Senate Health and Welfare Committee confirms director, approves broad package of Health and Welfare rule changes

The Senate Health and Welfare Committee sent Governor-appointed Department of Health and Welfare Director Alex Adams’ nomination to the full Senate with a recommendation for confirmation and approved a suite of administrative rule changes affecting hospitals, child welfare and foster care, and emergency medical services.

The committee moved quickly through the agenda on Oct. 24 during a meeting led by the committee chair. Committee members approved a temporary hospital rules docket that keeps previously enacted temporary rules in effect through July 1; a series of temporary and consolidated rule dockets for Children and Family Services that include changes to foster care licensing, contested-case procedures for the Child Protection Central Registry, elimination of adoption fees for children in state custody, and new supervised-visit requirements for parents substantiated for serious abuse; and consolidated EMS chapters that reduce continuing-education requirements to align with neighboring states.

Committee members and department staff said the rule changes are intended to reduce duplicative regulation, align state rules with federal standards where appropriate, and expand flexibility for child placements. Jared Larson, Legislative and Regulatory Affairs Chief for the Department of Health and Welfare, told the committee, “My name is Jared Larson, Legislative and Regulatory Affairs Chief of the Department of Health and Welfare,” and said the hospital docket largely preserves existing temporary rules that the legislature approved previously and keeps them in effect pending the specified date. Larson said the hospital licensing changes will allow hospitals already certified by the Centers for Medicare & Medicaid Services (CMS) to be “deemed licensed” by the state rather than subject to additional duplicative state licensing requirements.

The committee approved a set of temporary Children and Family Services dockets the department said were promulgated in response to recent litigation and to address urgent operational needs. Larson told the committee that one set of contested-case rules for the Child Protection Central Registry were made on the advice of the Attorney General’s office to help the state defend pending litigation. The committee also approved a temporary docket eliminating adoption application fees for families adopting children from state custody; Larson said that change took effect when Director Adams signed it on his first day in office.

On foster care licensing, the department presented a reworked chapter that implements the Reasonable Prudent Parent standard (a federal standard adopted in model rules) in place of some prior age limits, and lowers the minimum age to serve as a foster parent from 21 to 18 in some circumstances to increase placement options (for example, when an older sibling can provide the best placement for younger children). The department said it will continue to require training and safety standards and that the change is intended to improve placement matches. Julie Subcic, a program manager with Child and Family Services, confirmed certain long-standing safety requirements remain in the rules; among those is a requirement that weapons and ammunition in foster homes be stored out of children’s reach.

Senator Shippey raised concerns about that weapons-storage requirement as written, saying, “if all of my guns are locked up separately from my ammunition, and I need to, defend my home against a threat and defend foster children, I'm really not in a position to,” and urged consideration of alternatives such as secure safes where the licensed parent controls access. Larson replied that the department would “be more than happy to work with you, through the interim on this and help, and come up with appropriate language” and offered to pursue changes with the senator.

The committee also approved a temporary rule to fast-track reapplication for former foster parents who left in good standing and are seeking to license again within 12 months; Larson said the department has prioritized recruitment and retention of foster parents and cited a historical ratio the department tracks: when Director Adams took office the department was operating at roughly 74 foster parents per 100 children in care; the department reported that figure has risen to about 94 per 100 and that its internal goal is 150 per 100.

On EMS rules, the department consolidated several chapters into a single chapter and proposed reducing continuing-education requirements to align with averages in contiguous states. Wayne Denny, chief of the Bureau of EMS and Preparedness, said the department compared hours on a per-year basis and that the changes were prorated to reflect license renewal periods. The department described examples of the reductions as moving from about eight continuing-education hours to five per year for basic emergency medical technicians and reductions for higher licensure levels (department materials presented the reductions as roughly from 16 to 12 hours per year for certain advanced levels and from about 36 to 30 for paramedics, prorated to license terms).

Votes at a glance: the committee approved the nomination of Alex Adams to the Senate with a recommendation for confirmation; and it approved the following dockets by voice vote (docket numbers quoted as they were read into the record): 1603142301; 16-0601-2402; 16-0601-2403; 16-0601-2404; 16-0601-2405; 16-0602-2401; 16-0602-2402; 16-0602-2403; 16-062-2403; 16-101-2401 (EMS consolidation); and a batch repeal of earlier EMS chapters listed in the record as 16O1022401, 16O1052401, 16O107-2401, 16O1122401, 16O2012401 and 1602022401. Motions were typically moved and seconded from the dais (for example, Senator Harris moved the initial appointment motion and Senator Wintrow seconded); votes were taken by voice and recorded as approved on the record.

Committee members briefly discussed process and logistics, including page references for rulebooks and the department’s outreach in advance of controversial changes. Senator Wintrow noted she appreciated the department’s actions on child welfare, saying, “I really appreciate the swift and, serious action,” in reference to visitation and other protective measures. The committee chair noted additional administrative-rule hearings would continue the next day and mentioned an adoption-legislation preview scheduled in the Lincoln Auditorium.

What the committee did not do: the meeting did not produce substantive new statutory changes — the session was an administrative rules review and approval session. Committee members and department staff emphasized that some of the changes reflected federal standards or were temporary rules the department adopted to preserve continuity while litigation or statutory drafting moves through the legislative process.

The committee adjourned with plans to resume the administrative rules review at the next scheduled meeting.