Nebraska lawmakers are considering a bill to ensure managed health care companies cannot limit the state reimbursement rate for mental health service providers.

Advocates for the bill want to make sure in the future, the companies could not negotiate a lower rate. Right now, there's no requirement they use the posted rates, it has just been the practice. Legislative Bill 380 would keep "guardrails" in place.

Annette Dubas, executive director of the Nebraska Association of Behavioral Health Organizations, said providers have worked for 20 years just to get the reimbursement rates to meet the minimum state standards.

"Nebraska's rates were, two decades ago, towards the bottom," Dubas pointed out. "We've worked hard over those last two decades to get rates built up. It comes down to the ability to build capacity, so that people who are in need of mental health care can access that mental health care."

Dubas noted the bill was introduced after Nebraska autism care providers had to fight an effort to reduce their reimbursement rates last year. It awaits action in committee. Dubas emphasized her group opposes an amendment to remove the minimum pay "guardrails."

Dubas explained low wages and often challenging working conditions already make it difficult to find mental health care professionals, and lower reimbursement rates mean even lower wages and less stable employment. She added protecting the rates already in place is critical to ensuring the ability to recruit and retain workers.

"If rates do not stay up where they need to be, it just puts that much more pressure on these providers to be able not only bring in new workforce, but to retain the workforce that they have," Dubas explained. "Burnout is a huge issue."

Dubas added any rate adjustment legislation could also complicate a reimbursement process she described as already confusing and complex in Nebraska.

Four of five Americans surveyed want to know if they face a future with Alzheimer's disease before symptoms arise, according to the latest Alzheimer's Facts and Figures report.

At least 35,000 Nebraskans are living with the form of dementia and want to know what treatment options are available to slow its progress.

Michele Magner, board member of the Nebraska chapter of the Alzheimer's Association, said it is much easier to determine whether someone could develop the disease thanks to a simple blood test.

"They're willing to take that test," Magner emphasized. "Medications are more accessible to them now than they were in the past, so it allows them time to prevent the ongoing impact of the disease process."

The research showed three in five Americans said they would be willing to take a medication to slow the progression of Alzheimer's, even if it came with a risk. The chances of developing Alzheimer's disease are higher if a parent has it.

Magner pointed out the effects of Alzheimer's disease do not stop with the patient because it has a trickle-down effect on Nebraska's unpaid caregivers, usually family members.

"Of our 41,000 reported caregivers in the state of Nebraska, 57.6% are also managing their own chronic health condition," Magner noted. "It's really important to be thinking about not just that person living with dementia, but also the people who are providing their care."

She added more than 35,000 Nebraskans age 65 and older are living with Alzheimer's disease.


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May is Mental Health Awareness Month and the latest state data show the number of Wisconsin youth who are struggling with their mental health has spiked.

The report from the Wisconsin Office of Children's Mental Health showed the numbers have increased dramatically over the past 10 years. While rates of anxiety, depression, self-harm, and suicidal thoughts went up across the board, girls saw an overall higher increase. Wisconsin boys however, are two to four times more likely to die by suicide than girls, according to the report.

Amy Marsman, senior research analyst at the Wisconsin Office of Children's Mental Health, said the trends are worse for LGBTQ+ students and students of color.

"They feel less connected to their school and less likely to report that they feel they belong at their school," Marsman explained. "We know that there are target populations that we should really focus on."

Marsman pointed out teens are also getting less sleep than ever before which is foundational to their mental health. She stressed caregivers should ensure they get sufficient sleep and limit screen time at home.

More than 20% of teens reported self-harm and nearly 25% of girls reported seriously considering suicide, according to the report. Marsman noted factors like rising food insecurity, particularly among students of color, also play a significant role. She added additional support during the pandemic helped to eliminate food insecurity gaps but now, black children in Wisconsin are five times more likely to be hungry than their white counterparts.

"Some of these everyday situations really impact youth mental health," Marsman observed. "Whether you're getting enough sleep, whether you are getting enough to eat, whether there's financial stability in your household, all of those are factors and they are disproportionately impacting kids of color."

Marsman argued tax relief to help families meet basic needs and sustained investments in school mental health are crucial to combating the issue. She emphasized programs like peer mental health groups at the high school level can help prevent suicide and improve school culture.

"Knowing that they have a trusted adult in their school and in their home is essential," Marsman underscored. "It just needs to be one adult that they feel that they can go to, so it's very important that parents are building relationships with the teachers in their child's school."

Wisconsin's "Speak Up, Speak Out" tip line is available 24 hours a day when anyone can report a mental health crisis or threat and receive confidential and professional support.


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As youth mental health challenges rise and federal restructuring threatens key programs, former Ohio Gov. and 2016 Republican presidential candidate John Kasich is urging Congress to act.

He co-chaired a bipartisan task force calling for early intervention and stronger support for young people struggling with behavioral health and substance use issues.

Kasich stressed the need to remove stigma and integrate mental health care into routine pediatric services.

"If we can intervene early, then we can get kids to be able to overcome the challenges, to be stronger, to be able to have healthier, more positive lives," said Kasich. "And there's nothing more important than our children."

The report warns that proposed changes at Health and Human Services could result in funding cuts to programs - like youth violence prevention and crisis response, which are currently supported by the Substance Abuse and Mental Health Services Administration (SAMHSA).

Bipartisan Policy Center CEO Margaret Spellings warned that youth-focused programs could suffer if federal changes move forward without safeguarding behavioral health investments.

"There may be funding cuts ahead that could put critical programs at risk," said Spellings, "including those focused on youth violence prevention, adverse childhood experiences, crisis response, and support for a very much needed workforce."

The report recommends integrating mental health into pediatric care, supporting the behavioral health workforce, and expanding school-based services - steps mental health experts say are vital to improving the outcomes for youth in Ohio and nationwide.