LB 867 — Change provisions relating to special needs trusts, fingerprints under the Uniform Credentialing Act, child care grants, the Title IV-D Division Customer Service Unit, eligibility for young adults in the bridge to independence program, licensed and self-funded insurers under the Medical Assistance Act, medicaid nursing facility rates, assistance to aged, blind, or disabled persons, and the state Commodity Supplemental Food program; provide for a money follows the person program for medicaid benefits, a youth afterschool eligibility letter for child care employment, use of wholesale drug distributor license fees for the prescription drug monitoring program, and maintenance of epinephrine by certain schools; change provisions of and rename the Alzheimer's Disease and Other Dementia Support Act , the Alzheimer's Disease and Other Dementia Advisory Council, the State Advisory Committee on Mental Health, the Division of Developmental Disabilities of the Department of Health and Human Services, and the Director of Developmental Disabilities; and eliminate provisions relating to divisions of the Department of Health and Human Services, the Division of Medicaid and Long-Term Care Advisory Committee on Aging, the Maternal and Child Health and Public Health Work Fund, and an obsolete Nurse Licensure Compact

Customer service staff responsible for providing account information related to the State Disbursement Unit may be located at the same location as the State -2- LB867 LB867 2026 Disbursement Unit.

(2) The work group shall develop a practice and finance model for child welfare system transformation in Nebraska, with consultation from key stakeholders, judges from separate juvenile courts and judges of county courts sitting as juvenile courts, private child welfare providers, individuals with lived experience in the child welfare system, -5- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 the Nebraska Children's Commission, the Inspector General of Nebraska Child Welfare, the Foster Care Review Office, child advocacy centers, law enforcement, and county attorneys.

-6- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 43-4504 The bridge to independence program is available, on a voluntary basis, to a young adult:

673, if the young adult had attained sixteen years of age before the agreement became effective, or with respect to whom a state-funded guardianship assistance agreement or a state-fundedstate- funded adoption assistance agreement was in effect if the young adult had attained sixteen years of age before the agreement became effective;

673, if the young adult had attained sixteen years of age before the agreement became effective, or with respect to whom a state-state-funded funded guardianship assistance agreement or a state-fundedstate- funded adoption assistance agreement was in effect if the young adult had attained sixteen years of age before the agreement became effective;

or (c) Subdivision (1), (2), or (3)(b) of section 43-247 and (i) after January 1, 2025, upon one day prior to attaining nineteen years of age or the age of majority under relevant tribal law, was in a court-ordered out-of-home placement and (ii) such placement had been authorized or reauthorized in the -3- LB867 LB867 2026 six months prior to the juvenile attaining nineteen -7- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 years of age or the age of majority under relevant tribal law in a court order finding that it would be contrary to the welfare of the juvenile to remain in or return to the juvenile's family home;

or (e) Incapable of doing any of the activities described in subdivisions (3)(a)(3) (a) through (d) of this section due to a medical condition, which incapacity is supported by regularly updated information in the case plan of the young adult;

-8- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 (2) Coverage information means health information possessed by a licensed insurer or self-funded insurer that is limited to the following information about an individual:

(a) Determining an individual's eligibility for state benefit -9- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 programs, including the medical assistance program;

(2)(a) Coverage information requested pursuant to subsection (1) of this section regarding a limited benefit policy shall be limited to whether a specified individual has coverage and, if so, a description of that coverage, and such information shall be used solely for the purposes of subdivision (1)(a)(1) (a) of this section.

and (b) Not deny a claim submitted by the department solely on the basis of the date of submission, the type or format of the claim form, or a failure to present proper documentation at the point-of-sale, if (i) the claim is -4- LB867 LB867 2026 submitted by the department within the three-year period beginning on the date that the health care item or service was provided and (ii) an action by the department to enforce its rights with respect to such claim is commenced within six years after the date of the claim's submission.

Such information shall be provided to the department within -10- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 thirty days after the date of its request unless good cause is shown.

(4)(a) It is the intent of the Legislature that the total amount appropriated to the department for medicaid nursing facility rates be -11- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 identified as a dollar amount in the state budget and be used in the medicaid nursing facility rate calculation, including the calculation of the annual inflation factor.

(c) (b) The department shall file a report electronically with the Legislative Fiscal Analyst and the Clerk of the Legislature no later than June 15 August 1 of each year identifying how the inflation factor was calculated for that year's medicaid nursing facility rates and including the information described in subdivisions (4)(a) and (b) of this section.

(d) (c) The department shall file a report electronically with the Legislative Fiscal Analyst and the Clerk of the Legislature between December 15 and December 31 of each year identifying the amount of any remaining unobligated appropriation from the prior appropriations -12- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 earmarked for medicaid nursing facility payments.

68-1007 In determining need for assistance to the aged, blind, or disabled, the Department of Health and Human Services shall take into -5- LB867 LB867 2026 consideration all other income and resources of the individual claiming such assistance, as well as any expenses reasonably attributable to the earning of any such income, except as otherwise provided in this section.

In making such determination with respect to any individual who is blind, there shall be disregarded the first eighty-five dollars per month of earned income plus one-halfone- half of earned income in excess of eighty-five dollars per month and, for a period not in excess of twelve months, such additional amounts of other income and resources, in the case of an individual who has an approved plan for achieving self-support, as may be necessary for the fulfillment of such plan.

In making such determination with respect to an individual who has attained age sixty-five, or who is permanently and totally disabled, and is claiming aid to the aged, blind, -13- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 or disabled, the department shall disregard earned income at least to the extent such income was disregarded on January 1, 1972, as provided in 42 U.S.C.

-14- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 (c) Allow a family to self-direct services, including contracting for services and supports approved by the division;

(c) The number and demographics of children with disabilities and -15- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 their families who applied under the family support program but who were not found eligible and the reason such children and their families were not found eligible;

and (e) Recommendations to innovate the family support program, improve current programming, and maximize limited funding, including, but not limited to, the potential utilization of other medicaid pathways or medicaid waivers that could help increase access to medicaid and long-long-term term services and supports for children with disabilities or special health care needs.

Section 71-561, Revised Statutes Cumulative Supplement, 2024, is -6- LB867 LB867 2026 amended to read:

71-563 For71-563 For purposes of the Aging, Alzheimer's, and Disease and Other Dementia Support Act:

(a) SeventeenFourteen Twelve voting members appointed by the Governor.

(ii) an -16- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 individual who is a state representative of a nationwide organization that advocates for aging adults or individuals living with Alzheimer's disease or other dementia the family caregiver of an individual living with Alzheimer's disease or another dementia;

(iii) an individual who is a medicalstate professionalrepresentative withof experiencea diagnosingnationwide ororganization treatingthat Alzheimer'sadvocates diseasefor oraging otheradults; dementia represents nursing homes;

(iv) a medical professional with experience diagnosing or treating Alzheimer's disease or other dementia;

(v) a medical or licensed professional with experience working with aging populations;

(vi) an individual who conducts research relating to Alzheimer's disease and other dementia issues;

(vii) an individual who represents long-term care;

(viii) an individual who represents nursing facilities;

(ix) an individual who represents nonmedical home and community- based services, including home care, respite, or adult day care services;

(x) an individual who represents assisted-living facilities;

(xi) one representative from each congressional district representing a planning-and- service area as designated in the Nebraska Community Aging Services Act;

and (xii) an individual with experience with vulnerable aging populations the family caregiver of an individual living with Alzheimer's disease or another dementia;

(iii) an individual who represents nursing homes;

(v) an individual who represents providers of nonmedical home and community-based services, including home care, respite, or adult day care services represents providers of adult day care services;

(vi) an individual who conducts research regarding aging and dementia-related issues represents home care providers;

(vii) ana individualmedical representingprofessional nursingwho homes;has experience diagnosing and treating Alzheimer's disease;

(viii) an individual at large representing those who are aging in Nebraska;

(ix) an individual or an advocate with experience or expertise in aging and special populations;

and (x) one representative from each of the eight planning-and-service areas as designated in the Nebraska Community Aging Services Act a medical professional who has experience diagnosing and treating Alzheimer's disease;

(iii) the administrator a representative of the State Unit on Aging or the administrator's designee of the Division of -17- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 Medicaid and Long-Term Care designated by the Director of Medicaid and Long-Term Care;

(2) The terms of the initial members shall begin on the date of the first meeting as called by the Director of Public Health and (a) one-one-third third shall serve for two-year terms, (b) one-third shall serve for three-year terms, and (c) one-third shall serve for four-year terms, including the chairperson and vice-chairperson.

71-56571-565 (1) (1) The purpose of the council shall be to examine (a) the needs of aging individuals and individuals living with Alzheimer's disease or other dementia, (b) the services available in the state for -18- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 those individuals and their family caregivers, and (c) the ability of health care providers and facilities to meet the current and future needs of such individuals.

-7- LB867 LB867 2026 (2) The council shall collaborate with the department and other state departments as needed to gather input on issues and strategies that pertain to aging, Alzheimer's disease, and other dementia and identify proactive approaches on public health, workforce, caregiver support, and care delivery.

71-56671-566 The The council shall consider and make findings and recommendations on the following topics:

-19- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 (b) The availability of health care workers who can serve people with dementia, including, but not limited to, neurologists, geriatricians, and direct care workers;

(f) Improving services provided in the home and community to delay and decrease the need for institutionalized care for individuals sixty years of age or older or individuals diagnosed with Alzheimer's disease -20- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 or other dementia;

(7) The mutual exchange of ideas and information relating to aging individuals among federal, state, and local governmental agencies, -21-private ER165-8- ER165 LB867 LB867 DLM2026 - 03/27/2026 DLM - 03/27/2026 private organizations, and individuals;

 TheThe Aging, Alzheimer's, and Dementia Advisory Council Fund is created.

Any money in the fund available for investment shall be invested by the state investment officer pursuant to the Nebraska -22- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 Capital Expansion Act and the Nebraska State Funds Investment Act.

71-81471-814 (1) (1) The State Advisory Committee on Mental Health and Substance Use Services is created.

The committee shall consist of twenty-twenty-three three members appointed by the Governor as follows:

(2) The committee shall be responsible to the division and shall (a) serve as the state's mental health planning council as required by Public Law 102-321, (b) conduct regular meetings, (c) provide advice and assistance to the division relating to the provision of mental health services and, beginning July 1, 2026, substance use disorder services in the State of Nebraska, including, but not limited to, the development, implementation, provision, and funding of organized peer support services, (d) promote the interests of consumers and their families, including, but not limited to, their inclusion and involvement in all aspects of services design, planning, implementation, provision, education, evaluation, and research, (e) provide reports as requested by -23- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 the division, and (f) engage in such other activities as directed or authorized by the division.

For purposes of this section, temporary nonresidential child care program means a program in which child care is -9- LB867 LB867 2026 provided (a) for no more than twelve consecutive hours, (b) not on a continuous or regularly scheduled basis, and (c) in a location not ordinarily used as a licensed child care center.

(i) Complete all registry checks required for licensed child care -24- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 staff, including the child abuse and neglect and sex offender registries, and any additional registry checks required by the department;

(b) If the eligibility letter holder begins employment in a school-school-age age child care program or a temporary nonresidential child care program within one hundred eighty days after the date of issuance, the eligibility letter shall remain valid for purposes of such employment for one year after the date of issuance if the eligibility letter holder maintains continuous employment with such program.

(d) A youth afterschool eligibility letter may be renewed through an -25- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 expedited process established by the department.

71-2226 The71-2226 The Department of Health and Human Services is authorized to have a state CSF program to protect the health and welfare of the citizens of Nebraska by providing nutritious foods donated for such program by the United States Department of Agriculture, nutrition education, and such other benefits as are available to women, infants, children, and elderly persons in Nebraska who are low income and vulnerable to malnutrition as long as federal funds are available from the CSF program and are granted to the department.

To the extent consistent with state law, the Department of Health and Human Services may establish, operate, and maintain the program in a way that will qualify it to receive federal funds and that is uniform with United States Department of Agriculture's standards, enter into agreements with the federal government to establish a CSF program, adopt and promulgate rules and regulations to implement a CSF program which are consistent with federal regulations and such other rules and regulations -26- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 as may be necessary to implement the CSF program, and enter into such other agreements as may be necessary to implement the program within this state.

(3) If the licensure application is denied, the license fee shall be returned to the applicant, except that the department may retain up to twenty-fivetwenty- five dollars as an administrative fee and may retain the entire license fee if an inspection has been completed prior to such denial.

-10- LB867 LB867 2026 (4) The department shall also collect a fee for reinstatement of a license that has lapsed or has been suspended or revoked.

(6) The State Treasurer shall transfer three million seven hundred thousand dollars from the Health and Human Services Cash Fund to the General Fund on or before June 30, 2018, on such dates and in such -27- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 amounts as directed by the budget administrator of the budget division of the Department of Administrative Services.

(b) Appoint and convene a stakeholder advisory committee to assist in the review and development of the strategic plan, such committee members to include a representative from the State Advisory Committee on Mental Health and Substance Use Services, the Advisory Committee on Developmental Disabilities, the Nebraska Statewide Independent Living Council, the Nebraska Planning Council on Developmental Disabilities, the Division of Rehabilitation Services in the State Department of Education, the Public Service Commission, the Commission for the Deaf and Hard of Hearing, the Commission for the Blind and Visually Impaired, a housing authority in a city of the first or second class and a housing authority in a city of the primary or metropolitan class, the Assistive Technology Partnership, the protection and advocacy system for Nebraska, an -28- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 assisted-living organization, the behavioral health regions, mental health practitioners, developmental disability service providers, an organization that advocates for persons with developmental disabilities, an organization that advocates for persons with mental illness, an organization that advocates for persons with brain injuries, and an area agency on aging, and including two persons with disabilities representing self-advocacy organizations, and, at the department’s discretion, other persons with expertise in programs serving persons with disabilities;

-29- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 (h) All personnel of the court systems;

(p) All personnel of the Coordinating Commission for Postsecondary -11- LB867 LB867 2026 Education;

(v) The chief executive officers of all facilities operated by the Department of Correctional Services and the medical director for the -30- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 department appointed pursuant to section 83-4,156;

Number of Agency Number of Noncovered Employees Positions less than 25 0 25 to 100 1 101 to 250 2 251 to 500 3 -31- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 501 to 1000 4 1001 to 2000 5 2001 to 3000 8 3001 to 4000 11 4001 to 5000 40 over 5000 50 The purpose of having such noncovered positions shall be to allow agency heads the opportunity to recruit, hire, and supervise critical, confidential, or policymaking personnel without restrictions from selection procedures, compensation rules, career protections, and grievance privileges.

-12- LB867 LB867 2026 81-2205 Council Committee shall mean the Aging, Alzheimer's, and Dementia Advisory Council Division of Medicaid and Long-Term Care Advisory Committee on Aging.

-32- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 81-2212 The council In addition to duties enumerated in section 68-1104, the committee shall advise the department regarding:

Section 81-2234, Reissue Revised Statutes of Nebraska, is amended to read:

81-2234 (1) Care management clients may contribute to the costs of receiving care management services, as provided under section 81-2230.

A client family income schedule, using the federal poverty guidelines, shall be used to determine a care management client's voluntary contribution.

Individuals who have family income below three hundred percent of a poverty level determined by the Department of Health and Human Services based on any federal poverty index or similar guidelines may contribute shall pay from zero to ninety percent of the cost fee for the services provided by a care management unit.

The client family income schedule fee scale shall be adopted and promulgated as rules and regulations by the department and shall reflect the income range of individuals.

(2) A care management unit may receive reimbursement from state and federal government programs which allow for reimbursement for care management or case management services.

(3) Individuals not covered by subsection (1) or (2) of this section shall pay the full fee for services provided by a care management unit.

Sec.

31.

Section 81-2235, Reissue Revised Statutes of Nebraska, is amended to read:

81-2235 (1) Each care management unit may be reimbursed by the Department of Health and Human Services for costs not paid for by the individual or through other reimbursement specified in section 81-2234.

Reimbursement by the department shall be based on actual casework time units expended on all care management services provided and shall include expenses for personnel, administration and planning, client eligibility review, contractual services, and necessary support services and other necessary actual and indirect costs.

Standardized rates of reimbursement shall be adopted and promulgated by the department and shall be adjusted at least every three years.

(2) Appropriations for reimbursement by the department for services provided under sections 81-2229 to 81-2235 and for the costs of the department to administer the program shall be appropriated separately from funds appropriated under the Nebraska Community Aging Services Act.

Sec.

32.

The department shall have five divisions to be known as (1) the Division of Behavioral Health, (2) the Division of Children and Family Services, (3) the Division of Disability and Aging Developmental Disabilities, (4) the Division of Medicaid and Long-Term Care, and (5) the Division of Public -33- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 Health.

31.33.

-13- LB867 LB867 2026 (3) The Division of Disability and Aging Developmental Disabilities shall administer (a) the Beatrice State Developmental Center, (b) aging services, and (c) (b) publicly funded community-based developmental disabilities services;

32.34.

-34- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 83-1201 Sections 83-1201 to 83-1226 83-1228 shall be known and may be cited as the Developmental Disabilities Services Act.

33.35.

34.36.

35.37.

36.38.

OriginalSections sections1, 43-2624,2, 68-927,3, 68-928,4, 68-1006,5, 68-1007,6, 71-2226,7, 71-7450,8, 81-6,122,10, 81-2205,11, 81-2212,12, 81-2226,13, 81-3113,14, 81-3116,15, 83-1201,16, 83-1204,17, and18, 83-1206,19, Reissue20, Revised21, Statutes22, of23, Nebraska,24, sections25, 30-38,113,26, 43-4413,27, 43-4504,28, 68-949,29, 71-561,30, 71-563,31, 71-564,32, 71-565,33, 71-566,34, and35, 71-567,36, Revised37, Statutes39, Cumulativeand Supplement,41 2024,of andthis sectionsact 38-131,become 43-3342.04,operative 68-1530,three 71-814,calendar 71-1908,months andafter 81-1316,the Revisedadjournment Statutesof Supplement,this 2025,legislative aresession. repealed.

The other sections of this act become operative on their effective date.

37.39.

Original sections 43-2624, 68-927, 68-928, 68-1006, 68-1007, 71-2226, 71-7450, 81-6,122, 81-2205, 81-2212, 81-2226, 81-2234, 81-2235, 81-3113, 81-3116, 83-1201, 83-1204, and 83-1206, Reissue Revised Statutes of Nebraska, sections 30-38,113, 43-4413, 43-4504, 71-561, 71-563, 71-564, 71-565, 71-566, and 71-567, Revised Statutes Cumulative Supplement, 2024, and sections 38-131, 43-3342.04, 68-1530, 71-814, 71-1908, and 81-1316, Revised Statutes Supplement, 2025, are repealed.

Sec.

40.

Original section 68-949, Revised Statutes Supplement, 2024, is repealed.

Sec.

41.

2.Sec.

On42. page 1, strike beginning with "the" in line 1 through line 22 -35- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 and insert "public health and welfare;

toSince amendan sectionsemergency 43-2624,exists, 68-927,this 68-928,act 68-1006,takes 68-1007,effect 71-2226,when 71-7450,passed 81-6,122, 81-2205, 81-2212, 81-2226, 81-3113, 81-3116, 83-1201, 83-1204, and 83-1206,approved Reissueaccording Revisedto Statuteslaw. of Nebraska, sections 30-38,113, 43-4413, 43-4504, 68-949, 71-561, 71-563, 71-564, 71-565, 71-566, and 71-567, Revised Statutes Cumulative Supplement, 2024, and sections 38-131, 43-3342.04, 68-1530, 71-814, 71-1908, and 81-1316, Revised Statutes Supplement, 2025;

to-14- change requirements for rules and regulations relating to special needs trusts, fingerprints under the Uniform Credentialing Act, funding provisions for child care grants, the Title IV-D Division Customer Service Unit, and eligibility for young adults in the bridge to independence program;

to redefine a term and provide requirements for licensed and self-funded insurers under the Medical Assistance Act;

to change requirements relating to establishing medicaid nursing facility rates;

to provide for a money follows the person program for medicaid benefits;

to change and eliminate requirements relating to the application for, determination of need for, and payment of assistance to the aged, blind, or disabled;

to change provisions of and rename the Alzheimer's Disease and Other Dementia Support Act and the Alzheimer's Disease and Other Dementia Advisory Council and create a fund;

to rename the State Advisory Committee on Mental Health;

to provide requirements for a youth afterschool eligibility letter for child care employment;

to change a requirement of the state Commodity Supplemental Food program;

to provide for the use of wholesale drug distributor license fees for the prescription drug monitoring program;

to provide for the maintenance of epinephrine by certain schools;

to rename the Division of Developmental Disabilities of the Department of Health and Human Services and the Director of Developmental Disabilities;

to change and eliminate provisions relating to divisions of the Department of Health and Human Services;

to eliminate the Division of Medicaid and Long-Term Care Advisory Committee on Aging;

to eliminate provisions relating to the -36- ER165 ER165 LB867 LB867 DLM - 03/27/2026 DLM - 03/27/2026 Maternal and Child Health and Public Health Work Fund;

to eliminate an obsolete Nurse Licensure Compact;

to eliminate obsolete provisions;

to harmonize provisions;

to repeal the original sections;

and to outright repeal sections 68-1008, 68-1101, 68-1103, 68-1104, 68-1106, 71-1795, 71-1795.02, 71-2201, 71-2202, 71-2203, 71-2204, 71-2205, 71-2207, 71-2208, 81-3133.02, 81-3134, 83-1216.02, 83-1227, and 83-1228, Reissue Revised Statutes of Nebraska, and section 68-1105, Revised Statutes Cumulative Supplement, 2024.".

3. On page 2, strike lines 1 through 5.

-37-