To safeguard this goal, Wesely introduced LB 1070 at the request of Governor Nelson.LB 1070 required that the money that Nebraska was to receive from any settlement with the tobacco industry was to be deposited in the Tobacco Settlement Trust Fund to be invested so that it would generate interest that could be spent.While this fund was originally created with the Global Settlement Agreement in mind, the death of that agreement and Nebraska subsequent decision to participate in the Master Settlement Agreement meant that the money the state received from the Master Settlement Agreement was deposited in the Tobacco Settlement Trust Fund. LB 1070 specified not only where the settlement money would be deposited but also how it would be disbursed. The interest that accrued from the investment of the settlement money was to be deposited in another trust fund, entitled the Excellence in Health Care Trust Fund. A six-member council appointed by the governor, entitled the Excellence in Health Care Trust Fund Council, was to review applications and then, subject to the approval of the Director of Health and Human Services Finance and Support,indoor weed growing accessories award the interest income in the Excellence in Health Care Trust Fund through grants and loan guarantees.LB 1070 stipulated who was eligible to receive tobacco settlement dollars by stating that the Excellence In Health Care Trust Fund Council was only authorized to provide grants and loan guarantees to eight specific areas; tobacco prevention and control was not one of them.It was only under the public health services funding section that tobacco prevention and control was mentioned as a possible use of tobacco settlement dollars and then it was only mentioned as one of ten public health activities that were specifically deemed to be eligible for funding . While the Global Settlement Agreement was dying in Congress, the Legislature passed LB 1070 with strong support of Governor Nelson.
Nebraska had now dedicated the funds that the state would eventually receive as part of the Master Settlement Agreement to health improvements, but it had failed to establish tobacco prevention and control measures as a funding priority. Even with funding for tobacco control so weakly prioritized in law, at the time, health officials expressed confidence that tobacco settlement money would be used to reduce the harm done by smoking. Soon after it was announced that Nebraska would participate in the settlement, Deb Thomas, Policy Secretary of Health and Human Services, told the press that one of the primary purposes of the Excellence in Health Care Trust Fund would be to support education and research on smoking in addition to smoking prevention efforts, but at this timethere was little to support her belief.In April, 1999, the newly-elected governor, Republican Mike Johanns, made his appointments to the Excellence in Health Care Trust Fund Council – David Corbin, President of the Nebraska Public Health Association, Joel Gajardo, President of the Nebraska Minority Health Association, Sandra Massey, a consumer, Cordelia Okoye, a Director of a public health program and registered nurse, John Klosterman, a farmer, and Dr. Dale Michels, a physician and chairperson of the council.Johanns had been elected governor in a landside victory over his Democratic challenger in the 1998 election. One reason why Johanns won so easily was that he ran on an anti-tax platform which appealed to the traditionally conservative voters in Nebraska. Johanns’ stance toward tax increases would play a major role in the future of Nebraska’s tobacco control efforts.
In October, 1999, Harold W. Andersen, a contributing editor for the World-Herald, lamented the low priority that the Nebraska Health Care Trust Fund Act seemed to place on ensuring that the settlement money would be used for tobacco control in an op-ed piece entitled, “Too Little of Bonanza Goes to Stop Smoking.”As he stated, “But while the 1998 Nebraska law acknowledges that the money comes from ‘tobacco-related litigation for compensation for the costs of treating smoking-related illnesses,’ there’s no emphasis at all on efforts to discourage smoking.”Andersen also added, “Would it be appropriate that the 2000 Legislature take another look at the Nebraska Health Care Trust Fund Act and insist that a significant portion of the funds be directed to discouraging cigarette smoking? That, after all, is the national health problem which is the primary reason … why state governments have all those billions to spend.”At the time of Andersen’s op-ed piece, Nebraska still had not received its first payments from the settlement so neither the Excellence in Health Care Trust Fund Council nor the Legislature had actually established whether or not tobacco control would be a funded from the settlement money, but when the Council announced its top five funding priorities prior to the 2000 legislative session, tobacco control was not included.While not surprising given the language of LB 1070, this failure on the part of the Council to include programs to combat smoking as a primary focus prompted health advocates to push the Legislature to become involved in determining the use of the settlement dollars during the 2000 legislative session. On December 14, 1999, Nebraska received its first payment under the Master Settlement Agreement which totaled $14.7 million, and by the end of December, the state also received another $12.6 million.Saying that she was distressed by the fact that the Excellence in Health Care Trust Fund Council had not included efforts to reduce smoking among youth in its top five funding priorities, State Senator Ardyce Bohlke of Hastings, who was the Chairperson of the Education Committee, decided to bypass the council’s grant process by introducing a bill in the Legislature to annually allocate the first $560,000 in interest generated by the investment of the tobacco settlement to fund a tobacco control media campaign that was to be developed by youth.Thirty-six other state senators co-sponsored this bill, designated LB 1436.Bohlke felt that a media campaign designed by teenagers would be the most effective means of lowering the number of teenage smokers and she cited Florida’s Truth campaign, which included aggressive media spots designed to expose the tobacco industry’s lies, as an example. Her program, named the Teen Tobacco Education and Prevention Project, was to allow a 12 member committee to review proposals from high school students and then select four each year to fund for up to $100,000 each.The health advocates in Nebraska were not supportive of Senator Bohlke’s proposal because they felt it would be largely ineffectual on its own and that more substantial funding was needed to reduce the level of tobacco use in the state. At the hearing before the Education Committee, Brian Kranna witter, who was representing the American Heart Association, and Mark Welsch, the President of GASP, testified against the bill because of those reasons.Testifying in favor of the LB 1436 were individuals from the Nebraska Board of Education, the Nebraska State Education Association, the Independent Colleges and Universities Association, Omaha Public Schools and some students. No health advocates testified in support of Bohlke’s original proposal.
Despite the opposition from two tobacco control organizations, LB 1436 was voted out of committee by a vote of 8-0 with the annual funding reduced to $500,000.LB 1436 had a total of 37 sponsors – 12 more than was necessary to advance the bill on the floor of the Legislature.While the Legislature as a whole was highly supportive of Senator Bohlke’s proposal, there was still disagreement over her methods for funding the program. While some also agreed with health advocates that Senator Bohlke’s proposal did not go far enough in funding tobacco control,cannabis trimming the primary objection stated by these few legislators was that by avoiding the Excellence in Health Care Trust Fund Council’s grantawarding process, the settlement’s trust fund was being “raided.”Typical of the senators that opposed the bill was Senator Jim Jensen of Omaha who stated his support for the goal of the bill but said that Bohlke’s idea should compete for a grant from the Trust Fund Council just like any other public health measure. “It has destroyed that whole grant process,” he stated. “The grant process doesn’t mean anything – you can go to the Legislature and get it funded out of there.”Senator Thompson of Papillion was another state senator that was opposed to the original version of LB 1436. She said, “This is too early in the process [for the Legislature] to begin opening up the trust fund – no matter how worthy the cause.”While these few legislators protested loudly, the bill seemed destined to be passed by the Legislature. While on the floor of the Legislature, health advocates began pressuring state senators to increase the amount of funding for tobacco control to a level which would be more effective at reducing the amount of tobacco use. Prior to this refocusing on LB 1436, Citizens for a Healthy Nebraska had been fighting to secure increased funding for the pre-existing statewide tobacco control program, Tobacco Free Nebraska, through an earmark in an cigarette excise tax increase . When that proposal died on the floor of the Legislature in January 2000 due to opposition from the tobacco industry and its allies, Citizens for a Healthy Nebraska began focusing their lobbying and grassroots efforts on increasing the budget for Tobacco Free Nebraska using LB 1436 instead of an excise tax increase as a way of increasing funding to tobacco control. To accomplish this goal, they proposed that the Legislature fund Tobacco Free Nebraska at a level of $7 million per year. While this level of funding was only roughly half of the CDC’s minimum recommended level of $13.31 million per year,increasing the funding for tobacco control to this level would rank Nebraska 16th out of the states that had already made decision about how to use their settlement money and was similar to the amount of funding adopted by the neighboring states of Iowa and Colorado.One consequence of the funding increase that Tobacco Free Nebraska was able to receive during the 2000 legislative session was that medical groups began clamoring for a portion of the settlement dollars. The two loudest voices were those of the University of Nebraska Medical Center, the state’s medical school, and Creighton University, a private university in Omaha that also has a medical school.By June, 2000, these two institutions were calling for a large portion of the settlement money to be used biomedical research. “Tobacco use has resulted in significant health problems in Nebraska and for citizens in general and that leads to enormous health-care costs,” stated Dr. Roderick Nairn, the Chairperson of Creighton Medical School’s Department of Medical Microbiology and Immunology. I think the research we would do would be to develop a much better understanding of smoking-related diseases and its underlying causes and cures.”Ron Withem, a spokesperson for the University of Nebraska, told reporters that Michigan has set aside $1 billion of its settlement dollars for research and said, “There needs to be more of a legacy for the state, and we think medical research, particularly with the outstanding medical research centers we have in the state, would really provide a cutting-edge difference in the state.”Withem had also served as a state senator from Papillion from 1983 until 1997, receiving lifetime tobacco industry contributions of $3,300 and an additional $7,964 from tobacco industry allies . Dr. Dale Michels, Chairperson of the Nebraska Health Care Cash Fund Council, responded to this lobbying in June by saying that the grant process should be given time to work.The council had received 174 application – 24 from the University of Nebraska Medical Center and one from Creighton Medical School – requesting a total of $34 million for the $3 million that the would be awarding at that time.Michels said, “Lawmakers have set up a plan to finance public health care across the state, and some people are already set to change it before we get the plan off the ground.”Responding specifically to the desire to use the settlement money for biomedical research, Michels stated, “My concern is that what we have set up is going to benefit all the people in the State of Nebraska as opposed to a research project that may or may not benefit all of the state’s citizens.”