Nebraska saw nine long-term care facility closures in 2022, second only to 13 in Texas.

In the past three years, Nebraska has lost a combined 29 assisted living facilities and nursing homes. Inadequate funding for Medicaid patients, workforce issues and the rising costs of goods and services have all contributed to these closures.

Two bills to be heard in the Unicameral's Appropriations Committee today would mean substantial increases in state and federal funding for both types of facilities.

Jalene Carpenter, Nebraska Health Care Association CEO, says additional funding is crucial to stem the state's long-term care crisis.

"In Nebraska, 15 counties do not have a nursing home or an assisted-living [facility], and we are really starting to see a 'care desert' be created. And that causes significant issues for Nebraska seniors, " Carpenter expressed.

LB-941 would increase the daily reimbursement rate for assisted living residents on the Medicaid Waiver program. The new daily rate of just under $79 is based on a Nebraska Department of Health and Human Services study. LB-942 would increase the nursing home Medicaid reimbursement rate by about 5% over the next year. Both bills were introduced by state Sen. Myron Dorn, R-Adams.

Carpenter says the COVID-impacted long-term care workforce is improving in the state, but she stresses Medicaid reimbursement rates play a large part.

"A large portion of the Medicaid rate -- when you look at what it covers -- it's primarily going towards labor and benefits. Nursing-facility and assisted-living care is very hands-on, and we need adequate rates to be able to attract and retain team members," she added.

Carpenter said the state, educational institutions and organizations, including the Nebraska Health Care Association, are also focused on building the long-term care workforce -- including introducing young people to careers in health care and strengthening Certified Nursing Assistant programs.

"We're trying not only to increase the rates so that our facilities can attract and retain (employees), but then also, as an association, to look at other ways to drive people into the workforce for this profession, " she said.

In 2023, Gov. Jim Pillen approved a one-year, 3% increase in the Medicaid reimbursement rate, but vetoed the Legislature's 2% increase for the second year.

Virginia child advocates are calling on state lawmakers to improve school funding.

The concern grew when several bills focused on building up school mental health failed in their respective General Assembly committees. The state is ranked 48th for youth mental health by Mental Health America.

Cat Atkinson, mental health policy analyst at Voices for Virginia's Children, said given the ongoing youth mental health crisis, now is the time for action.

"Having mental health professionals in our schools creates a space where, one, our young people are able to be where they're comfortable," Atkinson recommended. "They have built relationships with staff and are able to be in their schools, and to be able to have their needs met in a place where they are consistently."

The mental health staff funding bills failed or were continued to the 2025 session due to high costs. Combined, the bills would have called for around $120 million to be spent in the 2025 and 2026 budgets.

Beyond money, a long-term workforce shortage is depriving schools of having proper mental health staff. A KFF report found 48% of schools nationally have insufficient access to licensed mental health professionals.

The funding inconsistencies affect more than just mental-health services. A 2023 report found not only are school divisions getting less funding than most other states, but Virginia is still using the Great Recession as a benchmark for cost-reduction measures.

Atkinson pointed out a lack of funding affects not just schools.

"The trickle-down effect of our state underfunding public schools places a burden on the local communities," Atkinson argued. "Which leaves the quality of our young people's education to depend entirely on the neighborhoods they reside in."

She added the current situation is not equitable because community resources across regions vary significantly, but noted there are other ways to get mental health care in schools.

In 2023, the General Assembly passed Senate Bill 1300, which requires teachers to get trauma-informed care training every three years. Gov. Glenn Youngkin's Right Help, Right Now plan would also bolster school and community mental health needs.


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Lawmakers and union leaders are calling on Congress for fiscal changes during the year. Along with conversations about the budget and fair pay, some lawmakers want more attention to Social Security.

The 2023 Social Security Trustee report showed trust-fund reserves could be depleted in 2034, meaning only 80% of benefits would get paid. It will fall to Congress and the White House to resolve it, but some are uncertain how it can occur given split opinions on Social Security.

Rep. John Larson, D-Conn., spoke at a rally about how taking action on Social Security speaks volumes.

"What we need is a vote in Congress on Social Security 2100 and not only extend solvency, but enhance benefits for the more than 70 million people," Larson contended.

Social Security 2100 is a bill Larson introduced to put reforms in place such as increasing benefits 2% across the board for all beneficiaries, restoring student benefits up to age 26, and improving the cost-of-living adjustment to reflect inflation. Average monthly amounts for single people are $1,700 per month but average rent prices in Connecticut are around $1,600.

Aside from Social Security, rallying lawmakers were urging their colleagues to pass a full budget next month. Months of negotiations in 2023 led to several continuing resolutions. The current two-tier continuing resolution has part of the federal government run out of funding on March 1, and other parts on March 8.

Rep. Maxwell Frost, D-Fla., said now is an inopportune time for a shutdown.

"We can't shut down any part of it at this point," Frost argued. "Not with the House crisis we have right now. Not with our veterans being left out right now. Not with retirees needing what they need right now. "

Lawmakers need to keep certain Fiscal Responsibility Act deadlines in mind. Breaching discretionary spending limits established in the bill could trigger sequestration cuts. In this case, the Office of Management and Budget has said if a budget is not in place by April 30, widespread cuts across certain federal programs will be made.

In a new poll, North Dakota voters say they'd like to see big changes to the state's Legacy Fund, which operates as a savings account funded by oil tax revenue.

In 2010, voters approved creating what's sometimes called the "people's fund," with 30% of tax revenue from oil production in the state flowing into the fund each month for long-term investments and general operations.

The North Dakota News Cooperative commissioned the poll, and 68% of respondents said they want the money used for economic development within North Dakota, rather than the current focus on out-of-state investments.

Trevor Smith, chief research officer for the analytics firm WPA Intelligence, led the project and said the results are telling.

"There's not a lot of familiarity with what the Legacy Fund is," Smith pointed out. "Three percent of eligible voters are 'very familiar;' 55% are 'very unfamiliar.' And then voters really want it to be transparent."

He added 84% of respondents want fund managers to ditch their current rule of having to file an information request and simply post the investments online. The poll, which connected with 500 eligible voters in North Dakota, was conducted earlier this month.

Smith noted there are no partisan splits in calling for more accountability and transparency with how the fund operates.

"Voters, regardless of who they are or what party they identify with, basically agreed very similarly here," Smith reported.

Smith added given how the public still views the Legacy Fund as a mystery, it would be reasonable for this to be brought up as a campaign issue. State records show the fund is currently valued at just below $10 billion.


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