn of Adams, would target $5.5 million in federal relief funds to help staff recruiting and retention at Nebraska’s assisted living facilities. It would also pay for masks and other personal protective equipment and COVID-19 testing.
Jeff Fritzen, executive director of a combined assisted living and nursing home facility in Adams, said the pandemic is far from over for staff at Gold Crest Retirement Center. The center employs about 95 people to help 20 assisted living residents and 40 nursing home residents.
Gold Crest recently had its worst week of positive COVID-19 tests since the start of the pandemic, Fritzen testified. Five residents tested positive. Thankfully, he said, all were vaccinated and boosted, and they’re doing OK.
But every positive test means staff members have to add gowns, goggles and gloves to their protective equipment, he said. They must deliver food and beverages in disposable containers. And staff have to be tested more often. The costs add up quickly, he explained.
“Assisted livings are receiving a lot of increased costs due to the pandemic,” Fritzen said.
He said LB 996 would provide $400 for every qualifying assisted living bed in the state, helping more assisted living facilities hold onto the workers who help care for the elderly.
Bonuses, ‘front-line’ nurses
LB 1055, proposed by Sen. Mike McDonnell of Omaha, would spend $50 million in federal relief funds for hospitals and federally qualified medical providers to offer bonuses and higher pay to “front-line” nurses caring for patients. About 20,000 of Nebraska’s nurses could receive about $2,000 each under the proposal.
Virginia Wolking, a nurse in the medical-surgical unit at Children’s Hospital & Medical Center in Omaha, said many of the nurses working with patients during the pandemic could use the gesture of goodwill. Many have spent months stressed about the health of their patients and the safety of their families.
Children’s, for example, has had trouble replacing 60% of the nurses it lost in 2021, she said. Like many hospital systems across the state, they’ve had to fill in with contracted nurses, also known as traveling nurses. That means local hospitals, like others nationally, are competing for a smaller pool of health care workers who are in high demand, she said.
“When we nurses are stretched so thin and do not have time to ease a parent’s fears or make a child laugh, that takes away from the art of nursing and what we enjoy most about our work,” she said.
Many of the nurses who testified Tuesday spoke about the mental strain of caring for so many sick patients, including Linda Stones, a member of the Nebraska Board of Nursing. That’s partly why Nebraska saw its first decline in 20 years in the number of nurses, she said.
Since the start of the pandemic, the state has lost about 2,600 nurses, or 9.5% of its nursing workforce, she testified. Nearly 1,000 more nurses in the state told researchers they might leave the field over the next year, she said.
“We know that monetary (compensation) doesn’t always retain nurses,” she said. “But appreciation is one of the strongest forms of influence for our employee retention.”
Nursing home pay
LB 1089, proposed by Sen. John Stinner of Gering, would set aside $60 million in federal relief funds to help nursing homes boost pay for direct-care employees. It would use $45 million of those funds on Medicaid beds at all nursing homes statewide and would concentrate $15 million on the nursing homes with the most residents in rooms funded by Medicaid.
Jalene Carpenter, president and CEO of the Nebraska Healthcare Association, said her group’s 190 nonprofit nursing homes in Nebraska need the money to help hold onto staff. Nursing homes were having to pay more to hire and retain staff before the pandemic. COVID-19 made things worse, she said.
The bill would provide retention bonuses for certified nursing assistants, medication aides, nurses, housekeeping and laundry staff, all of whom help keep patients healthy, she said.
Kari Wockenfuss, administrator of the Louisville Care Center, which offers 61 nursing home beds and 26 assisted living beds in Louisville, Nebraska, said facilities like hers need help to compete with larger hospital systems and jobs in other states. They’re hiring costlier traveling nurses to fill in.
They would use the funding for bonuses to staff who pick up extra shifts, scholarships for staff and help with licensing.
“I think that that would bring other people that have been, that would like to come to long-term care instead of maybe the hospital,” Wockenfuss said. “Some of my nurses, they didn’t want to leave, but the money was there.”
Rural care providers
LB 1269, proposed by Sen. Dave Murman of Glenvil, would earmark $10 million in federal relief funds to help medical professionals working in rural areas to repay more of their student loans. It would do so under the Rural Health Systems and Professional Incentive Act.
This bill would boost funding of an existing student loan repayment program administered by the Nebraska Department of Health and Human Services that pays off educational costs if doctors and other medical professionals agree to practice in a rural area for three or four years.
The program is open to doctors, physicians assistants, nurse practitioners, dentists, pharmacists, occupational therapists, physical therapists, psychologists and more.
Murman said the program has had a wait list in recent years, so the Legislature boosted funding. These federal funds would give rural areas more medical professionals who want to work and live in their communities.
“Currently it is my understanding that there are approximately 200 providers in the program,” he said. “This funding would accommodate approximately a thousand providers, making a huge immediate impact in rural health care.”
LB 1183, proposed by Sen. Ray Aguilar of Grand Island, would create $25 million in grants for the outpatient community clinics that serve Nebraska’s neediest patients, without regard to whether they can afford the care they need. The grants would be used on clinic-related construction projects.
Kenny McMorris, CEO of the Charles Drew Health Center in North Omaha, said the money would allow his center to build additional space and address more mental health needs, including more treatment for people battling substance abuse.
Statewide, he said, the bill would inject $40 million a year in economic inpact into local economies each year, boost local public health and create more than 400 high-paying jobs. It would add primary care, clinics, nurses, doctors, dentists, behavioral health professionals and support staff.
“This will give us an opportunity to have some bricks and mortar build additional locations that allows us to be able to do more,” McMorris said.
Rural mental health
LB 1066, proposed by Sen. John Stinner of Gering, would aim $5 million in federal money at grants for adding new mental health beds in rural Nebraska and $28 million at the University of Nebraska’s Behavioral Health Education Center to create a new internship program, add online mental health services and more.
Dr. Marley Doyle, a psychiatrist who directs the Behavioral Health Education Center of Nebraska at the University of Nebraska, testified in her private capacity about the importance of the state continuing to invest in the behavioral health workforce. She called it essential, regardless of the pandemic.
But she said the pandemic has negatively affected many people’s mental health. She cited an October 2021 survey that found about a third of Nebraskans saying they were depressed or anxious.
“There’s a dire need for behavioral health professionals in our state,” she said. “With the pandemic, we’ve seen an increased demand for services, so it’s just exacerbated the shortage that we already had.”
Doyle said the combination of the internship program and increased telehealth services for mental health would help make more mental health care accessible in more parts of Nebraska.
Developmental disability providers
LB 1172, proposed by Sen. Robert Hilkemann of Omaha, would earmark $111 million in federal relief funds, or $37 million a year for three years, to help DHHS pay more to providers who serve people with developmental disabilities and would help offset COVID-19-related losses and cost increases.
Hilkemann said people who got sick and were quarantined didn’t receive services, and fewer people sought services out of fear of getting their loved ones getting sick. He said the money should help make providers whole and help them pay staff more.
Leslie Bishop Hartung of the Autism Center of Nebraska said many service providers like hers, which employs 144 people, are unable to fill more than a third of their open positions because of funding challenges tied to reimbursement rates and competition for workers.
“We have staffs that are working 100 hours each week, and this is simply not sustainable,” she said. “Providing quality care and supports to persons with autism and other intellectual and developmental disabilities can be exhausting, physically and emotionally.”
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