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 6944 NOTE PREPARED: Dec 31, 2021
BILL NUMBER: HB 1178 BILL AMENDED:
SUBJECT: Implicit Bias Training.
FIRST AUTHOR: Rep. Summers BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State & Local
XDEDICATED
FEDERAL
Summary of Legislation: Hospitals and Birthing Centers - This bill 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. It requires the health care providers to complete the
training one time every two years.
Licensed Health Care Practitioners - The bill provides that after December 31, 2023, a practitioner must
complete implicit bias training before renewal of a license in a health care profession. It provides an
exemption for a license issued by the Board of Veterinary Medical Examiners. It 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. The bill also requires the board to approve and publish on its Internet
web site organizations approved to offer the implicit bias training to a practitioner. It allows the board to
grant the practitioner a hardship waiver from the training requirement. It provides that taking implicit bias
training satisfies the requirements for both training at a hospital or birthing center and the license renewal
requirements.
Effective Date: July 1, 2022.
Explanation of State Expenditures: The Indiana Department of Health (IDOH) and the Professional
Licensing Agency (PLA) will require additional workload prior to January 1, 2024 to adopt rules concerning
health care provider implicit bias training and to approve organizations that may conduct the trainings. The
IDOH and the PLA will also experience a minor increase in ongoing workload to investigate and correct any
reported violations of the training requirements by hospitals, birthing centers, or health practitioners once
HB 1178 1 the requirements take effect. Adopting rules and exercising oversight of licensees are routine administrative
functions of the IDOH and the PLA and are expected to be completed within existing staffing and resource
levels. [The IDOH receives appropriations for administrative expenses in a dedicated agency fund. The
PLA’s administrative costs are paid from General Fund appropriations.]
Explanation of State Revenues: Beginning January 1, 2024, if a violation of the bill’s requirements by a
hospital, birthing center, or health practitioner occurs, the IDOH or the PLA may take an action that could
impact state revenue. The IDOH could impose a civil penalty of up to $10,000 for violations committed by
hospitals or birthing centers. The PLA may impose a fine of up to $1,000 against violating practitioners.
Revenue from fines or civil penalties would be deposited in the General Fund. Additionally, if a violating
practitioner has a license denied or revoked, fee revenue to the General Fund would decrease. Health care
practitioner license fees typically range between $40 and $200 biennially. Overall impact to General Fund
revenues as a result of the bill is expected to be small.
Explanation of Local Expenditures: County-owned hospitals may experience a minor increase in workload
and administrative costs to ensure staff who provide perinatal treatment and care for pregnant women receive
regular implicit bias training.
Explanation of Local Revenues:
State Agencies Affected: Department of Health, Professional Licensing Agency.
Local Agencies Affected: County-owned hospitals.
Information Sources: Legislative Services Agency, Indiana Handbook of Taxes, Revenues, and
Appropriations, FY 2021.
IC 25-1-9-9;
IC 16-21-3-1.
Fiscal Analyst: Adam White, 317-234-1360.
HB 1178 2