Indiana 2023 Regular Session

Indiana Senate Bill SB0474 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
	1	+	ES0474.1
	2	+	April 11, 2023
	3	+	ENGROSSED
	4	+	SENATE BILL No. 474
	5	+	_____
	6	+	DIGEST OF SB 474 (Updated April 11, 2023 9:59 am - DI 140)
	7	+	Citations Affected: IC 16-18; IC 16-27; IC 22-4; IC 34-30.
	8	+	Synopsis: Home health agencies. Allows a home health agency to: (1)
	9	+	provide services in any county in Indiana; and (2) satisfy supervising
	10	+	home health aide services requirements by complying with federal law.
	11	+	Allows: (1) the Indiana department of health (state department) to
	12	+	adopt rules concerning the oversight and supervision of the services a
	13	+	home health agency provides in noncontiguous counties; and (2) the
	14	+	state health commissioner to waive rules adopted concerning home
	15	+	health agencies if certain conditions are met. Provides that a home
	16	+	health agency is not required to conduct a preemployment physical on
	17	+	a job applicant before the individual has contact with a home health
	18	+	agency patient. Allows a registered home health aide to administer
	19	+	gastrointestinal and jejunostomy tube feedings to a specific patient if
	20	+	specified conditions are met. Requires the state department to approve
	21	+	at least one training curriculum concerning the administration of tube
	22	+	feedings. Repeals laws concerning drug testing of home health agency
	23	+	employees.
	24	+	Effective: July 1, 2023.
	25	+	Becker, Johnson T, Charbonneau,
	26	+	Randolph Lonnie M
	27	+	(HOUSE SPONSORS — LEDBETTER, BARRETT)
	28	+	January 19, 2023, read first time and referred to Committee on Health and Provider
	29	+	Services.
	30	+	February 2, 2023, amended, reported favorably — Do Pass.
	31	+	February 6, 2023, read second time, ordered engrossed. Engrossed.
	32	+	February 7, 2023, read third time, passed. Yeas 48, nays 0.
	33	+	HOUSE ACTION
	34	+	February 28, 2023, read first time and referred to Committee on Public Health.
	35	+	April 11, 2023, reported — Do Pass.
	36	+	ES 474—LS 6849/DI 77 April 11, 2023
1	37		First Regular Session of the 123rd General Assembly (2023)
2	38		PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
3	39		Constitution) is being amended, the text of the existing provision will appear in this style type,
4	40		additions will appear in this style type, and deletions will appear in this style type.
5	41		Additions: Whenever a new statutory provision is being enacted (or a new constitutional
6	42		provision adopted), the text of the new provision will appear in this style type. Also, the
7	43		word NEW will appear in that style type in the introductory clause of each SECTION that adds
8	44		a new provision to the Indiana Code or the Indiana Constitution.
9	45		Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
10	46		between statutes enacted by the 2022 Regular Session of the General Assembly.
11		-	SENATE ENROLLED ACT No. 474
12		-	AN ACT to amend the Indiana Code concerning health.
	47	+	ENGROSSED
	48	+	SENATE BILL No. 474
	49	+	A BILL FOR AN ACT to amend the Indiana Code concerning
	50	+	health.
13	51		Be it enacted by the General Assembly of the State of Indiana:
14		-	SECTION 1. IC 16-18-2-173, AS AMENDED BY P.L.224-2017,
15		-	SECTION 6, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
16		-	JULY 1, 2023]: Sec. 173. (a) "Home health agency", for purposes of
17		-	IC 16-27-1, has the meaning set forth in IC 16-27-1-2.
18		-	(b) "Home health agency", for purposes of IC 16-27-2, and
19		-	IC 16-27-2.5, has the meaning set forth in IC 16-27-2-2.
20		-	SECTION 2. IC 16-27-1-7.5 IS ADDED TO THE INDIANA CODE
21		-	AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
22		-	1, 2023]: Sec. 7.5. The state health commissioner may waive a rule
23		-	adopted under this chapter if the state health commissioner
24		-	determines that the person requesting the waiver has:
	52	+	1 SECTION 1. IC 16-18-2-173, AS AMENDED BY P.L.224-2017,
	53	+	2 SECTION 6, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	54	+	3 JULY 1, 2023]: Sec. 173. (a) "Home health agency", for purposes of
	55	+	4 IC 16-27-1, has the meaning set forth in IC 16-27-1-2.
	56	+	5 (b) "Home health agency", for purposes of IC 16-27-2, and
	57	+	6 IC 16-27-2.5, has the meaning set forth in IC 16-27-2-2.
	58	+	7 SECTION 2. IC 16-27-1-7.5 IS ADDED TO THE INDIANA CODE
	59	+	8 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
	60	+	9 1, 2023]: Sec. 7.5. The state health commissioner may waive a rule
	61	+	10 adopted under this chapter if the state health commissioner
	62	+	11 determines that the person requesting the waiver has:
	63	+	12 (1) shown good cause; and
	64	+	13 (2) affirmatively demonstrated that the requested waiver of a
	65	+	14 rule will not adversely affect or increase any risk to the
	66	+	15 health, safety, or welfare of existing or potential patients or
	67	+	16 residents.
	68	+	17 SECTION 3. IC 16-27-1-18 IS ADDED TO THE INDIANA CODE
	69	+	ES 474—LS 6849/DI 77 2
	70	+	1 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
	71	+	2 1, 2023]: Sec. 18. (a) A home health agency may provide services in
	72	+	3 any county in Indiana.
	73	+	4 (b) The state department may adopt rules under IC 4-22-2 to
	74	+	5 provide appropriate oversight and supervision of the services a
	75	+	6 home health agency provides in noncontiguous counties.
	76	+	7 SECTION 4. IC 16-27-1-19 IS ADDED TO THE INDIANA CODE
	77	+	8 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
	78	+	9 1, 2023]: Sec. 19. A home health agency is not required to conduct
	79	+	10 a preemployment physical on a job applicant before the individual
	80	+	11 has contact with a home health agency patient.
	81	+	12 SECTION 5. IC 16-27-1-20 IS ADDED TO THE INDIANA CODE
	82	+	13 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
	83	+	14 1, 2023]: Sec. 20. Notwithstanding any other law or administrative
	84	+	15 rule, a home health agency may satisfy the requirements of
	85	+	16 supervising home health aide services by complying with 42 CFR
	86	+	17 484.80(h) et seq.
	87	+	18 SECTION 6. IC 16-27-1.5-6 IS ADDED TO THE INDIANA CODE
	88	+	19 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
	89	+	20 1, 2023]: Sec. 6. (a) A registered home health aide may administer
	90	+	21 gastrointestinal and jejunostomy tube feedings to a specific patient
	91	+	22 only if the following conditions are met:
	92	+	23 (1) The registered home health aide has completed the
	93	+	24 training curriculum described in subsection (b).
	94	+	25 (2) A registered nurse, providing registered nursing under
	95	+	26 IC 25-23-1-1.1(b)(6), either:
	96	+	27 (A) supervises the registered home health aide in
	97	+	28 administering the gastrointestinal and jejunostomy tube
	98	+	29 feedings; or
	99	+	30 (B) delegates responsibility for administering the
	100	+	31 gastrointestinal and jejunostomy tube feedings to the
	101	+	32 registered home health aide based on the registered nurse's
	102	+	33 assessment of the registered home health aide's
	103	+	34 competency to administer gastrointestinal and jejunostomy
	104	+	35 tube feedings.
	105	+	36 (3) The home health agency that the registered home health
	106	+	37 aide is employed with:
	107	+	38 (A) allows the registered home health aide to administer
	108	+	39 gastrointestinal and jejunostomy tube feedings;
	109	+	40 (B) establishes a procedure for:
	110	+	41 (i) the delegation of the administration of gastrointestinal
	111	+	42 and jejunostomy tube feedings from a registered nurse
	112	+	ES 474—LS 6849/DI 77 3
	113	+	1 to a registered home health aide that includes patient
	114	+	2 specific clinical parameters based on the registered
	115	+	3 nurse's assessment of the patient and the registered
	116	+	4 home health aide's competency to administer the
	117	+	5 gastrointestinal and jejunostomy tube feedings; and
	118	+	6 (ii) the assessment by the registered nurse of the patient
	119	+	7 specific clinical parameters;
	120	+	8 (C) retains documentation that the registered home health
	121	+	9 aide has completed the training curriculum described in
	122	+	10 subsection (b); and
	123	+	11 (D) notifies each patient requiring gastrointestinal and
	124	+	12 jejunostomy tube feedings upon admission that the home
	125	+	13 health aide agency may allow registered home health aides
	126	+	14 to administer gastrointestinal and jejunostomy tube
	127	+	15 feedings.
	128	+	16 (b) Training curriculum for home health aides to administer
	129	+	17 gastrointestinal and jejunostomy tube feedings must:
	130	+	18 (1) be approved by the state department; and
	131	+	19 (2) include the following concerning the administration of
	132	+	20 gastrointestinal and jejunostomy tube feedings:
	133	+	21 (A) At least four (4) hours and not more than eight (8)
	134	+	22 hours of classroom training.
	135	+	23 (B) At least two (2) hours and not more than four (4) hours
	136	+	24 of practical training.
	137	+	25 (C) A written and practical examination administered by
	138	+	26 the trainer.
	139	+	27 (c) A registered home health aide may not administer
	140	+	28 gastrointestinal and jejunostomy tube feedings until the home
	141	+	29 health aide has successfully:
	142	+	30 (1) completed the curriculum described in subsection (b); and
	143	+	31 (2) passed the examinations described in subsection (b)(2)(C).
	144	+	32 (d) The state department may require a registered home health
	145	+	33 aide who administers gastrointestinal and jejunostomy tube
	146	+	34 feedings under this section to annually complete not more than one
	147	+	35 (1) hour of in service training specific to the administration of
	148	+	36 gastrointestinal and jejunostomy tube feedings.
	149	+	37 (e) Before January 1, 2024, the state department must approve
	150	+	38 at least one (1) training curriculum described in subsection (b).
	151	+	39 SECTION 7. IC 16-27-2.5 IS REPEALED [EFFECTIVE JULY 1,
	152	+	40 2023]. (Drug Testing of Employees).
	153	+	41 SECTION 8. IC 22-4-15-1, AS AMENDED BY P.L.1-2022,
	154	+	42 SECTION 8, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	155	+	ES 474—LS 6849/DI 77 4
	156	+	1 JULY 1, 2023]: Sec. 1. (a) Regarding an individual's most recent
	157	+	2 separation from employment before filing an initial or additional claim
	158	+	3 for benefits, an individual who voluntarily left the employment without
	159	+	4 good cause in connection with the work or was discharged from the
	160	+	5 employment for just cause is ineligible for waiting period or benefit
	161	+	6 rights for the week in which the disqualifying separation occurred and
	162	+	7 until:
	163	+	8 (1) the individual has earned remuneration in employment in at
	164	+	9 least eight (8) weeks; and
	165	+	10 (2) the remuneration earned equals or exceeds the product of the
	166	+	11 weekly benefit amount multiplied by eight (8).
	167	+	12 If the qualification amount has not been earned at the expiration of an
	168	+	13 individual's benefit period, the unearned amount shall be carried
	169	+	14 forward to an extended benefit period or to the benefit period of a
	170	+	15 subsequent claim.
	171	+	16 (b) When it has been determined that an individual has been
	172	+	17 separated from employment under disqualifying conditions as outlined
	173	+	18 in this section, the maximum benefit amount of the individual's current
	174	+	19 claim, as initially determined, shall be reduced by an amount
	175	+	20 determined as follows:
	176	+	21 (1) For the first separation from employment under disqualifying
	177	+	22 conditions, the maximum benefit amount of the individual's
	178	+	23 current claim is equal to the result of:
	179	+	24 (A) the maximum benefit amount of the individual's current
	180	+	25 claim, as initially determined; multiplied by
	181	+	26 (B) seventy-five percent (75%);
	182	+	27 rounded (if not already a multiple of one dollar ($1)) to the next
	183	+	28 higher dollar.
	184	+	29 (2) For the second separation from employment under
	185	+	30 disqualifying conditions, the maximum benefit amount of the
	186	+	31 individual's current claim is equal to the result of:
	187	+	32 (A) the maximum benefit amount of the individual's current
	188	+	33 claim determined under subdivision (1); multiplied by
	189	+	34 (B) eighty-five percent (85%);
	190	+	35 rounded (if not already a multiple of one dollar ($1)) to the next
	191	+	36 higher dollar.
	192	+	37 (3) For the third and any subsequent separation from employment
	193	+	38 under disqualifying conditions, the maximum benefit amount of
	194	+	39 the individual's current claim is equal to the result of:
	195	+	40 (A) the maximum benefit amount of the individual's current
	196	+	41 claim determined under subdivision (2); multiplied by
	197	+	42 (B) ninety percent (90%);
	198	+	ES 474—LS 6849/DI 77 5
	199	+	1 rounded (if not already a multiple of one dollar ($1)) to the next
	200	+	2 higher dollar.
	201	+	3 (c) The disqualifications provided in this section shall be subject to
	202	+	4 the following modifications:
	203	+	5 (1) An individual shall not be subject to disqualification because
	204	+	6 of separation from the individual's employment if:
	205	+	7 (A) the individual left to accept with another employer
	206	+	8 previously secured permanent full-time work which offered
	207	+	9 reasonable expectation of continued covered employment and
	208	+	10 betterment of wages or working conditions and thereafter was
	209	+	11 employed on said job;
	210	+	12 (B) having been simultaneously employed by two (2)
	211	+	13 employers, the individual leaves one (1) such employer
	212	+	14 voluntarily without good cause in connection with the work
	213	+	15 but remains in employment with the second employer with a
	214	+	16 reasonable expectation of continued employment; or
	215	+	17 (C) the individual left to accept recall made by a base period
	216	+	18 employer.
	217	+	19 (2) An individual whose unemployment is the result of medically
	218	+	20 substantiated physical disability and who is involuntarily
	219	+	21 unemployed after having made reasonable efforts to maintain the
	220	+	22 employment relationship shall not be subject to disqualification
	221	+	23 under this section for such separation.
	222	+	24 (3) An individual who left work to enter the armed forces of the
	223	+	25 United States shall not be subject to disqualification under this
	224	+	26 section for such leaving of work.
	225	+	27 (4) An individual whose employment is terminated under the
	226	+	28 compulsory retirement provision of a collective bargaining
	227	+	29 agreement to which the employer is a party, or under any other
	228	+	30 plan, system, or program, public or private, providing for
	229	+	31 compulsory retirement and who is otherwise eligible shall not be
	230	+	32 deemed to have left the individual's work voluntarily without
	231	+	33 good cause in connection with the work. However, if such
	232	+	34 individual subsequently becomes reemployed and thereafter
	233	+	35 voluntarily leaves work without good cause in connection with the
	234	+	36 work, the individual shall be deemed ineligible as outlined in this
	235	+	37 section.
	236	+	38 (5) An otherwise eligible individual shall not be denied benefits
	237	+	39 for any week because the individual is in training approved under
	238	+	40 Section 236(a)(1) of the Trade Act of 1974, nor shall the
	239	+	41 individual be denied benefits by reason of leaving work to enter
	240	+	42 such training, provided the work left is not suitable employment,
	241	+	ES 474—LS 6849/DI 77 6
	242	+	1 or because of the application to any week in training of provisions
	243	+	2 in this law (or any applicable federal unemployment
	244	+	3 compensation law), relating to availability for work, active search
	245	+	4 for work, or refusal to accept work. For purposes of this
	246	+	5 subdivision, the term "suitable employment" means with respect
	247	+	6 to an individual, work of a substantially equal or higher skill level
	248	+	7 than the individual's past adversely affected employment (as
	249	+	8 defined for purposes of the Trade Act of 1974), and wages for
	250	+	9 such work at not less than eighty percent (80%) of the individual's
	251	+	10 average weekly wage as determined for the purposes of the Trade
	252	+	11 Act of 1974.
	253	+	12 (6) An individual is not subject to disqualification because of
	254	+	13 separation from the individual's employment if:
	255	+	14 (A) the employment was outside the individual's labor market;
	256	+	15 (B) the individual left to accept previously secured full-time
	257	+	16 work with an employer in the individual's labor market; and
	258	+	17 (C) the individual actually became employed with the
	259	+	18 employer in the individual's labor market.
	260	+	19 (7) An individual who, but for the voluntary separation to move
	261	+	20 to another labor market to join a spouse who had moved to that
	262	+	21 labor market, shall not be disqualified for that voluntary
	263	+	22 separation, if the individual is otherwise eligible for benefits.
	264	+	23 Benefits paid to the spouse whose eligibility is established under
	265	+	24 this subdivision shall not be charged against the employer from
	266	+	25 whom the spouse voluntarily separated.
	267	+	26 (8) An individual shall not be subject to disqualification if the
	268	+	27 individual voluntarily left employment or was discharged due to
	269	+	28 circumstances directly caused by domestic or family violence (as
	270	+	29 defined in IC 31-9-2-42). An individual who may be entitled to
	271	+	30 benefits based on this modification may apply to the office of the
	272	+	31 attorney general under IC 5-26.5 to have an address designated by
	273	+	32 the office of the attorney general to serve as the individual's
	274	+	33 address for purposes of this article.
	275	+	34 (9) An individual shall not be subject to disqualification if the
	276	+	35 individual:
	277	+	36 (A) has requested an exemption from an employer's
	278	+	37 COVID-19 immunization requirement;
	279	+	38 (B) has complied with the requirements set forth in
	280	+	39 IC 22-5-4.6; and
	281	+	40 (C) was discharged from employment for failing or refusing to
	282	+	41 receive an immunization against COVID-19.
	283	+	42 As used in this subsection, "labor market" means the area surrounding
	284	+	ES 474—LS 6849/DI 77 7
	285	+	1 an individual's permanent residence, outside which the individual
	286	+	2 cannot reasonably commute on a daily basis. In determining whether
	287	+	3 an individual can reasonably commute under this subdivision, the
	288	+	4 department shall consider the nature of the individual's job.
	289	+	5 (d) "Discharge for just cause" as used in this section is defined to
	290	+	6 include but not be limited to:
	291	+	7 (1) separation initiated by an employer for falsification of an
	292	+	8 employment application to obtain employment through
	293	+	9 subterfuge;
	294	+	10 (2) knowing violation of a reasonable and uniformly enforced rule
	295	+	11 of an employer, including a rule regarding attendance;
	296	+	12 (3) if an employer does not have a rule regarding attendance, an
	297	+	13 individual's unsatisfactory attendance, if good cause for absences
	298	+	14 or tardiness is not established;
	299	+	15 (4) damaging the employer's property through willful negligence;
	300	+	16 (5) refusing to obey instructions;
	301	+	17 (6) reporting to work under the influence of alcohol or drugs or
	302	+	18 consuming alcohol or drugs on employer's premises during
	303	+	19 working hours;
	304	+	20 (7) conduct endangering safety of self or coworkers;
	305	+	21 (8) incarceration in jail following conviction of a misdemeanor or
	306	+	22 felony by a court of competent jurisdiction; or
	307	+	23 (9) any breach of duty in connection with work which is
	308	+	24 reasonably owed an employer by an employee. or
	309	+	25 (10) testing positive on a drug test under IC 16-27-2.5.
	310	+	26 (e) To verify that domestic or family violence has occurred, an
	311	+	27 individual who applies for benefits under subsection (c)(8) shall
	312	+	28 provide one (1) of the following:
	313	+	29 (1) A report of a law enforcement agency (as defined in
	314	+	30 IC 10-13-3-10).
	315	+	31 (2) A protection order issued under IC 34-26-5.
	316	+	32 (3) A foreign protection order (as defined in IC 34-6-2-48.5).
	317	+	33 (4) An affidavit from a domestic violence service provider
	318	+	34 verifying services provided to the individual by the domestic
	319	+	35 violence service provider.
	320	+	36 SECTION 9. IC 34-30-2.1-207 IS REPEALED [EFFECTIVE JULY
	321	+	37 1, 2023]. Sec. 207. IC 16-27-2.5-5 (Concerning drug testing of home
	322	+	38 health employees by home health agencies).
	323	+	ES 474—LS 6849/DI 77 8
	324	+	COMMITTEE REPORT
	325	+	Madam President: The Senate Committee on Health and Provider
	326	+	Services, to which was referred Senate Bill No. 474, has had the same
	327	+	under consideration and begs leave to report the same back to the
	328	+	Senate with the recommendation that said bill be AMENDED as
	329	+	follows:
	330	+	Page 1, between lines 6 and 7, begin a new paragraph and insert:
	331	+	"SECTION 2. IC 16-27-1-7.5 IS ADDED TO THE INDIANA
	332	+	CODE AS A NEW SECTION TO READ AS FOLLOWS
	333	+	[EFFECTIVE JULY 1, 2023]: Sec. 7.5. The state health
	334	+	commissioner may waive a rule adopted under this chapter if the
	335	+	state health commissioner determines that the person requesting
	336	+	the waiver has:
25	337		(1) shown good cause; and
26	338		(2) affirmatively demonstrated that the requested waiver of a
27	339		rule will not adversely affect or increase any risk to the
28	340		health, safety, or welfare of existing or potential patients or
29		-	residents.
30		-	SECTION 3. IC 16-27-1-18 IS ADDED TO THE INDIANA CODE
31		-	AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
32		-	1, 2023]: Sec. 18. (a) A home health agency may provide services in
33		-	any county in Indiana.
34		-	(b) The state department may adopt rules under IC 4-22-2 to
35		-	provide appropriate oversight and supervision of the services a
36		-	SEA 474 2
37		-	home health agency provides in noncontiguous counties.
38		-	SECTION 4. IC 16-27-1-19 IS ADDED TO THE INDIANA CODE
39		-	AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
40		-	1, 2023]: Sec. 19. A home health agency is not required to conduct
41		-	a preemployment physical on a job applicant before the individual
42		-	has contact with a home health agency patient.
43		-	SECTION 5. IC 16-27-1-20 IS ADDED TO THE INDIANA CODE
	341	+	residents.".
	342	+	Page 2, delete lines 2 through 10, begin a new paragraph and insert:
	343	+	"SECTION 5. IC 16-27-1-20 IS ADDED TO THE INDIANA CODE
44	344		AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
45	345		1, 2023]: Sec. 20. Notwithstanding any other law or administrative
46	346		rule, a home health agency may satisfy the requirements of
47	347		supervising home health aide services by complying with 42 CFR
48	348		484.80(h) et seq.
49	349		SECTION 6. IC 16-27-1.5-6 IS ADDED TO THE INDIANA CODE
50	350		AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
51	351		1, 2023]: Sec. 6. (a) A registered home health aide may administer
52	352		gastrointestinal and jejunostomy tube feedings to a specific patient
53	353		only if the following conditions are met:
54	354		(1) The registered home health aide has completed the
55	355		training curriculum described in subsection (b).
56	356		(2) A registered nurse, providing registered nursing under
57	357		IC 25-23-1-1.1(b)(6), either:
58	358		(A) supervises the registered home health aide in
59	359		administering the gastrointestinal and jejunostomy tube
60	360		feedings; or
61	361		(B) delegates responsibility for administering the
62	362		gastrointestinal and jejunostomy tube feedings to the
63	363		registered home health aide based on the registered nurse's
64	364		assessment of the registered home health aide's
65	365		competency to administer gastrointestinal and jejunostomy
	366	+	ES 474—LS 6849/DI 77 9
66	367		tube feedings.
67	368		(3) The home health agency that the registered home health
68	369		aide is employed with:
69	370		(A) allows the registered home health aide to administer
70	371		gastrointestinal and jejunostomy tube feedings;
71	372		(B) establishes a procedure for:
72	373		(i) the delegation of the administration of gastrointestinal
73	374		and jejunostomy tube feedings from a registered nurse
74	375		to a registered home health aide that includes patient
75	376		specific clinical parameters based on the registered
76	377		nurse's assessment of the patient and the registered
77	378		home health aide's competency to administer the
78	379		gastrointestinal and jejunostomy tube feedings; and
79		-	SEA 474 3
80	380		(ii) the assessment by the registered nurse of the patient
81	381		specific clinical parameters;
82	382		(C) retains documentation that the registered home health
83	383		aide has completed the training curriculum described in
84	384		subsection (b); and
85	385		(D) notifies each patient requiring gastrointestinal and
86	386		jejunostomy tube feedings upon admission that the home
87	387		health aide agency may allow registered home health aides
88	388		to administer gastrointestinal and jejunostomy tube
89	389		feedings.
90	390		(b) Training curriculum for home health aides to administer
91	391		gastrointestinal and jejunostomy tube feedings must:
92	392		(1) be approved by the state department; and
93	393		(2) include the following concerning the administration of
94	394		gastrointestinal and jejunostomy tube feedings:
95	395		(A) At least four (4) hours and not more than eight (8)
96	396		hours of classroom training.
97	397		(B) At least two (2) hours and not more than four (4) hours
98	398		of practical training.
99	399		(C) A written and practical examination administered by
100	400		the trainer.
101	401		(c) A registered home health aide may not administer
102	402		gastrointestinal and jejunostomy tube feedings until the home
103	403		health aide has successfully:
104	404		(1) completed the curriculum described in subsection (b); and
105	405		(2) passed the examinations described in subsection (b)(2)(C).
106	406		(d) The state department may require a registered home health
107	407		aide who administers gastrointestinal and jejunostomy tube
108	408		feedings under this section to annually complete not more than one
	409	+	ES 474—LS 6849/DI 77 10
109	410		(1) hour of in service training specific to the administration of
110	411		gastrointestinal and jejunostomy tube feedings.
111	412		(e) Before January 1, 2024, the state department must approve
112		-	at least one (1) training curriculum described in subsection (b).
113		-	SECTION 7. IC 16-27-2.5 IS REPEALED [EFFECTIVE JULY 1,
114		-	2023]. (Drug Testing of Employees).
115		-	SECTION 8. IC 22-4-15-1, AS AMENDED BY P.L.1-2022,
116		-	SECTION 8, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
117		-	JULY 1, 2023]: Sec. 1. (a) Regarding an individual's most recent
118		-	separation from employment before filing an initial or additional claim
119		-	for benefits, an individual who voluntarily left the employment without
120		-	good cause in connection with the work or was discharged from the
121		-	employment for just cause is ineligible for waiting period or benefit
122		-	SEA 474 4
123		-	rights for the week in which the disqualifying separation occurred and
124		-	until:
125		-	(1) the individual has earned remuneration in employment in at
126		-	least eight (8) weeks; and
127		-	(2) the remuneration earned equals or exceeds the product of the
128		-	weekly benefit amount multiplied by eight (8).
129		-	If the qualification amount has not been earned at the expiration of an
130		-	individual's benefit period, the unearned amount shall be carried
131		-	forward to an extended benefit period or to the benefit period of a
132		-	subsequent claim.
133		-	(b) When it has been determined that an individual has been
134		-	separated from employment under disqualifying conditions as outlined
135		-	in this section, the maximum benefit amount of the individual's current
136		-	claim, as initially determined, shall be reduced by an amount
137		-	determined as follows:
138		-	(1) For the first separation from employment under disqualifying
139		-	conditions, the maximum benefit amount of the individual's
140		-	current claim is equal to the result of:
141		-	(A) the maximum benefit amount of the individual's current
142		-	claim, as initially determined; multiplied by
143		-	(B) seventy-five percent (75%);
144		-	rounded (if not already a multiple of one dollar ($1)) to the next
145		-	higher dollar.
146		-	(2) For the second separation from employment under
147		-	disqualifying conditions, the maximum benefit amount of the
148		-	individual's current claim is equal to the result of:
149		-	(A) the maximum benefit amount of the individual's current
150		-	claim determined under subdivision (1); multiplied by
151		-	(B) eighty-five percent (85%);
152		-	rounded (if not already a multiple of one dollar ($1)) to the next
153		-	higher dollar.
154		-	(3) For the third and any subsequent separation from employment
155		-	under disqualifying conditions, the maximum benefit amount of
156		-	the individual's current claim is equal to the result of:
157		-	(A) the maximum benefit amount of the individual's current
158		-	claim determined under subdivision (2); multiplied by
159		-	(B) ninety percent (90%);
160		-	rounded (if not already a multiple of one dollar ($1)) to the next
161		-	higher dollar.
162		-	(c) The disqualifications provided in this section shall be subject to
163		-	the following modifications:
164		-	(1) An individual shall not be subject to disqualification because
165		-	SEA 474 5
166		-	of separation from the individual's employment if:
167		-	(A) the individual left to accept with another employer
168		-	previously secured permanent full-time work which offered
169		-	reasonable expectation of continued covered employment and
170		-	betterment of wages or working conditions and thereafter was
171		-	employed on said job;
172		-	(B) having been simultaneously employed by two (2)
173		-	employers, the individual leaves one (1) such employer
174		-	voluntarily without good cause in connection with the work
175		-	but remains in employment with the second employer with a
176		-	reasonable expectation of continued employment; or
177		-	(C) the individual left to accept recall made by a base period
178		-	employer.
179		-	(2) An individual whose unemployment is the result of medically
180		-	substantiated physical disability and who is involuntarily
181		-	unemployed after having made reasonable efforts to maintain the
182		-	employment relationship shall not be subject to disqualification
183		-	under this section for such separation.
184		-	(3) An individual who left work to enter the armed forces of the
185		-	United States shall not be subject to disqualification under this
186		-	section for such leaving of work.
187		-	(4) An individual whose employment is terminated under the
188		-	compulsory retirement provision of a collective bargaining
189		-	agreement to which the employer is a party, or under any other
190		-	plan, system, or program, public or private, providing for
191		-	compulsory retirement and who is otherwise eligible shall not be
192		-	deemed to have left the individual's work voluntarily without
193		-	good cause in connection with the work. However, if such
194		-	individual subsequently becomes reemployed and thereafter
195		-	voluntarily leaves work without good cause in connection with the
196		-	work, the individual shall be deemed ineligible as outlined in this
197		-	section.
198		-	(5) An otherwise eligible individual shall not be denied benefits
199		-	for any week because the individual is in training approved under
200		-	Section 236(a)(1) of the Trade Act of 1974, nor shall the
201		-	individual be denied benefits by reason of leaving work to enter
202		-	such training, provided the work left is not suitable employment,
203		-	or because of the application to any week in training of provisions
204		-	in this law (or any applicable federal unemployment
205		-	compensation law), relating to availability for work, active search
206		-	for work, or refusal to accept work. For purposes of this
207		-	subdivision, the term "suitable employment" means with respect
208		-	SEA 474 6
209		-	to an individual, work of a substantially equal or higher skill level
210		-	than the individual's past adversely affected employment (as
211		-	defined for purposes of the Trade Act of 1974), and wages for
212		-	such work at not less than eighty percent (80%) of the individual's
213		-	average weekly wage as determined for the purposes of the Trade
214		-	Act of 1974.
215		-	(6) An individual is not subject to disqualification because of
216		-	separation from the individual's employment if:
217		-	(A) the employment was outside the individual's labor market;
218		-	(B) the individual left to accept previously secured full-time
219		-	work with an employer in the individual's labor market; and
220		-	(C) the individual actually became employed with the
221		-	employer in the individual's labor market.
222		-	(7) An individual who, but for the voluntary separation to move
223		-	to another labor market to join a spouse who had moved to that
224		-	labor market, shall not be disqualified for that voluntary
225		-	separation, if the individual is otherwise eligible for benefits.
226		-	Benefits paid to the spouse whose eligibility is established under
227		-	this subdivision shall not be charged against the employer from
228		-	whom the spouse voluntarily separated.
229		-	(8) An individual shall not be subject to disqualification if the
230		-	individual voluntarily left employment or was discharged due to
231		-	circumstances directly caused by domestic or family violence (as
232		-	defined in IC 31-9-2-42). An individual who may be entitled to
233		-	benefits based on this modification may apply to the office of the
234		-	attorney general under IC 5-26.5 to have an address designated by
235		-	the office of the attorney general to serve as the individual's
236		-	address for purposes of this article.
237		-	(9) An individual shall not be subject to disqualification if the
238		-	individual:
239		-	(A) has requested an exemption from an employer's
240		-	COVID-19 immunization requirement;
241		-	(B) has complied with the requirements set forth in
242		-	IC 22-5-4.6; and
243		-	(C) was discharged from employment for failing or refusing to
244		-	receive an immunization against COVID-19.
245		-	As used in this subsection, "labor market" means the area surrounding
246		-	an individual's permanent residence, outside which the individual
247		-	cannot reasonably commute on a daily basis. In determining whether
248		-	an individual can reasonably commute under this subdivision, the
249		-	department shall consider the nature of the individual's job.
250		-	(d) "Discharge for just cause" as used in this section is defined to
251		-	SEA 474 7
252		-	include but not be limited to:
253		-	(1) separation initiated by an employer for falsification of an
254		-	employment application to obtain employment through
255		-	subterfuge;
256		-	(2) knowing violation of a reasonable and uniformly enforced rule
257		-	of an employer, including a rule regarding attendance;
258		-	(3) if an employer does not have a rule regarding attendance, an
259		-	individual's unsatisfactory attendance, if good cause for absences
260		-	or tardiness is not established;
261		-	(4) damaging the employer's property through willful negligence;
262		-	(5) refusing to obey instructions;
263		-	(6) reporting to work under the influence of alcohol or drugs or
264		-	consuming alcohol or drugs on employer's premises during
265		-	working hours;
266		-	(7) conduct endangering safety of self or coworkers;
267		-	(8) incarceration in jail following conviction of a misdemeanor or
268		-	felony by a court of competent jurisdiction; or
269		-	(9) any breach of duty in connection with work which is
270		-	reasonably owed an employer by an employee. or
271		-	(10) testing positive on a drug test under IC 16-27-2.5.
272		-	(e) To verify that domestic or family violence has occurred, an
273		-	individual who applies for benefits under subsection (c)(8) shall
274		-	provide one (1) of the following:
275		-	(1) A report of a law enforcement agency (as defined in
276		-	IC 10-13-3-10).
277		-	(2) A protection order issued under IC 34-26-5.
278		-	(3) A foreign protection order (as defined in IC 34-6-2-48.5).
279		-	(4) An affidavit from a domestic violence service provider
280		-	verifying services provided to the individual by the domestic
281		-	violence service provider.
282		-	SECTION 9. IC 34-30-2.1-207 IS REPEALED [EFFECTIVE JULY
283		-	1, 2023]. Sec. 207. IC 16-27-2.5-5 (Concerning drug testing of home
284		-	health employees by home health agencies).
285		-	SEA 474 President of the Senate
286		-	President Pro Tempore
287		-	Speaker of the House of Representatives
288		-	Governor of the State of Indiana
289		-	Date: Time:
290		-	SEA 474
	413	+	at least one (1) training curriculum described in subsection (b).".
	414	+	Renumber all SECTIONS consecutively.
	415	+	and when so amended that said bill do pass.
	416	+	(Reference is to SB 474 as introduced.)
	417	+	CHARBONNEAU, Chairperson
	418	+	Committee Vote: Yeas 12, Nays 0.
	419	+	_____
	420	+	COMMITTEE REPORT
	421	+	Mr. Speaker: Your Committee on Public Health, to which was
	422	+	referred Senate Bill 474, has had the same under consideration and
	423	+	begs leave to report the same back to the House with the
	424	+	recommendation that said bill do pass.
	425	+	(Reference is to SB 474 as printed February 3, 2023.)
	426	+	BARRETT
	427	+	Committee Vote: Yeas 10, Nays 0
	428	+	ES 474—LS 6849/DI 77