Introduced Version
HOUSE BILL No. 1178
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 16-18-2; IC 16-21-18; IC 25-0.5-11-1;
IC 25-1-21.
Synopsis: Implicit bias training. Provides that after December 31,
2023, a hospital that provides inpatient maternity services and a
birthing center shall implement an evidence based implicit bias training
program for all health care providers who regularly provide perinatal
treatment and care to pregnant women at the hospital or birthing center.
Requires the health care providers to complete the training one time
every two years. Provides that after December 31, 2023, a practitioner
must complete implicit bias training before renewal of a license in a
health care profession. Provides an exemption for a license issued by
the board of veterinary medical examiners. Provides that a practitioner
is not required to complete implicit bias training more than one time
every two years unless specified by the board that regulates the
practitioner. Requires the board to approve and publish on its Internet
web site organizations approved to offer the implicit bias training to a
practitioner. Allows the board to grant the practitioner a hardship
waiver from the training requirement. Provides that taking implicit bias
training satisfies the requirements for both training at a hospital or
birthing center and the license renewal requirements.
Effective: July 1, 2022.
Summers
January 6, 2022, read first time and referred to Committee on Public Health.
2022 IN 1178—LS 6944/DI 77 Introduced
Second Regular Session of the 122nd General Assembly (2022)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
Constitution) is being amended, the text of the existing provision will appear in this style type,
additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional
provision adopted), the text of the new provision will appear in this style type. Also, the
word NEW will appear in that style type in the introductory clause of each SECTION that adds
a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
between statutes enacted by the 2021 Regular Session of the General Assembly.
HOUSE BILL No. 1178
A BILL FOR AN ACT to amend the Indiana Code concerning
health.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. IC 16-18-2-36.5, AS AMENDED BY P.L.111-2018,
2 SECTION 7, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 JULY 1, 2022]: Sec. 36.5. (a) "Birthing center", for purposes of
4 IC 16-21-2, and IC 16-21-13, and IC 16-21-18, means a freestanding
5 entity that has the sole purpose of delivering a normal or uncomplicated
6 pregnancy.
7 (b) The term does not include a hospital that is licensed as a hospital
8 under IC 16-21-2.
9 SECTION 2. IC 16-18-2-185.5 IS ADDED TO THE INDIANA
10 CODE AS A NEW SECTION TO READ AS FOLLOWS
11 [EFFECTIVE JULY 1, 2022]: Sec. 185.5. "Implicit bias", for
12 purposes of IC 16-21-18, has the meaning set forth in
13 IC 16-21-18-1.
14 SECTION 3. IC 16-18-2-185.6 IS ADDED TO THE INDIANA
15 CODE AS A NEW SECTION TO READ AS FOLLOWS
16 [EFFECTIVE JULY 1, 2022]: Sec. 185.6. "Implicit stereotype", for
17 purposes of IC 16-21-18, has the meaning set forth in
2022 IN 1178—LS 6944/DI 77 2
1 IC 16-21-18-2.
2 SECTION 4. IC 16-21-18 IS ADDED TO THE INDIANA CODE
3 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
4 JULY 1, 2022]:
5 Chapter 18. Implicit Bias Training
6 Sec. 1. As used in this chapter, "implicit bias" means a bias in
7 judgment or behavior that results from subtle cognitive processes,
8 including implicit prejudice and implicit stereotypes, that may
9 operate at a level below conscious awareness and without
10 intentional control.
11 Sec. 2. As used in this chapter, "implicit stereotype" means the
12 unconscious attribution of particular qualities to a member of a
13 certain social group that is influenced by experience and based on
14 learned associations between various qualities and social
15 categories, including race and gender.
16 Sec. 3. (a) After December 31, 2023, a:
17 (1) hospital that provides inpatient maternity services; and
18 (2) birthing center;
19 shall implement an evidence based implicit bias training program
20 for all health care providers who regularly provide perinatal
21 treatment and care to pregnant women at the hospital or birthing
22 center.
23 (b) A hospital that implements an implicit bias training program
24 under this section shall ensure that the program is structured in a
25 manner that permits a health care provider who is required to
26 complete continuing education to be eligible to receive continuing
27 education credits for participation in the program.
28 (c) A health care provider who has successfully completed an
29 implicit bias training program under IC 25-1-21 within the
30 previous two (2) years satisfies the requirements under this
31 chapter.
32 Sec. 4. The training program required under this chapter must
33 include the following components:
34 (1) Identifying previous and current unconscious biases and
35 misinformation when providing perinatal treatment and care
36 to pregnant women.
37 (2) Identifying personal, interpersonal, institutional, and
38 cultural barriers to inclusion.
39 (3) Information on the effects of historical and contemporary
40 exclusion and oppression of minority communities.
41 (4) Information about cultural identity across racial and
42 ethnic groups.
2022 IN 1178—LS 6944/DI 77 3
1 (5) Information about communicating more effectively across
2 racial, ethnic, religious, and gender identities.
3 (6) Information about reproductive justice.
4 (7) A discussion on power dynamics and organizational
5 decision making and their effects on implicit bias.
6 (8) A discussion on health inequities and racial and ethnic
7 disparities within the field of perinatal care, and how implicit
8 bias may contribute to pregnancy related deaths and
9 maternal and infant health outcomes.
10 (9) Corrective measures to decrease implicit bias at the
11 interpersonal and institutional levels.
12 Sec. 5. A health care provider who regularly provides perinatal
13 treatment and care to pregnant women at a hospital that provides
14 inpatient maternity services or a birthing center shall:
15 (1) complete the training program on implicit bias at the times
16 and intervals required by the hospital or birthing center;
17 (2) complete a refresher course under the training program,
18 designed to provide the health care provider with updated
19 information about racial, ethnic, and cultural identity and
20 best practices in decreasing interpersonal and institutional
21 implicit bias, at least every two (2) years, or more frequently
22 if required by the hospital or birthing center; and
23 (3) receive a certification from the hospital or birthing center
24 on the successful completion of the training program.
25 Sec. 6. The state department shall adopt rules under IC 4-22-2
26 to implement this chapter.
27 SECTION 5. IC 25-0.5-11-1, AS ADDED BY P.L.3-2014,
28 SECTION 5, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
29 JULY 1, 2022]: Sec. 1. As used in IC 25-1-9 and IC 25-1-21, "board"
30 means any of the entities described in this chapter.
31 SECTION 6. IC 25-1-21 IS ADDED TO THE INDIANA CODE AS
32 A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
33 1, 2022]:
34 Chapter 21. Implicit Bias Training
35 Sec. 1. As used in this chapter, "agency" refers to the
36 professional licensing agency.
37 Sec. 2. As used in this chapter, "board" means any of the
38 entities described in IC 25-0.5-11. However, the term does not
39 include the Indiana board of veterinary medical examiners
40 (IC 25-38.1-2).
41 Sec. 3. As used in this chapter, "implicit bias" means a bias in
42 judgment or behavior that results from subtle cognitive processes,
2022 IN 1178—LS 6944/DI 77 4
1 including implicit prejudice and implicit stereotypes, that may
2 operate at a level below conscious awareness and without
3 intentional control.
4 Sec. 4. As used in this chapter, "implicit stereotype" means the
5 unconscious attribution of particular qualities to a member of a
6 certain social group, that is influenced by experience and based on
7 learned associations between various qualities and social
8 categories, including race and gender.
9 Sec. 5. As used in this chapter, "license" includes a license,
10 certificate, registration, or permit.
11 Sec. 6. As used in this chapter, "practitioner" means an
12 individual who holds:
13 (1) an unlimited license, certificate, or registration;
14 (2) a limited or probationary license, certificate, or
15 registration;
16 (3) a temporary license, certificate, registration, or permit;
17 (4) an intern permit; or
18 (5) a provisional license;
19 issued by the board regulating the profession in question, including
20 a certificate of registration issued under IC 25-20.
21 Sec. 7. After December 31, 2023, a practitioner who seeks to
22 renew a license issued by a board must first complete, before a
23 license may be issued, an evidence based implicit bias training
24 program that includes the following components:
25 (1) Identifying previous and current unconscious biases and
26 misinformation when providing perinatal treatment and care
27 to pregnant women.
28 (2) Identifying personal, interpersonal, institutional, and
29 cultural barriers to inclusion.
30 (3) Information on the effects of historical and contemporary
31 exclusion and oppression of minority communities.
32 (4) Information about cultural identity across racial and
33 ethnic groups.
34 (5) Information about communicating more effectively across
35 racial, ethnic, religious, and gender identities.
36 (6) Information about reproductive justice.
37 (7) A discussion on power dynamics and organizational
38 decision making and their effects on implicit bias.
39 (8) A discussion on health inequities and racial and ethnic
40 disparities within the field of perinatal care, and how implicit
41 bias may contribute to pregnancy related deaths and
42 maternal and infant health outcomes.
2022 IN 1178—LS 6944/DI 77 5
1 (9) Corrective measures to decrease implicit bias at the
2 interpersonal and institutional levels.
3 Sec. 8. (a) Unless specifically required by the board regulating
4 a practitioner, a practitioner is not required to complete the
5 implicit bias training program required in section 7 of this chapter
6 more than one (1) time in a two (2) year period.
7 (b) A practitioner who has successfully completed an implicit
8 bias training program under IC 16-21-18 within the previous two
9 (2) years satisfies the requirements under section 7 of this chapter.
10 Sec. 9. (a) The board shall approve and publish on its Internet
11 web site organizations and persons approved to offer the implicit
12 bias training program to a practitioner.
13 (b) The agency may offer an online course to practitioners that
14 fulfills the requirements under section 7 of this chapter.
15 (c) The board shall allow the implicit bias training program to
16 be counted toward fulfilling any continuing education requirement
17 required by law.
18 Sec. 10. The practitioner shall do the following:
19 (1) Provide the agency with a sworn statement executed by the
20 practitioner that the practitioner has fulfilled the implicit bias
21 training requirement.
22 (2) Retain copies of certificates of completion for implicit bias
23 training for four (4) years from the end of the licensing period
24 for which the implicit bias training applied. The practitioner
25 shall provide the board or agency with copies of the
26 certificates of completion upon the board's or agency's
27 request.
28 Sec. 11. A board may grant a practitioner a waiver from the
29 implicit bias training requirement for a renewal period if the
30 practitioner was not able to fulfill the requirement due to a
31 hardship that resulted from any of the following:
32 (1) Service in the armed forces of the United States during a
33 substantial part of the renewal period.
34 (2) An incapacitating illness or injury.
35 (3) Other circumstances determined by the board.
36 Sec. 12. The board may adopt rules under IC 4-22-2 to
37 implement this chapter.
2022 IN 1178—LS 6944/DI 77