Nebraska saw nine long-term care facility closures in 2022, second only to 13 in Texas.

In the past three years, Nebraska has lost a combined 29 assisted living facilities and nursing homes. Inadequate funding for Medicaid patients, workforce issues and the rising costs of goods and services have all contributed to these closures.

Two bills to be heard in the Unicameral's Appropriations Committee today would mean substantial increases in state and federal funding for both types of facilities.

Jalene Carpenter, Nebraska Health Care Association CEO, says additional funding is crucial to stem the state's long-term care crisis.

"In Nebraska, 15 counties do not have a nursing home or an assisted-living [facility], and we are really starting to see a 'care desert' be created. And that causes significant issues for Nebraska seniors, " Carpenter expressed.

LB-941 would increase the daily reimbursement rate for assisted living residents on the Medicaid Waiver program. The new daily rate of just under $79 is based on a Nebraska Department of Health and Human Services study. LB-942 would increase the nursing home Medicaid reimbursement rate by about 5% over the next year. Both bills were introduced by state Sen. Myron Dorn, R-Adams.

Carpenter says the COVID-impacted long-term care workforce is improving in the state, but she stresses Medicaid reimbursement rates play a large part.

"A large portion of the Medicaid rate -- when you look at what it covers -- it's primarily going towards labor and benefits. Nursing-facility and assisted-living care is very hands-on, and we need adequate rates to be able to attract and retain team members," she added.

Carpenter said the state, educational institutions and organizations, including the Nebraska Health Care Association, are also focused on building the long-term care workforce -- including introducing young people to careers in health care and strengthening Certified Nursing Assistant programs.

"We're trying not only to increase the rates so that our facilities can attract and retain (employees), but then also, as an association, to look at other ways to drive people into the workforce for this profession, " she said.

In 2023, Gov. Jim Pillen approved a one-year, 3% increase in the Medicaid reimbursement rate, but vetoed the Legislature's 2% increase for the second year.

The Internal Revenue Service will be in the crosshairs in the second Trump administration, as the president-elect's recently announced choice to run the agency has called for it to be abolished.

Former Missouri Congressman Billy Long, Trump's choice for IRS Commissioner, cosponsored a bill to get rid of the IRS and implement a national sales tax in its place.

Ryan Polk, assistant professor of accountancy at Clemson University, said if the new administration starts laying off IRS workers, taxpayers and businesses in California and across the U.S. would see big delays.

"When you defund or reduce the funding at the IRS, you run the risk of a less helpful IRS," Polk contended. "The average, everyday taxpayer might be worse off when they have a question."

During the Biden administration, the IRS got an $80 billion boost in funding from the Inflation Reduction Act and used it to overhaul old computer systems and add agents, raising its phone call response rate from an abysmal 15% to over 80%. And the agency added a portal allowing people to upload documents instead of mailing them.

The IRS also debuted Direct File, a system allowing people to file their federal income taxes without paying a tax preparer, available in California and 22 other states. Polk argued the new Congress should understand cutting the IRS budget will limit its ability to pay for the administration's priorities.

"Just last year, they audited taxpayers and collected 100 additional billion dollars that wouldn't otherwise have been collected," Polk pointed out. "That's a pretty significant amount of money. It can go a long way, depending on regardless of the government program or tax cut you're trying to get through."

The IRS said it collects $100 in revenue for every 34 cents it spends on enforcement. Conservative critics of the agency alleged it has been weaponized, with some audits being targeted for political reasons.


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The word "fraud" is likely to circulate in the upcoming Minnesota legislative session. One political expert said state agencies are being targeted but the response requires careful thought.

The recent Feeding our Future scandal has spurred demand for more oversight of government spending in Minnesota. There are renewed concerns about organizations claiming to provide various medical services but engage in phony Medicaid billing.

Tim Lindberg, associate professor of political science at the University of Minnesota-Morris, said larger entities are making a more coordinated effort to defraud key agencies. He pointed out it mirrors global crime rings preying on consumers.

"There is some legitimate concern out there but it is also a global phenomenon that is increasing in size and importance," Lindberg observed. "I think government from the top down needs to sort of figure out a new way to deal with this."

Lindberg pointed out the state has investigative resources and internal controls but he thinks the public sector at large likely has some outdated monitoring approaches, especially as technology evolves. He argued it is important to remember agencies in the spotlight are helping people in need who are not part of these scams, and even with the best controls, completely eliminating fraud is impossible.

The cases have garnered headlines and since Democrats have the upper hand in controlling Minnesota government, Lindberg predicted Republicans will use the trend as part of their push for restrictions or cutbacks. He believes Democrats might agree to certain moves to win back public trust but stressed fraud against government is not a partisan issue.

"People doing these frauds, they don't care who's in office," Lindberg asserted. "They don't care who's in power. And Republicans and Democrats themselves have been in various levels, in various states, overseeing governments where this happens."

Taxpayer dollars are at the center of what's happening. Lindberg added the private sector must also mitigate fraud with steps like major retailers locking up essential items in cases. He suggested lawmakers have to avoid veering off-path.

"What are these ways in which government can work better, more efficiently, but also not eliminate the benefits that these programs are designed to do?" Lindberg asked.


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Four east Texas communities will share more than $1 million in grant money to upgrade their radio infrastructure systems.

The grants are funded by House Bill 442 from 2011 and construction is slated to start next year.

Lindsay Vanderbilt, director of communications for the East Texas Council of Governments, said smaller communities do not have the budgets to upgrade equipment regularly and the funds will improve security for first responders and the community.

"It's kind of a lot of technology that people don't think about," Vanderbilt pointed out. "In the governmental world, these are systems that are in place to handle emergency response and to back up that response system for safety. "

The projects will take place in Rains, Harrison and Van Zandt counties and the City of Kilgore.

Funds in the State Emergency Radio Infrastructure program are distributed by the governor's office. Vanderbilt noted the council of governments is the primary planning entity for 911 communications in 14 east Texas counties.

"It's very common for these opportunities to get proposed to us by the state, and then we connect with our local governments and we reach out to them to see who has needs and who would be eligible to apply," Vanderbilt outlined.

She added the Rains County project will address a serious communications problem.

"They're currently having severe operability issues and it's actually keeping their officers and their dispatch from being able to communicate effectively all the time," Vanderbilt observed. "That's a safety risk for the officers, it is for the public."

Other projects include construction of new Motorola towers and expansion of the TX-WARN program, which works with water and wastewater utilities during system outages.


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