LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
FISCAL IMPACT STATEMENT
LS 6048 NOTE PREPARED: Oct 1, 2024
BILL NUMBER: HB 1011 BILL AMENDED:
SUBJECT: End of Life Options.
FIRST AUTHOR: Rep. Pierce M BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State & Local
XDEDICATED
XFEDERAL
Summary of Legislation: Request: The bill allows individuals with a terminal illness who meet certain
requirements to make a request to an attending provider for medication that the individual may
self-administer to bring about death. It specifies requirements a provider must meet in order to prescribe the
medication to a patient.
Life Insurance Policy: It prohibits an insurer from denying payment of benefits under a life insurance policy
based upon a suicide clause in the life insurance policy if the death of the insured individual is the result of
medical aid in dying.
Criminal Penalties: The bill establishes a Level 1 felony if a person: (1) without authorization of the patient,
willfully alters, forges, conceals, or destroys a request for medication or a rescission of a request for
medication with the intent or effect of causing the individual's death; or (2) knowingly or intentionally
coerces or exerts undue influence on an individual to request medication to bring about death or to destroy
a rescission of a request for medication to bring about death. It also establishes a Class A misdemeanor if
a person, without authorization of the patient, willfully alters, forges, conceals, or destroys a request for
medication or a rescission of a request for medication in order to affect a health care decision by the
individual.
Immunity: The bill establishes certain criminal and civil immunity for health care providers.
Effective Date: July 1, 2025.
Explanation of State Expenditures: Indiana Department of Health (IDOH): The bill will increase the
workload for the IDOH. The bill’s requirements are within the IDOH’s routine administrative functions 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.]
Medicaid and State Employees Health Plan: Any change in state costs for Medicaid or the State Employees
HB 1011 1 Health Plan is expected to be minimal.
Penalty Provision: A Level 1 felony is punishable by a prison term ranging from 20 to 40 years, with an
advisory sentence of 30 years. The sentence depends on mitigating and aggravating circumstances. Assuming
offenders can be housed in existing facilities with no additional staff, the marginal cost for medical care,
food, and clothing is approximately $4,719 annually, or $12.93 daily, per prisoner. However, any additional
expenditures are likely to be small.
Explanation of State Revenues: Penalty Provision: If additional court cases occur and fines are collected,
revenue to both the Common School Fund (from fines) and the state General Fund (from court fees) would
increase. The maximum fine for a Class A misdemeanor is $5,000 and the maximum fine for a Level 1 felony
is $10,000. The total fee revenue per case would range between $113 and $138. The amount of court fees
deposited will vary depending on whether the case is filed in a court of record or a municipal court. The
following linked document describes the fees and distribution of the revenue: Court fees imposed in criminal,
juvenile, and civil violation cases.
Explanation of Local Expenditures: Penalty Provision: If more defendants are detained in county jails
prior to their court hearings, local expenditures for jail operations may increase. However, any additional
expenditures would likely be small. A Class A misdemeanor is punishable by up to one year in jail.
Explanation of Local Revenues: Penalty Provision: If additional court actions occur and a guilty verdict
is entered, more revenue will be collected by certain local units. If the case is filed in a court of record, the
county general fund will receive $47.40 and qualifying municipalities will receive a share of $3.60. If the
case is filed in a municipal court, the county receives $30, and the municipality will receive $46. The
following linked document describes the fees and distribution of the revenue: Court fees imposed in
criminal, juvenile, and civil violation cases.
State Agencies Affected: Indiana Department of Health; Office of Medicaid Policy and Planning, Family
and Social Services Administration; Department of Correction.
Local Agencies Affected: Trial courts, local law enforcement agencies.
Information Sources: Indiana Supreme Court, Indiana Trial Court Fee Manual; Department of Correction.
Fiscal Analyst: Karen Rossen, 317-234-2106.
HB 1011 2