AN ACT to amend Tennessee Code Annotated, Title 52; Title 56 and Title 71, relative to prescribed pediatric extended care centers.
HB1887 creates a new licensing and regulatory framework for prescribed pediatric extended care centers in Tennessee. These centers are defined as nonresidential facilities, operated for profit or nonprofit, that serve at least four medically dependent or technologically dependent minors who are not related to the owner or operator. The bill sets out detailed definitions for covered children, basic services, controlling persons, and center operations, and it limits services to minors age 20 and under who need ongoing technology-based skilled nursing care prescribed by a physician.
The bill requires anyone owning or operating a center to obtain a state license, with separate licenses for each location. It establishes an application process, fees, renewal requirements, background checks for employees and other associated persons, inspection authority, recordkeeping obligations, and standards for denial, suspension, revocation, fines, injunctions, and criminal penalties for unlicensed operation. It also prohibits these centers from operating in the same location as a child care agency or other licensed facility, limits care to no more than 12 hours in a 24-hour period, and caps patient capacity at 60.
HB1887 also directs the Department of Health to promulgate rules covering building standards, staffing, sanitation, medical records, transportation, and service requirements. The bill emphasizes parent or guardian involvement in care decisions and states that the department may not interfere with parental authority except to limit the maximum amount of authorized services. It further provides that admission to a center does not replace a TennCare private duty nursing benefit when medically necessary.
In addition to the licensing provisions, the bill amends TennCare law to require coverage and benefits for services rendered at prescribed pediatric extended care centers, subject to federal approval. The TennCare director must seek any necessary federal waiver by December 31, 2026. The act takes effect immediately for rulemaking purposes, with the substantive provisions taking effect January 1, 2027.
The overall sentiment reflected in committee action is strongly favorable: the bill advanced unanimously through the House Health Subcommittee, House Health Committee, House Insurance Committee, and House Government Operations Committee. There is no recorded opposition in the available votes or transcripts. The main policy focus appears to be on ensuring safety, oversight, and access to specialized care for medically fragile children while integrating the new facility type into TennCare coverage.
The bill adds a new part to Tennessee Code Annotated Title 52 governing prescribed pediatric extended care centers and amends Title 71 to require TennCare coverage for services provided in those centers, subject to federal approval. It creates new licensing, inspection, enforcement, and rulemaking authority for the Department of Health, while also establishing criminal and civil penalties for noncompliance. The measure affects facility owners/operators, employees, parents or guardians of eligible minors, and TennCare enrollees who may use these services.
Available committee votes show unanimous support at every stage reported, with no recorded nays. The bill appears to have been received as a child-health and access-to-care measure, with the discussion implied by the text focusing on regulation, safety, and coverage rather than controversy. No committee transcript is available, but the voting history suggests broad agreement across health, insurance, and government operations committees.
No explicit opposition is reflected in the available voting record or transcripts. The most likely areas of policy sensitivity are the new licensing burden on providers, the requirement for background checks and inspections, the prohibition on operating alongside other licensed facilities, and the TennCare coverage mandate, which depends on federal approval and may require a waiver. The bill also draws a clear line around which children qualify, excluding less acute conditions such as asthma, diabetes, or epinephrine-dependent conditions from the definition of medically dependent or technologically dependent minors.