by Guest Author | Jan 29, 2025 | Policy
The Bowen Center recently analyzed state and national trends to examine whether Indiana faces a shortage of Licensed Practical Nurses now and into the future.
Check out the findings below:
You can also read or download the above in PDF form here:
by Guest Author | Jan 29, 2025 | Policy
Certified Nursing Aide Regulation
Certified Nurse Aides (CNAs) are regulated by state-level agencies. All states require CNAs to complete state-approved training and pass a state exam in order to be registered with the state. The specific agency(ies) involved in CNA regulation varies by state.
The Bowen Center completed a 50-state scan of state approaches to CNA regulation. We reviewed existing summaries from 2022 and 2024, and explored current statutes and administrative codes to categorize state approaches to regulation as being led by the nursing board, occupational regulatory agency, health agency, or a combination. The map below shows the results of the scan.
Read or download the above blog post in PDF form here:
by Guest Author | Jan 28, 2025 | Data, Policy
The 2025 legislative session is in full swing, and the landscape just got easier to navigate. Almost 300 bills related to health, the health workforce, or the workforce generally were introduced this session. The Bowen Center will be tracking these bills as the session continues. While you’ll still find our comprehensive bill tracking table with all the details on each bill being considered, we’re excited to introduce a new dynamic dashboard that puts the session’s pulse at your fingertips. Our interactive infographic gives you real-time insights into the status of health care workforce legislation, from start to finish, across both chambers. Whether you’re tracking workforce initiatives, regulatory changes, or public health measures, you can now visualize the flow of bills through the legislative process and quickly identify trends in health care policy priorities. We have summarized a few pieces of legislation below that intersect with work previously done by the Bowen Center. Check out the dedicated Bowen Bill Brief page for full details on all the bills we’re tracking.
Nursing Workforce
- There are several bills this session focused on the advanced practice registered nurse (APRN) workforce. SB 447 aims to establish a license specifically for APRNs in Indiana. APRNs are licensed registered nurses (RN) with additional training that provides the clinical knowledge and experience to deliver advanced nursing care. Currently, all Indiana APRNs are required to hold an Indiana RN license, and many, but not all, also hold an APRN prescriptive authority license. In 2023, the Bowen Center completed a national review of state approaches to APRN licensing to see how Indiana’s approach compared to other states. Only one other state (Wisconsin) has an approach similar to Indiana’s, and this is still the case in 2025. Check out the full report here.)
Physician Workforce
- Indiana is facing a physician workforce shortage due to multiple factors, including burnout, an aging population, and competition from other states. Both HB1068 and HB1400 focus on workforce incentives targeted toward retaining physician talent in Indiana. HB1068 seeks to establish a program for medical school loan forgiveness while HB1400 seeks to provide a tax credit for preceptors in medical education. Many states have used tax credits to retain and recruit the clinical preceptors required for health professions’ education. In 2024, the Bowen Center reviewed tax credits as an incentive strategy for clinical preceptors using data from other state program evaluations. More information can be found here, including considerations for Indiana.
- Recruitment of physicians plays a role in alleviating physician workforce shortages. HB 1555 focuses on the recruitment of foreign trained physicians to Indiana. HB1555 seeks to establish a limited medical license for those who have graduated from international medical programs, obtained a sponsor, and agreed to work in a medically underserved area. In 2021, 22% of actively practicing physicians licensed in Indiana reported completing their education in another country. This suggests that HB1555 may have significant impacts on workforce supply. Check out the education tab on the Bowen Center’s Indiana Physician Workforce Dashboard to get information on Indiana Physicians who completed medical school in another country.
Behavioral Health
- All of Indiana’s 92 counties contain a federally designated mental health workforce shortage. As a part of the Playbook Project, the Bowen Center convened stakeholders to discuss challenges and opportunities for strengthening the pathway to practice for the mental and behavioral health professionals in Indiana. Opportunities to streamlining licensing while maintaining safety and quality were identified as a top priority by many stakeholders. HB1520 and SB216 include proposed changes to licensing policies for selected professions.
- Workforce incentives were another priority identified by stakeholders during the Playbook Project. Incentives are needed to recruit and retain qualified behavioral health and human services professionals into the workforce. HB1154 aims to establish a behavioral health preceptor tax credit. This bill, in hopes of aiding retention, would provide a $1,000 state tax credit for a behavioral health professional who precepts a qualified student. HB 1261HB 1261 seeks to establish a behavior analyst license, which would add a profession to the licensed behavioral health and human services workforce in Indiana.
Direct Care Workforce
- Indiana’s population is steadily getting older, with an estimated 1 in 5 Hoosiers over the age of 65. An aging population typically indicates a greater demand for health care professionals, specifically direct care workers, such as home health aides (HHAs) and certified nursing aides (CNAs). HB1161 would establish a license, training, and competency requirements for home health aides. SB 449 would require home health agencies to run a criminal background check on employees on an annual basis.
- Currently, statute does not allow an individual with a felony offense related to substances to work as a CNA within five years of the offense. HB1385 alters this requirement to allow an exception if the CNA becomes certified as a peer recovery coach. The Bowen Center is excited to launch workforce dashboards for CNAs, HHAs, and qualified medication aides later in 2025! In the meantime, you can review a summary of research we completed in 2024 on direct care workforce data here.
by Guest Author | Jan 15, 2025 | News, Policy
Indiana’s Health Workforce Council is exploring an approach to strengthen rural health care training: a tax credit for health care providers who mentor students through clinical preceptorships. Bowen Center Director Dr. Hannah Maxey was recently quoted in IPB News discussing the possible tax credit program for health care mentors.
“It is critically important for states that are developing tax credit programs to clearly define the program, goals and metrics before and prior to developing it,” Maxey notes. Her research indicates these programs typically serve better as retention tools for existing clinical preceptors rather than recruiting new ones.
Want to learn more about Maxey’s insights on program design, retention impacts, and fiscal considerations? Read the full story at IPB News.
The Bowen Center recently published a policy brief on exactly this subject, read more here or in the brief below:
by Guest Author | Jan 9, 2025 | Policy
As Indiana continues to lose health care talent to burnout and out-of-state competition, policymakers are searching for innovative solutions. A new policy brief from the Bowen policy team examines how state tax credits could help address our growing health care workforce shortage.
Clinical preceptors are critical for ensuring students are equipped with clinical skills prior to entering the workforce. Several states have already implemented tax credit programs to recruit and retain health care professionals into clinical preceptor roles, and in this brief we take an in-depth look at two of them: Colorado and Hawai’i. These programs offer substantial incentives — up to $10,000 annually in some cases — for medical professionals serving in high-need roles or locations. In 2023, the Indiana General Assembly considered establishing a similar program through HB 1598, which would have provided tax credits for nursing preceptors, but it didn’t make it past its first reading.
The brief outlines key considerations for policymakers, including program administration costs and the importance of strategic targeting. While tax credits aren’t a silver bullet, they represent one evidence-based approach to strengthening Indiana’s health care workforce.
Read the full brief here to learn more about how tax credit strategies could help secure Indiana’s health care future.
by Guest Author | Feb 1, 2024 | Policy, Topics of Interest
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Total Bills introduced in Indiana’s 2024 Legislative Session
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Total Bills identified with direct impact on health, health workforce or workforce included in the 2024 B4
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Total bills identified with direct implications for health workforce & distinguished separately.
Top Health Workforce Themes in the 2024 Legislative Session
Let’s cut to the chase. What health workforce legislation has been introduced in the 2024 session? There were a few major themes that arose. We have conceptualized these themes and summarized the outcomes below.
Nursing Workforce
- This session has seen many legislative initiatives related to the nursing workforce. One such bill (SB 45) would establish additional training requirements in trauma-informed care for all licensed Registered Nurses (RN). One bill would modify certain licensure requirements for health facility administrators, allow NCLEX passage to satisfy English proficiency requirements for internationally-educated nurse applicants, and eliminate telehealth certification requirement for telehealth nurses and other telehealth providers (HB 132). The final nursing-focused bill making progress this session makes various changes to nurse licensing, education, and training regulations regarding requirements for clinical preceptors, and requirements for certain foreign nursing applicants (HB 1259).
- Bills under this theme that were introduced but did not progress include: a bill removing the collaborative practice agreement with physicians and APRNS, and allows a APRN with prescriptive authority to prescribe a schedule II substance (HB 1059); a requirement for nurses to complete implicit bias training as part of their continuing education requirements (HB 1167); establishment of nurse staffing councils within hospitals in order to develop nurse staffing plans (HB 1015); allowing Certified Registered Nurse Anesthetists to administer anesthesia under the immediate presence of a podiatrist or dentist, which is currently only allowed under the presence of a physician (HB 1371).
EMS
- There have been several bills introduced regarding Hoosier emergency medical services professionals (EMS) this session. HB 1142 would establish a program of recognition for first responders killed or injured in the line of duty. A new grant pilot program was introduced in SB 10 for the purpose of assisting in the costs of mobile integrated health care programs and mobile crisis teams across Indiana. Finally, SB 142 would require healthcare coverage for mobile integrated healthcare and emergency medical services for all state employees on the state employee health plan (and other insurers).
- Bills under this theme that were introduced but did not progress include: HB 1118 would establish a program to support the mental health of first responders through the Indiana first responders mental health wellness fund and program.
Regulatory Changes
- House Bill 1214 would add Indiana to the Dental and Dental Hygienist Licensure Compact.
- Bills under this theme that were introduced but did not progress include: A bill proposing the expansion of eligible clinical experience supervision to include physicians, and psychologists for the Clinical Social Work Licensure and expansion of supervision through telehealth (SB 261); bills that would establish new licenses – Professional Music Therapists (HB 1103) and Naturopathic Physicians (SB 262); and a bill (SB 110) that would add Indiana as a member of the Social Work Compact.
Behavioral Health Workforce
- A bill proposed in the House would allow a Social Worker licensee applicant to take the social worker examination during their last term of a program that meets educational requirements, and provides a letter of good standing from the director of the academic department (HB 1138). This bill would allow a student to sit for their professional exam early if all requirements in the bill are met. House Bill 1238 would add certain physician assistants and advanced practice nurses as potentially qualifying professionals to serve as competency evaluators in criminal proceedings (previously only psychiatrists and psychologists).
- Bills under this theme that were introduced but did not progress include: SB 166 which would have allowed community mental health center staff to provide social work services without a license and remove examination requirement for BHHS temporary permits; SB 261 which would have expanded the qualifications for clinical experience supervisors for clinical social workers and expanded tele-supervision.
Other health workforce themes from legislators that didn’t make it to the second chamber:
Health Workforce Incentives
- There were a few bills related to health workforce specific incentives, including a bill that would establish a medical school loan forgiveness pilot program (HB 1175). Another bill would establish an Indiana rural hospital and critical health care services fund, new health workforce student loan repayment program, and associated health workforce advisory board (advisory board (HB 1196).
There’s More on the B4!
One way we monitor health workforce trends is by tracking Indiana health workforce legislation through implementation of the Bowen Bi-Weekly Bill Brief or “B4.” There are many other health and workforce/education-related bills that have been introduced this session. Check out the full B4 to learn more about those bills and keep track of the active bills as they progress through the second half of session!
