In 2016, the Nebraska Department of Health and Human Services and its Division of Behavioral Health, as a part of its strategic plan, identified the need to study of the costs associated with providing mental health and substance use disorder services.

Agency leaders believed the findings of this study would help them ensure “statewide capacity and access to behavioral health services.”

That cost modeling, which looked at behavioral health services, identified state reimbursement rates far below the costs associated with providing care. Many services were receiving 7% to 35% below actual costs.

The Nebraska Legislature and Appropriations Committee Chairman John Stinner and Vice Chair Kate Bolz led needed efforts to increase rates. This, in turn, allowed providers to expand and improve access to care and take steps to maintain and expand workforce.

Funding Priorities

Unfortunately, too many people still cannot afford access to mental health care, and that is why the Legislature should continue making behavioral health care a priority. Medicaid is one of the primary payers for mental health and substance use disorder services, resulting in many of our community providers relying on those rates for a high percentage of their revenues.

Providers are paid for their services through a managed care system in which the state contracts with insurance companies, which then negotiate reimbursement rates with providers.

The Legislature appropriates funds for the Medicaid program, which includes provider rates. Each July, after the start of a new fiscal year, the Medicaid division posts the legislatively approved rates.

These rates are what managed care companies use when negotiating contracts with providers. But uncertain times have providers worried about maintaining their services and meeting the needs of their clients. So they need to know that the rates appropriated by the Legislature will be the minimum rate they receive.

Potential Changes

One way to do this is Legislative Bill 380, a proposal from State Sen. John Fredrickson of Omaha aimed at tightening up managed care and provider audit statutes.

The bill establishes that posted rates will be the floor for rates paid to providers. Knowing that they won’t be paid less than what the Legislature budgets gives providers, who are business people, too, some assurances for maintaining and growing their workforce.

Businesses require such certainty to add services and meet people where they live. Addressing this planning issue is critical to ensuring that the progress Nebraska mental health and substance use disorder providers have made is not jeopardized.

Statistics around mental illness and substance use disorders are still disturbing. In Nebraska, suicide is the second-leading cause of death for 10- to 24-year-olds and 25- to 34-year-olds. We have four times more deaths by suicide than car accidents.

One in six youth ages 6 to 17, and one in three young adults ages 18 to 25, struggle with a mental illness. Yet we know that many people do not receive the care they need for these treatable illnesses.

We must continue building a strong, more resilient system of care that improves access and helps us, as a state, to keep moving the trends involving mental health in the right direction.

Annette Dubas was the first executive director for the Nebraska Association of Behavioral Health Organizations (NABHO). She began that role after serving eight years as a state senator.

This story was published by Nebraska Examiner, an editorially independent newsroom providing a hard-hitting, daily flow of news. Read the original article: https://nebraskaexaminer.com/2025/04/17/nebraska-should-help-mental-heal...

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