RELATING TO HEALTH AND SAFETY-- DETERMINATION OF NEED FOR NEW, HEALTHCARE EQUIPMENT AND NEW INSTITUTIONAL HEALTH SERVICES
S2388 would place a moratorium on the issuance of new home care provider, home nursing care provider, and hospice provider licenses in Rhode Island until July 1, 2031. During that period, the Health Services Council and state licensing agencies would generally be barred from reviewing or approving new licenses, with limited exceptions for emergencies, certain pending applications, changes in ownership or effective control, and other compelling circumstances affecting access or quality of care at home.
The bill also requires the Department of Health to conduct a statewide utilization and capacity study focused on home-based care and hospice services. That study would assess current availability, utilization, underserved areas, future demand, and duplicative services, and the Health Services Council would be limited to using gaps identified in that five-year study when considering new certificates of need. The bill further sets the number of licenses in effect as of June 30, 2026, as the maximum number allowed, with reductions in that cap if licenses decline by at least 5% in a year or if a provider closes without a change in control. It also requires providers to maintain a physical non-residential office location and gives the section priority over conflicting statutes or regulations.
This bill would amend Rhode Island’s certificate-of-need and licensure framework in chapter 23-15 to restrict expansion of home care, home nursing care, and hospice provider capacity for five years, while creating a planning and reporting requirement for the Department of Health. It would effectively freeze the number of licenses in each category at current levels, subject to limited exceptions and downward adjustments, and would narrow the factors the Health Services Council may consider when evaluating future applications. The measure would directly affect home care agencies, home nursing agencies, hospice providers, state licensing agencies, and patients seeking home-based services, especially in areas already experiencing shortages or access gaps.
The bill’s stated purpose suggests a policy preference for controlled growth and state planning rather than open-ended expansion of home-based care licensing. In the absence of recorded committee testimony or votes, the available text indicates a generally regulatory and cautious approach, with an emphasis on studying utilization, identifying underserved areas, and preventing potentially duplicative services. The inclusion of exceptions for emergencies and access-related circumstances also suggests an attempt to balance restriction with flexibility.
The main likely point of contention is the moratorium itself, since opponents may view a five-year freeze on new licenses as limiting competition, reducing provider entry, and potentially worsening access in underserved communities. Supporters are likely to argue that the cap is needed to manage system capacity, avoid redundant services, and ensure quality and geographic balance in home-based care and hospice. Another possible dispute is the bill’s requirement that the Department of Health’s five-year study control future licensing decisions, which could be seen either as a useful planning tool or as an overly rigid constraint on agency discretion.