LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
200 W. Washington St., Suite 301
Indianapolis, IN 46204
(317) 233-0696
iga.in.gov
FISCAL IMPACT STATEMENT
LS 6280 NOTE PREPARED: Nov 29, 2021
BILL NUMBER: HB 1001 BILL AMENDED:
SUBJECT: Administrative Authority; COVID-19 Immunizations.
FIRST AUTHOR: Rep. Lehman BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State
DEDICATED
XFEDERAL
Summary of Legislation: Medicaid: The bill allows the Secretary of Family and Social Services (FSSA
Secretary) to issue a waiver of human services statutory provisions and administrative rules if the FSSA
Secretary determines that the waiver is necessary to claim certain enhanced federal matching funds available
to the Medicaid program.
Supplemental Nutrition Assistance Program (SNAP): The bill allows the FSSA Secretary to issue an
emergency declaration for purposes of participating in specified authorized federal SNAP emergency
allotments.
Reporting: It requires the FSSA Secretary to prepare and submit any waivers or emergency declarations to
the Budget Committee.
Immunizations: The bill allows the State Health Commissioner of the State Department of Health (IDOH)
or the IDOH Commissioner's designated public health authority to issue standing orders, prescriptions, or
protocols to administer or dispense certain immunizations for individuals who are at least five years old.
(Current law limits the age for the Commissioner's issuance of standing orders, prescriptions, and protocols
for individuals who are at least 11 years old).
Immunization Passports: The bill defines "Indiana governmental entity" and specifies that an Indiana
governmental entity (current law refers to a state or local unit) may not issue or require an immunization
passport.
Employers: The bill provides that an employer may not impose a requirement that employees receive an
LS 6280 1 immunization against COVID-19 unless the employer provides individual exemptions that allow an employee
to opt out of the requirement on the basis of medical reasons or religious reasons. The bill requires an
employer to provide employees with an option to submit to testing for the presence of COVID-19 not more
than once a week at no cost to the employee in lieu of receiving an immunization against COVID-19. It also
provides that an employer may not require an employee who has tested positive for and recovered from
COVID-19 to receive an immunization against COVID-19 for the six month period following the employee's
date of recovery. It provides that an employer may not take an adverse employment action against an
employee because the employee has requested or used an exemption from an employer's COVID-19
immunization requirement.
Effective Date: Upon passage.
Explanation of State Expenditures: Employers: The provisions related to COVID-19 vaccine mandates
and employers may increase workload at the Department of Labor (DOL). The DOL enforces Indiana’s labor
laws. Enforcing labor laws are within the DOL’s routine administrative functions and should be able to be
implemented with no additional appropriations, assuming near customary agency staffing and resource levels.
Reporting: The FSSA Secretary would have very minimal increased workload to report on waivers or
emergency declarations to the Budget Committee.
Explanation of State Revenues: Summary - The bill would allow waivers to state law and rules, emergency
declarations, standing orders, prescriptions, or protocols to be issued by the FSSA Secretary or the IDOH
Commissioner under state statute rather than the Governor's Executive Orders (EO) concerning the
COVID-19 public health emergency. The authority granted under the bill is limited by the expiration of these
provisions for SNAP and immunizations on March 31, 2022, and for Medicaid when additional federal funds
are no longer available.
Additional Information – Medicaid: Under EOs, the FSSA Secretary has had authority to waive state laws
or rules concerning Medicaid enrollment and cost-sharing, resulting in the state receiving additional federal
reimbursement of Medicaid costs estimated at $120 M per quarter. At the same time, caseload and provider
payments have also increased; Medicaid enrollment is estimated to be 470,000 more than prior to the
pandemic.
Supplemental Nutrition Assistance Program (SNAP): SNAP benefits are paid with federal funds, and the
program administration is shared between the state and federal governments. During the federal public health
emergency, the state’s declared emergency has resulted in emergency allotments, pandemic electronic
benefits transfers for households with school aged children affected by school closures, and eased application
processing requirements and reporting. Indiana's initial request to the United States Department of
Agriculture was in March 2020, and it has been extended each month through November 2021.
The most recent extension of the federal public health emergency will expire in January 2022. The enhanced
federal reimbursement lasts until the last day of the calendar quarter after the expiration of the public health
emergency declaration, which currently would be March 31, 2022.
Explanation of Local Expenditures:
Explanation of Local Revenues:
LS 6280 2 State Agencies Affected: Family and Social Services Agency; Department of Health; Department of Labor.
Local Agencies Affected:
Information Sources: CMS, COVID-19 Frequently Asked Questions (FAQs) for State Medicaid and
Children’s Health Insurance Program (CHIP) Agencies, updated January 6, 2021; CMS, Temporary
Increases to FMAP, SHO# 21-004; USDA, Administration for Children and Families, Pandemic Emergency
Assistance Fund - Allotment Request Form; Families First Coronavirus Response Act, Public Law 116-127-
March 18, 2020; State of Indiana Executive Order 21-17; IC 22-1-1-16.
Fiscal Analyst: Karen Rossen, 317-234-2106; Camille Tesch, 317-232-5293.
LS 6280 3