Indiana Rural Health Association Legislative Conference Call

January 28, 2021 Heather H. Willey Kristin Schwartz Barnes & Thornburg LLP Indiana Hospital Association

Indiana House of Representatives Indiana State Senate

71 Republicans* 39 Republicans* House Speaker, President Pro Todd Huston (R) Tempore, Fishers Rodric Bray (R) Martinsville

29 Democrats* 11 Democrats* House Minority Senate Minority Leader, Leader, Phil GiaQuinta (D) Greg Taylor (D) Fort Wayne Indianapolis

Indiana House Indiana Senate • District 6 – Maureen Bauer (D) • District 20 – Scott Baldwin (R) • District 7 – Jake Teshka (R) • District 30 – Fady Qaddoura (D) • District 12 – Mike Andrade (D) • District 40 – Shelli Yoder (D) • District 15 – Hal Slager (R) • District 18 – Craig Snow (R) • District 19 – Julie Olthoff (R) • District 35 – Elizabeth Roway (R) • District 58 – Michele Davis (R) • District 66 – Zach Payne (R) • District 75 – Cindy Ledbetter (R) • District 89 – Mitch Gore (D) • District 92 – Renee Pack (D) • District 93 – John Jacob (R)

• The 2021 session is a long, budget session • Key Dates* – November 17, 2020  Organization Day – December 8, 2020  Bill request deadline – January 4, 2021  First day of session – April 29, 2021  Latest day for General Assembly to adjourn sine die *Subject to change due to COVID-19.

• Legislative Continuity Committee has been meeting since July to discuss protocol for interim study committees, bill drafting procedures, Organization Day, and the 2021 Legislative Session in light of COVID-19. • Key Recommendations to Date: – House & Senate have been reviewing the rules and statutes that will need to be amended to provide flexibility during session. – Deadline for bill requests was moved up, filing limit of 10 bills/legislator, LSA can ask legislators to prioritize bill drafts. • 2021 Session Changes – Operating from alternative/additional locations. • The House is meeting in the Indiana Government Center South. – Will also utilize technology and change the committee and session schedules to accommodate social distancing needs.

• Constitutional Requirements – Redistricting – Timing of certified data – Biennial Budget

• In 2021, the Indiana General Assembly will pass the next biennial state budget. • Will include a long, hard look at state revenue forecast. • Expect budget to be tighter – cutting and monitoring expenditures. – State has asked agencies for 15% budget cut as a starting point.

• State Budget Committee received a revenue forecast in December 2020. • December 2020 forecast will shape discussions around the FY 2021-2022 budget. – Dealing with impact of COVID-19, federal policy and other changes. – December forecast did show stronger revenue projections than originally anticipated.

• COVID-related issues – Executive Authority • Public health emergency statute • Proposed restrictions on executive power • Proposed restrictions on powers of the local health department, health department officers and boards

– COVID-19 Legislation • Keeping operational changes in place • Limitation of liability for employers and health care providers • Ghost employment/remote work

• HB 1001 State Budget – Author: Brown – Appropriates money for capital expenditures, the operation of the state, K-12 and higher education, the delivery of Medicaid and other services, and various other distributions and purposes. – Replaces the governor with the budget director or the budget director's designee on the state board of finance.

• HB 1447 Good Faith Health Care Estimates – Author: Vermilion – Adds and amends definitions for purposes of providing good faith estimates. – Specifies information to be provided in a good faith estimate by a practitioner and a provider facility. – Removes requirements concerning posting information in waiting rooms.

• HB 1421 Various Health Care Matters – Author: Schaibley – Requires the attorney general to review mergers, acquisitions, and other transactions concerning hospitals, hospital systems, and investors of hedge funds and public equity funds. – Authorizes the attorney general to approve or deny the merger, acquisition, or transaction and allows for a waiver under certain circumstances.

CONFIDENTIAL © 2017 Barnes & Thornburg LLP. All Rights Reserved. This page, and all information on it, is confidential, proprietary and the property of Barnes & Thornburg LLP, which may not be disseminated or disclosed to any person or entity other than the intended recipient(s), and may not be reproduced, in any form, without the express written consent of the author or presenter. The information on this page is @BTLawNews intended for informational purposes only and shall not be construed as legal advice or a legal opinion of Barnes & Thornburg LLP. Civil Immunity (COVID-19) • SB 1 Civil Immunity Related to COVID-19 – Authors: Messmer, Koch, Brown – Protects people and businesses from civil liability regarding COVID-19. • HB 1002 Civil Immunity Related to COVID-19 – Author: TORR – Protects health care providers from civil liability regarding COVID-19. – Provides that the protection applies to the provision of health care services after February 29, 2020, and before April 1, 2022.

• SB 4 Health Care Provider Immunity – Author: Charbonneau – Removes the immunity requirement that the health care service be provided by a person who has an Indiana license to provide the health care service and that the service is within the scope of practice of the license.

• SB 74 Workplace Immunization Prohibition – Authors: Kruse, Boots, Raatz – Prohibits an employer from requiring an employee to receive any immunization. – Allows for a civil action against an employer for a violation. • HB 1488 Vaccination Exemptions – Author: Ledbetter – Similar to SB 74, prohibits an employer from requiring an immunization.

• SB 3 Telehealth Matters – Authors: Charbonneau, Doriot, Crider – Changes the use of the term "telemedicine" to "telehealth". – Ensures Indiana health care providers may continue to utilize telehealth after the emergency orders end. • HB 1286 Telehealth Matters – Authors: Barrett, Vermilion, Teshka – Similar goals as SB 3.

CONFIDENTIAL © 2017 Barnes & Thornburg LLP. All Rights Reserved. This page, and all information on it, is confidential, proprietary and the property of Barnes & Thornburg LLP, which may not be disseminated or disclosed to any person or entity other than the intended recipient(s), and may not be reproduced, in any form, without the express written consent of the author or presenter. The information on this page is @BTLawNews intended for informational purposes only and shall not be construed as legal advice or a legal opinion of Barnes & Thornburg LLP. Home Health Services • SB 61 Written Orders for Home Health Services – Authors: Becker, Charbonneau – Adds advanced practice registered nurses, clinical nurse specialists, and physician assistants as providers who may make written orders for home health services for use by licensed home health agencies. – Note: Bill is being withdrawn by Senator Becker. • HB 1347 Telemedicine – Author: Lindauer – Provides that advanced practice registered nurses may operate in multiple locations in collaboration with a physician.

CONFIDENTIAL © 2017 Barnes & Thornburg LLP. All Rights Reserved. This page, and all information on it, is confidential, proprietary and the property of Barnes & Thornburg LLP, which may not be disseminated or disclosed to any person or entity other than the intended recipient(s), and may not be reproduced, in any form, without the express written consent of the author or presenter. The information on this page is @BTLawNews intended for informational purposes only and shall not be construed as legal advice or a legal opinion of Barnes & Thornburg LLP. Advanced Practice Registered Nurses • HB 1399 Advanced Practice Registered Nurses – Author: Mayfield – Gives an advanced practice registered nurse (APRN) the ability to sign, authorize, certify, etc., various health care matters. – Examples of authority given to an APRN: • sign the individualized family service plan; • sign certain health documents concerning driving privileges; • certify to a day care ministry that an immunization that may be detrimental to the child is not required; • issue permission for a student athlete who had a symptom of sudden cardiac arrest to return to play or practice; and • perform an examination and provide a statement concerning an injured employee for purposes of worker's compensation claims.

• SB 366 Physician Assistants – Author: Leising – Expands the authority of licensed physician assistants under the home health agency law. – A physician assistant, without being delegated authority by a collaborating physician, may: • (1) prescribe, dispense, administer, and procure drugs and medical devices; • (2) plan and initiate a therapeutic regimen; and • (3) prescribe and dispense schedule II-V substances and legend drugs.

• HB 1012 Health Care Consent for Pelvic Examinations – Author: Jackson – Prohibits health practitioners and other specified individuals from performing pelvic examinations on an anesthetized or unconscious patient except in specified circumstances.

• HB 1127 Mental Health and Addiction Forensic Treatments – Author: Steuerwald – Removes a provision that allows a: (1) delinquent child's; or (2) person's; Medicaid participation to be terminated following a two year suspension due to certain adjudications or incarceration. – Adds competency restoration services to services available for certain persons in the criminal justice system and persons that qualify for mental health and addiction forensic treatment services. – Requires demographic data concerning race and ethnicity to be included in certain demographic research performed by the division.

• SB 325 Hospital Price Disclosure List – Author: Busch, Charbonneau – Increases the number of common services that a hospital and ambulatory outpatient surgical center are required to post. – If do not provide a specified shoppable service, the hospital or ambulatory outpatient surgical center must: • (1) indicate that the service is not offered; and • (2) select an additional common service so that the total number of shoppable and common services is at least 300.

• HB 1245 Pregnancy and Childbirth Discrimination – Author: Bauer – Prohibits an employer from discriminating against a pregnant job applicant or employee. – Requires an employer to provide reasonable employment accommodations for a pregnant employee. – Requires the civil rights commission to investigate complaints and attempt to resolve complaints. • HB 1358 Pregnancy and Childbirth Accommodation – Authors: Negele, Barrett, Ziemke – Requires an employer to provide reasonable employment accommodations for a pregnant employee, similar to HB 1245. – Requires the department of labor to investigate complaints and attempt to resolve complaints through the use of an administrative law judge.

• HB 1032 Newborn Safety Devices – Author: Frye – Provides for placement of a newborn safety device at any facility that is staffed by an emergency medical services provider on a 24/7 basis. – The newborn safety device must be: • located in an area that is conspicuous and visible to staff; and • include a dual alarm system that is connected to the facility and tested at least once per month.

• SB 10 Statewide Maternal Mortality Review Committee – Author: Leising – Amends the definition of "maternal mortality" to include deaths of pregnant women from any cause. – Specifies that a health care provider includes a mental health professional for purposes of the review of records by the statewide maternal mortality review committee.

• HB 1350 Coverage for Doula Services – Authors: Bauer, Summers – Requires a state employee health plan, a policy of accident and sickness insurance, and a health maintenance organization contract to provide coverage for services provided by a doula to an insured before, during, and after childbirth. Requires a hospital to allow a doula to accompany a patient at the hospital, including attending a live birth, at the request of the patient.

CONFIDENTIAL © 2017 Barnes & Thornburg LLP. All Rights Reserved. This page, and all information on it, is confidential, proprietary and the property of Barnes & Thornburg LLP, which may not be disseminated or disclosed to any person or entity other than the intended recipient(s), and may not be reproduced, in any form, without the express written consent of the author or presenter. The information on this page is @BTLawNews intended for informational purposes only and shall not be construed as legal advice or a legal opinion of Barnes & Thornburg LLP. Abortion • HB 1310 Abortion – Author: Prescott – Provides that the general assembly shall convene in an "initiated session" to consider legislation to restrict abortion if either of the following occur: 1) the Supreme Court of the United States overrules the central holding of Roe v. Wade, Doe v. Bolton, and Planned Parenthood of Southeastern Pennsylvania v. Casey and clearly establishes that a state may prohibit abortion; or 2) an amendment to the Constitution of the United States is adopted that in whole or part clearly establishes that a state may prohibit abortion.

CONFIDENTIAL © 2017 Barnes & Thornburg LLP. All Rights Reserved. This page, and all information on it, is confidential, proprietary and the property of Barnes & Thornburg LLP, which may not be disseminated or disclosed to any person or entity other than the intended recipient(s), and may not be reproduced, in any form, without the express written consent of the author or presenter. The information on this page is @BTLawNews intended for informational purposes only and shall not be construed as legal advice or a legal opinion of Barnes & Thornburg LLP. Schools • SB 51 Medicaid Reimbursement for Schools – Authors: Zay, Rogers – Allows school corporations to seek Medicaid reimbursement for medically necessary, school based Medicaid covered services that are provided under federal or state mandates. • HB 1040 Sudden Cardiac Arrest of Students – Author: Pressel – Requires cardiac arrest information sheets provided by schools to include: 1) the nature and warning signs of sudden cardiac arrest; 2) information about electrocardiogram testing; and 3) information for the parent about how to request electrocardiogram testing for the applicable student. • HB 1553 Next Generation Hoosier Educators Scholarship – Author: Behning – Changes requirements for the next generation Hoosier educators scholarship.

• HB 1158 Medicaid Reimbursement of Assisted Living Services – Author: Karickhoff – Requires the office of the secretary of family and social services to reimburse for home and community based services provided to a Medicaid recipient beginning on the date of the individual's Medicaid application. – Current law allows rather than requires the reimbursement. – Would begin July 1, 2021.

• HB 1237 Health Care Advance Directives – Author: Young – Allows an individual to make a health care advance directive. • SB 204 Health Care Advance Directives – Authors: Rogers, Koch, Brown – Same wording in digest as HB 1237, only difference is it adds “Defines certain terms” towards the end.

• SB 235 Service Location on Health Care Forms – Author: Charbonneau. – Requires a provider to include the service facility location in order to obtain Medicaid reimbursement from the office of the secretary of family and social services or a managed care organization. Specifies health care billing forms to be used in certain health care settings.

• HB 1159 Extension of Risk Based Managed Care Prohibition – Author: Karickhoff – Extends the prohibition against the inclusion of certain Medicaid recipients in a risk based managed care program or capitated managed care program from June 30, 2021, to June 30, 2023.

• SB 296 Health Matters – Author: Breaux – Removes requirements of cost sharing in the healthy Indiana plan. – Removes requirements concerning prescribing a drug to a patient receiving services through telemedicine when the individual has not been previously examined by the prescriber.

CONFIDENTIAL © 2017 Barnes & Thornburg LLP. All Rights Reserved. This page, and all information on it, is confidential, proprietary and the property of Barnes & Thornburg LLP, which may not be disseminated or disclosed to any person or entity other than the intended recipient(s), and may not be reproduced, in any form, without the express written consent of the author or presenter. The information on this page is @BTLawNews intended for informational purposes only and shall not be construed as legal advice or a legal opinion of Barnes & Thornburg LLP. Programs • HB 1007 State Health Grant Program – Author: Vermilion – Establishes the prevention and addressing of health issues and challenges grant program and fund. – Requires the state department of health to administer the grant program. – Provides requirements for grant proposals. • HB 1109 INSPECT Program Reporting – Author: Bartels – Provides that a dispenser who is also authorized to prescribe ephedrine, pseudoephedrine, or a controlled substance is required only to report to the Indiana scheduled prescription electronic collection and tracking (INSPECT) program actual dispensations within 24 hours of the dispensation.

• SB 416 Hospitals and Certificates of Public Advantage – Author: Jon Ford – Establishes a certificate of public advantage pertaining to mergers between hospitals located in counties that meet certain requirements to be issued by the state department of health. – Sets forth the procedure and standards for obtaining a certificate and maintaining the certificate. – Allows the state department to establish fees for the application of a certificate and the monitoring of an entity holding a certificate.

• HB 1379 Pharmacist Contraceptive Prescriptions – Authors: Ziemke, Fleming, Vermilion, Shackleford – Allows pharmacists to prescribe and dispense self- administered oral hormonal contraceptives and hormonal contraceptive patches (contraceptives). – Establishes requirements for pharmacists who want to prescribe and dispense contraceptives.

• SB 78 Hospital Police Departments – Author: Crider – Provides that a hospital police department has statewide territorial jurisdiction unless the governing board for the hospital specifies a smaller territorial jurisdiction for its department. – Requires the governing board of a hospital to provide certain persons and entities with notice of a department's extended territorial jurisdiction in certain instances.

• District 6 – Maureen Bauer (D) – Hometown: South Bend, IN – Education: IUPUI – Work Experience: Spent four years working for the Indiana House of Representatives. • District 7 – Jake Teshka (R) – Hometown: South Bend, IN – Education: St. Joseph’s College, B.A. in Political Science; MPA through IU – Occupation: Business Development Officer, InTerra Credit Union – Prior Public Service: Council Member, South Bend Common Council • District 12 – Mike Andrade (D) – Hometown: Munster, IN – Occupation: Small business owner

• District 15 – Hal Slager (R) – Hometown: Schererville, IN – Education: Butler University, Accounting – Occupation: Small Business Owner and Certified Public Accountant – Prior Public Service: State Representative, 2012-2018; Schererville Town Council, 2003-2012 • District 18 – Craig Snow (R) – Hometown: Warsaw, IN – Education: Grace College, Business – Occupation: Chairman of the board of the Silveus Insurance Group and CEO of Cedar Holdings, Inc. – Prior Public Service: Winona Lake Town Council • District 19 – Julie Olthoff (R) – Hometown: Crown Point, IN – Education: Indiana University Northwest – Occupation: President and owner of VIA Marketing – Prior Public Service: State Representative, 2014-2018

• District 35 – Elizabeth Roway (R) – Hometown: Yorktown, IN – Education: Ball State University, English – Occupation: Non-profit consulting – Prior Public Service: Yorktown School Board • District 58 – Michele Davis (R) – Hometown: Greenwood, IN – Education: Ball State University, B.S. in Elementary Education; Purdue University, Masters of Education in Curriculum and Instruction – Occupation: Director of Adult Education at Central Nine Career Center • District 66 – Zach Payne (R) – Hometown: Charlestown, IN – Education: MBA from University of Southern Indiana – Occupation: Small business owner – Prior Public Service: County recorder • District 75 – Cindy Ledbetter (R) – Hometown: Newburgh, IN – Education: Ivy Tech, ADN; University of Southern Indiana, BSN and MSN/Family Psychiatric Nurse Practitioner – Occupation: Nurse Practitioner – Prior Public Service: Warrick County Council, 2018-2020

• District 89 – Mitch Gore (D) – Hometown: Indianapolis, IN – Education: University of Indianapolis – Occupation: Captain with the Marion County Sheriff’s Office • District 92 – Renee Pack (D) – Hometown: Indianapolis, IN – Education: Parent & Community Liaison, MSD of Wayne Township – Occupation: Indiana Wesleyan, IUPUI; Business and Education • District 93 – John Jacob (R) – Hometown: Indianapolis, IN – Education: IUPUI, Accounting & Finance – Occupation: Small business owner

• District 20 – Scott Baldwin (R) – Hometown: Noblesville, IN – Occupation: Owner and President of Envoy, Inc., a construction and real estate development firm • District 30 – Fady Qaddoura (D) – Hometown: Indianapolis, IN – Education: B.S. and M.S. in computer science from the University of New Orleans; MPA and Doctor of Philosophy degree in philanthropy and public policy, IUPUI – Occupation: Chief Innovation Officer, KSM • District 40 – Shelli Yoder (D) – Hometown: Bloomington, IN – Education: B.S. in Communication, Purdue; M.S. in Counseling, IU South Bend; M. Div. in Theology, Vanderbilt University – Occupation: Lecturer, IU Kelly School of Business – Prior Public Service: Monroe County Councillor, 2013-2019

Kristin Schwartz Director of Advocacy and Federal Relations Indiana Hospital Association 500 N. Meridian Street, Suite 250 Indianapolis, IN 46204 [email protected] (317) 423-7798