A BILL to amend and reenact § 32.1-127 of the Code of Virginia and to amend the Code of Virginia by adding in Title 32.1 a chapter numbered 21, consisting of sections numbered 32.1-376 and 32.1-377, relating to Palliative Care Information and Education Program; Palliative Care and Quality of Life Advisory Council established.
HB435, as substituted, would create a statewide Palliative Care Consumer and Professional Education and Information Program within the Department of Health and establish a Palliative Care and Quality of Life Advisory Council. The Department would be required to publish and regularly update palliative care information and resources for the public, providers, and facilities, including consumer education materials, referral information, best practices, and continuing education opportunities. The new council would study palliative and hospice care access in Virginia, identify barriers to care, and advise the Department on education and information initiatives.
The bill also directs the council to examine the feasibility of a fiscally sustainable Medicaid palliative care benefit and whether Virginia should create a licensure scheme for palliative care providers, with a report due to legislative committee chairs by November 1, 2026. In addition, the Board of Health would be required to develop a statewide advance care planning campaign to increase awareness of palliative care options, including in-person and virtual services and discussions of patient goals of care. The bill amends the definition of palliative care in the Code to emphasize patient-centered, family-centered care focused on quality of life, symptom relief, autonomy, and concurrent use with curative or life-prolonging treatment.
Beyond the new palliative care chapter, HB435 makes extensive changes to hospital, nursing home, and certified nursing facility licensing standards in § 32.1-127. These include requirements related to patient visitation, discharge planning, neonatal care, infection prevention, organ donation protocols, workplace violence reporting, emergency department security, fentanyl testing in urine drug screens, smoke evacuation during surgery, temporary bed exemptions during emergencies, and facility fee-setting for licensure and inspection costs. It also adds requirements for facilities to identify patients who may benefit from palliative care and to facilitate access to those services.
The bill’s impact on state law would be broad, especially for licensed health care facilities, which would face new operational, reporting, staffing, security, and patient-rights obligations. It would also create a new advisory body in state government and expand the Department of Health’s role in public education on palliative care. Because the substitute is very expansive, it would affect hospitals, nursing homes, certified nursing facilities, patients, families, and health care providers across multiple areas of care delivery and regulation.
The available legislative history shows no recorded votes or committee debate, but the bill ultimately was left in the House Appropriations Committee. That outcome suggests the measure did not advance, likely reflecting concerns about scope, administrative burden, or fiscal impact. The most notable point of contention appears to be the bill’s very large regulatory package, which combines a palliative care initiative with numerous unrelated facility mandates and new compliance requirements, any of which could raise implementation and cost concerns for hospitals and long-term care providers.
HB435 would amend § 32.1-127 and § 32.1-162.1 and add a new Chapter 21 in Title 32.1, creating new duties for the Department of Health, the Board of Health, hospitals, nursing homes, and certified nursing facilities. It would require palliative care education, public information, and access-facilitation systems, establish an advisory council, and direct a study of Medicaid coverage and provider licensure. It would also impose or expand numerous facility licensing and operational requirements, including patient visitation, security, discharge planning, reporting, and quality-of-care protocols.
No committee transcript or vote record is available, so sentiment must be inferred from the bill’s procedural outcome. The bill was left in House Appropriations, indicating it did not receive enough support or was not advanced for fiscal or policy reasons. The substance of the substitute suggests support for palliative care access and education, but the overall package appears to have been too broad and potentially costly to move forward.
The main likely point of contention is the bill’s breadth: it combines a palliative care education program with a long list of unrelated regulatory mandates for health care facilities. Potential concerns include implementation burden, compliance costs, staffing and security requirements, new reporting obligations, and the fiscal implications of creating a new advisory council, public education program, and possible Medicaid benefit. Providers and budget-minded legislators would likely focus on these costs and administrative impacts, while supporters would emphasize improved access to palliative care and patient-centered planning.