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 6432 NOTE PREPARED: Jan 25, 2022 BILL NUMBER: SB 365 BILL AMENDED: SUBJECT: Psychology Interjurisdictional Compact. FIRST AUTHOR: Sen. Messmer BILL STATUS: As Passed Senate FIRST SPONSOR: Rep. Ziemke FUNDS AFFECTED:XGENERAL IMPACT: State DEDICATED FEDERAL Summary of Legislation: This bill establishes the Psychology Interjurisdictional Compact concerning interjurisdictional telepsychology and the temporary authorization to practice psychology in another compact state. The bill sets forth requirements of a compact state. It also sets forth the duties of the Psychology Interjurisdictional Compact Commission. Effective Date: July 1, 2022. Explanation of State Expenditures: Summary - Joining the compact would require additional workload and resources for the Professional Licensing Agency (PLA) and State Board of Psychology (ISBP) that extend beyond routine administrative functions. Implementation of the compact is expected to require between $24,800 and $42,200 in staff salary costs in FY 2023. After implementation, the PLA is expected to incur between $8,800 and $16,300 in ongoing annual operating expenses related to administering the compact. PLA operating expenses are paid from General Fund appropriations. Additionally, the Attorney General’s Office and the ISBP could experience an increase in workload for investigatory and disciplinary procedures to the extent that complaints are made against out-of-state practitioners practicing in Indiana under the compact or Indiana licensees practicing in other states. The ISBP would also be required to pay any witness fees and travel expenses necessary to summon witnesses from other compact states for hearings held by the ISBP. The volume of such complaints and disciplinary actions is expected to be minimal. SB 365 1 Estimated PLA Expenditures for the Psychology Interjurisdictional Compact Expense FY 2023 Subsequent Years Low Estimate High Estimate Low Estimate High Estimate PLA & ISBP Implementation Costs* $24,800 $42,200 - - PLA & ISBP Ongoing Administrative Costs* - - $6,800 $10,300 Annual Assessment Fee** - - $2,000 $6,000 TOTAL $24,800 $42,200 $8,800 $16,300 *Estimated salary cost of existing staff to complete the bill’s requirements. **The compact’s annual assessment is currently set at the lesser of $10 per authorization holder or $6,000. Additional Information - The Psychology Interjursidictional Compact is a multi-state agreement that allows psychologists that are licensed in a compact state to: (1) practice telepsychology for clients in distant compact states; (2) temporarily practice in-person, face-to-face psychology in another compacting state for up to 30 days per calendar year. There are currently 27 states that have adopted the compact, and an additional three states with pending legislation. The Commission was formally established in July 2019. PLA Workload: The PLA will likely dedicate a significant amount of staff time in FY 2023 toward adopting rules relating to the compact, facilitating data sharing between the ISBP and the Compact Commission, educating license holders on the compact, and other planning activities. Expected salary costs associated with this workload are estimated between $24,800 and $42,200 based on current PLA staff salaries for the various employee types likely to be involved and across a range of total hours that may be spent on compact implementation. Ongoing workload for functions such as verifying licensure for compact applicants, submitting investigative and disciplinary information to the compact database, and providing staff support for Indiana’s Compact Commissioner is estimated to require between $6,800 and $10,300 in salary cost per year. The funds and resources required for this work could be supplied through existing staff and resources currently being used in other programs or with new appropriations. Ultimately, the source of funds and resources required to satisfy the requirements of this bill will depend on legislative and administrative actions. Commission Membership: The Psychology Interjurisdictional Compact Commission is a body politic made up of one delegate from each compact state. The ISBP would appoint one voting delegate to serve as Indiana’s Compact Commissioner. The bill authorizes the Commission to levy an annual assessment on Indiana as a compact state. This assessment is currently set at the lesser of $6,000 or $10 per compact authorization holder licensed in a compact state. The bill states that the annual assessment is meant to cover the cost of the Commission’s operations and activities. Therefore, it is assumed that any travel required of Indiana’s appointed Compact Commissioner for Commission business would not result in additional costs to the state beyond the amount of the annual assessment. SB 365 2 Current ISBP License Counts: As of November 2021, there were 1,394 psychologists physically located in Indiana with active Indiana licenses. In order for Indiana to be subject to the maximum $6,000 annual assessment, 600 or more of these licensees would need to receive telepsychology authorization or temporary authorization to practice in distant states under the compact. As a point of comparison, the State of Missouri joined the compact in 2018 and now has approximately 200 licensees that live in-state and have obtained compact privileges. Given that Indiana and Missouri have nearly identical numbers of licensed psychologists and similar population sizes, the ISBP may reasonably expect approximately 200 current in-state license holders to obtain compact privileges. In this case, the ISBP’s annual assessment fee would be approximately $2,000. Uniform Data Set: Upon joining the compact, the bill would require the ISBP to submit a uniform data set containing certain identifying, licensure, and disciplinary information to the Commission’s coordinated database on all participating practitioners. Rules adopted by the Compact Commission require compact states to provide proof of active licensure for compact authorization applicants and to submit investigatory and disciplinary information to the existing database managed by the Association of State and Provincial Psychology Boards (ASPPB). Similar requirements were included in the authorization of the Nurse Licensure Compact, which was recently implemented by the PLA. The PLA reported costs of approximately $130,000 for harmonizing its licensure database with the Nurse Licensure Compact’s national database, an effort that was funded through a grant awarded by the Nurse Licensure Compact Commission. To the extent that PLA determines that the data sharing requirements of the compact necessitate similar customization of PLA’s existing licensure database, similar information technology costs may be incurred. However, the Psychology Interjurisdictional Compact Commission’s rules do not expressly require the harmonization of states’ databases with the ASPPB’s, and the Compact Commission does not currently offer funding for this type of project. Adverse Action: The bill requires the ISBP or the Attorney General’s Office to investigate and take appropriate action concerning reported inappropriate conduct engaged in by: (1) an ISBP licensee practicing in a distant state; and (2) a psychologist practicing under temporary authorization in Indiana in the same manner that ISBP would act if the conduct had occurred by a licensee in Indiana. Additionally, ISBP may take adverse action against: (1) a distant state psychologist’s authority to practice telepsychology in Indiana; and (2) an ISBP licensee as a result of adverse action taken by a distant state against that practitioner. Explanation of State Revenues: Summary - If a significant number of out-of-state psychologists who hold Indiana licenses choose to forego license renewal for compact authorization to practice virtually or on a limited basis in-person in Indiana, there could be a reduction in General Fund revenue from license fees estimated between $13,700 and $41,100 per biennium. Any reduction in revenue would not be expected until FY 2024 when compact privileges begin to be granted in Indiana. [Approximately 70% of psychologist license fee revenue is collected in odd numbered years.] Additional Information - ISBP currently collects a biennial license fee of $100 for psychologists. In FY 2020 and FY 2021, ISBP collected approximately $237,800 from license fees. As of November 2021, 548 out of Indiana’s 1,942 licensed psychologists live outside of Indiana. Estimates of possible revenue reduction assume between 25% and 75% of these individuals would choose not to renew their Indiana licenses upon receiving compact privileges. SB 365 3 Explanation of Local Expenditures: Explanation of Local Revenues: State Agencies Affected: Professional Licensing Agency, State Board of Psychology; Attorney General. Local Agencies Affected: Information Sources: PLA, Search and Verify Tool; PSYPACT, Map of Participating States: https://psypact.site-ym.com/page/psypactmap; PSYPACT, Rule on Coordinated Licensure Information System: https://cdn.ymaws.com/psypact.site-ym.com/resource/resmgr/final_rules/Rule_on_Coordinated_Licensur .pdf; Missouri Division of Professional Registration, Licensee Search: https://pr.mo.gov/licensee-search-division.asp; Legislative Services Agency, Indiana Handbook of Taxes, Revenues, and Appropriations, Fiscal Year 2021; Eric Sears, Professional Licensing Agency. Fiscal Analyst: Adam White, 317-234-1360. SB 365 4