H 8214Medical Services

Health and Safety - Determination of Need for New Healthcare Equipment and New Institutional Health Services

This bill halts new home care and hospice business licenses until 2031 and limits the total number of allowed providers.

Held for study

Population
Affected

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Introduced Feb 27, 2026Committee House Health & Human Services

Plain-English Summary

This legislation establishes a moratorium on issuing new licenses for home care providers, home nursing care providers, and hospice providers until July 1, 2031. It allows for exceptions in cases of emergency, ownership changes, or compelling needs in specific geographic areas. The Department of Health is required to conduct a study on the capacity and utilization of these services. Additionally, the bill caps the number of licenses at the level existing on June 30, 2026, and permanently lowers this cap whenever a provider closes without selling their business. It also mandates that providers maintain a physical non-residential office.

For younger readers

This new law says that for five years, the state will not allow any new companies to open up that provide nursing or hospice care in people's homes. The government wants to study if there are already enough companies doing this work. The law also sets a maximum limit on how many of these companies can exist. If an existing company goes out of business, that spot is lost forever, meaning there will be fewer companies allowed over time. It also says these businesses must have a real office building and cannot just work out of a house.

Who & Where It Applies

Impacted groups

Home care providersHospice providersElderly residentsDisabled residentsHome health aides

Impacted communities

All

Constitutional & Fiscal Check

None Likely

Estimated cost

Amount unknown

Estimated revenue

None

Bill Analysis

Both viewpoints

For Progressives

Mandates a statewide utilization and capacity study to identify underserved geographic areas and subpopulations, ensuring future healthcare planning is based on data and community needs.
Includes specific exceptions to the moratorium for "compelling circumstances," such as pain control and symptom management, ensuring that patient quality of life remains a priority over administrative caps.
May stabilize the existing workforce by preventing an influx of low-quality, "fly-by-night" agencies that often exploit caregivers and drive down wages in the sector.
Artificially restricts the supply of home care and hospice providers, which will likely decrease access and increase wait times for the elderly, disabled, and poor who rely on these services.
Protects incumbent corporations from competition, potentially allowing them to degrade service quality or inflate prices without fear of losing market share to new entrants.
The "ratchet-down" provision, which permanently eliminates a license slot if a provider closes, systematically dismantles the social safety net's capacity to care for a growing aging population.

For Conservatives

Protects established businesses and corporations from new market competition, preserving the market share and value of current license holders.
Mandates that providers maintain a physical non-residential office, preventing "kitchen table" businesses and enforcing traditional business infrastructure standards.
Implementing a mechanism that permanently reduces the number of state-issued licenses when a business closes, thereby shrinking the size of the regulated industry over time.
Interferes directly with the free market by banning new entrepreneurs from entering the industry, regardless of demand or their ability to provide better services.
Empowers the administrative state (Department of Health) with significant authority to decide who can and cannot do business based on government-run studies rather than market forces.
Restricts property rights and business freedom by preventing individuals from operating valid healthcare businesses out of their homes or other non-traditional settings.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 47 additions

SECTION 1. Chapter 23-15 of the General Laws entitled "Determination of Need for New Healthcare Equipment and New Institutional Health Services" is hereby amended by adding thereto the following section: 23-15-12. System planning and licensure control for home care provider, home nursing care provider and hospice provider licenses -- Moratorium.

(a) The health services council shall not review, and applicable state licensing agencies shall not issue, any approvals for new home care provider, home nursing care provider or hospice provider licenses prior to July 1, 2031; provided, however, that any review by the health services council of the department of health and approval by state agencies may be conducted during the moratorium period in the case of an emergency circumstance; a certificate of need application not previously approved; a change in ownership with respect to an existing home care provider, home nursing care provider or hospice provider license; a change in the effective control of a home care provider, home nursing care provider or hospice provider license or a compelling circumstance affecting the quality of life with respect to a certain geographic area or subpopulation including, but not limited to, pain control and symptom management delivered to the home. Provided, however, that any certificate of need application pending at the time of the effective date of this section shall continue to be reviewed pursuant to the provisions of chapter 15 of title 23; and shall not be subject to the moratorium provisions of this section.

(b) During the moratorium period provided in subsection (a) of this section, the department of health shall conduct a statewide utilization and capacity study separate and apart from any other statutory study or report of services delivered by home care providers, home nursing care providers and hospice providers. Such study may include, but not be limited to, an assessment of:

(1) The current availability and utilization of home care provider, home nursing care provider and hospice provider services;

(2) The geographic areas and subpopulations that may be underserved or have reduced access to specific types of health care services; and

(3) Other factors that the department deems pertinent to health care utilization at home. The report may also include the department of health's recommendations for addressing identified gaps in the provision of health care services to homebound patients, recommendations concerning a lack of access to care at home, projection of future demand, and duplicative and/or redundant services.

(c) Should the department not produce a report by July 1, 2031, or at any time within a subsequent five (5) year interval, the moratorium on issuing home care provider, home nursing care provider and hospice provider licenses shall remain in effect.

(d) The department’s health services council can only consider gaps as identified in the department’s five (5) year study as factors to determine new home care provider, home nursing care provider or hospice provider certificates of need.

(e) The number of home care providers, home nursing care providers and hospice providers licenses in effect as of June 30, 2026, shall be the maximum number of licenses issued in each licensure category. In the event of a five percent (5%) or more reduction of licenses within a calendar year, this new figure on December 31 of that year shall be the new maximum number of licenses for that licensure category.

(f) In the event a home care provider, home nursing care provider or hospice provider closes its operations without a change of effective control, this closure will reduce the maximum number of licenses for that licensure category by one license.

(g) All home care providers, home nursing care providers and hospice providers shall maintain a physical non-residential office location in accordance with any and all requirements by the department of state and the department of health.

(h) If any statute or regulation conflicts with the provisions of this section, the provisions of this section shall prevail.

SECTION 2. This act shall take effect on July 1, 2026.