LEGISLATIVE SERVICES AGENCY OFFICE OF FISCAL AND MANAGEMENT ANALYSIS FISCAL IMPACT STATEMENT LS 6951 NOTE PREPARED: Dec 30, 2024 BILL NUMBER: SB 375 BILL AMENDED: SUBJECT: Dietitian Licensure Compact. FIRST AUTHOR: Sen. Goode BILL STATUS: As Introduced FIRST SPONSOR: FUNDS AFFECTED:XGENERAL IMPACT: State DEDICATED FEDERAL Summary of Legislation: The bill adopts the dietitian licensure compact (DL Compact). Effective Date: July 1, 2025. Explanation of State Expenditures: Dietician Compact– Joining the DL Compact would increase the workload of the Professional Licensing Agency (PLA) and the Medical Licensing Board (Board) beyond routine administrative functions. Implementation of the DL Compact is expected to require between $170 and $41,600 in IT staff time and implementation costs in FY 2026. After implementation, the PLA would incur between $0 and $7,000 in ongoing annual operating expenses related to administering the DL Compact. (As of December 2024, there were three states that have joined the DL Compact, with pending legislation in Ohio.) PLA operating expenses are paid from state General Fund appropriations. The following table provides a breakdown of estimated initial and ongoing expenditures required for the State to join the DL Compact. SB 375 1 Table. Estimated PLA Expenditures for the Dietician Licensure Compact Expense FY 2026^ FY 2027 & Subsequent Years Low Estimate High Estimate Low Estimate High Estimate PLA IT Staff Costs to Implement * $170 $34,000 - - PLA IT Database Implementation/Start-Up Costs** $0 $3,300 - - Delegate Travel*** - - $0 $1,000 Annual Assessment Fee**** - - $0 $6,000 TOTAL $170 $37,300 $0 $7,000 ^Assumes Indiana would join Compact in FY 2026. *Estimated salary cost of existing staff to complete the bill’s requirements. **Estimate is based on PLA provided estimates for IT implementation costs for currently operational compacts the State has joined. The estimate has been modified by OFMA by the amount licenses currently active in the profession in question. ***Includes average costs for domestic airfare, lodging, meals, and ground transportation. ****Possible assessment fee range based on assessments of similar license compacts. Attorney General– The Attorney General and the Board would experience an increase in workload for investigatory and disciplinary procedures to the extent that complaints are made against out-of-state practitioners practicing in Indiana under the DL Compact or Indiana licensees practicing in other states. The Board would also be required to pay any witness fees and travel expenses necessary to summon witnesses from other compact states for hearings held by the Board. The volume of such complaints and disciplinary actions is expected to be minimal. Additional Information– Commissioner Travel– It is assumed that any business travel required of Indiana’s appointed delegate for the DL Compact Commission would be at the expense of the PLA. However, the bill provides that the Commission must meet at least once per year and may meet by telecommunication, video conference, or other similar electronic means. Costs for Indiana’s delegate to attend annual meetings are estimated between $0 (if electronic meetings are held) and $1,000 per year, based on recent domestic airfare and lodging costs. Uniform Data Set– Upon joining the DL Compact, the bill would require the PLA to submit a uniform database containing certain identifying, licensure, and disciplinary information to the Commission’s coordinated database on all participating practitioners. Each member state is required to monitor the database to determine whether adverse action has been taken against any licensee or license applicant. Similar requirements were included in the authorization of the Nurse Licensure Compact, which was recently implemented by the PLA. The PLA estimated costs of IT implementation/start-up costs for harmonizing its licensure database with the Nurse Licensure Compact’s national database, at $165,250, which was funded through a grant awarded by the National Council of State Boards of Nursing. Also, the PLA has estimated the cost at $60,000 in implementation/start-up costs of harmonizing their database with the Physical Therapist Compact’s database. The cost of implementation was also covered with a grant from the Federation of State Boards of Physical Therapy. SB 375 2 Adverse Action– The bill grants Indiana the authority to investigate and take adverse action against a dietician’s compact privileges in Indiana. It is likely the Attorney General and the Board would be the state’s advocates for investigating and taking adverse action. It is likely the Attorney General and the Board would conduct any investigations and take action within their existing staff and resource levels. Annual Compact Membership Fee– The bill does not specifically stipulate a “membership fee”. However, the bill does authorize the DL Compact Commission to charge fees. Whether or not the DL Compact charges a membership fee will be up to the Commission. Currently, the Interstate Medical Licensure Compact Commission charges a service fee to each individual applicant. However, the Nursing Compact charges member states an annual fee of $6,000. Therefore, the fiscal impact estimate assumes a minimum fee of $0 to a maximum fee of $6,000 that would be assessed, depending on what the DL Compact Commission decides. Explanation of State Revenues: Summary– If a significant number of out-of-state dieticians holding an Indiana license forego renewal for compact authorization to practice in Indiana, the bill could potentially result in a reduction in state General Fund revenue from license fees. However, the estimated loss is likely to be small and estimated between $3,800 and $11,400 per biennium. To help recoup the potential fee revenue loss, the bill provides that member states may charge a fee for granting compact privileges. Any revenue impact would not be expected until the fiscal year that compact privileges begin to be granted in Indiana (FY 2026 at the earliest). Additional Information– The Board currently collects a biennial license renewal fee of $20 for dieticians. In FY 2023 and FY 2024, the Board collected approximately $51,700 from license fees, with a significant majority of that amount [$42,800] collected in FY 2023. As of November 2024, there were 2,391 dieticians with an active Indiana license, and 1,633 licensed dieticians with an in-state address. Estimates of the possible revenue reduction assume between 25% and 75% of the out-of-state licensees would choose not to renew their Indiana licenses upon receiving compact privileges. Explanation of Local Expenditures: Explanation of Local Revenues: State Agencies Affected: Professional Licensing Agency; Medical Licensing Board. Local Agencies Affected: Information Sources: Legislative Services Agency, Indiana Handbook of Taxes, Revenues and Appropriations, FY 2023 and 2024; PLA license search and verify tool, November 2024; https://dietitianscompact.org/?page_id=10. Fiscal Analyst: Chris Baker, 317-232-9851. SB 375 3