NEBRASKA
Although budget shortfalls threatened to limit state spending on long-term care services in FY 2003 and FY 2004, the Nebraska Department of Health and Human Services continued to develop a consumer-directed focus for its home and community-based services. The state also was developing a public information campaign about alternatives to nursing homes for people who need long-term care services.
The Budget
In January 2003, Governor Mike Johanns proposed cutting the state's Medicaid budget by $15 million over two years (July 1, 2003 through June 30, 2005), resulting in the loss of an additional $21 million in federal matching payments. In 2002, the Legislature approved a one-year, half-cent sales tax increase, a one-year 2.2 percent income tax increase, and a two-year 30-cent per pack cigarette tax increase.
Grant Initiatives
The state received a $2 million federal Real Choice Systems Change grant in 2001, which it planned to use to implement a consumer-directed model of services across all populations of people with disabilities. To develop a plan, the state held a two-day consumer-directed services meeting in April 2002. Participants represented various consumer populations, advocates, providers and public agencies.
Eight town hall meetings also were held through the state in the fall of 2002. The purpose of the town hall meetings was to share information, determine the make-up of consumer-directed services, and identify barriers to the provision of consumer-directed services. A consumer task force and steering committee are providing direction and guidance to the project. The Nebraska Department of Health and Human Services is responsible for carrying out and sustaining project initiatives.
Nebraska also received a $600,000 Systems Change grant to develop a communication/marketing campaign to inform the public about long-term care options, particularly alternatives to nursing facility placement. Part of the campaign involves using Area Agencies on Aging to enlist nursing home staff to identify possible candidates who could move into the community. Specially trained ombudsmen volunteers also will help identify candidates and facilitate successful transitions.
Work Force
The Legislature in 2002 increased to 40 hours the competency course required of medication aides in assisted living facilities; it now is the same as for medication aides in nursing homes and in intermediate care facilities for the mentally retarded. The lawmakers also made changes to provisions relating to nursing home administration, including eliminating a required state examination for licensure as a nursing home director and providing for a range of licensure fees.
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