The Nebraska Department of Health and Human Services reminds Nebraskans that bats are very active this time of year, which means the possibility of exposure to rabies increases.

“Bats are a common carrier of rabies in Nebraska,” said Dr. Joseph Acierno, Chief Medical Officer and Director of Public Health for DHHS.  “Several have tested positive for rabies over the last three months. People should be cautious around bats and other wild animals.”   In addition to bats, skunks, foxes, coyotes and raccoons can have rabies and transmit it to people. Rabies is caused by a virus that affects the nervous system and is transmitted by the bite of an infected animal or if saliva from a rabid animal gets directly into an open wound or a person’s eyes, nose, or mouth. Rabies is generally fatal without preventive treatment.

Help prevent the spread of rabies by following these tips:

  • Be a responsible animal owner. Keep vaccinations up-to-date for all dogs, cats, ferrets, and other animals you own.
  • Seek immediate veterinary assistance for your pet if it’s bitten by a wild animal or exposed to a bat.
  • Call your local animal control agency about removing stray animals in your neighborhood.
  • Do not touch, feed, or unintentionally attract wild animals with open garbage cans or litter.
  • Never adopt wild animals or bring them into your home. Do not try to nurse sick, wild animals to health. Call animal control or an animal rescue agency for assistance.
  • Teach children never to handle unfamiliar animals, wild or domestic, even if they appear friendly. “Love your own, leave other animals alone” is a good principle for children to reduce the risk of contact with rabid animals.
  • Maintain homes and other buildings so bats can’t get inside.
  • If a bat is in your house, don’t let it outside until you talk to animal control or public health officials. If you can do it without putting yourself at risk for physical contact or being bitten, try to cover the bat with a large can or bucket, and close the door to the room.

If you think you’ve been bitten by a bat:

  • Seek immediate medical attention if you’ve been in direct contact with or bitten by a bat.
  • If you wake up and find a bat in your room, you should try to safely capture the bat and have it tested. The same precautions should be used if you see a bat in a room with an unattended child.
  • If you or a family member has been in close proximity to a bat, consult your doctor or local health department for assistance to determine if you might have been exposed to rabies and need preventive treatment.
  • People often know when they’ve been bitten by a bat but its small teeth can make a bite mark difficult to find. It’s better to be safe than sorry. Try to safely capture the bat or call animal control, have the bat tested and seek medical advice.

Rabies cases in Nebraska No human cases of rabies have occurred among Nebraskans since the 1920s.

2014 – 16 animals tested positive for rabies so far including:

  • 7 bats
  • 6 skunks
  • 3 cattle

2013 – 33 cases

2012 – 59 cases

2011 – 35 cases

2010 – 53 cases

2009 – 90 cases

For more stats on the number of rabies cases in Nebraska, go to –

Find more information on bat-proofing your home –

General information about rabies can be found here –

10,000 people are turning 65 today!

More than one in eight Americans are 65 or older, and the number of Americans who will reach 65 over the next twenty years increased by 31% over the past decade. Our older population also reflects the country’s increasing diversity.

Are you prepared to provide this growing population with the best possible care?

NYU’s Hartford Institute for Geriatric Nursing, in collaboration with the NY Consortium of Geriatric Education Centers and the National Nursing Centers Consortium, has developed 11 evidence-based e-Learning clinical training modules aimed at advanced practice nurses and focused demonstrating interprofessional standards of care for chronic disease management and geriatric syndromes. Free Nursing Continuing Education will be available for those who qualify!

The modules can also be accessed through Hartford Institute’s page ( or on the GenerationNP PCOA group page (, where advanced practice nurses in primary care have the opportunity to collaborate virtually to enhance their knowledge and skills.


The Dental Quality Alliance (DQA) is happy to announce that the National Quality Forum (NQF) has endorsed five DQA measures!

  1. Prevention: Dental Sealants for 6-9 Year Old Children at Elevated Caries Risk
  2. Prevention: Dental Sealants for 10-14 Year-Old Children at Elevated Caries Risk
  3. Utilization of Services: Dental Services
  4. Prevention: Topical Fluoride for Children at Elevated Caries Risk, Dental Services
  5. Oral Evaluation: Dental Services

NQF endorsement is considered the gold standard for measuring healthcare quality and is valued for the selection of measures to assess quality of care within federal programs such as Medicaid and the emerging ACA Marketplaces. To find more information on the NQF endorsed measures, please visit the Health & Wellbeing website.

The State Board of Health is seeking professional members to serve on several health care boards.  Professional boards are responsible for granting license privileges to health care providers. Terms are five years in length and run through November 30, 2019, and then members would be eligible for reappointment to a five-year term.  The following boards have vacancies:

  • Alcohol and Drug Counseling
  • Audiology and Speech Language Pathology
  • Chiropractic
  • Cosmetology
  • Dentistry
  • Mental Health Practice
  • Nursing
  • Psychologists
  • Podiatry
  • Registered Environmental Health Specialists
  • Veterinary Medicine and Surgery

Persons interested in serving on a board can obtain an application and documents related to the appointment process at Completed applications must be received by October 13th.  Members would be appointed on November 17th.

There are also vacancies on the Board of Emergency Medical Services, the Nebraska Center for Nursing Board, and the State Board of Health.  Members of these three boards are appointed by the Governor.  Applications may be accessed at and are now being accepted for current vacancies.

To receive an application by mail contact the Nebraska Department of Health and Human Services, Division of Public Health, Licensure Unit/RPQI, P.O. Box 95026, Lincoln, NE 68509-5026; by email at; or by phone at (402) 471-6515.

Thank you for your continued support helping consumers resolve their outstanding immigration and citizenship data matching issues.  CMS is working hard to process the thousands of documents that consumers have submitted to confirm their coverage and resolve both immigration/citizenship and income data matching issues. They are making progress thanks to your continued support. Eighty-eight percent of the 966,000 citizenship or immigration data matching issues as of May 30, 2014 are now closed or are in the process of being reviewed.  Of the 1.2 million households with income data matching issues, as of May 30, 2014, 897,000 households’ cases are now closed or in progress. CMS knows they still have more work to do, and they wanted to share some new information about helping consumers who have outstanding income verification issues and from whom they still need more information to verify the household income listed on their applications.  

Last week, the Department of Health and Human Services (HHS) Secretary Sylvia M. Burwell announced $60 million in Navigator grant awards to 90 organizations in states with Federally-facilitated and State Partnership Marketplaces.  These awards support enrollment and outreach activities in year two of the Marketplace and build on lessons learned from last year.

The open enrollment period for the 2015 plan year will begin on November 15, 2014 and continue through February 15, 2015.

Remember that if a consumer wants new coverage, or wants to make changes to existing coverage, the consumer will need to select a plan by December 15, 2014 in order for the coverage to go into effect on January 1, 2015. If a consumer selects a plan between December 16, 2014 and January 15, 2015 the new plan will be effective February 1, 2015. If a consumer selects a plan between January 16, 2015 and February 15, 2015, the new plan will be effective March 1, 2015.

In the coming weeks, CMS webinars and newsletters will continue to feature information to help you prepare for open enrollment, from reviewing the online application to presenting innovative ways to reach out to culturally and economically diverse communities.

As a reminder, while open enrollment offers the opportunity for all qualified individuals to apply for coverage, consumers may be able to enroll in health coverage outside of open enrollment if they qualify for a special enrollment period (SEP), if they are enrolling through the Small Business Health Options Program (SHOP), or if they are eligible for Medicaid or the Children’s Health Insurance Program (CHIP).

The Department of Health and Human Services (HHS) Secretary Sylvia M. Burwell announced $60 million in Navigator grant awards to 90 organizations in states with Federally-facilitated and State Partnership Marketplaces.  These awards support enrollment and outreach activities in year two of the Marketplace and build on lessons learned from last year.

For more details about this announcement, please visit the press release at:

HRSA clarified in last week’s Primary Health Care Digest that it will no longer require submission of Financial Recovery Plans as the formal monitoring of financial performance. HRSA stressed that while it will continue to assess Health Center compliance with financial management requirements, it believes that financial viability is an individual health center responsibility. HRSA also addressed the reduction of Health Center grants for projects that fail to meet the proposed patient projections. For more information regarding these developments, check out the NACHC website Policy Shop blog.

The CMS August 22 webinar included a presentation by Young Invincibles featuring lessons learned and best practices to engage and help enroll young adults (individuals from 18-34 years old) in the Marketplace.

As a supplement on this important topic, and in the spirit of the “Back to School” mindset, CMS wants to highlight the following strategies and best practices for Marketplace outreach and enrollment to colleges and universities. The first list of tips is geared towards helping you brainstorm strategies for outreach and enrollment as you engage with College and University Staff, and the second is targeted to an audience of university leaders, faculty, and staff to illustrate how to frame your conversations with these important actors.

Strategies for Colleges and Universities: Health Insurance Marketplace Outreach and Enrollment

1)     Partner with student organizations to maximize reach and garner credibility.

2)     Get the mascot involved– they are unbelievably popular at enrollment events!

3)     Recognize that many college students also have a University Student Health program as a  coverage option.  Meet with the Dean of Administration to ensure you understand their enrollment timeframe and talk through the best way to collaborate. Working closely with college and university Administrations in  your area will help you learn more about the differences between QHPs and student health coverage so that you can better serve your consumers.

4)     Arrange a collaborative agreement with the school to formalize commitments to:

  • Send information to their students
  • Send information to their employees
  • Host enrollment events for their students and the community
  • Post information in the campus newspaper
  • Allow tabling at appropriate campus events
  • Establish an internship where students can train as CACs and receive credit or community service credits
  • Incorporate ACA materials and education in student orientation and parents weekend activities

5)     The greatest campus champions are often leadership from the Dean of Student Services, the President of Student Life, and the Dean of Health and Career Services.  It is often useful to enlist the help of a local elected official to host or set up this type of meeting for you.

6)     Ask school leaders to record a video message or PSA to students to raise awareness about how to get covered that can be shared through campus media.

7)     Create a friendly competition between local schools to see who can get the most students covered.

8)     Spend quality time meeting with community colleges and trade and vocational schools.  Their students are key candidates for ACA enrollment.

  • Seek the same commitments in #4, above.
  • Consider asking them to sit on the coalition or your “kitchen cabinet.”

9)     Keep in mind that the Affordable Care Act provides coverage to children through their parents’ plans until the age of 26, and help make sure that students understand this benefit and how to take advantage of it.

Remember that Marketplace rules place certain restrictions on directly contacting consumers for the purpose of soliciting enrollment—as opposed to general outreach and education. For more information, see the Market Standards final rule and CMS’s slide presentation: Overview for Assisters of Exchange and Insurance Market Standards for 2015 and Beyond — Final Rule.

Best Practices for Working with Colleges and Universities: Health Insurance Marketplace Outreach and Enrollment

College and university leaders, faculty, and staff, are well positioned to help young adults secure health insurance that will allow them to stay physically and financially healthy to achieve their academic and career goals. When you approach college or university staff, it may help to share the messages and information below.

1)     Have one or more of your school departments apply to serve as a certified application counselor (CAC); in this capacity, your staff can get trained to help students to understand the healthcare law and enroll in   health care coverage (See

  • Create a college credit-based student intern program for students to serve as certified application counselors.

2)     Appoint a member of your leadership team to serve as the point person to work with the local Marketplace coalition of application counselors and navigators.

3)     Provide weekly enrollment information to your faculty and students through the school newspaper, website postings, social media, emails and/or phone calls. Remember that if your faculty or students are serving as Navigators, CACs, or in-person assisters, Marketplace rules on outreach and enrollment assistance apply to you. For more information, see the Market Standards final rule and CMS’s slide presentation: Overview for Assisters of Exchange and Insurance Market Standards for 2015 and Beyond — Final Rule.

4)      Have Marketplace information available at your school events.

5)      Host regular enrollment appointments and events for students, faculty, staff, and the community November 15- February 15. The local coalition of application counselors and Navigators can provide speakers and information.

6)      Write a letter to the local newspaper editor encouraging residents to enroll in the Marketplace and work with local television and radio stations to air announcements.

7)      Get more information from the Young Invincibles toolkit at:

8)      Get the mascot involved they are unbelievably popular at enrollment events!

9)      Have the school president, a popular professor or coach record a video message to students to raise awareness that can be shared through campus media.

10)     Keep in mind that the Affordable Care Act provides coverage to children through their parents’ plans until the age of 26, and help make sure that students understand this benefit and how to take advantage of it.

Resources: As a reminder, below are some resources for helping young adults as they consider their new coverage options. Please check out the outreach and education section of Under this section, look for the link “special populations” where you can click to find more information for young adults such as tips, info for college graduates, and knowing your rights.