Nebraska

Nebraska, the Cornhusker State, was named after its largest river, the Platte, which a local American Indian tribe called “Nebraska” meaning “flat water.”  Nebraska is also home to three American Indian reservations.  Nebraska covers 76,872 square miles, with a 2007 estimated population of 1,774,571 people – 745,905 living in rural Nebraska (USDA-ERS). Lincoln, the capital, is located in the south-eastern region of the state. The state’s largest cities are Lincoln, Omaha, and Bellevue.  According to the 2006 Census, 91.8% of the state’s population is white, 4.4% is Black/African-American, 1% is American Indian & Alaska Native, 1.7% is Asian, and 7.4% is of Hispanic/Latino origin.

There are 86 hospitals in Nebraska, 71 of which are located in rural areas (North Carolina Rural Health Research and Policy Analysis Center, 2007). The state has 65 hospitals currently identified by the Flex Monitoring Team as Critical Access Hospitals. There are 89 Rural Health Clinics in Nebraska, and five Federally Qualified Health Centers provide services at 13 sites in the state (Kaiser, 2004). Nebraska's not-for-profit hospitals and public health departments are connected to a telehealth backbone that uses T1 lines and cable lines for connectivity. Additional CRHC's will be added to the same network in the future. Most Nebraskans have some form of health insurance coverage, although 10% of its residents lack any health insurance (Kaiser, 2004-2005.)

According to the Economic Research Service, the average per-capita income for all Nebraskans in 2005 was $32,923 although rural per-capita income lagged at $27,839. 2004 estimates indicate a poverty rate of 10.6% exists in rural Nebraska, compared to a 10.0% level in urban areas of the state. Data from 2000 finds that 15.9% of the rural population has not completed high school, while only 11.3% of the urban population lacks a high school diploma. The unemployment rate in rural Nebraska is at 2.9%, while in urban Nebraska it is at 3.0% (USDA-ERS, 2006).

For a national comparison, please see an overview of the United States.

Data Sources:

U.S. Census Bureau: State & County QuickFacts

USDA Economic Research Service: State Fact Sheets

North Carolina Rural Health Research and Policy Analysis Center

Kaiser Family Foundation State Health Facts

Flex Monitoring Team: Critical Access Hospital List

State Contacts

Directory of Rural Health Contacts: Nebraska
Contact information for people and organizations in Nebraska with an interest in rural health.

Organizations

Center for Rural Affairs (CRA)
Nonprofit/Foundation
Works to strengthen small businesses, family farms and ranches, and rural communities throughout the nation.

Community Action of Nebraska, Inc. (CAN)
State government
Works on the behalf of the nine Community Action Agencies, serving as a bridge between the agencies and State, Federal and private organizations. Coordinates a few statewide programs such as the Nebraska Food Pantry Network and the Low-Income Tax Assistance and Outreach Project.

HUD Community Development Block Grants: Nebraska
Federal government
Contact information for the State CDBG program. Provides funding for community development projects.

Iowa-Nebraska Primary Care Association (IA/NEPCA)
State/regional organization
Provides development, support services and programs to its member community and migrant health centers. Promotes the concept of quality, primary, preventative and ameliorative health care through a comprehensive primary health care delivery system.

Midwest Assistance Program (MAP)
State/regional organization
Aims to help rural communities in Iowa, Kansas, Minnesota, Missouri, Montana, Nebraska, North Dakota, South Dakota, and Wyoming to improve their environment, quality of life and be self-sustaining.

Nebraska 2-1-1
State/regional organization
In addition to serving 38 counties in Nebraska, the Center services eight counties in Southwest Iowa. Provides service to 79% of Nebraskan's who can access health and human services 24/7 by dialing 2-1-1. The statewide 2-1-1 Resource Call Center is housed at United Way of the Midlands. Efforts continue to build partnerships to get 2-1-1 telephone service statewide.

Nebraska Center for Rural Health Research
Academic/Research
Conducts research and analysis related to improving health care delivery in rural areas. Focuses on special populations among rural residents, including the elderly, children, minorities, mentally ill, under and uninsured, and new immigrants whose needs for assistance are unique.

Nebraska Department of Economic Development (NEDED)
State government
Helps businesses locate the information and resources they need to succeed, grow, and prosper. Provides tools and resources provided by the Nebraska Legislature, to grow, diversify and develop the capability of Nebraska's economy.

Nebraska Department of Education: Special Populations
State government
Provides services to children needing special services.

Nebraska Health and Human Services
State government
Assists people through communication, collaboration, cooperation, customer service, and confidence.

Nebraska Health and Human Services: Public Health Assurance
State government
Provides information on communicable diseases, emergency medical services, epidemiology, radiation control programs, chronic diseases, environmental health, and immunization.

Nebraska Health and Human Services: Substance Abuse Division
State government
Provides programs and information on behavioral health, criminal justice, substance abuse, and compulsive gambling.

Nebraska Health and Human Services: Aging and Disabilities Services
State government
Provides certification, technical assistance, regulations and payment for providers of community-based developmental disabilities services and provides specialized services for Nebraskans with developmental disabilities.

Nebraska Health and Human Services: Child Support Enforcement
State government
Helps children obtain financial support from both parents, enables current public assistance recipients to end their reliance on welfare, and helps prevent single parents from entering public assistance.

Nebraska Health and Human Services: Mental Health Services
State government
Designed for individuals and their families who have a serious and persistent mental illness that can create lifetime disabilities, and in some cases make the individuals dangerous to themselves or others. Services are also designed for people experiencing acute, serious mental illnesses, which in some cases may cause a life threatening event such as suicide attempts. In addition, services are provided for children and to their families.

Nebraska Health and Human Services: Office of Minority Health
State government
Works to improve access to health services for racial/ethnic minorities; improve data collection strategies; increase racial/ethnic minority representation in science and health professions; develop relevant and comprehensive research agenda; and expand community-based health promotion and disease prevention outreach efforts.

Nebraska Hospital Association
State/regional organization
Provides the unified voice for Nebraska's hospitals and health systems, helping hospitals provide comprehensive care to their communities. Provides collaborative leadership, assisting its members to improve the health status of their communities.

Nebraska Investment Finance Authority (NIFA)
State/regional organization
Provides financial resources for homeownership, rental housing, agriculture, manufacturing, medical and community development endeavors. Provides technical assistance for activities related to these areas.

Nebraska Office of Rural Health
State government
Assures the availability and accessibility of quality health care services to meet the needs of people living in rural Nebraska through programs and activities, recruitment and retention, and networking.

Nebraska Rural Health Association (NRHA)
State/regional organization
Works for the improvement and preservation of rural health in Nebraska by providing leadership on rural health issues through advocacy, communication and education.

Nebraska Rural Health Education Network & Area Health Education Centers (RHEN)
State/regional organization
Works to provide a health care workforce for rural Nebraska.

Nebraska Statewide Telehealth Network (NSTN)
State/regional organization
An interactive video and data network that provides integration among the hospitals, public health departments, public health laboratories and other entities across the state of Nebraska. The major functions of the Network are to improve quality and access to care, particularly in rural Nebraska, to provide patient, provider and community education and to provide another communication source in the event of a natural, man-made or terrorist emergency.

Nebraska Vocational Rehabilitation
State government
Helps people with disabilities join the workforce through counseling, job placement, independent living, custom training, and transition.

Nebraska Workforce Development
State government
Provides information and programs on persons looking for a job, needing career information, or wanting to know more about benefits and rights as a worker in Nebraska.

Northern Great Plains Inc.
Nonprofit/Foundation
Works to maximize the potential of the Northern Great Plains region through regional collaboration, by identifying and promoting policies and practices that support an integrated approach to economic opportunity, a healthy environment and vital rural communities.

Partnership for Rural Nebraska (PRN)
State/regional organization
Based on strategic partnerships, works together to stretch resources thereby benefiting more Nebraskans; educates each other on available resource and rural development needs, using educational opportunities such as the annual Rural Institute, agency orientations, and seminars; communicates to Nebraskans and others regarding rural development activities; and provides opportunities and challenges through a newsletter.

Proyecto/Project IDEAS
State/regional organization
Srives to improve HIV prevention services for Latino/Hispanic populations living in Colorado, Iowa, Kansas, North Dakota, South Dakota, Missouri, Montana, Nebraska, Utah and Wyoming. Focuses on adapting and tailoring CDC-approved interventions that are culturally, linguistically and educationally appropriate. This is a capacity building assistance program for community-based organizations and state and local health departments.

RUPRI Center for Rural Health Policy Analysis
Academic/Research
One of eight Rural Health Research Centers funded by the Office of Rural Health Policy. Focuses on rural health care financing/system reform, rural systems building, and meeting the health care needs of special rural populations.

U.S. Department of Housing and Urban Development: Nebraska
Federal government
Works to increase homeownership, support community development and increase access to affordable housing. The HUD state office provides information about HUD housing programs and local contacts for the state.

USDA Rural Development Nebraska State Office
Federal government
Committed to helping improve the economy and quality of life in all of rural America. The Rural Development State Office provides information about Rural Development programs and applications for financial assistance.

Tools

ERS State Fact Sheet: Nebraska
Web site
Statistics on population, educational attainment, employment, income, farm characteristics, and farm financial indicators for the state.
Sponsoring organization: USDA Economic Research Service

Great Plains Telehealth Resource and Assistance Center
Web site
Assists rural health care providers, facilities, and organizations within the region and around the nation in order to better utilize and implement telehealth technology. Assists those just beginning their telehealth program development as well as those looking to add new telehealth-related services.
Sponsoring organization: Office for the Advancement of Telehealth

Meadowlark Project
Web site
Describes a two year process aimed at systemic change by bringing a diverse sample of the Northern Great Plains region's population to the table to discuss the region's future.
Sponsoring organization: Northern Great Plains Inc.

National Healthcare Quality Report State Snapshot: Nebraska
Web site
Health care quality report for the state, based on the National Healthcare Quality Report.
Sponsoring organization: Agency for Healthcare Research and Quality

Nebraska QuickFacts
Web site
Basic demographic and economic statistics for the state, with links to county-level data.
Sponsoring organization: U.S. Census Bureau

Nebraska AgrAbility
Web site
Helps individuals with disabilities overcome barriers to continue in their chosen profession in agriculture. The program collaborates with community professionals to modify farm and ranch operations, adapt equipment, increase farmstead accessibility, provide financial counseling, identify funding sources, and coordinate community services.
Sponsoring organization: University of Nebraska Cooperative Extension

Nebraska Community Level Information on Kids (CLIKS)
Web site
Provides data on child well-being for the state.
Sponsoring organization: Annie E. Casey Foundation

Nebraska Health Centers Data
Web site
Provides access to information on Federally Qualified Health Centers for the state. Includes a map of FQHC locations, as well as information on the populations served by health centers, services provided, staff, patient visits, costs of care, and use of electronic health information.

Nebraska Health Workforce: Highlights from the Health Workforce Profile
Web site
Highlights compile 2000 data on levels of employment, projected growth and key environmental factors that affect demand for health care. Details for medicine, nursing, dentistry, pharmacy, mental health and aides.
Sponsoring organization: National Center for Health Workforce Analysis

Nebraska Rural Living
Web site
Highlights the amenities of rural communities in Nebraska, spotlights successful entrepreneurs and rural businesses, and offers links to a wide variety of sources and resources.
Sponsoring organization: Business Beyond the Farm

Nebraska Rural Response Line
Web site
Links callers to services like no-cost mental health counseling, farm and ranch clinics addressing financial issues, legal advice, mediation, and immediate assistance. Also provides referrals to other programs. 1-800-464-0258.
Sponsoring organization: Farm Crisis Response Council of Interchurch Ministries of Nebraska

Nebraska State Data Center
Web site
Provides easy and efficient access to U.S. Census Bureau demographic, economic, and social statistics data and information through a wide network of lead, coordinating and affiliate agencies in the state.
Sponsoring organization: U.S. Census Bureau

Nebraska State Health Facts
Database
The latest state-level data on demographics, health, and health policy, including health coverage, access, financing, and state legislation. Individual state profiles and 50-state comparisons.
Sponsoring organization: Kaiser Family Foundation

Nebraska State Medicaid Profile
Web site
Provides data on Medicaid and the State Children's Health Insurance Program (SCHIP) for the state.
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center (Cecil G. Sheps Center)

NN/LM MidContinental Region: Nebraska Resources
Web site
Overview of the state, with links to state agencies, health associations, and other resources for Nebraskans.
Sponsoring organization: National Network of Libraries of Medicine

Rural Enterprise Assistance Project (REAP)
Technical assistance
Rural small business development program that includes business management training, a loan fund, networking, and technical assistance.
Sponsoring organization: Center for Rural Affairs

State Profiles- Nebraska: Health Information Technology (HIT)
Web site
Profiles the state’s health information technology (HIT) issues. Contains sections on demographics, HIT legislation, telemedicine, Health Information Exchanges (HIE) & Regional Health Information Organizations (RHIO), grant funded HIT projects, and HIT survey information.
Sponsoring organization: Rural Health Resource Center

See also: Resources for All States: Tools

Maps & Map Collections

Nebraska Rural Definition Maps
Geographic coverage: Nebraska
Set of maps showing the geographic coverage provided by 9 different rural definitions for the state.
Sponsoring organization: USDA Economic Research Service

See also: Resources for All States: Maps

Funding

Midwest Assistance Program Loan Fund
Provides low-cost, short and intermediate term loans for community water and wastewater projects through its Community Revolving Loan Fund.

Nebraska Loan Repayment Program
Provides funding to physicians, nurse practitioners, and physician assistants practicing the specialties of family practice, general internal medicine, general pediatrics, obstetrics/gynecology, general surgery, and psychiatry.

Nebraska Rural Housing Program
Loans and grants are available to low-income applicants to remove health or safety hazards and/or improve or modernize their home.

REAP Direct Loan Program
Loan products designed to fill a gap for financing needs of startup and existing small businesses in rural Nebraska.

Inactive Funding

Inactive Funding Opportunities - Lists additional funding programs for this state that are not currently accepting applications. Programs that are inactive may be offered again in the future.

Documents, Reports and Other Publications

Assessment of Acute Stroke Treatment in Nebraska Hospitals
Author(s): Katherine Jones, Michelle Mason, Michael Shambaugh-Miller, Liyan Xu
Sponsoring organization: Nebraska Center for Rural Health Research
In June 2005, the Nebraska Health and Human Services System contracted with the University of Nebraska Medical Center (UNMC) to assess the readiness of Nebraska hospitals to treat acute stroke.
Date: 07 / 2006

Assessment of Emergency Care for Children in Nebraska
Author(s): Michelle Mason, Michael Shambaugh-Miller, Liyan Xu, Kelly Shaw-Sutherland
Sponsoring organization: Nebraska Center for Rural Health Research
Results of a three-part study designed to assess the structures and processes in place to deliver emergency health care to the pediatric population in Nebraska.
Date: 02 / 2007

Assessment of Potential Uses of and Needs for Telehealth Services in Rural Nebraska
Author(s): Alan Diener, Keith J. Mueller, Jami Fletcher
Sponsoring organization: Nebraska Center for Rural Health Research
Discusses potential uses of information technology to deliver health care services in rural Nebraska. Covers current telehealth services in Nebraska, technology infrastructure, and reimbursement issues for telehealth services.
Date: 01 / 2001

Current Issues and New Approaches: The EMS Survey in Nebraska
Author(s): Keith Mueller, Wanqing Zhang, Woodrow Lucas
Sponsoring organization: Nebraska Center for Rural Health Research
Results of survey of Nebraska Emergency Medical Services (EMS) providers. Includes information on staffing, services, training, funding, and needs.
Date: 10 / 2001

Demographic and Economic Profile: Nebraska
Author(s): Kathleen K. Miller
Sponsoring organization: Rural Policy Research Institute
Presents demographics and economic data on Nebraska. Includes statistics and data, charts, and graphs.
Date: 05 / 2006

E-Commerce in Nebraska: A Survey of Business Technology Use
Sponsoring organization: Center for Applied Rural Innovation
Reports the results of a survey of Nebraska businesses on the use of technology in their businesses and interest in e-commerce. Includes comparisons based on community size and type of business.
Date: 2004

Economic Impact of Family Physicians in Nebraska
Sponsoring organization: American Academy of Family Physicians
Discusses family physicians and their impact in Nebraska. Includes information on medical homes and HPSAs.
Date: 06 / 2007

Emergency Medical Service Volunteer Personnel in Nebraska: Workforce of the Present, Hope for the Future?
Author(s): Fred Ullrich, Keith Mueller, Michael Shambaugh-Miller
Sponsoring organization: Nebraska Center for Rural Health Research
Discusses survey of rural Nebraska emergency services providers regarding use of volunteers to provide EMS services. Includes information on why people volunteer, benefits provided to volunteers, and recruitment.
Date: 12 / 2004

Financial Impact of CAH Conversion on Rural Hospitals in Nebraska: A Report to the Nebraska CAH Steering Committee
Author(s): Li-Wu Chen, Keith Mueller, Susan Puumala, Julie Stoner, Catherine Makhanu, Liyan Xu
Sponsoring organization: Nebraska Center for Rural Health Research
Describes the improvement of financial viability for Nebraska hospitals after conversion to Critical Access Hospital (CAH) status.
Date: 05 / 2004

Finding a Home in the Country: Business Success Stories in Rural Nebraska
Author(s): Nebraska Business Higher Education Forum
Describes a variety of rural Nebraska businesses that have successfully handled marketing, labor and other issues.
Date: 2004

How Farmers and Ranchers Get Health Insurance and What They Spend for Health Care
Author(s): Carol Pryor, Jeffrey Prottas, Bill Lottero, Mark Rukavina, Alana Knudson
Sponsoring organization: Access Project
Issue brief examining health insurance costs and health care spending of farmers and ranchers. Based on a 2007 survey of farm and ranch operators in Iowa, Minnesota, Missouri, Montana, Nebraska, North Dakota, and South Dakota.
Date: 12 / 2007

Nebraska Rural Hospital Flexibility Grant Program Evaluation Report
Author(s): Keith J. Mueller
Sponsoring organization: Nebraska Center for Rural Health Research
The purpose of this assessment of the Nebraska Rural Hospital Flexibility Grant (Flex) program is to report findings regarding the administration and activities of hospital networks in Nebraska and initiatives being undertaken in Nebraska's critical access hospitals (CAHs) related to patient safety and quality improvement (QI).
Date: 07 / 2006

Need to Permit Broadband from Public Entities
Author(s): Brennan Center for Justice at NYU School of Law
Sponsoring organization: Center for Rural Affairs
Rural broadband white paper discussing Nebraska's ban on municipal broadband and its impact on the digital divide in Nebraska.
Date: 05 / 2006

Small Business Profile: Nebraska
Sponsoring organization: U.S. Small Business Administration
Profile of the state's economy, covering the number of firms, industry composition, small business income, banking, women and minority business ownership, and employment.
Date: 2006

Small Works in Nebraska: How Poverty and the Size of Schools and School Districts Affect School Performance in Nebraska
Author(s): Jerry Johnson,
Sponsoring organization: Rural School and Community Trust
Results of a study in Nebraska showing that smaller schools reduce the harmful effects of poverty on student achievement.

State Profiles - Nebraska: Reforming the Health Care System
Sponsoring organization: AARP Public Policy Institute
Detailed profile of the state's health care system. Covers demographics, expenditures and financing, health status, utilization and quality of services, health care providers, Medicare, Medicaid, health insurance coverage, and key trends.
Date: 12 / 2005

See also: Resources for All States: Documents

Journals

Nebraska - NeRHA E-News
Monthly newsletter of the NeRHA. Informs on latest issues in rural health at the state and federal levels as well as what is happening with NeRHA.
Sponsoring organization: Nebraska Rural Health Association

Nebraska - Access
Quarterly newsletter of both the NE SORH and the NE RHA. Informs and shares current issues impacting the rural health care system.
Sponsoring organization: Nebraska Office of Rural Health

Success Stories

Behaviorial Health Resource Consortium
Using an approach that integrates behavioral health into primary care practice, the consortium will add behavioral health faculty and trainees from the training program at UNMC to its existing array of services at the Good Neighbor CHC and to the diagnostic and treatment services of the Boys and Girls Homes programs.

Butler County Rural Comprehensive Care
The Rural Comprehensive Care Network was established to provide health care services to the residents of 15 rural counties in southeast Nebraska.

Call-Care
The primary objective of this project was to establish a public health nurse-based, toll-free telephone triage service that would be available to all rural residents in southeast Nebraska 24 hours a day, seven days a week.

Children's Outreach Program
This program conducted home visits to families with newborns within a few days after the mother's return home through a consortium consisting of nine hospitals and two public health/social service agencies.

EMS Co-op Helps Rural Providers
Using the power of group purchasing within a cooperative structure, the North Central EMS Cooperative (NCEMSC) is an Emergency Medical Services (EMS) cooperative developed to serve Minnesota and surrounding states.

Hispanic Adolescent Access Project Network (HAAPN)
HAAPN was created to reduce teen pregnancies among Hispanic adolescents living in the service area through a consortium of local hospitals, nonprofit organizations, schools, mental health providers, resource centers, churches, businesses, and industries.

North Platte Dental Clinic
This is to be a permanent dental clinic in North Platte, Nebraska, to serve Medicaid recipients and low-income self-paying residents.

Prairie Rural Health Consortium
A mobile unit housing a full service family practice clinic is bringing much needed primary and preventive care services to four rural, medically underserved Nebraska counties.

Rural Chronically Ill Women: Online Support Network (aka "Women to Women")
The Women to Women Project (WTW) aims to help isolated rural women with chronic illnesses adapt more successfully to living with their conditions in the face of limited access to health information and services.

Rural Health Outreach Elder Care Project
Targeted to adults aged 65 and older living in a six county area, the goal of the program was to enable older adults to remain independent in their own homes and prevent premature institutionalization and repetitive hospitalizations.

Rural Health Outreach Grant Program, Nebraska
Project in defense of region in the Midwest known as the "Cancer Belt," the county's incidence and mortality rates for lung, colon, and rectal cancers exceeds state averages.

Western Plaines Community Health Services
Western Plaines Community Health Services was established to address a range of perceived problems with health care delivery in rural Nebraska, including provider recruitment and retention, organized service delivery, and patient outmigration.