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LB 257

Change licensure and scope of practice provisions regarding marriage and family therapy and occupational therapy and licensure requirements under the Child Care Licensing Act

109th Legislature (2025-2026) Introduced by Dan Quick

Nebraska streamlines licensure reciprocity for out-of-state LMFTs, allowing them to practice more easily and expand local access to mental-health care.

Provisions/portions of LB274 amended into LB257 by AM947
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Bill Summary · LB 257

Summary — LB 257 (2025)

Status: Enacted (approved by Governor May 20, 2025)
Introduced: Jan 14, 2025 — Primary Sponsor: Sen. Dan Quick
Committees/Amendments: Health & Human Services; amendments adopted include AM866 (occupational therapy provisions) and AM947 (child care licensing provisions; incorporated portions of LB274). Final passage: May 14, 2025 (46–3–0).

Main purpose

LB 257 (as amended) makes three principal sets of changes:
1. Establishes streamlined reciprocity/portability rules for Licensed Marriage and Family Therapists (LMFTs) licensed in another U.S. state or territory.
2. Updates and clarifies licensure, definitions, and scope-of-practice language in the Occupational Therapy Practice Act.
3. Strengthens certain licensing and inspection requirements under the Child Care Licensing Act related to liability insurance and background checks.

Key provisions (by topic)

Marriage and Family Therapy (sec. 38-2125, 38-2130)
- DHHS, with the Board of Mental Health Practice recommendation, must issue a Nebraska mental health practitioner license or certificate to an applicant who:
- Holds a valid, independent, unrestricted LMFT license in another state or territory that is in good standing;
- Submits an application and pays fees; and
- Passes the Nebraska jurisprudence examination.
- Applies to issuance of both full licenses and certificates; temporary licensing provisions for military spouses remain.

Occupational Therapy (multiple sections, e.g., 38-2501 et seq.; amendments via AM866)
- Revisions and clarifications of definitions (e.g., “deep thermal agent modalities,” “electrotherapeutic agent modalities”) and exclusion lists (diathermy, lasers, ultraviolet light).
- Expanded and modernized statement of the practice of occupational therapy emphasizing occupation‑based evaluation, clinical reasoning, habilitation/rehabilitation, health promotion, and prevention.
- Detailed list of components and permitted interventions (e.g., functional assessments, ADL and IADL training, virtual interventions, driver rehabilitation, wound care, assistive technology, seating and mobility assessment, feeding/swallowing management).

Child Care Licensing Act (secs. 71-1911.03, 71-1912; amendments via AM947)
- Applicants must provide written proof of liability insurance of at least $100,000 per occurrence before license issuance; existing licensees were required to obtain such coverage by July 1, 2014 (continuing requirement).
- Licensees must maintain coverage while children are in care; failure to maintain required coverage is noncompliance and may lead to suspension.
- Inspections are unannounced except for initial licensure and consultation visits. Inspectors must request and verify proof of current liability insurance at each unannounced inspection. If proof is not provided, licensee has three business days to submit proof or license will be suspended until coverage is verified.
- Clarifies criminal-history screening requirements (national fingerprint-based checks, NCIC sex-offender registry, state databases); cost responsibility provisions and availability of federal funds to assist fingerprinting costs are addressed.

Who is affected

  • Out‑of‑state LMFTs seeking to practice in Nebraska (easier licensure portability).
  • Nebraska DHHS and the Board of Mental Health Practice (administration of new reciprocity rules).
  • Occupational therapists and employers/providers in Nebraska (clarified/expanded scope and permitted modalities).
  • Child care providers, licensees, inspectors, and staff — particularly regarding insurance compliance and background checks; potential administrative and cost implications for providers.

Procedural/timeline notes

  • Advanced through Health & Human Services Committee (hearing Feb 7, 2025). Multiple floor and enrollment amendments adopted (including AM866 and AM947). Portions of other bills (LB630, LB274) were incorporated by amendment. Passed final reading May 14, 2025; presented to and signed by Governor May 20, 2025.
  • Fiscal notes were filed (dates included in record), but specific fiscal impacts are not detailed in this summary.

Anticipated impacts

  • Likely reduced licensure barriers for LMFTs relocating to Nebraska and potential modest expansion of behavioral‑health workforce.
  • Occupational therapy language modernizes statutory scope and may affect permitted clinical practices and regulatory oversight.
  • Child care licensees may face stricter enforcement of insurance requirements and ongoing verification obligations; providers may incur costs for insurance and periodic background checks if federal assistance is unavailable.

Compiled from official sources — confirm details with the bill’s official record.

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