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: Jan 13, 2022
BILL NUMBER: HB 1001 BILL AMENDED: Jan 13, 2022
SUBJECT: Administrative Authority; COVID-19 Immunizations.
FIRST AUTHOR: Rep. Lehman BILL STATUS: 2
nd
Reading - 1
st
House
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State
XDEDICATED
XFEDERAL
Summary of Legislation: (Amended) 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): Allows the FSSA Secretary to issue an emergency
declaration for purposes of participating in specified authorized federal Supplemental Nutrition Assistance
Program (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.
Temporary Licensure: The bill establishes certain requirements for the temporary licensure of retired or
LS 6280 1 inactive emergency medical services personnel, retired or inactive health care professionals, out-of-state
health care professionals, or recently graduated students who have applied for a physician assistant, nurse,
respiratory care practitioner, or pharmacist license. It also allows a health care provider or an officer, agent,
or employee of a health care provider who has a temporary license to qualify for coverage under the Medical
Malpractice Act.
Unemployment Insurance: The bill provides that an individual is not disqualified from unemployment
benefits if the individual has complied with the requirements for seeking an exemption from an employer's
COVID-19 immunization requirement and was discharged from employment for failing or refusing to receive
an immunization against COVID-19.
Employers: The bill provides that an employer may not impose a requirement that employees receive an
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, religious reasons, an agreement to submit to
testing for the presence of COVID-19, or immunity from COVID-19 acquired from a prior infection with
COVID-19. 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: Employer Reimbursements for COVID-19 Testing: The bill may
increase state expenditures to reimburse businesses for COVID-19 testing. The bill allows employers who
mandate the COVID-19 vaccine to receive a reimbursement of up to $50 per COVID-19 test for employees
who receive a vaccine exemption. Employers who mandate the vaccine may require weekly testing for
employees who receive an exemption. The bill also requires DWD to verify and authenticate reimbursement
requests as well as distribute reimbursements in a timely manner. The bill does not make an appropriation.
Ultimately, the source of funds and resources required to satisfy the requirements of this bill will depend on
legislative and administrative action. The bill states that the reimbursements will be paid from any state or
federal funds that may be used for COVID-19 testing.
Federal COVID-19 relief funding from the Coronavirus Relief Fund (from the CARES Act and the
Coronavirus Response and Relief Supplemental Appropriations Act) is not available for expenses incurred
after December 31, 2021. In addition, it in uncertain whether there is sufficient available funding from the
State Fiscal Recovery Fund (SFRF) to fund the testing under the bill. SFRF funds were allocated to states
in the American Rescue Plan Act of 2021 (ARPA). According to reporting from the State Budget Agency,
HEA 1001-2021 appropriated approximately 100% of Indiana’s total $3.1 B allotment from the SFRF.
Unemployment Insurance: The bill could increase expenditures from the Unemployment Insurance Benefit
Fund. The bill allows individuals to receive unemployment benefits if they are fired for failure to get
vaccinated for COVID-19 and they requested an exemption.
If a state agency were to fire an employee for failure to receive a COVID-19 vaccine who requested an
exemption, the agency would have increased costs to pay unemployment benefits for the individual who was
fired. The state is a reimbursable employer for unemployment benefits. This means that rather than paying
State Unemployment Tax (SUTA) into the Unemployment Insurance Benefit Fund, the state pays the actual
cost of unemployment benefits when state employees are laid off. [This bill has the potential to impact all
agencies as employers, thus impacting all funds that provide operating funds to agency staff.]
LS 6280 2 Unemployment Benefits are administered by the Department of Workforce Development (DWD). DWD
should be able to process any additional claims for unemployment benefits within current resources.
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.
Temporary Licenses: The bill would continue a program of issuing temporary licenses to health providers
and emergency medical services providers who have retired, are inactive or from out-of-state, or certain
students. These measures increase the workload on the Professional Licensing Agency (PLA) and the
Emergency Medical Services Commission (EMSC) for licensing and certification, and the Department of
Insurance (DOI) concerning the Indiana Patient’s Compensation Fund and Medical Malpractice Act
enforcement. These sections expire on March 31, 2022.
Explanation of State Revenues: Medicaid, Immunizations, and Supplemental Nutrition Assistance
Program (SNAP): 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 immunization matters on March 31, 2022,
and for Medicaid and SNAP when additional federal funds are no longer available.
(Revised) Unemployment Insurance: The bill could increase SUTA revenues paid by employers to the
Unemployment Insurance Benefit Fund beginning in FY 2024 if individuals who requested an exemption
are laid off for failure to be vaccinated against COVID-19.
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.
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.
(Revised) Unemployment Insurance: Typically, employer SUTA tax rates increase for employers who lay
LS 6280 3 off employees and use the unemployment system more frequently, except in certain cases. New employers
pay a fixed SUTA rate for the first three years in operation while employers who lay off employees most
frequently already pay the maximum SUTA rate of 9.4% on the first $9,500 of wages per employee per
calendar year. An employer’s SUTA tax rate is adjusted annually based on the employer’s experience
account status as of June 30 each year.
Explanation of Local Expenditures: (Revised) Unemployment Insurance: If a local unit were to fire an
employee for failure to receive a COVID-19 vaccine and who requested an exemption, the local unit could
have increased costs related to unemployment insurance. Local units that are reimbursable employers pay
the cost of unemployment benefits when local employees are laid off. Local units with experience accounts
could pay a higher SUTA tax rate in the future when they lay off employees.
Explanation of Local Revenues:
State Agencies Affected: Family and Social Services Agency; Department of Health; Department of Labor;
Professional Licensing Agency; the Emergency Medical Services Commission; the Department of Insurance;
Department of Workforce Development.
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;
Indiana Department of Workforce Development. (2021, December 22). Unemployment Insurance Employer
Handbook. https://www.in.gov/dwd/files/Employer_Handbook.pdf
State Budget Agency. State of Indiana Recovery Plan. State and Local Fiscal Recovery Funds, 2021 Report.
https://www.in.gov/sba/files/SLFRF-Recovery-Plan-Performance-Report-Indiana-08312021.pdf
State Budget Agency. (2021, July 28). COVID-19 Relief and Recovery Funding presentation to the State
Budget Committee. https://www.in.gov/sba/files/COVID-19-Funding-and-Response-July-28,-2021.pdf
Fiscal Analyst: Karen Rossen, 317-234-2106; Camille Tesch, 317-232-5293; Adam White, 317-234-1360;
Matthew Leahy, 317-234-9476.
LS 6280 4