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 6727 NOTE PREPARED: Jan 4, 2024 BILL NUMBER: HB 1213 BILL AMENDED: SUBJECT: Statewide Stroke Plan. FIRST AUTHOR: Rep. Zent BILL STATUS: As Introduced FIRST SPONSOR: FUNDS AFFECTED: GENERAL IMPACT: State & Local XDEDICATED FEDERAL Summary of Legislation: This bill requires the Indiana Department of Health (IDOH) to establish and implement a statewide stroke plan. It sets forth requirements of the plan and requirements for certain health care providers to report stroke data. It requires the IDOH to establish a data base for the reported data and sets forth additional requirements. It also requires the IDOH to annually report certain stroke data to the Governor and the executive director of the Legislative Services Agency. Effective Date: July 1, 2024. Explanation of State Expenditures: Summary: The Indiana Department of Health (IDOH) currently does not have a stroke-focused data base. Developing a new data base is estimated to cost between $300,000 and $750,000 in initial costs, with ongoing annual estimated costs of $30,000 to $75,000 plus licensing fees. Cost for a new data base vary based on multiple factors, including but not limited to: the amount of data to be collected, authenticating mechanisms, data security measures, and software licensing. Any costs associated with the stroke data base could be mitigated to the extent that the IDOH is able to utilize existing agency or statewide tools or resources to meet the requirements for the data base. Also, the IDOH will experience an increase in workload to establish and implement the statewide stroke plan, as well as establish guidelines and submit an annual report, as required by the bill. The bill’s requirements represent an additional workload [and/or expenditure] on the IDOH outside of the agency’s routine administrative functions, and existing staffing and resource levels, if currently being used to capacity, may be insufficient for full implementation. The additional funds and resources required could be supplied through existing staff and resources currently being used in another program or with new HB 1213 1 appropriations. Ultimately, the source of funds and resources required to satisfy the requirements of this bill will depend on legislative and administrative actions. [The IDOH’s administrative expenditures are currently paid from the Tobacco Master Settlement Fund, a dedicated fund.] Additional Information: The IDOH must establish and implement a statewide stroke plan for the purpose of achieving continuous quality improvements in stroke response and treatment in the state. The plan requires: coordination with national organizations, the use of nationally recognized data platforms, as well as the development and maintenance of a statewide stroke data base to compile information and statistics on stroke care in the state. Implementing the statewide stroke plan includes establishing a data oversight process, conducting analyses of data reported to the stroke data base, and making recommendations to improve stroke care. The IDOH must also establish guidelines for health care providers regarding follow up care for stroke patients and submit an annual report to the Governor and the Legislative Services Agency and post the report on the IDOH website. Explanation of State Revenues: Explanation of Local Expenditures: Hospitals that are certified as either a comprehensive stroke center, a thrombectomy-capable stroke center, or a primary stroke center will have an increase in workload to report data to the IDOH regarding stroke cases and stroke treatment. Starting in July 2018, per IC 16-31-2-9.5, the IDOH is responsible for compiling and maintaining a list of certified stroke centers and hospitals, as well as stroke network participating hospitals in Indiana. Explanation of Local Revenues: State Agencies Affected: Indiana Department of Health. Local Agencies Affected: Locally owned hospitals that are certified as either a comprehensive stroke center, a thrombectomy-capable stroke center, or a primary stroke center. Information Sources: Graig Lubsen, Indiana Office of Technology; State staffing tables, December 2023; https://www.in.gov/health/trauma-system/indiana-stroke-centers. Fiscal Analyst: Jason Barrett, 317-232-9809. HB 1213 2