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
27 provisions identified: 8 benefits, 4 costs, 15 mixed.
Endorsed training for community health workers
The law creates a statewide endorsement for community health worker (CHW) training. Endorsed programs make CHW services eligible for Medicaid and private insurance payment. The health department sets core skills, applications, and fees by July 1, 2027. Endorsement is not a license and does not allow tasks that require a professional license.
Stronger child care staff bans
You cannot work in child care if you refuse fingerprint checks, lie on those checks, are on a sex offender registry, or have convictions for violence, moral turpitude, or dishonesty. A provider that employs an ineligible person loses its license eligibility and cannot take child care subsidy funds.
Athletic trainer compact: discipline and data
If your qualifying license is disciplined, your Compact Privilege is deactivated everywhere until resolved and you have two years with no restrictions. Remote states can act against your privilege and can subpoena for investigations; states may recover investigation costs where allowed. The compact runs a shared data system with license, action, and a yes/no investigation flag, but states cannot upload criminal‑history records and only states can see investigation indicators. A state cannot punish you for conduct that was legal where it happened.
Athletic trainers: multistate practice rules
Athletic trainers can practice in other member states with a Compact Privilege. You must hold an unencumbered, Compact‑qualifying license and meet education/certification, background, and any remote‑state law tests. States may charge fees to issue or renew the privilege. The privilege lasts until your qualifying license expires, and you must follow the remote state’s scope of practice. You can designate only one qualifying license at a time, and you can still apply for a single‑state license if you do not use the compact.
Child care background checks and hiring
The department lets a new child care staffer start work after a qualifying FBI or state fingerprint result, with constant supervision until all checks are done. Background‑check proof is portable for at least 180 days. Staff must repeat FBI fingerprint checks and state sex‑offender, criminal, and child‑abuse registry searches at least every five years. If federal funds are not available, the staff member, applicant, or licensee pays the actual costs. Screened volunteers may count in staff‑to‑child ratios up to 10 hours per week with supervision, and the state tracks complaints and violations.
Multistate practice for respiratory therapists
The law lets licensed respiratory therapists work in other member states with a Compact Privilege. You must keep an active home‑state license and NBRC credential, have no adverse action in the past two years, notify the Commission, meet any state law tests, and pay fees. Your privilege ends if your home license expires or is encumbered. States can investigate and discipline your license or your Compact Privilege, and may require an alternative program instead of public discipline. A state may also make you pay investigation and case costs when its law allows. Active military members and spouses do not pay Commission fees, and states may reduce their own fees.
More surprise checks and insurance proof
The department makes unannounced inspections of child care programs: at least once a year for fewer than 30 children, and at least twice a year for 30 or more. Inspectors will ask for proof of liability insurance. If proof is not provided within three business days, the license is suspended until proof is verified.
Respiratory Compact commission and data rules
The Compact creates a multistate commission and a shared database for licenses, Compact Privileges, denials, adverse actions, and investigation flags. States must submit a standard data set; certified records count as business records. States can mark some data nonpublic, and expunged records must be removed. The Commission can make binding rules after public notice, and states must enforce them. Subpoenas are enforceable across states, and the issuing authority pays witness and travel fees. The Commission and its staff are indemnified. Court cases go where the Commission’s main office is, and the Commission must be served and can intervene.
Easier prescription transfers and pickups
Pharmacies that share a real‑time database can transfer refill information up to the legal maximum with the prescriber’s OK. Noncontrolled prescriptions can transfer up to the original refills if still valid; controlled transfers must follow federal law. Both pharmacies must keep detailed records for five years. Facilities may accept prepaid, noncontrolled prescriptions for patient pickup if items stay in original packaging, counseling was offered, unclaimed items after 30 days are returned, destroyed, or donated, and delivery logs are kept. Staff who follow these rules are not practicing pharmacy, and the facility is not liable for contents.
Compact-licensed athletic trainers can practice
The law recognizes anyone licensed under the state act or the Athletic Trainer Compact as an athletic trainer. People licensed under the compact may perform the trainer functions listed in state law. No one may call themselves an athletic trainer without a license under the state act or the compact.
Military families: easier licensing, lower fees
Active‑duty service members and spouses can keep a Home State license designation while serving. They do not pay the Compact Commission fee for a Compact Privilege. A state may also reduce or waive its own state fee.
No compact fees for active-duty families
Active-duty service members and their spouses do not pay Compact Commission fees to get compact practice privileges. A remote state may also reduce or waive its own state fee for them.
No local residency rule for home child care
Cities and counties cannot require family child care home II operators to live where they operate. Local governments may still enforce rules on appearance, nuisances, and public health or safety.
More fluoroscopy authority for NPs and radiographers
Nurse practitioners who finish department‑and‑board approved training may use fluoroscopy for procedures within their scope. They may also direct fluoroscopy when working with a licensed medical radiographer. Medical radiographers may use fluoroscopy under, or in collaboration with, more licensed practitioners, including certified registered nurse anesthetists and nurse practitioners. Radiographers still may not perform interpretative fluoroscopic procedures.
Athletic Trainer Compact adopted
Nebraska adopts the Athletic Trainer Compact. After seven states join, licensed athletic trainers can use Compact Privileges to work across member states. To join and stay in the Compact, a state must license athletic trainers, require continuing competence, run complaint and investigation systems, share data, perform FBI checks, and follow Commission rules.
New FBI checks for first licenses
First-time applicants for athletic trainer or respiratory care licenses must submit fingerprints for an FBI background check, allow results to go to the department, and pay the actual costs. The compacts do not change initial licensure rules; you still must meet your state’s usual steps.
Domestic‑abuse training for mental health
Licensed mental health practitioners must complete two hours of domestic‑abuse training every two years. Starting September 1, 2027, provisional applicants must complete three hours covering screening, safety planning, referrals, and other listed topics. Trainers must meet experience rules and use board‑approved materials.
Massage must be in licensed sites
Massage therapy must occur in a licensed massage therapy establishment unless state law or department rules allow another setting. This limits practice in unlicensed or mobile locations.
Physical therapists can file medical liens
Physical therapists have a lien on a patient’s injury settlement or judgment for their usual charges. Liens do not apply to workers’ compensation cases. If the patient has private insurance, the lien is reduced by the insurer’s contracted discounts. Courts measure medical expense damages using the private‑party rate.
Respiratory care requires license or compact
You must be licensed in Nebraska or hold a compact privilege to practice respiratory care. Exemptions include students in approved programs, certain credentialed technologists, other licensed clinicians acting within their scope, and federal employees on duty.
Stable rules for license compacts
Where a compact and state law conflict, the compact controls in the conflicting parts. A compact change takes effect only after every member state passes it into law. Only member states can enforce the compact against the Commission; private people and companies cannot sue the Commission under the compact.
Pharmacy staffing limits and exam timing
A pharmacist may supervise up to four people total (technicians and interns). If supervising four technicians, at least one must be a certified pharmacy technician. Pharmacist applicants must pass both the pharmacy and jurisprudence exams. The accredited program may decide if the jurisprudence exam happens before or after graduation.
Licensing and rules for pharmacy kiosks
Pharmacies must get an annual state license for each automated pickup kiosk; fees are capped at $200 to start and $50 to renew. The state inspects kiosks. A pharmacist must verify each prescription, offer pharmacist care, and keep records for five years. Kiosks cannot store or dispense controlled substances, except hospital kiosks inside a hospital. Facilities that use automated systems or kiosks must keep written policies on access, security, training, quality checks, and downtime. Automated medication systems require pharmacist care and do not include pickup kiosks. The law adds these rules to the Automated Medication Systems Act.
Old pharmacy and health laws repealed
The law repeals several pharmacy, health, and insurance sections: 38‑404, 38‑409, 38‑2101, 38‑2123, 38‑3208, 38‑131, 71‑2444, 71‑2445, 71‑2447, 38‑1915, 38‑2315, 38‑2850, 71‑1918, 38‑1716, 38‑2801, 52‑401, 71‑1908, 71‑1912, 38‑2871, 38‑2852, 38‑2866.01, and 38‑2053. These sections are no longer law; agencies now operate under the updated rules in this act.
When these changes take effect
Start dates are staggered. Sections 6, 7, 8, 9, 10, 13, 14, 15, 23, and 35 take effect January 1, 2027. Sections 30, 31, 32, 33, and 36 take effect May 1, 2027. Many other listed sections start three calendar months after adjournment; others start on their own stated date.
Compact membership, defaults, and lawsuits
The Compact starts when seven states join. The Commission treats pre‑start actions as its own and owns related intellectual property. If a state defaults, the Commission gives written notice and help; a majority can end membership if it is not fixed. A removed state must tell licensees and keep recognizing Compact licenses for at least 180 days. The removed state still owes its assessments and costs, and the Commission does not pay them unless agreed in writing. Either side can sue in federal court and recover costs and attorney fees if they win. The Compact continues even if membership later drops below seven. This law takes effect immediately.
Compact rules, joining, and exit
Compact Commission rules have the force of law in member states after public notice and hearings; emergency rules get quick notice and later review. A state that joins later follows the existing rules. A state may leave by repealing the compact, with withdrawal taking effect 180 days after enactment. The state must notify licensees right away, keep compact licenses recognized for at least 180 days, and keep reporting pre‑withdrawal investigations and actions. The Commission can deny or end a state’s participation for material departures and must defend and indemnify its officials for acts in their official roles.
Sponsors & Cosponsors
Sponsor
Brian Hardin
Senate
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
4/14/2026legislaturePresident/Speaker signed
4/10/2026legislaturePassed on Final Reading with Emergency Clause 48-1*-0
4/10/2026legislaturePlaced on Final Reading
4/7/2026legislatureAdvanced to Enrollment and Review for Engrossment
4/7/2026legislaturePlaced on Select File
3/25/2026legislatureAdvanced to Enrollment and Review Initial
3/20/2026legislaturePlaced on General File
3/19/2026legislatureDate of introduction
3/19/2026legislature
Bill Text
Introduced
3/19/2026
Enrolled / Slip Law
Final / Enacted