Task Force, Committees, and Professional Organizations

LB 1083 – Nebraska’s Behavioral Health Service Act

Legislative Bill 1083, the Nebraska Behavioral Health Systems Act, was signed into law April 14, 2004 by then Governor Mike Johanns. The legislation set out to reform Nebraska’s behavioral health services by moving from institutionalized settings including state run Regional Centers to community-based services where individuals could access behavioral health services closer to home, family, and support services. The Act established the creation of the Behavioral Health Oversight Commission and charged the Commission with overseeing and supporting the implementation of LB 1083.

Commission members were appointed in June 2004 and met regularly until, pursuant to the statute, the Oversight Commission’s expiration on June 30, 2008. The Commission completed a final summary including a report, findings, and recommendations for distribution to the Health and Human Services Committee of the Legislature and the Legislature as a whole.

The report lists accomplishments to date, reports findings, and includes fourteen recommendations citing that many of the goals and responsibilities set out in LB 1083 have not been accomplished. Abbreviated recommendations from the Commission include:

• Recommendation #1: The Commission recommends that the Department fulfill the mandate of the Act which stipulates “consumer involvement in all aspects of service planning and delivery.”
• Recommendation #2: The Commission recommends the Department establish an information system for all persons receiving state-funded behavioral health services.
• Recommendation #3: The Commission recommends the Department develop a comprehensive, statewide workforce development and funding plan by December, 2008 in collaboration with consumers, physicians, provider/employers, and academic institutions representing all levels of the behavioral health workforce.
• Recommendation #4: The Commission recommends the formation of a task force comprised of consumers, providers, physicians, regional administrators, a representative of the Regional Centers, and a representative of the Department to study and define the role of the regional centers.
• Recommendation #5: The Commission recommends the Department, utilizing current funding appropriated to the Regional Centers, or the Legislature through additional appropriation to Program 38, provide the funding necessary for Behavioral Health Region 5 to develop acute and sub-acute capacity in the community, and discontinue utilization of Lincoln Regional Center for this purpose.
• Recommendation #6: The Commission recommends the transfer of all funding at the regional centers (Program 365) devoted to providing capacity for behavioral health patients to the regions (Program 38) effective in fiscal year 2010.
• Recommendation #7: The Commission recommends that all state operated Regional Centers be required to seek and continuously maintain national accreditation as a baseline measure of quality of care for the patients it serves.
• Recommendation #8: The Commission recommends the immediate cessation of the Department’s practice of moving patients from the Lincoln Regional Center to the Norfolk Regional Center.
• Recommendation #9: The Commission recommends the development and funding of two 16 bed, secure, longer stay residential facilities to facilitate the accomplishment of the discharge of all behavioral health patients from Norfolk Regional Center as outlined above.
• Recommendation #10: The Commission recommends closing the adolescent chemical dependency unit and the 14 person unit for developmental disabilities at the Hastings Regional Center at the earliest possible date and no later than June 30, 2009, and moving all commensurate behavioral health funding to the community consistent with the requirements of the Nebraska Behavioral Health Services Act.
• Recommendation #11: The Commission recommends both a financial and performance audit of the operations of the Division of Behavioral Health for purposes of providing an opportunity to start with a “clean slate” and resolve any ongoing disagreements regarding funding.
• Recommendation #12: The Commission recommends parity and equality of treatment for Nebraska citizens in the funding of Medicaid services for physical health conditions and behavioral health conditions.
• Recommendation #13: The Commission recommends that the State Medicaid plan be revised to include all behavioral health services developed to date and those planned for development as part of this reform effort, including secure residential services, intensive community support services, dual diagnosis services, intensive residential rehabilitation services, emergency community support, crisis response, and peer support services.
• Recommendation #14: The Commission recommends that the Department contract for an independent study to identify and report back findings and recommendations for Legislative consideration relative to various treatment models and comparative effectiveness and costs for programs to deal with committed sex offenders.
• Recommendation # 15: The Commission recommends that, upon expiration of the replacement Commission effective June 30, 2009, the Legislature establish a subsequent oversight body structured in a manner that assures (1) independence from the Department of Health and Human Services; (2) broad stakeholder representation inclusive of consumers of behavioral health services; (3) participation and/or direct access to members of the Legislature or Legislative committee; and (4) public meetings and wide-spread web posting and other public dissemination of reports, findings, analysis and recommendations.

A new, 12-member Oversight Commission convened in July 2008 and will operate under the Department of Health and Human Services Division of Behavioral Health for a one year period. Members of the new commission include:

• TyLynne Bauer, Representative from the Norfolk Regional Center
• Beth Baxter, Region III Behavioral Health Administrator
• Dr. Brad Bigelow, Representative of Providers of Behavioral Health Services
• Jim Egley, Representative from Norfolk
• Bill Gibson, Representative from the Lincoln Regional Center
• Rhonda Hawks, Consumer Advocate
• Mary Hepburn-O’Shea, Representative of Providers of Behavioral Health Services
• J. Rock Johnson, Consumer Representative
• Patti Jurjevich, Region VI Behavioral Health Administrator
• Joe Patterson, Representative from Hastings
• Kathy Seacrest, Region II Behavioral Health Administrator
• Pete Tulipana, Representative of Providers of Behavioral Health Services

On August 11, 2008 the commission adopted the following strategic focus:

1. Behavioral Health Overview
   How are services delivered? How are funds being used to increase
   community-based services and reduce reliance on Regional Centers?
   
2. Moving Behavioral Health Forward
   Now that LB 1083 is being implemented, how does the behavioral health
   system continue to move forward fostering recovery for behavioral health
   consumers? What should a balanced Nebraska behavioral health system
   look like?
   
3. Behavioral Health Workforce Shortage
   There is a behavioral health workforce shortage nationally and in the state
   of Nebraska. There are an inadequate number of psychiatrists and other
   mental health and substance abuse professionals to provide necessary
   services to consumers. Education and training are needed to grow the
   workforce.
   
4. Enhanced Communication and Partnering
   Foster, encourage and promote creative ways to develop services and
   supports that consumers want and need while maximizing existing funding, using open communication and developing trusting relationships. We accomplish this by promoting partnerships and multi-dimensional communication among consumers, the divisions of the Department of Health and Human Services, the Behavioral Health Regions, Regional Centers, Community-Based Agencies, peer providers and Behavioral Health Division advisory committees.

Future meetings of the newly formed Behavioral Health Oversight Commission are scheduled for:

• February 2, 2009
• April 1, 2009
• June 10, 2009

More information about the Commission including meeting agendas and minutes can be found at the Department of Health and Human Services website at http://www.dhhs.ne.gov/Behavioral_Health/BHcommission/.