PREPARED BY: Mikayla Findlay
LB 374 DATE PREPARED: January 30, 2025
PHONE: 402-471-0062
Revision: 00
FISCAL NOTE
LEGISLATIVE FISCAL ANALYST ESTIMATE
ESTIMATE OF FISCAL IMPACT – STATE AGENCIES (See narrative for political subdivision estimates)
FY 2025-26 FY 2026-27
EXPENDITURES REVENUE EXPENDITURES REVENUE
GENERAL FUNDS
CASH FUNDS
FEDERAL FUNDS
OTHER FUNDS
TOTAL FUNDS See below See below
Any Fiscal Notes received from state agencies and political subdivisions are attached f ollowing the Legislative Fiscal Analyst Estimate.
This bill provides for the Licensed Midwives Practice Act. The provisions require the Department of Health and Human Services
(DHHS) to create a new board to oversee the profession of midwifery. The costs associated with compensating board members
depends on the frequency of meetings. Additional operational expenses include appr oximately $60,000 to update the licensing systems
and staff time to process new applications.
Midwifes would be required to obtain licenses, for which a fee would be established by rules and regulations. The revenue from fees
would be deposited in the Professional Licensure Cash Fund and b e used to offset expenditures of the new board and processing
applications. Revenues and expenditures would be directed through Program 178 Professional Licensure.
DHHS notes that aid expenditures for Medicaid as a result of the bill are unknown.
ADMINISTRATIVE SERVICES STATE BU DGET DIVISION: REVIEW OF AGENCY & POLT. SUB. RESPONSE
LB: 374 AM: AGENCY/POLT. SUB: Nebraska Department of Health & Human Services
REVIEWED BY: Ann Linneman DATE: 1 -30-2025 PHONE: (402) 471-4180
COMMENTS: Concur with the Nebraska Department of Health and Human Services’ assessment of fiscal impact.
LB (1) 374 FISCAL NOTE 2025
ESTIMATE PROVIDED BY STATE AGENCY OR POLITICAL SUBDIVISION
State Agency or Political Subdivision Name:(2) Department of Health and Human Services
Prepared by: (3) John Meals Date Prepared 1-30-25 Phone: (5) 471-6719
FY 2025-2026 FY 2026-2027
EXPENDITURES REVENUE EXPENDITURES REVENUE
GENERAL FUNDS $67,330
CASH FUNDS
FEDERAL FUNDS
OTHER FUNDS
TOTAL FUNDS $67,330 $0 $0 $0
Return by date specified or 72 hours prior to public hearing, whichever is earlier.
Explanation of Estimate:
LB374 creates a new profession, professional midwifery, by adopting the Licensed Midwives Practice Act.
Additionally, this bill requires the Department of Health and Human Services (DHHS) to create a new board, the Board of
Licensed Midwives. Board membership includes one physician licensed under the Uniform Credentialing Act (UCA) who
has professional experience consulting for and collaborating with direct-entry midwives, three certified professional
midwives licensed under the UCA, and one public member who has received direct-entry midwifery services.
There are new costs associated with creating this board. The total of which will depend on the frequency of meetings and
the location of board members related to travel reimbursement. Per diems are also paid to board members for each day
involved in board business and will include board meetings and any national meetings a board member may attend on
behalf of the board.
Updates in the Occupational Licensure Unit database, My License Office (MLO), will involve additional cost. The contract
for MLO will include ongoing subscription fees for maintenance of the system, but there may be limits on the number of
updates made within the contract per year. If the limit of updates is exceeded, a change order would be required which
will also result in an additional cost. The projected cost for database updates is $67,330.
Any additional cost related to Medicaid is unknown at this time because managed care organizations do not cover non-
clinically licensed midwife services.
This bill will generate revenue with credentialing fees established. The revenue from credentialing fees would be intended
to offset the costs of credentialing and the board.
MAJOR OBJECTS OF EXPENDITURE
PERSONAL SERVICES:
NUMBER OF POSITIONS 2025-2026 2026-2027
POSITION TITLE 25-26 26-27 EXPENDITURES EXPENDITURES
Benefits...............................................................................................................................
Operating............................................................................................................................
$67,330
Travel..................................................................................................................................
Capital Outlay.....................................................................................................................
Aid......................................................................................................................................
Capital Improvements.........................................................................................................
TOTAL............................................................................................................
$67,330 $0