- Associated Press - Monday, May 15, 2017

Omaha World-Herald. May 14, 2017

Moving past safe haven

Nebraska suffered a shock in 2008 with the safe haven crisis.

That year, the state adopted a law intended to provide parents and guardians a way to place infants in state custody, without fear of prosecution, at a hospital or other public site.

Once the law took effect, drop-offs soon began. But none of the children dropped off in succeeding months were babies.

Instead, most of them were troubled youngsters, largely teens and preteens. In all, three dozen children were affected.

Parents and guardians said they resorted to such an extreme measure out of desperation, unable to deal with their children’s mental health challenges or, in some cases, violent behavior.

The situation drew national attention to Nebraska and to the state’s need to bolster its support for families in crisis.

In an emergency session called by then-Gov. Dave Heineman in November 2008, the Legislature rewrote the law to apply only to infants 30 days and younger. But the complicated question of what Nebraska should do to improve its help for troubled young people and their families remained for state leaders and the nonprofit community.

In succeeding years, the state passed laws and made program adjustments to begin improvements.

Here are two examples. A Nebraska Family Helpline was set up at 888-866-8660 to guide parents and guardians through services and keep families from falling through the cracks. The state created a “peer navigator” program, in which incoming families are helped by an adult with family experience in dealing with the behavioral health system.

One of the most complex and ambitious responses to the safe haven situation was the effort to create what’s called a “system of care.” Wide-ranging discussions going back at least to 2012 have worked to build close ties of communication and coordination among Nebraska government agencies and nonprofits. This “system of care” approach aims to deliver services in a more efficient, timely and appropriate manner.

Nebraska has begun using this strategy in some communities, and the Ricketts administration is now taking the effort statewide, thanks to a $12 million, four-year federal grant.

A key goal is to connect a family in crisis with a mental health professional, either in the family home or online, within an hour of a call for help. A quick, appropriate response often can spare children and families from resorting to more intensive, and more expensive, services.

Such a response for adults with behavioral health problems has kept about 75 percent of those adults out of hospitals or other intensive services, said Sheri Dawson, behavioral health director for the Nebraska Department of Health and Human Services.

The Ricketts administration has proposed that the state HHS take over operation of Right Turn, a program created after the safe haven crisis to provide support for families formed through adoption or guardianship. The Legislature’s Appropriations Committee has included funding in the budget that, barring a gubernatorial veto, would enable nonprofits to continue providing the service.

Nebraska has a considerable need for behavioral health help for children. More than 37,000 boys and girls across the state have behavioral health disorders, the Data Resource Center for Child and Adolescent Health reports.

Findings presented this year at a national pediatric conference offered a relevant and disturbing national statistic. From 2008 to 2015, the percentage of children ages 5 to 17 hospitalized for suicidal thoughts or actions more than doubled.

Boys Town reported last week that the number of teens contacting its national hotline for help with mental health concerns jumped 12 percent from 2012 to 2016, and contacts seeking help about suicidal thoughts were up by 8 percent since 2012.

Mental health experts report that half of all lifetime mental illnesses begin by the average age of 14, and three-fourths by age 24.

Nebraska emerged from the safe haven crisis recognizing the need to do far more for families in crisis. The latest plan, to help families in crisis, shows the state’s commitment to continue moving forward with further improvements.___

The Grand Island Independent. May 10, 2017

Congress enters long path to health care reform

The Republican bill passed by the House last week established a starting point for a long process to create a sustainable health care system for Americans.

As with all complex bills that attempt to fulfill a broad social need, the final product will look vastly different from the first draft. The Senate will now take its turn at crafting a health care repeal and replacement law that will be financially sustainable and palatable to consumers, providers, state governments and insurers.

The seven-year history of the Affordable Care Act (ACA) provides clear postmortem for a costly, problematic and ultimately unsustainable experiment. Though millions of people gained insurance under ACA, the formula for sustainability was constructed on shaky assumptions such as participation by healthy young people, full participation by state governments in a robust expansion of Medicaid, and willing buy-in from private insurers who would underwrite the ACA exchanges across the land.

Many states, Nebraska included, challenged the constitutionality of the law. The states that accepted the billions in Medicaid incentives in the beginning face hard budget realities as federal mandates now require state coffers to cover a larger share of the Medicaid expansion.

The Senate faces a daunting challenge to make ACA 2.0 financially sustainable. GOP senators facing midterm elections will be hard-pressed to jeopardize Medicaid-subsidized coverage for their constituents. GOP House leadership established the basic principles and set the process on the right track.

Now it’s up to majority leadership in the Senate to hammer out the myriad details of the new law. That will require compromise on both sides of the aisle and collaboration with all stakeholders. This evolutionary process will take weeks, or more likely months, to get to a vote, which is sure to ride on a razor-thin margin.

In the meantime, with each passing week, the insured, insurers, providers and state governments are left in an uncomfortable state of uncertainty. The urgency for Congress to act is great as the ACA continues to deteriorate rapidly. Last week Iowa’s last major insurer threatened to pull out. In Virginia Aetna is leaving. The exchanges in Kansas and New Hampshire are on life support.

The Senate’s mission is to take an impossibly complicated and unworkable law and remake it so that healthy young people can afford to participate, the subsidies for everyone else are attractive enough to foster broad participation, and insurers are given the freedom to provide a range of options and products that consumers want and can afford.

___

Lincoln Journal Star. May 13, 2017

State wise to aid mothers in school

The week of Mother’s Day, a common-sense bill that should push more young Nebraska mothers to graduate from high school became law.

When Gov. Pete Ricketts signed LB427, introduced by Sen. Tony Vargas of Omaha, into law Tuesday, a bipartisan coalition of lawmakers ensured the youngest and most vulnerable mothers — those still in high school — will have ample opportunity to succeed in school despite their new full-time job of motherhood.

One line from the bill says it all: “Young women should not have to choose between completing their education and parenthood.”

The measure establishes that all school districts must have a policy to aid in the academic success of pregnant students before the start of the 2018-19 school year. Language in the bill includes rules for pregnancy-related absences, offering accessible coursework when the new mother is out of school and creating accommodations for nursing mothers.

In enacting such a law, Nebraska lawmakers ensured young mothers would no longer be second-class citizens in their schools. Encouraging their success will help boost more of these teens to financial independence, rather than reliance on state assistance, and a better life for their babies going forward.

Those who give birth before earning their diplomas — and their children — face a steep uphill battle as it is.

A PBS analysis of U.S. Census Bureau data show that high school dropouts earn an average of $20,241 annually — a far cry from the $30,627 for those with a high school diploma and $56,665 for those with a bachelor’s degree. Dropouts also find it harder to enter the job market and face a higher unemployment rate than those with at least a high school diploma.

But only half of teen mothers go on to graduate high school, according to the Centers for Disease Control and Prevention. In turn, the CDC data indicate children of mothers who fail to earn a diploma are at an increased likelihood to continue the cycle — with lower academic achievement but higher chances of health problems and becoming dropouts or teen parents themselves.

During debate on the bill, Lincoln Sen. Patty Pansing Brooks cited an ACLU of Nebraska study that said 79 percent of school districts have no policies or written guidelines on providing alternative education for pregnant or parenting students. That figure alone highlights the now-met need for such programs.

Within the next 16 months, the number will drop to zero because of the wise action taken by the Legislature and governor to help boost Nebraska’s future by supporting its most vulnerable parents.

And that future, we hope, will include fewer of the state’s youngest mothers and children as statistics — and more happy Mother’s Days for harmonious, healthy families.____

Kearney Hub. May 12, 2017

Legislators make right decisions on $8.9B budget

Lawmakers acted courageously this week, voting 36-12 on Tuesday to approve the state of Nebraska’s main budget bill for the next two years. Passage of the $8.9 billion spending document reveals a number of encouraging qualities about the Nebraska Legislature, a body of lawmakers some observers believed was too inexperienced, too young and too obligated to Gov. Pete Ricketts, who helped a good number of them win their seats in 2016.

Despite those perceived handicaps, members of the 2017 Legislature proved they possess the intellect and backbone to do the heavy lifting and address the unprecedented $1.1 billion revenue gap. Lawmakers appropriately reined in spending, prudently tapped the state’s cash reserve, and acknowledged Ricketts’ priorities by including added money for the Department of Corrections and education.

Lawmakers failed to achieve tax reform and meaningful property tax relief, a shortcoming that will displease property owners, particularly farmers and ranchers who carry too heavy of a burden.

Hopefully, after this year of hard-won experience, our legislators will return next year ready to craft a solution to our state’s nagging taxation and property valuation inequities.

Until then, and unless the governor exercises his options to veto the spending bill or certain spending line items, Nebraskans will live with current tax policies and hope some of the philosophies underpinning the $8.9 billion budget bear fruit.

Wisely, lawmakers agreed with Ricketts that education is a priority. Education is a great equalizer, and in hard times, it can be an economic engine. We in Kearney have a ringside seat. Through the University of Nebraska at Kearney we see how education changes lives and builds stronger communities.

Our state’s legislators approached University of Nebraska spending carefully. They cut with a scalpel rather than a buzz saw so the system will remain strong, not dismembered. NU has already absorbed $10 million in spending cuts and will make further spending and job cuts in the next two years. However, research will continue, departments won’t be eradicated, and importantly, students won’t face 20-percent tuition hikes.

To his credit, NU President Hank Bounds called early on for a hiring freeze, travel restrictions and other efficiencies. Today campus leaders and the NU Regents are further refining operations to be leaner and stronger, balance costs and quality, and preserve NU as a catalyst for economic development. The best cure for our state’s revenue crisis is economic recovery.

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