Lawmakers moved several meaty health care bills forward Wednesday, though many have a fiscal component that will trigger additional scrutiny.
Many supporters and advocates saw two bills heard before the Senate health committee as companion bills, with one funding seed money for communities to start programs and another aimed at sustaining those services.
Under Senate Bill 10, the Division of Mental Health and Addiction, housed under the Family and Social Services Administration, would oversee the Community Cares Initiative Grant Pilot Program and its accompanying fund. But Senate Bill 142 would provide a mechanism for ongoing funding by requiring reimbursement for medical services for mobile integrated health.
Author Sen. Scott Baldin, R-Noblesville, said he saw Senate Bill 10 as a way to reduce public safety expenses by creating programs for non-emergency calls often routed to first responders. Communities could cater such offerings to address mental health, addiction, homelessness, elder care or maternity care deserts.
“Imagine a team of people — or one person in a very small community — whose sole job it is to be proactive instead of reactive. Whose sole job is to understand every single resource in your community, be it food insecurity, places to find food or housing, mental health,” Baldwin said. “(This is) encouraging local communities to adopt this type of response by providing seed money and encouraging them to put their own money in and sustain it for more than three years.”
Sens. Ed Charbonneau and Mike Crider, both members of the committee, said they saw this bill as a continuation of their 2023 legislative efforts to reform public health funding and 988 crisis line funding, respectively.
Several mayors testified in support of the bill, pointing to how their community could use the funding to redirect 911 calls to other services or connect with residents before a mental health crisis.
Noblesville Mayor Chris Jensen, who approached Baldwin with the idea for the legislation, said his community’s program launched just weeks before the COVID-19 pandemic surged in early 2020. Stakeholders aimed to identify at-risk community members and try to proactively reduce 911 calls, as public safety counts for over 50% of the city’s budget.
“We’ve reduced the number of repeat calls to emergency services for some residents who needed support while connecting them with the full spectrum of resources,” Jensen said.
Mobile Integrated Health
The bill passed unanimously and was recommitted to the Appropriations Committee to approve the spending, which comes from existing funds. While cities and communities can now use the dollars to establish mobile crisis or mobile integrated health care programs, Senate Bill 142 would be the one tackling long-term funding.
Sen. Brian Buchanan, the author, described the legislation as another pilot program that would require insurer reimbursement for services provided by a mobile integrated health program. The experiment for coverage would be limited to three counties — Delaware, White and Montgomery — with existing, established mobile integrated health units and run from July 1, 2024 until June 30, 2027.
“A mobile integrated health system integrates (Emergency Medical Services) professional and at-risk individual care plans to ensure that proper needs are being taken care of to mitigate hospital readmissions through preventative and comprehensive health care services,” said Buchanan, R-Lebanon.
One of the most recognized programs in Crawfordsville aims to provide “cradle to grave” care through partnerships with local health providers and state grant funding. Getting reimbursed, rather than depending on charitable funding, would grant stability.
“Access to care is an issue everywhere but your health outcomes should not be determined by your zip code,” said Paul Miller, the division chief of the Crawfordsville Fire Department.
In rural Monticello, located in White County, Nick Green highlighted his community’s brand of paramedicine that focused on reducing hospital readmissions and connecting pregnant and postpartum moms with a local nurse’s expertise. In the more urban Muncie, Mayor Dan Ridenour said the focus is more on repeat 911 callers who request ambulance services to the emergency department and tie up resources for routine care.
Currently, the Indiana Department of Homeland Security offers a mobile integrated health grant with a $500,000 appropriation, awarding grants of either $50,000 or $75,000 to qualifying communities.
The bill passed unanimously and now moves to the Indiana Senate.
An unrelated bill seeks to tackle high health care costs by targeting monopolies through a notification process with the Attorney General’s Office. Author Sen. Chris Garten, R-Charlestown, said that 29 other states had such a requirement and many went even further, mandating that health care entities also get approval from that state department before merging.
The legislation’s language conforms with recommendations from an interim task force led by Garten.
Under the bill, the office may analyze antitrust concerns, which “shall” be shared with the parties providing a notice of acquisition or merger. The department may also issue a civil investigative demand to a health care entity for more information — which Scott Barnhart, the chief counsel and director of consumer protection with the office, said would be kept confidential.
Gloria Sachdev, with the Employers’ Forum of Indiana, said that current anti-monopoly reviews required by the Federal Trade Commission and Department of Justice weren’t sufficient because of the high bar set by the agency, which she said missed acquisitions of smaller practices.
But representatives on behalf of the Indiana Hospital Association argued that this would duplicate federal efforts and didn’t adequately address private equity concerns.
Despite those objections, the bill passed unanimously.
The Senate Health and Provider Services Committee also unanimously bills establishing requirements for nurses to learn about trauma-informed care and requirements for contract negotiations between providers and managed care organizations.
The Indiana Capital Chronicle is an independent, not-for-profit news organization that covers state government, policy and elections.