Indiana 2024 Regular Session

Indiana Senate Bill SB0272 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	~~SB0272.1~~
2		-	~~January 26, 2024~~
	1	+
	2	+	Introduced Version
3	3		SENATE BILL No. 272
4	4		_____
5		-	DIGEST OF SB 272 (Updated January 24, 2024 3:34 pm - DI 55)
6		-	Citations Affected: IC 12-7; IC 12-15; IC 16-19; IC 20-19; IC 20-26;
7		-	IC 20-34.
8		-	Synopsis: School based health centers and student health. Authorizes
9		-	a school corporation to contract with a health care provider, a health
10		-	system, or community partner to establish a school based health center
11		-	for the purpose of providing primary health services to students.
12		-	Requires that a school based health center be a legal entity separate
13		-	from the school corporation, that student participation in the services
14		-	provided by the school based health center be voluntary, and that health
15		-	records be maintained by a school based health center in compliance
16		-	with federal confidentiality requirements. Requires each school
17		-	corporation to employ at least one registered nurse who holds a
18		-	bachelor of science degree in nursing to coordinate health services in
19		-	the school corporation. Requires the office of the secretary of family
20		-	and social services to apply to the United States Department of Health
21		-	and Human Services for a state plan amendment to allow school based
22		-	health centers to seek Medicaid reimbursement for health services
23		-	provided by school based health centers. Requires the state department
24		-	of health to develop first aid guidelines for school emergencies.
25		-	Requires the state department of education to publish those first aid
26		-	guidelines for school emergencies on its Internet website. Prohibits a
27		-	school corporation from conducting a vision test or an audiometer test
28		-	on a student without the prior written consent of the student's parent or
29		-	guardian.
	5	+	DIGEST OF INTRODUCED BILL
	6	+	Citations Affected: IC 12-7-2-170.2; IC 12-15-1-16; IC 16-19-3-32.7;
	7	+	IC 20-19-3-11.9; IC 20-26-22.5; IC 20-34-3.
	8	+	Synopsis: School based health centers and student health. Requires a
	9	+	school corporation to provide certain health services to students.
	10	+	Allows a school corporation to contract with a health care provider,
	11	+	health system, or community partner to establish a school based health
	12	+	center (center). Sets forth requirements to establish a center. Requires
	13	+	the office of the secretary of family and social services to apply to the
	14	+	United States Department of Health and Human Services for a state
	15	+	plan amendment to allow school corporations and centers to seek
	16	+	Medicaid reimbursement for certain covered services. Requires the
	17	+	Indiana department of health to develop first aid guidelines for school
	18	+	emergencies that include certain information. Provides that the
	19	+	governing body of a school corporation may not conduct a certain
	20	+	vision test or hearing test on a student without the prior written consent
	21	+	from the student's parent or guardian.
30	22		Effective: July 1, 2024.
31		-	Zay~~, Crider~~
	23	+	Zay
32	24		January 16, 2024, read first time and referred to Committee on Insurance and Financial
33	25		Institutions.
34		-	January 25, 2024, reported favorably — Do Pass; reassigned to Committee on
35		-	Appropriations.
36		-	SB 272—LS 6698/DI 152 January 26, 2024
	26	+	2024 IN 272—LS 6698/DI 152 Introduced
37	27		Second Regular Session of the 123rd General Assembly (2024)
38	28		PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
39	29		Constitution) is being amended, the text of the existing provision will appear in this style type,
40	30		additions will appear in this style type, and deletions will appear in this style type.
41	31		Additions: Whenever a new statutory provision is being enacted (or a new constitutional
42	32		provision adopted), the text of the new provision will appear in this style type. Also, the
43	33		word NEW will appear in that style type in the introductory clause of each SECTION that adds
44	34		a new provision to the Indiana Code or the Indiana Constitution.
45	35		Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
46	36		between statutes enacted by the 2023 Regular Session of the General Assembly.
47	37		SENATE BILL No. 272
48	38		A BILL FOR AN ACT to amend the Indiana Code concerning
49	39		education.
50	40		Be it enacted by the General Assembly of the State of Indiana:
51	41		1 SECTION 1. IC 12-7-2-170.2 IS ADDED TO THE INDIANA
52	42		2 CODE AS A NEW SECTION TO READ AS FOLLOWS
53	43		3 [EFFECTIVE JULY 1, 2024]: Sec. 170.2. "School based health
54	44		4 center", for purposes of IC 12-15-1-16, means a health clinic that:
55	45		5 (1) is located in or near a school or school facility of a school
56	46		6 corporation;
57	47		7 (2) is organized or promoted through school, community, or
58	48		8 health care provider relationships;
59	49		9 (3) provides primary health services to children by health
60	50		10 care providers, in accordance with state and federal law; and
61	51		11 (4) meets any other requirements necessary for the operation
62	52		12 of a school based health center.
63	53		13 SECTION 2. IC 12-15-1-16, AS AMENDED BY P.L.35-2022,
64	54		14 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
65	55		15 JULY 1, 2024]: Sec. 16. (a) Each:
66	56		16 (1) school corporation, including a school based health center;
67	57		17 or
68		-	SB 272—LS 6698/DI 152 2
	58	+	2024 IN 272—LS 6698/DI 152 2
69	59		1 (2) school corporation's employed, licensed, or qualified provider;
70	60		2 must enroll in a program to use federal funds under the Medicaid
71	61		3 program (IC 12-15-1 et seq.) with the intent to share the costs of
72	62		4 services that are reimbursable under the Medicaid program and that are
73	63		5 provided to eligible children by the school corporation or school based
74	64		6 health center. However, a school corporation or a school corporation's
75	65		7 employed, licensed, or qualified provider is not required to file any
76	66		8 claims or participate in the program developed under this section.
77	67		9 (b) The secretary and the department of education may develop
78	68		10 policies and adopt rules to administer the program developed under this
79	69		11 section.
80	70		12 (c) The federal reimbursement for services provided under this
81	71		13 section must be distributed to the school corporation. The state shall
82	72		14 retain the nonfederal share of the reimbursement for Medicaid services
83	73		15 provided under this section.
84	74		16 (d) The office of Medicaid policy and planning, with the approval
85	75		17 of the budget agency and after consultation with the department of
86	76		18 education, shall establish procedures for the timely distribution of
87	77		19 federal reimbursement due to the school corporations. The distribution
88	78		20 procedures may provide for offsetting reductions to distributions of
89	79		21 state tuition support or other state funds to school corporations in the
90	80		22 amount of the nonfederal reimbursements required to be retained by the
91	81		23 state under subsection (c).
92	82		24 (e) Before December 1, 2024, the office may shall apply to the
93	83		25 United States Department of Health and Human Services for a state
94	84		26 plan amendment to allow school corporations and school based health
95	85		27 centers to seek Medicaid reimbursement for medically necessary,
96	86		28 school based Medicaid covered services that are provided under federal
97	87		29 or state mandates. If the state plan amendment is approved and
98	88		30 implemented, services may be provided by a qualified provider in a
99	89		31 school setting or school based health center to Medicaid enrolled
100	90		32 students. Subject to subsection (f), the services may be pursuant to any
101	91		33 of the following:
102	92		34 (1) An individualized education program (as defined in
103	93		35 IC 20-18-2-9).
104	94		36 (2) A plan developed under Section 504 of the federal
105	95		37 Rehabilitation Act, 29 U.S.C. 794.
106	96		38 (3) A behavioral intervention plan (as defined in IC 20-20-40-1).
107	97		39 (4) A service plan developed under 511 IAC 7-34.
108	98		40 (5) An individualized health care plan.
109	99		41 The office may, in consultation with the department of education,
110	100		42 develop any necessary state plan amendment under this subsection. The
111		-	SB 272—LS 6698/DI 152 3
	101	+	2024 IN 272—LS 6698/DI 152 3
112	102		1 office may apply for any state plan amendment necessary to implement
113	103		2 this subsection.
114	104		3 (f) Services under subsection (e) may not include the following:
115	105		4 (1) An abortion.
116	106		5 (2) Counseling for abortion procedures.
117	107		6 (3) Referrals for abortion services.
118	108		7 (4) Abortifacients.
119	109		8 (5) Contraceptives.
120	110		9 (g) If the state plan amendment described in subsection (e) is
121	111		10 approved and implemented, the medically necessary, school based
122	112		11 Medicaid covered services described in subsection (e):
123	113		12 (1) may only be performed by a qualified provider;
124	114		13 (2) must be within the qualified provider's scope of practice; and
125	115		14 (3) must be provided in accordance with this article and
126	116		15 administrative rules concerning the Medicaid program.
127	117		16 SECTION 3. IC 16-19-3-32.7 IS ADDED TO THE INDIANA
128	118		17 CODE AS A NEW SECTION TO READ AS FOLLOWS
129	119		18 [EFFECTIVE JULY 1, 2024]: Sec. 32.7. (a) The state department
130	120		19 shall develop and publish on its website first aid guidelines for
131	121		20 school emergencies for use by schools in Indiana.
132	122		21 (b) The first aid guidelines for school emergencies described in
133	123		22 subsection (a) must include at least the following:
134	124		23 (1) General emergency guidelines and information on
135	125		24 administering emergency assistance before emergency
136	126		25 medical personnel arrive to an individual who is sick or
137	127		26 injured.
138	128		27 (2) Standard precautions for handling blood and bodily fluids
139	129		28 in school settings, including handwashing procedures, and the
140	130		29 disposal and clean up of infectious waste.
141	131		30 (3) First aid procedures for injuries and illnesses, including
142	132		31 bleeding, chest pain, shock, concussions, heat emergencies,
143	133		32 seizures, and poisoning.
144	134		33 (4) Emergency procedures for chemical, biological, radiologic,
145	135		34 nuclear, or explosive events or bomb threats.
146	136		35 (5) Instructions for managing behavioral and mental health
147	137		36 emergencies, including suicide risk and active shooter
148	138		37 situations.
149	139		38 (6) Emergency care procedures in life threatening medical
150	140		39 situations, including cardiopulmonary resuscitation,
151	141		40 automated external defibrillator use, and emergency choke
152	142		41 saving methods.
153	143		42 (7) Guidelines concerning parent or guardian notification for
154		-	SB 272—LS 6698/DI 152 4
	144	+	2024 IN 272—LS 6698/DI 152 4
155	145		1 an incident described in this subsection.
156	146		2 SECTION 4. IC 20-19-3-11.9 IS ADDED TO THE INDIANA
157	147		3 CODE AS A NEW SECTION TO READ AS FOLLOWS
158	148		4 [EFFECTIVE JULY 1, 2024]: Sec. 11.9. The department shall
159	149		5 publish on its website the first aid guidelines for school
160	150		6 emergencies developed by the Indiana department of health under
161	151		7 IC 16-19-3-32.7.
162	152		8 SECTION 5. IC 20-26-22.5 IS ADDED TO THE INDIANA CODE
163	153		9 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
164	154		10 JULY 1, 2024]:
165	155		11 Chapter 22.5. School Health Services
166	156		12 Sec. 1. As used in this chapter, "health care provider" has the
167	157		13 meaning set forth in IC 16-18-2-163(a).
168	158		14 Sec. 2. As used in this chapter, "health records" has the
169	159		15 meaning set forth in IC 16-18-2-168(a).
170	160		16 Sec. 3. (a) As used in this chapter, "health services" means
171	161		17 prevention, assessment, intervention, and referral services
172	162		18 available to students of a school corporation that meet the criteria
173	163		19 set forth in section 7 of this chapter.
174	164		20 (b) The term does not include services provided in a school
175	165		21 based health center.
176	166		22 Sec. 4. As used in this chapter, "informed consent" has the
177	167		23 meaning set forth in IC 16-36-7-16.
178	168		24 Sec. 5. As used in this chapter, "school based health center"
179	169		25 means a health clinic that:
180	170		26 (1) is located in or near a school or school facility of a school
181	171		27 corporation;
182	172		28 (2) is organized or promoted through school, community, or
183	173		29 health care provider relationships;
184	174		30 (3) provides primary health services to children by health
185	175		31 care providers, in accordance with state and federal law; and
186	176		32 (4) meets any other requirements necessary for the operation
187	177		33 of a school based health center.
188	178		34 Sec. 6. (a) Except as provided in subsection (b), a school
189	179		35 corporation shall employ at least one (1) registered nurse who
190	180		36 holds a bachelor of science in nursing to coordinate health services
191	181		37 in the school corporation.
192	182		38 (b) A school corporation may employ a registered nurse who
193	183		39 does not hold a bachelor of science in nursing to coordinate health
194	184		40 services in the school corporation if the registered nurse:
195	185		41 (1) was employed by the school corporation on June 30, 2000,
196	186		42 to coordinate health services; and
197		-	SB 272—LS 6698/DI 152 5
	187	+	2024 IN 272—LS 6698/DI 152 5
198	188		1 (2) has been continuously employed by the school corporation
199	189		2 to coordinate health services described in subdivision (1) since
200	190		3 June 30, 2000.
201	191		4 Sec. 7. A school corporation shall provide health services to
202	192		5 students in accordance with:
203	193		6 (1) all state and federal laws and regulations;
204	194		7 (2) the applicable standard of care; and
205	195		8 (3) the first aid guidelines for school emergencies, developed
206	196		9 by the Indiana department of health under IC 16-19-3-32.7.
207	197		10 Sec. 8. A school corporation may contract with a health care
208	198		11 provider, health system, or community partner to establish a
209	199		12 school based health center for the purpose of providing primary
210	200		13 health services to students if the following requirements are met:
211	201		14 (1) The school based health center must be a distinct legal
212	202		15 entity that is separate from the school corporation.
213	203		16 (2) The establishment of a school based health center may not
214	204		17 replace the role of school nurses who are employed by the
215	205		18 school corporation to provide first aid and emergency
216	206		19 services.
217	207		20 (3) Student participation in services provided by a school
218	208		21 based health center must be voluntary.
219	209		22 (4) The school based health center or school corporation may
220	210		23 not offer an incentive to a student or parent of a student in
221	211		24 exchange for participation in services provided by the school
222	212		25 based health center.
223	213		26 (5) A student, if the student is an adult or emancipated minor,
224	214		27 or a student's parent or guardian must provide written
225	215		28 informed consent for the student to receive services at a
226	216		29 school based health center, and the parent must be present at
227	217		30 the time the student receives services at a school based health
228	218		31 center.
229	219		32 (6) Services provided at a school based health center must be
230	220		33 provided by a health care provider.
231	221		34 (7) A health care provider employed by or working in a school
232	222		35 based health center must maintain health records in
233	223		36 accordance with the federal Health Insurance Portability and
234	224		37 Accountability Act (HIPAA).
235	225		38 (8) Except as required by law, a school or school corporation
236	226		39 may not access a student's health records.
237	227		40 (9) A school, school corporation, or health care provider may
238	228		41 not be obligated to violate this section, including participating
239	229		42 in a grant program that requires a school, school corporation,
240		-	SB 272—LS 6698/DI 152 6
	230	+	2024 IN 272—LS 6698/DI 152 6
241	231		1 or health care provider to violate this section.
242	232		2 Sec. 9. The state board shall amend any rules necessary to
243	233		3 comply with this section.
244	234		4 SECTION 6. IC 20-34-3-12, AS AMENDED BY P.L.164-2023,
245	235		5 SECTION 52, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
246	236		6 JULY 1, 2024]: Sec. 12. (a) For purposes of this section, "modified
247	237		7 clinical technique" means a battery of vision tests that includes:
248	238		8 (1) a visual acuity test to determine an individual's ability to see
249	239		9 at various distances;
250	240		10 (2) a refractive error test to determine the focusing power of the
251	241		11 eye;
252	242		12 (3) an ocular health test to determine any external or internal
253	243		13 abnormalities of the eye; and
254	244		14 (4) a binocular coordination test to determine if the eyes are
255	245		15 working together properly.
256	246		16 (b) For purposes of this section, "vision screening" means the testing
257	247		17 of visual acuity to determine an individual's ability to see at various
258	248		18 distances using:
259	249		19 (1) the Snellen chart;
260	250		20 (2) Sloan letter charts;
261	251		21 (3) HOTV letter or LEA symbol charts for younger students; or
262	252		22 (4) technology devices, including photoscreens or autorefractors,
263	253		23 for a child who is unable to perform the tests described in
264	254		24 subdivisions (1) through (3);
265	255		25 at a distance of either ten (10) or twenty (20) feet for distance vision,
266	256		26 depending on the calibration of the chart being used, and a distance of
267	257		27 fourteen (14) inches for near vision.
268	258		28 (c) The modified clinical technique shall be performed by an
269	259		29 ophthalmologist licensed as a physician under IC 25-22.5 or an
270	260		30 optometrist licensed under IC 25-24.
271	261		31 (d) Subject to subsection (l), the governing body of each school
272	262		32 corporation shall conduct a vision test for each student enrolling in or
273	263		33 transferring into:
274	264		34 (1) either kindergarten or grade 1;
275	265		35 (2) grade 3;
276	266		36 (3) grade 5; and
277	267		37 (4) grade 8;
278	268		38 and for each student suspected of having a visual defect.
279	269		39 (e) The vision test for students in kindergarten and grade 1 shall be
280	270		40 conducted using the modified clinical technique unless a waiver is
281	271		41 granted under section 13 of this chapter. If a waiver is granted for a
282	272		42 school corporation, the governing body shall conduct a vision screening
283		-	SB 272—LS 6698/DI 152 7
	273	+	2024 IN 272—LS 6698/DI 152 7
284	274		1 described in subsection (b) upon each student's enrollment in
285	275		2 kindergarten or grade 1.
286	276		3 (f) Each student described in subsection (d)(2), (d)(3), and (d)(4),
287	277		4 and each student suspected of having a visual defect shall be tested
288	278		5 using a vision screening of the student's visual acuity.
289	279		6 (g) The following standards apply for a vision screening under
290	280		7 subsections (e) and (f):
291	281		8 (1) A student in kindergarten or grade 1 who is unable to read
292	282		9 with each eye the 20/30 line of the Snellen chart or the 20/32 line
293	283		10 of the Sloan letters, HOTV, or LEA symbol optotypes shall be
294	284		11 recommended for further examination based upon the
295	285		12 recommendation of the individual performing the screening.
296	286		13 (2) A student:
297	287		14 (A) in grade 3, grade 5, or grade 8; or
298	288		15 (B) suspected of having a visual defect;
299	289		16 who is unable to read with each eye the 20/30 line of the Snellen
300	290		17 chart or the 20/32 line of the Sloan letters shall be recommended
301	291		18 for further examination based upon the recommendation of the
302	292		19 individual performing the screening.
303	293		20 (3) If a student at any grade level is recommended for further
304	294		21 examination, the school must provide a written recommendation
305	295		22 for further examination to the parent or legal guardian of the
306	296		23 student.
307	297		24 (h) Records of all tests shall be made and continuously maintained
308	298		25 by the school corporation to provide information useful in protecting,
309	299		26 promoting, and maintaining the health of students. The Indiana
310	300		27 department of health, in consultation with the state board, shall adopt
311	301		28 rules concerning vision testing equipment, qualifications of vision
312	302		29 testing personnel, visual screening procedures, and criteria for failure
313	303		30 and referral in the screening tests based on accepted medical practice
314	304		31 and standards.
315	305		32 (i) The school corporation's governing body and the superintendent
316	306		33 shall receive annually the following information concerning the tests
317	307		34 conducted under this section:
318	308		35 (1) The number of students eligible for testing, by grade.
319	309		36 (2) The number of students tested, by grade.
320	310		37 (3) The number of students by grade who were tested using the
321	311		38 modified clinical technique.
322	312		39 (4) The number of students by grade who were tested using a
323	313		40 vision screening.
324	314		41 (5) The number of students by grade who passed a test.
325	315		42 (6) The number of students by grade who failed a test or were
326		-	SB 272—LS 6698/DI 152 8
	316	+	2024 IN 272—LS 6698/DI 152 8
327	317		1 referred for further testing.
328	318		2 (7) The name of the individual or department that supervised the
329	319		3 testing.
330	320		4 (j) Each school corporation shall annually provide to the
331	321		5 department, for each school within the school corporation, the
332	322		6 following information concerning the tests conducted under this
333	323		7 section:
334	324		8 (1) the number of students tested by grade;
335	325		9 (2) the number of students by grade who were tested using the
336	326		10 modified clinical technique;
337	327		11 (3) the number of students by grade who were tested using a
338	328		12 vision screening;
339	329		13 (4) the number of students who passed a test by grade; and
340	330		14 (5) the number of students who failed a test or who were referred
341	331		15 for further testing.
342	332		16 (k) Not later than October 1 each year, the department shall report
343	333		17 for the previous school year:
344	334		18 (1) a compilation of the information received from school
345	335		19 corporations under subsection (j);
346	336		20 (2) information received under section 13 of this chapter,
347	337		21 including:
348	338		22 (A) the number of school corporations that applied for a
349	339		23 waiver;
350	340		24 (B) the number of waivers approved;
351	341		25 (C) the number of waivers denied;
352	342		26 (D) the name of each school corporation that applied for a
353	343		27 waiver and whether the waiver was approved or denied; and
354	344		28 (E) the reason for the approval or denial;
355	345		29 (3) the total number of students eligible for testing; and
356	346		30 (4) the total number of students tested;
357	347		31 to the legislative council in electronic format under IC 5-14-6.
358	348		32 (l) The governing body of a school corporation may not conduct
359	349		33 a vision test described in subsection (d) on a student without the
360	350		34 prior written consent of the student's parent or guardian if the
361	351		35 student is an unemancipated minor.
362	352		36 SECTION 7. IC 20-34-3-14, AS ADDED BY P.L.1-2005,
363	353		37 SECTION 18, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
364	354		38 JULY 1, 2024]: Sec. 14. (a) The governing body of each school
365	355		39 corporation shall annually conduct an audiometer test or a similar test
366	356		40 to determine the hearing efficiency of the following students:
367	357		41 (1) Students in grade 1, grade 4, grade 7, and grade 10.
368	358		42 (2) A student who has transferred into the school corporation.
369		-	SB 272—LS 6698/DI 152 9
	359	+	2024 IN 272—LS 6698/DI 152 9
370	360		1 (3) A student who is suspected of having hearing defects.
371	361		2 (b) A governing body may appoint the technicians and assistants
372	362		3 necessary to perform the testing required under this section.
373	363		4 (c) Records of all tests shall be made and continuously maintained
374	364		5 by the school corporation to provide information that may assist in
375	365		6 diagnosing and treating any student's auditory abnormality. However,
376	366		7 diagnosis and treatment shall be performed only on recommendation
377	367		8 of an Indiana physician who has examined the student.
378	368		9 (d) The governing body may adopt rules for the administration of
379	369		10 this section.
380	370		11 (e) The governing body of a school corporation may not conduct
381	371		12 an audiometer test or a similar test described in subsection (a) on
382	372		13 a student without the prior written consent of the student's parent
383	373		14 or guardian if the student is an unemancipated minor.
384		-	SB 272—LS 6698/DI 152 10
385		-	COMMITTEE REPORT
386		-	Madam President: The Senate Committee on Insurance and
387		-	Financial Institutions, to which was referred Senate Bill No. 272, has
388		-	had the same under consideration and begs leave to report the same
389		-	back to the Senate with the recommendation that said bill DO PASS
390		-	and be reassigned to the Senate Committee on Appropriations.
391		-	(Reference is to SB 272 as introduced.)
392		-	BALDWIN, Chairperson
393		-	Committee Vote: Yeas 6, Nays 1
394		-	SB 272—LS 6698/DI 152
	374	+	2024 IN 272—LS 6698/DI 152