In 2024, State Sen. Beau Ballard, a Republican from Lincoln, introduced a bill meant to improve the way Nebraska tracks overdoses. It became law, and now requires first responders to report suspected overdoses, in real time, to a national mapping platform called ODMAP.
But 16 months after it became law, this mapping use hasn’t been widely implemented in Nebraska.
According to internal emails obtained through a public records request in March, Nebraska Department of Health and Human Services employees were stuck awaiting approval of a data use agreement with their lawyers and leaders. Employees were also concerned that they weren’t complying with the law.
“Statewide implementation is ongoing due to unforeseen issues with the data software,” a DHHS spokesperson said in an emailed statement. DHHS declined to make anyone working on the system available to be interviewed about ODMAP and other overdose tracking efforts.
Confusion around the mapping has led to worse data collection in the meantime, emails suggest.
Emails exchanged between employees in February discussed growing concern that law enforcement had stopped uploading their information into the platform because they believed emergency medical services data was being entered automatically.
“This lack of data is making it hard to determine the impact in the recent surge of overdoses,” former drug overdose prevention coordinator Davidson Wissing said in the email.
Before Ballard’s bill, the state had no centralized home for overdose information.
“The biggest issue within the state of Nebraska is there’s a lot of silos for different areas of medical information and health information and public safety information, and none of that’s coordinated,” Nathaniel Cacy, a public health analyst for the state, said in his testimony for the ODMAP bill.
This siloing of data, handled by different organizations with different policies, slows down the release of information about opioids to the public, said Charity Menefee, former director of public health at DHHS.
It also slows the flow of information to organizations working to address Nebraska’s opioid epidemic, places like treatment centers and local health departments that depend on state data to plan their responses.
And the lack of a mapping program — and now the slow implementation of Nebraska’s mapping law — may result in the state undercounting drug deaths. And that undercounting may be costing Nebraska millions in federal money meant to help with overdoses.
“Hopefully, as a result of getting our numbers more in line with where they should be or what the reality is, hopefully we’ll be able to maybe find federal funding at a higher level than maybe we do now,” Assistant Attorney General Mike Guinan said during the ODMAP committee hearing.
Ballard’s bill got rolled into a larger bill related to drugs, which the Nebraska Legislature passed as an emergency measure, going into immediate effect in April 2024.
But reporting systems are often built incrementally over time with different pieces of legislation, like the ODMAP bill was, Menefee said. Each law sets different parameters for how the data is collected and used.
“So you end up with this piecemeal system where you can have multiple laws affecting the reporting of that data, and especially when you’re trying to get mixed data sets,” Menefee said.
These overlapping data sets, with inconsistent laws, create legal challenges for state researchers as they try to get information out to the public.
If lawmakers standardized those policies, Menefee said, public health analysts at DHHS would be able to release information faster.
The state also needs to update its death investigation system, Menefee said. If establishing a medical examiner’s office isn’t feasible, she said, Nebraska should at least standardize training and make technical support, like autopsies and lab testing, available to county attorneys as they navigate the coroner role.
