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 6698 NOTE PREPARED: Jan 25, 2024
BILL NUMBER: SB 272 BILL AMENDED:
SUBJECT: School Based Health Centers and Student Health.
FIRST AUTHOR: Sen. Zay BILL STATUS: CR Adopted - 1
st
House
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State & Local
XDEDICATED
XFEDERAL
Summary of Legislation: This bill requires a school corporation to provide certain health services to
students. It allows a school corporation to contract with a health care provider, health system, or community
partner to establish a school based health center (SBHC). It sets forth requirements to establish a SBHC.
This bill requires the Office of the Secretary of Family and Social Services to apply to the United States
Department of Health and Human Services for a state plan amendment to allow school corporations and
SBHCs to seek Medicaid reimbursement for certain covered services. It requires the Indiana Department of
Health to develop first aid guidelines for school emergencies that include certain information. It also provides
that the governing body of a school corporation may not conduct a certain vision test or hearing test on a
student without the prior written consent from the student's parent or guardian.
Effective Date: July 1, 2024.
Explanation of State Expenditures: This bill requires that:
•The Indiana Department of Health (IDOH) develop and publish on its website first aid guidelines
for school emergencies;
•The Office of Medicaid Policy and Planning (OMPP) submit, by December 1, 2024 a state plan
amendment to allow school corporations and school based health centers (SBHC)s to seek Medicaid
reimbursement for certain covered services (current law allows, but does not require, OMPP to
submit the state plan amendment); and
•The Indiana Department of Education post the IDOH’s first aid guidelines on its website.
SB 272 1 These requirements are within the routine administrative functions of each agency and should be able to be
implemented with no additional appropriations, assuming near customary agency staffing and resource levels.
[Administrative expenses of the IDOH are paid from the Tobacco Master Settlement Fund, a dedicated
fund.]
Additional Information: With federal approval of the state plan amendment required under this bill, more
Medicaid eligible students may have access to care more frequently. This may, in some cases, reduce overall
costs to the extent that conditions are found earlier in the disease process or that children adhere to treatment
regimes. Additionally, the Centers for Medicare and Medicaid Services reports that SBHCs allow more
students to become aware of programs and may increase enrollment in Medicaid or the Children's Health
Insurance Program. To the extent that schools provide the state share of Medicaid costs and receive the
federal reimbursement, even with service or enrollment expansion, the bill may not increase state costs.
Explanation of State Revenues:
Explanation of Local Expenditures: School Nurses: The bill requires school corporations to hire at least
one school nurse that has a Bachelor of Science in Nursing (unless the current school nurse has been
continuously employed by the school since prior to June 30, 2000). This is already a requirement of school
corporations under 511 IAC 4-1.5-6. The 2022 Indiana Governor’s Public Health Commission Report states
that, while there is no formal data collection on the number of school nurses hired by school corporations,
it is known that not all school corporations meet the recommended standard in 511 IAC 4-1.5-2 of one RN
for every 750 students. To the extent, if any, school corporations hire additional nurses under the bill, school
corporation expenditures would increase.
Parental Consent: The bill specifies that school corporations must get parental consent before conducting
a vision or hearing test, resulting in a minor workload increase that can be implemented with existing school
staff and resources.
Explanation of Local Revenues:
State Agencies Affected: Indiana Department of Health; Office of Medicaid Policy and Planning, Family
and Social Services Administration; Department of Education.
Local Agencies Affected: School corporations.
Information Sources: https://www.in.gov/health/files/GPHC-Report-FINAL-2022-08-01.pdf.
Fiscal Analyst: Jason Barrett, 317-232-9809.
SB 272 2