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Improving Operations at Health and Human Services


By Governor Pete Ricketts

December 11, 2017


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Here at the State of Nebraska, we’re working every day to build a government which is more effective and more efficient.  When I took office, I identified the Department of Health and Human Services (DHHS) as a priority for operational improvements.  It’s one of our state’s biggest agencies with over $1.5 billion in state funding flowing through it annually.  It’s no secret that the agency has faced challenges, but they’ve been focused on putting those in the past and running a new kind of operation.  Thanks to the hard work of the team at DHHS, the agency has made great strides the past few years.  This is really important not only to the people they serve, but also to the taxpayers who are funding the agency’s mission and operations.


One of the first things that I set out to change was our ACCESSNebraska program.  When I entered office, the federal government was threatening to pull $17 million in funding for the program because of poor performance.  This could have been expensive for Nebraska taxpayers.  Working with my office, the DHHS team brought the average call wait time down from an average of 24 minutes to hitting our target of five minutes or less. 


DHHS is also working with our Department of Labor to help our families on food stamps find better jobs and reduce their reliance on this government entitlement.  We piloted the program in Grand Island where 14 participants changed jobs, resulting in an average increased annual salary of $6,900.  Because of higher salaries, more than half of those families receive fewer benefits, and almost half stopped using food stamps altogether.  We have now expanded the program to Hastings and Columbus.


DHHS’ Division of Public Health is responsible for licensing numerous medical and healthcare-related professions.  We have been working to deliver professional licenses at the speed of business so Nebraskans can pursue the career of their dreams and employers can help Nebraskans get to work more quickly.  One process we’ve sped up is medication aide licensing.  Medication aides saw significant improvement as we reduced the licensing process from 39 days to an average of 11 days over the past 15 months.  We also reduced the nurse licensing process from 96 days in November 2015 to 37 days in November 2017.  Additionally, licenses are now delivered electronically and people can print them off at their own convenience.


In the Division of Developmental Disabilities, we streamlined the application process for services.  By working in partnership with families, individuals, and stakeholders to create efficiencies, the application was reduced from 14 pages to three, and was placed online so it can be accessed easily.  Additionally, the division went to work cleaning up a waiting list for services that had the names of deceased individuals and others who had moved away.  Today, we are making eligibility determinations for families in 16 days on average down from 69 days, a nearly 80 percent reduction.


In the Division of Behavioral Health, we have launched a new System of Care in response to the needs of children and youth using existing state resources.  This statewide public-private partnership builds on existing behavioral health relationships, and realigns existing dollars so families can more easily navigate the behavioral health system.  The System of Care is a great example of how government can provide a higher level of service and live within its means.  A framework has been established and the first statewide service, crisis response, began in May.  Previously these services were only available in some areas.  Now, families can reach out for crisis services across the state by using the Nebraska Family Helpline, 888-866-8660, to connect with these and other services. 


Finally, we transformed Nebraska’s Medicaid program this year with a new program administration model which is delivering traditional services and also bringing a new level of oversight to ensure that the agency is a good steward of taxpayer dollars.  Three plans are providing services and are subject to rigorous oversight by state and federal officials.  While other states who have adopted this “managed care” model have faced big challenges during their transition, Nebraska’s transition has been comparatively very smooth.  The team at DHHS proactively worked to identify challenges ahead of time, and have quickly addressed others as they’ve arisen.  We believe this will deliver better outcomes while managing our costs. 


These are just a few examples of how DHHS has become a better steward of taxpayer resources while delivering better customer service.  We are continuing to work to identify new opportunities to run the organization more effectively and efficiently.  As we continue to work, we believe improving customer-focus requires the input of Nebraskans across the state.  Your input helps us deliver better service.  If you have any input or suggestions, please call my office at 402-271-2244 or email me at