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 6614 NOTE PREPARED: Jan 6, 2022
BILL NUMBER: HB 1331 BILL AMENDED:
SUBJECT: Dental Hygienists.
FIRST AUTHOR: Rep. Zent BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State & Local
XDEDICATED
XFEDERAL
Summary of Legislation: This bill provides that a dental hygienist may administer an immunization that
is recommended by the federal Centers for Disease Control and Prevention Advisory Committee on
Immunization Practices for individuals who are not less than 11 years of age on the order of a dentist or other
health care provider qualified to order the immunization, if the dental hygienist:
(1) is certified in cardiopulmonary resuscitation;
(2) has successfully completed a course of training in immunization that meets specified
requirements; and
(3) administers the immunization in accordance with a protocol that includes specified requirements
and procedures.
The bill prescribes reporting requirements for a dental hygienist who administers an immunization. It
provides that a dental hygienist:
(1) is not required to administer immunizations; and
(2) is not required to complete immunization training if the dental hygienist chooses not to
administer immunizations.
Effective Date: Upon passage.
Explanation of State Expenditures: Summary - Authorizing dental hygienists to administer immunizations
may result in greater claims volume for immunizations within the state’s Medicaid and employee health plans
due to increased accessibility or convenience. The Department of Health (IDOH) could experience a small
increase in workload to facilitate required reporting by dental hygienists to the Immunization Data Registry.
The State Board of Dentistry and the Professional Licensing Agency (PLA) may also experience a small
workload increase to adopt rules and approve a course of training for immunizations as required by the bill.
HB 1331 1 Additionally, violations of the bill’s requirements by hygienists administering immunizations would be
subject to disciplinary action by the board. These actions can likely be accomplished within the IDOH and
PLA’s existing staffing and resource levels. [The IDOH receives appropriations for administrative expenses
in a dedicated agency fund. The PLA receives General Fund appropriations for administrative expenses.]
Additional Information -
Medicaid State Share: Medicaid and the Children’s Health Insurance Program (CHIP) are jointly funded
between the state and federal governments. The standard state share of costs for most Medicaid medical
services for FFY 2022 is 34%, or 10% for the age 19 to 64 expansion population within the Healthy Indiana
Plan (HIP). The standard state share of CHIP costs is 24%. The state share of administrative costs is 50%.
The state share of most Medicaid and CHIP expenditures is paid from General Fund appropriations.
However, the state share of HIP costs is paid from dedicated funds.
State Employee Health Plans: Costs for the state health plans are shared between the state and state
employees covered by the plan as determined in the plans’ designs, including premiums, coinsurance,
copayments, and deductibles. An increase in premiums cost may be mitigated with adjustments to other
benefits or to employee compensation packages, or through the division of premium costs between the state
and state employees.
Explanation of State Revenues: Penalties: If a violation of the bill’s requirements for administering
immunizations is committed by a dental hygienist, the State Board of Dentistry may take an action that could
impact state revenue. If the violator has a license denied or revoked, General Fund revenue from license fees
would decrease. Dental hygienist’s license renewal fees are $50 biennially. The board may also impose a fine
of up to $1,000, which would be deposited in the General Fund. Any increase in penalty revenue is likely
to be minimal.
Insurance Premiums Tax: An increase in private insurance claims for immunizations may create upward
pressure on premiums collected in the state. Any increase in insurance company premiums will increase
General Fund revenue from either insurance premium tax collections or Adjusted Gross Income (AGI) tax
collections. This impact is likely to be minimal.
Explanation of Local Expenditures: The bill potentially impacts local units of government that offer health
insurance coverage for employees. Added local health coverage costs may be mitigated with adjustments to
other benefits or to the total employee compensation packages, or through the division of costs between the
local unit and employees.
Explanation of Local Revenues: Local government units offering employee health plans.
State Agencies Affected: Professional Licensing Agency, Board of Dentistry; State Department of Health;
Family and Social Services Administration; State Personnel Department.
Local Agencies Affected:
Information Sources: IC 25-1-9-9; Legislative Services Agency, Indiana Handbook of Taxes, Revenues,
and Appropriations, FY 2021.
Fiscal Analyst: Adam White, 317-234-1360.
HB 1331 2