All Roll Calls
Yes: 79 • No: 2
NebraskaLB912A109th Legislature 1st and 2nd SessionslegislatureWALLET
Appropriation Bill
Sponsored By: Brian Hardin
Signed by Governor
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Bill Overview
Analyzed Economic Effects
18 provisions identified: 4 benefits, 1 costs, 13 mixed.
Community health worker training endorsement
The law creates a statewide endorsement for community health worker (CHW) training. DHHS sets core skills and program rules by July 1, 2027, including applications, renewals, fees, and appeals. CHW services from graduates of endorsed programs can be billed to Medicaid and private insurers. The law does not create CHW licensure or expand any licensed scope of practice.
Insurers pay for endorsed community health workers
Community health worker services are covered by Medicaid and private insurers when the worker finished a DHHS‑endorsed training program. This helps patients get preventive and care‑coordination help with lower out‑of‑pocket costs. It also lets trained community health workers get paid for their services.
Provider liens on injury settlements expanded
Doctors, hospitals, and emergency medical providers have a lien on money an injured person recovers to cover usual and customary charges. This lien does not apply to people covered by Nebraska workers’ compensation. If the person has private insurance, the lien is reduced by the insurer’s contracted discounts. In personal injury cases, medical expense damages are measured at the private party rate.
Stronger child care inspections and tracking
Licensed child care programs get unannounced inspections: at least once a year for under 30 children, and at least twice a year for 30 or more. Inspectors must verify current liability insurance; if proof is not given within three business days, the license is suspended until coverage is verified. The Department keeps a central system that tracks complaints and violations from inspections and self‑reports.
Safety rules for prescription pickup kiosks
Beginning May 1, 2027, facilities that use automated medication systems or pickup kiosks must keep written safety policies made with the pharmacist in charge. A kiosk cannot dispense until pharmacist care is offered and available. Outdoor kiosks need approved temperature controls and strong security. Kiosks cannot dispense controlled substances, except those run by a hospital pharmacy inside a hospital or its facility. Long‑term care automated systems stay under their current rules and are not treated as kiosks.
Stronger child-care checks; limited volunteers
Child-care staff must pass national and FBI fingerprint checks before working, with supervised work allowed after qualifying fingerprint results. Checks repeat at least every five years, and records follow the worker for 180 days. Providers can count vetted volunteers in staff ratios for up to 10 hours per week; this ends December 31, 2028. Cities and counties cannot require Family Child Care Home II operators to live where they work. If someone refuses checks or has disqualifying crimes, they cannot work and the provider risks losing a license or subsidy.
Interstate practice for respiratory therapists
The state joins the Respiratory Care Interstate Compact. A therapist licensed in one member state can practice in another by getting a Compact Privilege. You must keep an active home‑state license and NBRC credential, have no adverse action in the past two years, pay fees, meet each state’s law test, report address and adverse‑action changes, and accept service at your listed address. The practice is considered to occur where the patient is. Remote states can act against a Compact Privilege and use subpoenas. The law also lists activities that do not need a respiratory license, including approved student training, unpaid family help, other licensed professionals working within their own scope, federal practitioners, some pulmonary function testing, and a registered sleep technologist starting oxygen or noninvasive ventilation under a physician at an accredited sleep facility.
New interstate and practice rules for athletic trainers
The state joins the Athletic Trainer Compact. Licensed athletic trainers who pass a criminal background check and hold current BOC certification (or the approved education plus exam) can get Compact Privileges to work in other member states. Your license must be clear for two years, and you must pay fees, meet continuing‑competence and each state’s law test, and report certain adverse actions. Only people with the right license (athletic trainer, physician, osteopathic physician, chiropractor, nurse, physical therapist, or podiatrist) or Compact Privilege may do athletic trainer work or use that title. The home state can discipline its license; other states can act against a Compact Privilege and share investigative information, and investigation costs may be charged to the licensee if state law allows.
How the respiratory compact runs
The Compact creates a multi‑state Commission to run shared rules and a licensing data system. Member states must license therapists, share adverse‑action data, handle complaints, follow Commission rules, and may charge privilege fees. Commission rules have the force of law, include public‑notice hearings, and allow emergency rules; state scope‑of‑practice laws still control if there is a conflict. Certified Commission records are admissible as evidence. The Compact starts when seven states enact it. States can default, be terminated, or withdraw after 180 days; during wind‑down, they must recognize privileges and keep reporting. The Commission and states can mediate disputes or sue to enforce compliance.
Fluoroscopy expanded for nurse practitioners and radiographers
Nurse practitioners may use and direct fluoroscopy after completing training approved by the department and the board. Medical radiographers may use fluoroscopy when directed by or collaborating with a nurse practitioner, within the approved scope and board rules. These steps can improve access to imaging‑guided procedures.
No compact fees for active military
Active-duty service members and their spouses do not pay the compact commission fee when getting compact privileges for respiratory care or athletic training. A member or remote state can still choose to charge a reduced fee or no fee.
Fingerprint checks for many health licenses
Applicants for many health profession licenses must submit fingerprints to the Nebraska State Patrol for a national FBI background check. The FBI sends results to the Department. Applicants pay the actual costs. Limited exceptions apply for some temporary permits.
Domestic abuse training for therapists
Licensed mental health practitioners must complete at least two hours of domestic abuse continuing education every two years. Starting September 1, 2027, provisional practitioners must complete three hours on screening, high‑risk warning signs, documentation, referrals, effects on children, ethics, and trauma‑informed, victim‑centered care. Instructors must meet minimum training and experience rules.
Updates to pharmacy staffing and transfers
A pharmacist may supervise up to four people at once, but if supervising four, at least one must be a certified pharmacy technician. Workers who accept prepaid medications for pickup under set conditions are not practicing pharmacy. Pharmacies may transfer original prescription information one time for Schedule III–V and for noncontrolled refills; with a shared real‑time database, they may transfer up to the allowed maximum refills. Both pharmacies must keep the original and transferred prescriptions for five years. Pharmacy law exams can be scheduled before or after graduation at the school’s chosen time.
New rules and fees for pharmacy kiosks
Starting May 1, 2027, each automated pickup kiosk must be licensed every year, and inspected as part of the application. The Board can set fees up to $200 to start and $50 to renew, and each kiosk location needs its own license. A pharmacist must oversee policies, storage, labeling checks, and review each drug before release, with records kept five years. Prescriptions from kiosks must meet the same labeling rules as in‑pharmacy fills. Facility employees can hand out prepaid, non‑controlled prescriptions without being considered to practice pharmacy if packaging, storage, counseling, 30‑day return/donate rules, and documentation are met. The law also updates related pharmacy definitions, including telepharmacy.
Old sections repealed to match new rules
The law repeals several listed statutes to align with the new frameworks. Some sections end January 1, 2027, and others end May 1, 2027. These repeals remove outdated rules tied to health licensing, child care, and pharmacy so the new systems govern.
When these new rules take effect
Because the law declares an emergency, it takes effect upon approval. Sections 1–5, 11, 12, 16–19, 24–29, 37, and 39 start three calendar months after the Legislature adjourns. Sections 6–10, 13–15, 23, and 35 start January 1, 2027. Sections 30–33 and 36 start May 1, 2027.
Interstate compact rules for athletic trainers
The state joins a shared system that lets athletic trainers use compact privileges across member states. The law creates a joint commission, requires a data system for licenses and discipline, and makes states report adverse actions and key investigations. Each state picks a commissioner within 60 days of the compact taking effect in that state. The commission can make rules and collect fees, and compact changes only take effect if all member states enact them.
Sponsors & Cosponsors
Sponsor
Brian Hardin
legislature
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
legislature vote • 4/10/2026
Final Reading
Yes: 48 • No: 1
legislature vote • 3/20/2026
Vote
Yes: 31 • No: 1 • Other: 17
Actions Timeline
Presented to Governor on April 10, 2026
4/17/2026legislatureApproved by Governor on April 14, 2026
4/17/2026legislaturePassed on Final Reading with Emergency Clause 48-1*-0
4/10/2026legislaturePresident/Speaker signed
4/10/2026legislatureAdvanced to Enrollment and Review for Engrossment
4/7/2026legislaturePlaced on Final Reading
4/7/2026legislaturePlaced on Select File
3/25/2026legislatureAdvanced to Enrollment and Review Initial
3/20/2026legislatureDate of introduction
3/19/2026legislaturePlaced on General File
3/19/2026legislature
Bill Text
Introduced
4/17/2026
Enrolled / Slip Law
Final / Enacted