*SB0045.1* January 26, 2024 SENATE BILL No. 45 _____ DIGEST OF SB 45 (Updated January 24, 2024 12:34 pm - DI 104) Citations Affected: IC 25-23. Synopsis: Trauma informed care. Requires the Indiana state board of nursing to study whether trauma informed care should be included as part of the required curriculum for nursing education programs. Requires an individual who holds an active license as a nurse and has direct patient contact to complete a trauma informed care training program within a specified time. Requires the employer of an employee who is required to obtain the training to maintain a record of the completion of the training in the employee's employment records. States that receiving the training as part of curriculum at a nursing education program satisfies the training requirement. Effective: July 1, 2024. Crider, Charbonneau January 8, 2024, read first time and referred to Committee on Health and Provider Services. January 25, 2024, amended, reported favorably — Do Pass; reassigned to Committee on Appropriations. SB 45—LS 6277/DI 147 January 26, 2024 Second Regular Session of the 123rd General Assembly (2024) 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 2023 Regular Session of the General Assembly. SENATE BILL No. 45 A BILL FOR AN ACT to amend the Indiana Code concerning professions and occupations. Be it enacted by the General Assembly of the State of Indiana: 1 SECTION 1. IC 25-23-1-1.7 IS ADDED TO THE INDIANA CODE 2 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 3 1, 2024]: Sec. 1.7. As used in this chapter, "trauma informed care" 4 refers to an approach used to provide health care to a patient that 5 acknowledges the effects of trauma and adversity on the patient. 6 SECTION 2. IC 25-23-1-7, AS AMENDED BY P.L.69-2022, 7 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE 8 JULY 1, 2024]: Sec. 7. (a) The board shall do the following: 9 (1) Adopt under IC 4-22-2 rules necessary to enable it to carry 10 into effect this chapter. 11 (2) Prescribe standards and approve curricula for nursing 12 education programs preparing persons for licensure under this 13 chapter. 14 (3) Provide for surveys of such programs at such times as it 15 considers necessary. 16 (4) Accredit such programs as meet the requirements of this 17 chapter and of the board. SB 45—LS 6277/DI 147 2 1 (5) Deny or withdraw accreditation from nursing education 2 programs for failure to meet prescribed curricula or other 3 standards. 4 (6) Examine, license, and renew the license of qualified 5 applicants. 6 (7) Issue subpoenas, compel the attendance of witnesses, and 7 administer oaths to persons giving testimony at hearings. 8 (8) Cause the prosecution of all persons violating this chapter and 9 have power to incur necessary expenses for these prosecutions. 10 (9) Adopt rules under IC 4-22-2 that do the following: 11 (A) Prescribe standards for the competent practice of 12 registered, practical, and advanced practice registered nursing. 13 (B) Establish with the approval of the medical licensing board 14 created by IC 25-22.5-2-1 requirements that advanced practice 15 registered nurses must meet to be granted authority to 16 prescribe legend drugs and to retain that authority. 17 (C) Establish, with the approval of the medical licensing board 18 created by IC 25-22.5-2-1, requirements for the renewal of a 19 practice agreement under section 19.4 of this chapter, which 20 shall expire on October 31 in each odd-numbered year. 21 (10) Keep a record of all its proceedings. 22 (11) Collect and distribute annually demographic information on 23 the number and type of registered nurses and licensed practical 24 nurses employed in Indiana. 25 (12) Adopt rules and administer the interstate nurse licensure 26 compact under IC 25-42. 27 (13) Adopt or amend rules to implement the nursing licensure by 28 endorsement available for foreign nursing school graduates under 29 sections 11 and 12 of this chapter. 30 (b) The board may do the following: 31 (1) Create ad hoc subcommittees representing the various nursing 32 specialties and interests of the profession of nursing. Persons 33 appointed to a subcommittee serve for terms as determined by the 34 board. 35 (2) Utilize the appropriate subcommittees so as to assist the board 36 with its responsibilities. The assistance provided by the 37 subcommittees may include the following: 38 (A) Recommendation of rules necessary to carry out the duties 39 of the board. 40 (B) Recommendations concerning educational programs and 41 requirements. 42 (C) Recommendations regarding examinations and licensure SB 45—LS 6277/DI 147 3 1 of applicants. 2 (3) Appoint nurses to serve on each of the ad hoc subcommittees. 3 (c) Nurses appointed under subsection (b) must: 4 (1) be committed to advancing and safeguarding the nursing 5 profession as a whole; and 6 (2) represent nurses who practice in the field directly affected by 7 a subcommittee's actions. 8 (d) The board shall study whether trauma informed care 9 training described in section 36 of this chapter should be included 10 as part of the required curriculum for nursing education 11 programs. 12 SECTION 3. IC 25-23-1-36 IS ADDED TO THE INDIANA CODE 13 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 14 1, 2024]: Sec. 36. (a) An individual who holds an active license 15 under this article and has direct contact with patients shall 16 complete a trauma informed care training program that meets one 17 (1) of the following: 18 (1) The trauma informed care training program provides a 19 foundational trauma informed care curriculum that includes 20 information on: 21 (A) the definition of trauma informed care; 22 (B) the prevalence and impact of trauma; 23 (C) trauma informed care as a universal precaution; 24 (D) the five (5) principles of trauma informed care; 25 (E) the difference between trauma informed treatment and 26 trauma specific treatment; 27 (F) practical strategies for adopting and integrating 28 trauma informed care into practice; and 29 (G) trauma informed care as a strategy to promote 30 resilience and prevent secondary traumatic stress in 31 nurses. 32 (2) The trauma informed care training program: 33 (A) is substantially equivalent to the curriculum described 34 in subdivision (1), as determined by the board; and 35 (B) has been approved by the board. 36 (b) The employer of an employee required to complete training 37 under this section shall maintain a record of the completion of the 38 training in the individual's employment records. 39 (c) An individual who meets the requirements under this section 40 to complete trauma informed care training under this section shall 41 complete the training not later than five (5) years from the date the 42 individual meets the requirements for the training. SB 45—LS 6277/DI 147 4 1 (d) An individual who completes trauma informed care training 2 within a nursing education program satisfies the requirements of 3 this section. SB 45—LS 6277/DI 147 5 COMMITTEE REPORT Madam President: The Senate Committee on Health and Provider Services, to which was referred Senate Bill No. 45, 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, between lines 5 and 6, begin a new paragraph and insert: "SECTION 2. IC 25-23-1-7, AS AMENDED BY P.L.69-2022, SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 7. (a) The board shall do the following: (1) Adopt under IC 4-22-2 rules necessary to enable it to carry into effect this chapter. (2) Prescribe standards and approve curricula for nursing education programs preparing persons for licensure under this chapter. (3) Provide for surveys of such programs at such times as it considers necessary. (4) Accredit such programs as meet the requirements of this chapter and of the board. (5) Deny or withdraw accreditation from nursing education programs for failure to meet prescribed curricula or other standards. (6) Examine, license, and renew the license of qualified applicants. (7) Issue subpoenas, compel the attendance of witnesses, and administer oaths to persons giving testimony at hearings. (8) Cause the prosecution of all persons violating this chapter and have power to incur necessary expenses for these prosecutions. (9) Adopt rules under IC 4-22-2 that do the following: (A) Prescribe standards for the competent practice of registered, practical, and advanced practice registered nursing. (B) Establish with the approval of the medical licensing board created by IC 25-22.5-2-1 requirements that advanced practice registered nurses must meet to be granted authority to prescribe legend drugs and to retain that authority. (C) Establish, with the approval of the medical licensing board created by IC 25-22.5-2-1, requirements for the renewal of a practice agreement under section 19.4 of this chapter, which shall expire on October 31 in each odd-numbered year. (10) Keep a record of all its proceedings. (11) Collect and distribute annually demographic information on SB 45—LS 6277/DI 147 6 the number and type of registered nurses and licensed practical nurses employed in Indiana. (12) Adopt rules and administer the interstate nurse licensure compact under IC 25-42. (13) Adopt or amend rules to implement the nursing licensure by endorsement available for foreign nursing school graduates under sections 11 and 12 of this chapter. (b) The board may do the following: (1) Create ad hoc subcommittees representing the various nursing specialties and interests of the profession of nursing. Persons appointed to a subcommittee serve for terms as determined by the board. (2) Utilize the appropriate subcommittees so as to assist the board with its responsibilities. The assistance provided by the subcommittees may include the following: (A) Recommendation of rules necessary to carry out the duties of the board. (B) Recommendations concerning educational programs and requirements. (C) Recommendations regarding examinations and licensure of applicants. (3) Appoint nurses to serve on each of the ad hoc subcommittees. (c) Nurses appointed under subsection (b) must: (1) be committed to advancing and safeguarding the nursing profession as a whole; and (2) represent nurses who practice in the field directly affected by a subcommittee's actions. (d) The board shall study whether trauma informed care training described in section 36 of this chapter should be included as part of the required curriculum for nursing education programs.". Page 1, line 8, delete "At least once every two (2) years, an" and insert "An". Page 1, line 9, after "article" insert "and has direct contact with patients". Page 2, delete lines 13 through 15, begin a new paragraph and insert: "(b) The employer of an employee required to complete training under this section shall maintain a record of the completion of the training in the individual's employment records. (c) An individual who meets the requirements under this section to complete trauma informed care training under this section shall SB 45—LS 6277/DI 147 7 complete the training not later than five (5) years from the date the individual meets the requirements for the training. (d) An individual who completes trauma informed care training within a nursing education program satisfies the requirements of this section.". Renumber all SECTIONS consecutively. and when so amended that said bill do pass and be reassigned to the Senate Committee on Appropriations. (Reference is to SB 45 as introduced.) CHARBONNEAU, Chairperson Committee Vote: Yeas 10, Nays 0. SB 45—LS 6277/DI 147