Opening Remarks
Outreach Partnership Program 2005 Annual Meeting
Friday April 1, 2005
Senator Jim Jensen, Nebraska Legislature
Senator Jensen was introduced by Pat Connell, the Nebraska Outreach Partner, who directs Government Relations and the Behavioral Health Division at Boys Town National Research Hospital. Senator Jensen is a well-known friend and advocate for persons with mental illness in Nebraska. He was first elected to the Nebraska legislature in 1994 and has been chair of the Health and Human Services Committee since 1999. In 2003, he sponsored, and the Nebraska legislature passed, Legislative Bill (LB) 724, which established a framework for behavioral health care reform in the state. During the summer and fall of that year, he organized many local and regional meetings with health care providers, hospitals, consumers, families, state employees, and others in the mental health system to ensure their input as enabling legislation for behavioral health reform was developed. In 2004, under Senator Jensen’s direction and leadership, the legislature passed LB 1083, which established Nebraska’s first Division of Behavioral Health in the Department of Health and Human Services, with the responsibility to coordinate and expand community services and implement statewide behavioral health reform in Nebraska.
Senator Jensen welcomed NIMH to his state and briefly described Nebraska’s unique, nonpartisan legislative structure. He came into the legislature with a background as a building contractor and developer in Omaha, and joined the Health and Human Services Committee. He discovered in his travels around the state, in both sparsely populated and metropolitan areas, that it is a challenge to provide health services to all of the population. But with modern technology, there are also opportunities to develop and use techniques like distance learning and telepsychiatry.
Talking with mental health consumers and their families made it clear that the system of care in Nebraska needed improvement. Nebraska became a state in 1867 and in 1871 opened its first mental hospital (in those days, it was called a hospital for the incurably insane). Two more mental hospitals were established in 1888 and 1889. Each hospital housed 2,000-2,500 patients. The three state hospitals for the mentally ill, known as “regional centers” in Nebraska, are located in Hastings, Lincoln and Norfolk. During the 1960s and ’70s, psychotropic medications made it possible for many patients to leave the hospital and live in the community, and some were able to hold jobs. All of the psychiatric hospital beds at the Hastings Regional Center have now been closed, and at present, each of the others has an average of about 200 inpatients. One hospital is for forensic cases and sexual perpetrators, who require very long rehabilitation. The patients’ care is paid out of the state’s general fund dollars and there is no Medicaid match.
Until quite recently, Nebraska still had a commitment process that involved sending patients to a facility that was often hundreds of miles from their families, community support systems, and health professionals with whom they had established relationships. LB 724, passed in the legislature in 2003, established a roadmap of mental health reform leading to community-based care. The hope is to close more hospital beds as more community-based services become available. Under LB 1083, passed last year, an oversight commission and tracking system will ensure that as people are transitioned out of hospital care, they don’t fall through the cracks and that services are available. Included in the bill is a provision for subsidized housing and for wrap-around services that will enable people with mental illnesses to live independently and productively. Recovery is the goal.
In response to a question about length of stay, Senator Jensen said that there are people who have been living in institutions for 6 or 7 years. The state is looking at alternative residential housing for patients who may never be able to live in the community. For example, a nursing home in a very small town in western Nebraska, which was facing closure because it was less than half-full, arranged for special training for staff and opened up a wing for people with long-term mental illness. Now the facility, which is providing excellent care, is full and has a waiting list. Some of the patients have even been able to transition to other settings. One purpose of the tracking system previously mentioned is to monitor length of stay in acute, sub-acute and residential care.
Senator Jensen works closely with the National Alliance for the Mentally Ill in Nebraska, trying to combat the stigma of mental illness. He said that he has come to realize that there is great power in the consumer. Senator Jensen also serves on the NIH Director’s Council of Public Representatives (COPR), which, among other issues, has been looking at concerns about clinical trials. A priority is to ensure that people who are enrolled in a clinical trial understand the study’s purpose, feel safe and are informed about the results of the trial in which they participate.
Senator Jensen concluded by saying that because of term limits, he will finish his tenure in the legislature in the next year, but his desire to improve the lives of people, particularly those with mental illness, will continue. He also urged everyone to take full advantage of the excellent speakers at the OPP meeting and to take the information they gain back to their communities.
