state policy initiative.
Nebraska Legislative Planning Committee
The purpose of the Policy Briefs is to identify and explore in greater depth issues identified by the evidence presented. The Policy Briefs do not recommend specific policies but rather describe options and considerations that relate to the issues. Summaries of the 2013 Policy Briefs are below or you can download the entire report.
These briefs identify some of the issues that were identified when reviewing the indicators presented in the Legislative Planning Database 2013-2014, a joint initiative with the Nebraska Legislature's Planning Committee and the University of Nebraska at Omaha College of Public Affairs and Community Services. The database is presented in a series of reports that consist of data and summaries of data for each of the nine categories of benchmarks established by the Planning Committee. The 2013-2014 Database will be posted soon.
Addressing the Long-Term Care Needs of Nebraska’s Aging Population through Home and Community-Based Services
In this brief, Jerry Deichert and Christopher Kelly emphasize the fact that the number of persons aged 65 or older in Nebraska will increase greatly during the next 40 years. One immediate concern to Nebraska’s policymakers is the financial impact of the long-term care needs of this growing population on Medicaid. The authors suggest that the most efficient way to save costs in the Nebraska Medicaid program is to delay or eliminate the need for nursing home placement. They indicate that the most effective way to do so is to develop alternatives to nursing home placement with home and community-based services.
They indicate that in the past, assisted living (which is the fastest growing category of residential facilities in Nebraska) has been discussed as an alternative to nursing home placement; however, these settings are viewed today as limited in their capacity to meet the current and future long-term care needs of older Nebraskans. The supply of assisted living facilities in Nebraska is limited (especially in rural areas). Finally, assisted living is expensive to families (most facilities do not accept Medicaid).
They suggest that the best option, in controlling the State’s Medicaid long-term care costs, is to support continued expansion of lower-cost home and community-based services (HCBS) through the Medicaid waiver program. This includes working in continued partnership with public programs delivering HCBS to older Nebraskans, particularly the state’s eight Area Agencies on Aging (AAAs), and by working with providers in the private sector (both for-profit and nonprofit) to expand coverage of underserved populations, particularly low-income and/or rural elders.
Finally they point out that in order to expand HCBS in Nebraska, the State needs to address current and future shortages in its direct care workforce, particularly in rural counties.
Adult Children with Disabilities Living with Parents: Policy Implications
Karen Rolf and Jerry Deichert review the living arrangements of adults with developmental disabilities. They point out that most adult children with a disability live with a family member. These family members represent an important caregiving resource. When family members are no longer available, the state provides residential care. They suggest that the population of adult children with disabilities is growing over time and is living with family caregivers. Many of these caregivers are faced with both their own health care challenges and finding suitable care for their adult child with a disability after their own death.
They note that, in order to plan effectively, more will need to be known about the needs and the capacity of caregivers as well as the capacity of the current structured continuum of care in Nebraska for adults with disabilities. This information will help with planning for the most appropriate services for both older adult caregivers and their adult children with disabilities and will decrease the amount of time spent on waiting lists for adult children with disabilities for group home services.
Finally, they write that funding has shifted toward Home and Community Based Waivers to support individuals in their homes through supported living. This can help adult children and their older adult parent caregivers maintain supported living in their communities as long as possible. In addition, the development of housing for adults with disabilities remains a priority for most communities.
Challenges for Water Quality Policy in Nebraska: Short- and Long-Term
This policy brief by Peter Calow, Daniel Snow, Shannon Bartelt-Hunt, and Valery Forbes focuses on water quality issues in Nebraska. It is important to recognize the importance of water quality as well as quantity for both human health and ecology. The authors argue for an integrated approach to the management of surface water and ground water, as well as the development of integrated databases to allow for monitoring and better resource management. The most important causes for concern currently are nutrients (specifically nitrates and phosphates), largely from agriculture. Overall, Nebraska’s water quality compares poorly to neighboring states.
Nonpoint pollution is the dominant source of pollution, but is not easily managed. Point sources of pollution are more easily managed but are not necessarily the most cost-effective approach to doing so. The quality of drinking water is likely to come under increasing pressure as agriculture intensifies and drought complicates the dynamics of the water system. It is important to make decisions with a more explicit understanding of their costs and benefits, although sometimes the decisions are very situation-specific depending on soil types and farming practices. Cost-effective decision-making will require improved information systems and management practices.
Policy Challenges for Drinking Water Quality in Nebraska
Snow, Calow, Bartelt-Hunt, and Forbes point out that public drinking water accounts for a very small percentage of all water used, but very likely represents the most costly and heavily regulated use in the state. The public expects a high level of service to ensure that drinking water meets minimum guidelines for safety. Approximately 1300 public water systems provide drinking water to approximately 80% of Nebraska’s residents. Roughly 20% obtain drinking water from private domestic wells not regulated or monitored under federal regulations. Of the public systems, 95% of the population is served by community water systems (CWS).
Under the Safe Drinking Water Act, the US Environmental Protection Agency sets legal limits on allowable concentration of contaminants in drinking water. Nitrates and rising treatment costs are likely to be an increasing problem, especially for smaller systems in Nebraska in part due to the legacy of previous fertilizer use. Bacterial contamination is recurrent and could become more of a problem under the joint influence of aging infrastructure and weather extremes. Improved understanding of the causes of water quality changes includes identification and remediation or control of contaminant sources. Because monitoring is voluntary, drinking water quality in private (domestic) wells is at risk of exceeding health-based guidelines.
Public expectations for clean and safe water are high, but the costs of maintaining a safe drinking water supply will increase. It is not practical or economical to treat drinking water to remove all contaminants, thus monitoring is the only practical method for managing drinking water. Improved source water and distribution system management will likely be the most cost-effective methods for providing safe drinking water in Nebraska’s rural communities.
Tax Comparisons for Nebraska
This policy brief by John R. Bartle provides two perspectives on taxes. The first is an analysis of state and local revenue collections over time, with comparisons to the nation and the region. This shows patterns of growth in each of these revenue sources, as well as Nebraska’s relative position compared to the nation and the region. The major findings of this section are:
The second perspective presents an analysis of the tax burden on representative Nebraska families in 2011, also with comparisons to the nation and the region. This shows both the distribution of the tax burden at different income levels, as well as the importance of four different taxes on the family budget. The hypothetical families are in the largest city in each state, so the Nebraska data is based on the tax burden in Omaha. This section finds:
This site last updated 2/25/2014 by Melanie Kiper