All Roll Calls
Yes: 608 • No: 2
NebraskaLB912109th Legislature 1st and 2nd SessionslegislatureWALLET
Adopt the Community Health Worker Training Endorsement Act, the Athletic Trainer Compact, and the Respiratory Care Interstate Compact, change provisions relating to child care licensing and the practice of athletic training, respiratory care, massage therapy, medical radiography, nurse practitioners, pharmacy, and pharmacists, provide for liens for physical therapy services and automated pickup kiosks for certain prescription medication, and eliminate provisions relating to physician liability for physician assistants
Sponsored By: Brian Hardin
Signed by Governor
Health and Human Services Committee
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Bill Overview
Analyzed Economic Effects
18 provisions identified: 7 benefits, 3 costs, 8 mixed.
Insurance pays trained community health workers
Medicaid and private plans can pay for services from community health workers who finished a state‑endorsed training. The Health Department runs a CHW training endorsement and is authorized to set core skills, approval, renewal, and fees by July 1, 2027. Finishing an endorsed program does not create a license and does not expand CHW duties into licensed professions.
Easier staffing for child care programs
Licensed child care programs can count volunteers in staff ratios if they pass fingerprint and background checks. Volunteers must be supervised while counted, and can be counted for no more than 10 hours per week. They can count without supervision only if they meet full staff training and qualification rules. This rule ends December 31, 2028. Also, cities and counties cannot require Family Child Care Home II operators to live in a certain place, but they can still enforce appearance, nuisance, and health and safety rules.
Medical providers can lien injury settlements
Doctors, nurses, chiropractors, physical therapists, hospitals, and EMS providers who treat an injured person can place a lien on that person’s lawsuit settlement or judgment for their usual charges. If the patient had private insurance, the lien amount is reduced by the insurer’s contracted discount. These liens do not apply to workers’ compensation claims.
Stronger checks on licensed child care
The state makes unannounced inspections of licensed child care programs. Smaller programs get at least one visit a year; programs with 30 or more children get at least two. Inspectors will ask for proof of liability insurance; if it is not provided within three business days, the license is suspended until proof is verified. Staff must pass national fingerprint background checks before starting and repeat checks at least every five years; portable results and clear disqualifiers apply. The Department keeps a system to track violations found by complaints, inspections, or self‑reports.
Licensed pharmacy pickup kiosks with safeguards
The law defines automated pickup kiosks and allows pharmacies to use them with pharmacist care. Each kiosk must have its own annual license; fees are up to $200 to start and $50 to renew, and the state inspects them. A pharmacist in charge must name a responsible pharmacist and set policies for security, access, filling, verification, training, maintenance, and downtime. A pharmacist must review each prescription before release, and kiosks cannot dispense controlled substances, except hospital kiosks inside hospitals. Employees who handle prepaid patient pickups under the statute are not considered to be practicing pharmacy.
Easier prescription pickup at care facilities
Facility employees may accept prepaid prescriptions for patients to pick up without being considered to practice pharmacy. The pharmacist must have offered counseling, items must stay sealed and properly stored, no controlled substances are allowed, and unclaimed items are returned, donated, or destroyed after 30 days. Facilities keep delivery records and are not liable for the contents when these rules are met.
Simpler prescription refill transfers between pharmacies
Pharmacies can transfer prescription refill information one time between them. If they share a real-time online system, they can transfer up to the maximum refills allowed by the prescriber. Transfers must be done directly between two pharmacists or pharmacist interns, unless using a shared real-time system.
Easier multistate practice for athletic trainers
Nebraska enacts the Athletic Trainer Compact. If you pass a criminal background check, hold a qualifying license and either active BOC certification or qualifying education plus the exam, have no encumbrance in the past two years, pick one qualifying license, meet other states’ rules, and pay fees, you can practice in member states. A compact commission and shared data system run portability, discipline, and rulemaking. Active‑duty military members and spouses do not pay the commission fee, and states may reduce their state fees. The compact starts once seven states enact it, and a state leaving must keep recognizing privileges for at least 180 days.
Easier multistate practice for respiratory therapists
Nebraska joins the Respiratory Care Interstate Compact. If you keep an active home‑state license, hold the needed NBRC credential, have no adverse action in the past two years, pass required state and FBI checks, meet each state’s rules, and pay fees, you can get a Compact Privilege to work in other member states. A commission and shared data system run the compact and handle discipline. Active‑duty military members and spouses do not pay the commission fee, and they may keep their home‑state license designation while on duty. The compact starts once seven states enact it, and withdrawing states must keep recognizing privileges for at least 180 days.
More fluoroscopy duties for nurse practitioners and radiographers
Nurse practitioners who finish approved training may perform fluoroscopy for procedures and direct fluoroscopy with a licensed medical radiographer. Medical radiographers may use fluoroscopy in more settings when directed by or working with approved clinicians, including nurse practitioners.
Domestic abuse training for mental health providers
Licensed mental health practitioners must complete at least two hours of domestic abuse continuing education every two years from qualified trainers. Starting September 1, 2027, applicants for a provisional mental health license must complete three hours of domestic abuse training that covers screening tools, danger signs, documentation, referrals, children’s impact, ethics, and trauma‑informed care.
Fingerprint checks for many health licenses
If you apply for an initial health or behavioral health license, you must submit fingerprints for a state and FBI background check. You must allow release of the FBI results to the Health Department and pay the actual costs. The State Patrol sends the prints to the FBI and reports back. Some temporary physician training permits have set timelines to complete prints.
Massage therapy businesses must be licensed
You must have a state license to operate a massage therapy establishment. Massage therapy cannot be practiced in unlicensed locations unless the law or department rules allow it.
Respiratory care must be licensed or compact
To practice respiratory care in Nebraska, you must hold a state license or a compact privilege. Exceptions include supervised students, family or friends giving unpaid help, other licensed professionals working within their scope, federal employees on duty, pulmonary function testing technologists, and polysomnographic technologists. In member states, compact rules control if they conflict with state law.
Only licensed people may do athletic training
Only licensed athletic trainers, or certain other licensed clinicians (doctors, chiropractors, nurses, physical therapists, podiatrists), may perform athletic training duties. You cannot call yourself an athletic trainer unless you hold a license under state law or the compact. The definition of athletic trainer now clearly includes providers licensed through the compact.
New staffing limits for pharmacists
A pharmacist can supervise up to four pharmacy technicians and pharmacist interns at one time. If supervising four, at least one must be a certified pharmacy technician. Interns must be supervised unless they are in accredited experiential training.
Old health licensing sections repealed
The law repeals listed older sections tied to health licensing and replaces them with updated rules in this act. This cleans up and consolidates prior statutes.
When these changes take effect
Because of the emergency clause, the law takes effect as soon as it is passed and approved. Some sections begin January 1, 2027. Other sections begin May 1, 2027. Many sections start three calendar months after the legislative session ends.
Sponsors & Cosponsors
Sponsor
Brian Hardin
legislature
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
legislature vote • 4/24/2026
Vote
Yes: 31 • No: 0 • Other: 18
legislature vote • 4/24/2026
Vote
Yes: 32 • No: 1 • Other: 16
legislature vote • 4/24/2026
Vote
Yes: 35 • No: 0 • Other: 14
legislature vote • 4/24/2026
Vote
Yes: 34 • No: 0 • Other: 15
legislature vote • 4/24/2026
Vote
Yes: 36 • No: 0 • Other: 13
legislature vote • 4/24/2026
Vote
Yes: 32 • No: 0 • Other: 17
legislature vote • 4/24/2026
Vote
Yes: 31 • No: 0 • Other: 18
legislature vote • 4/24/2026
Vote
Yes: 33 • No: 0 • Other: 16
legislature vote • 4/10/2026
Final Reading
Yes: 49 • No: 0
legislature vote • 3/31/2026
Vote
Yes: 36 • No: 0 • Other: 13
legislature vote • 3/31/2026
Vote
Yes: 34 • No: 0 • Other: 15
legislature vote • 3/31/2026
Vote
Yes: 35 • No: 0 • Other: 14
legislature vote • 3/31/2026
Vote
Yes: 32 • No: 1 • Other: 16
legislature vote • 3/12/2026
Vote
Yes: 31 • No: 0 • Other: 18
legislature vote • 3/12/2026
Vote
Yes: 31 • No: 0 • Other: 18
legislature vote • 3/12/2026
Vote
Yes: 32 • No: 0 • Other: 17
legislature vote • 3/12/2026
Vote
Yes: 33 • No: 0 • Other: 16
legislature vote • 3/12/2026
Vote
Yes: 31 • No: 0 • Other: 18
Actions Timeline
Presented to Governor on April 10, 2026
4/17/2026legislatureApproved by Governor on April 14, 2026
4/17/2026legislatureDispensing of reading at large approved
4/10/2026legislaturePassed on Final Reading with Emergency Clause 49-0-0
4/10/2026legislaturePresident/Speaker signed
4/10/2026legislaturePlaced on Final Reading with ST81
4/7/2026legislatureEnrollment and Review ST81 filed
4/7/2026legislatureEnrollment and Review ST81 recorded
4/7/2026legislatureEnrollment and Review ER144 adopted
3/31/2026legislatureKauth FA572 withdrawn
3/31/2026legislatureDeKay AM2642 adopted
3/31/2026legislatureRiepe AM2760 adopted
3/31/2026legislatureHardin AM2833 adopted
3/31/2026legislatureBallard AM2923 adopted
3/31/2026legislatureAdvanced to Enrollment and Review for Engrossment
3/31/2026legislatureBallard AM2923 filed
3/25/2026legislatureHardin AM2833 filed
3/24/2026legislatureRiepe AM2760 filed
3/20/2026legislaturePlaced on Select File with ER144
3/18/2026legislatureEnrollment and Review ER144 filed
3/18/2026legislatureHansen AM2423 adopted
3/12/2026legislatureDeKay AM2409 withdrawn
3/12/2026legislatureRiepe AM2464 adopted
3/12/2026legislatureBallard AM2578 adopted
3/12/2026legislatureHealth and Human Services AM2224 adopted
3/12/2026legislature
Bill Text
Introduced
4/17/2026
Enrolled / Slip Law
Final / Enacted