*ES0321.2*
Reprinted
April 4, 2023
ENGROSSED
SENATE BILL No. 321
_____
DIGEST OF SB 321 (Updated April 3, 2023 3:23 pm - DI 149)
Citations Affected: IC 20-26.
Synopsis: Student health matters. Allows a school corporation to
contract with a health care provider, health system, or community
partner to establish a school based health center (center) and provide
services to certain students. Sets forth requirements to establish a
center. Provides that the state board shall amend any rules necessary to
comply with the requirements to establish a center.
Effective: July 1, 2023.
Zay, Baldwin
(HOUSE SPONSORS — TESHKA, KING)
January 12, 2023, read first time and referred to Committee on Insurance and Financial
Institutions.
February 9, 2023, amended, reported favorably — Do Pass.
February 13, 2023, read second time, amended, ordered engrossed.
February 14, 2023, engrossed. Read third time, passed. Yeas 49, nays 0.
HOUSE ACTION
February 28, 2023, read first time and referred to Committee on Education.
March 23, 2023, amended, reported — Do Pass.
March 28, 2023, read second time, call withdrawn.
April 3, 2023, re-read second time, amended, ordered engrossed.
ES 321—LS 7136/DI 147 Reprinted
April 4, 2023
First Regular Session of the 123rd General Assembly (2023)
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 2022 Regular Session of the General Assembly.
ENGROSSED
SENATE BILL No. 321
A BILL FOR AN ACT to amend the Indiana Code concerning
education.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. IC 20-26-21.5 IS ADDED TO THE INDIANA CODE
2 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
3 JULY 1, 2023]:
4 Chapter 21.5. School Health Services
5 Sec. 1. As used in this chapter, "health care provider" has the
6 meaning set forth in IC 16-18-2-163(a).
7 Sec. 2. As used in this chapter, "health records" has the
8 meaning set forth in IC 16-18-2-168(a).
9 Sec. 3. As used in this chapter, "informed consent" has the
10 meaning set forth in IC 16-36-7-16.
11 Sec. 4. As used in this chapter, "school based health center"
12 means a health clinic that:
13 (1) is located in or near a school or school facility of a school
14 corporation;
15 (2) is organized or promoted through school, community, or
16 health care provider relationships; and
17 (3) provides primary health services to a student of the school
ES 321—LS 7136/DI 147 2
1 corporation on a day that the student is in attendance at
2 school by health care providers, in accordance with state and
3 federal law.
4 Sec. 5. (a) As used in this chapter, "school nursing services"
5 refers to the responsibilities of a school nurse as described in
6 IC 20-34-3-6.
7 (b) The term does not include services provided:
8 (1) in a school based health center; or
9 (2) by an individual who is not employed by the school.
10 Sec. 6. School nursing services must be provided in accordance
11 with:
12 (1) all state and federal laws and regulations; and
13 (2) the applicable standard of care.
14 Sec. 7. A school corporation may contract with a health care
15 provider, health system, or community partner to establish a
16 school based health center for the purpose of providing services to
17 students beyond the scope of school nursing services if the
18 following requirements are met:
19 (1) The school based health center must be a distinct legal
20 entity that is separate from the school corporation.
21 (2) The establishment of a school based health center may not
22 replace the role of school nurses who are employed by the
23 school corporation to provide first aid and emergency
24 services.
25 (3) Student participation in services provided by a school
26 based health center must be voluntary.
27 (4) The school based health center or school corporation may
28 not offer an incentive to a student or parent of a student in
29 exchange for participation in services provided by the school
30 based health center.
31 (5) A student, if the student is an emancipated minor, or the
32 student's parent (as defined in IC 20-18-2-13), if the student
33 is an unemancipated minor, must provide written informed
34 consent as described in IC 16-36-7-16 for the student to
35 receive services at a school based health center.
36 (6) If the student is an unemancipated minor:
37 (A) the parent; or
38 (B) an adult approved by the parent;
39 must be present at the time the student receives services at a
40 school based health center.
41 (7) Services provided at a school based health center must be
42 provided by a health care provider.
ES 321—LS 7136/DI 147 3
1 (8) A health care provider employed by or working in a school
2 based health center must maintain health records in
3 accordance with the federal Health Insurance Portability and
4 Accountability Act (HIPAA).
5 (9) Except as required by law, a school or school corporation
6 may not access a student's health records.
7 (10) A school, school corporation, or health care provider may
8 not be obligated to violate this section, including participating
9 in a grant program that requires a school, school corporation,
10 or health care provider to violate this section.
11 Sec. 8. The state board shall amend any rules necessary to
12 comply with this chapter.
ES 321—LS 7136/DI 147 4
COMMITTEE REPORT
Madam President: The Senate Committee on Insurance and
Financial Institutions, to which was referred Senate Bill No. 321, has
had the same under consideration and begs leave to report the same
back to the Senate with the recommendation that said bill be
AMENDED as follows:
Page 1, delete lines 1 through 17.
Delete page 2.
Page 3, delete lines 1 through 15.
Page 4, delete lines 8 through 42.
Delete page 5.
Page 6, delete lines 1 through 2.
Page 6, delete lines 19 through 42.
Delete pages 7 through 9.
Renumber all SECTIONS consecutively.
and when so amended that said bill do pass.
(Reference is to SB 321 as introduced.)
BALDWIN, Chairperson
Committee Vote: Yeas 9, Nays 0.
_____
SENATE MOTION
Madam President: I move that Senate Bill 321 be amended to read
as follows:
Page 2, line 33, after "subsection (a)." insert "However, a school
corporation shall not include in a student's high school transcript:
(1) any information from the student's immunization record
that is kept by the student's school under IC 20-34-4-1; or
(2) any other health related record concerning the student.".
(Reference is to SB 321 as printed February 10, 2023.)
ZAY
ES 321—LS 7136/DI 147 5
COMMITTEE REPORT
Mr. Speaker: Your Committee on Education, to which was referred
Senate Bill 321, has had the same under consideration and begs leave
to report the same back to the House with the recommendation that said
bill be amended as follows:
Delete everything after the enacting clause and insert the following:
(SEE TEXT OF BILL)
and when so amended that said bill do pass.
(Reference is to SB 321 as reprinted February 14, 2023.)
BEHNING
Committee Vote: yeas 12, nays 0.
_____
HOUSE MOTION
Mr. Speaker: I move that Engrossed Senate Bill 321 be amended to
read as follows:
Page 2, delete lines 10 through 23, begin a new paragraph and
insert:
"Sec. 6. School nursing services must be provided in accordance
with:".
Page 2, line 26, delete "8." and insert "7.".
Page 3, line 21, delete "9." and insert "8.".
Page 3, delete lines 23 through 36.
(Reference is to ESB 321 as printed March 23, 2023.)
TESHKA
_____
HOUSE MOTION
Mr. Speaker: I move that Engrossed Senate Bill 321 be amended to
read as follows:
Page 1, line 16, after "relationships;" insert "and".
Page 1, line 17, delete "children" and insert "a student of the school
corporation on a day that the student is in attendance at school".
ES 321—LS 7136/DI 147 6
Page 2, line 1, delete "; and" and insert ".".
Page 2, delete lines 2 through 3.
Page 3, line 2, delete "or guardian," and insert "(as defined in
IC 20-18-2-13),".
Page 3, line 5, after "center" delete "," and insert ".".
Page 3, line 5, delete "and the parent of a", begin a new line block
indented and insert:
"(6) If the student is an unemancipated minor:
(A) the parent; or
(B) an adult approved by the parent;
must be present at the time the student receives services at a
school based health center.".
Page 3, delete lines 6 through 8.
Page 3, line 9, delete "(6)" and insert "(7)".
Page 3, line 11, delete "(7)" and insert "(8)".
Page 3, line 15, delete "(8)" and insert "(9)".
Page 3, line 17, delete "(9)" and insert "(10)".
(Reference is to ESB 321 as printed March 23, 2023.)
MELTZER
ES 321—LS 7136/DI 147