What is the B4?  

The Bowen Center is committed to providing relevant and timely data to inform health workforce policy. A few years ago, we realized the best way to fulfill that commitment was to keep close tabs on the topics of interest by Indiana stakeholders. One way we monitor this is by tracking Indiana health workforce legislation through implementation of the Bowen Bi-Weekly Bill Brief or “B4.” When we first developed the B4, we kept it as an internal tracker to keep our team up-to-date on health workforce happenings. We quickly realized that this tracker could serve additional audiences and we could pivot its dissemination to a forward-facing tool. 

Now in its fifth iteration, the B4 experienced a re-design in 2022 to enhance accessibility of customized information for users through the use of an interactive table hosted on the Bowen Portal. Users can now search for keywords of interest and filter by topic area. Below are this year’s topical categories for health workforce-related legislation: (Note: in the instance a bill may fall under multiple categories, it was assigned to a primary topic. We are already making plans for 2024’s B4 to allow for tagging of multiple topical areas.) 

Topic Areas

• Behavioral Health (substance use and mental health), 
• Corrections 
• Direct Care Workforce 
• Maternal/Child Health 
• Nursing Workforce 
• Oral health 
• Other 
• Physician Workforce 
• Prevention & awareness (public health, infrastructure, and healthy and active living) 
• Regulatory (Agency, Boards, PLA) 
• Safety net (Medicaid, SNAP, TANF, SNAP, etc.) 
• School Health 
• Workforce Pipeline (Education) 
• Workforce Incentive Program 

What else did we do new in 2023? 

In addition to making the B4 more interactive, we expanded its reach. Before 2023, we focused almost exclusively on bills with a primary focus on the health workforce. Think health workforce incentive program development, new license types, educational policy changes, etc. While planning for 2023, we realized that there are many instances where the bills that impact health care professionals the most are broader bills that impact both the health workforce and other sectors. In 2023, we developed a new structure that monitors bills with a primary focus on the health workforce (of course), but we began including bills that also impact health or workforce/education. These major category areas can be found within the 2023 B4.  

Top Health Workforce Themes in the 2023 Legislative Session 

Let’s cut to the chase. What health workforce legislation passed in the 2023 session? There were a few major themes that arose. We have conceptualized these themes, and summarized the outcomes below.  

• Outlines that a home health agency is not required to conduct a preemployment physical on prospective staff prior to patient contact; Allows home health aides to administer g- or j-tube feedings if certain criteria are met (Senate Enrolled Act 474) 
• Outlines requirements for a direct support professional registry which direct support professionals must be on in order to provide direct support services, and describes requirements for the creation of a training curriculum and growth opportunities for direct support professionals (House Enrolled Act 1342) 

• Provides that the Family and Social Services Agency Division of Aging may hire a dementia care coordinator to establish a “dementia care specialist” program to establish training requirements for dementia care specialists employed by area agencies (House Enrolled Act 1422) 
• Sets the professional requirements for an individual to serve as a residential care facility administrator and creates notification requirements to the Indiana department of health when there is a vacancy or new hire of a residential care administrator. (House Enrolled Act 1461) 

• Establishes Indiana’s participation in Occupational Therapy Licensure Compact to allow occupational therapists and occupational therapy assistants to practice in Indiana under an out-of-state license if certain criteria are met (Senate Enrolled Act 73) 
• Professional Counselors Licensure Compact to allow professional counselors to practice in Indiana under an out-of-state license if certain criteria are met (Senate Enrolled Act 160) 
• Recommendation for interim study committee to study whether Indiana should adopt an interstate mobility to allow individuals with licenses in another state to practice in Indiana (Senate Enrolled Act 400) 

• Beginning July 1, 2023, primary care physicians and employers may not enter into a noncompete agreement. This legislation also outlines procedures for eligible physicians to purchase a release from a noncompete agreement for agreements entered into after July 1, 2023. The legislation also establishes circumstances under which an agreement is not enforceable (Senate Enrolled Act 7)  

• Modifies field experience requirements for marriage and family therapist or a therapist associate licenses (Senate Enrolled Act 11) 
• The Office of Medicaid Policy and Planning may not require telehealth providers to have a physical address in Indiana in order to be enrolled in Medicaid. (House Enrolled Act 1352) 
• Would allow nursing practice (RN and LPN) under a temporary permit while pending application review. Would allow information to be collected from IDOH consumer services occupations (home health aides, qualified medication aides, certified nurse aides) and state board of physical therapy. Transitions nearly all initial licenses and registrations from paper to electronic. Removes provisional license language and requires issuance of license by endorsement (if license held in other state or jurisdiction) in 30 days (House Enrolled Act 1460) 
• Establishment of a “Temporary Health Care Services Agencies” registration (under Indiana Department of Health), including outlining which Indiana licensed health professions met its criteria, services provided, regulatory requirements, and prohibited services (ex. restricting employment opportunities) (House Enrolled Act 1461) 
• Removal of requirement for dentist and dental hygiene licensees pay a $20 compliance fee (House Enrolled Act 1113) 
• Pharmacists are able to prescribe and dispense certain hormonal contraceptives if certain criteria are met (House Enrolled Act 1568)  

What other resources do you have that might be of interest to me? 

The Bowen Bi-Weekly Bill Brief is just one way the Bowen Center seeks to provide stakeholders with high-quality, objective information about Indiana’s health workforce. Through the Bowen Library, you can stay in the know about Indiana’s health workforce professions through bi-annual health workforce data reports, policy briefs, and more.