VirginiaHB4562026 Regular SessionHouseWALLET

Health, State Board of, regulations; standards for levels of neonatal care.

Sponsored By: Rodney T. Willett (Democratic)

Became Law

Summary

State Board of Health regulations; standards for levels of neonatal care. Directs the State Board of Health to establish standards for designation of care in neonatal services consistent with, but not necessarily identical to, standards published by the American Academy of Pediatrics. The bill directs the Board of Health to promulgate regulations to implement the provisions of the bill by July 1, 2027, and prohibits enforcement of such regulations until July 1, 2029. This bill is identical to SB 291.

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Bill Overview

Analyzed Economic Effects

14 provisions identified: 13 benefits, 0 costs, 1 mixed.

Safer hospital care for newborns and parents

Starting July 1, 2029, the State sets clear levels for neonatal care and labels hospitals by level. Hospitals that deliver babies must have protocols to admit or transfer women in labor and to counsel and manage stillbirths. When a postpartum woman is identified with substance use, the hospital creates a written discharge plan with referrals and alerts the local community services board to help manage it. If a hospital gives a minor online access to records, the parent or guardian must also get access, unless privacy laws block it or required consent is missing.

Stronger ER safety and patient notices

Starting July 1, 2029, every emergency room must have a Virginia‑licensed physician on site at all times. Each ER must use a security plan based on risk and, if needed, have trained security or an off‑duty police officer present at all times. Urine drug screens used for diagnosis must include fentanyl testing. Before non‑emergency air transport, hospitals must tell patients they may choose ground transport and that they will owe charges if the air provider is out‑of‑network or not covered. ERs must also use substance‑use discharge protocols that can include take‑home naloxone and referrals. Psychiatric units must speak directly with referring doctors about refusals and consult a poison specialist when toxicology raises safety questions if requested.

Stronger protections for nursing home residents

Starting July 1, 2029, facilities must offer yearly flu shots and a pneumococcal vaccine unless declined or medically contraindicated. Nursing homes must refund any unspent resident funds within 30 days of a written request (to the estate after death), and fully disclose admissions policies at application. If the family council asks, facilities must send up to six notices a year to the responsible party and allow family participation. Staff who are mandated reporters must be trained on how to report abuse. Facilities must register for sex‑offender notices and carry at least $1,000,000 per‑incident general liability insurance and professional liability at or above the legal recovery limit.

New safety standards and licensing fees

Starting July 1, 2029, the State sets minimum rules for hospital and nursing‑home buildings, operations, staffing, equipment, and training for non‑licensed staff. It also sets baseline infection control, disaster planning, and security policies, and rules for when facilities may deliver care in a patient’s home. The Board may classify and license by specialty and bed capacity. License and inspection fees may change no more than once a year and only when program finances differ by more than 10% from costs. In declared disasters or emergencies, facilities can add temporary beds or sites without a new license for the order’s duration plus 30 days.

Broader hospital visitation for adults

Hospitals must let adult patients get visits from people they choose. Hospitals can still limit visits for medical reasons or room capacity. This takes effect July 1, 2029.

Faster emergency care with verbal orders

Hospitals can take emergency phone or other verbal orders for treatment. A prescriber must sign the order within 72 hours. This rule starts July 1, 2029.

Hospitals must track workplace violence

Starting July 1, 2029, each hospital must run a workplace‑violence reporting system and explain it to all employees, including at orientation. Hospitals must keep detailed incident records for at least two years. Leaders must receive reports at least every quarter. Hospitals must also send a yearly, de‑identified report to the state health department.

More adult day centers can open

Starting July 1, 2029, licensed hospitals, nursing homes, and certified nursing facilities may operate adult day centers if they get any required license. This can expand options for seniors and caregivers.

Naloxone help for uninsured patients

Hospitals may sign agreements with the Department of Health to give naloxone or other opioid antidotes to uninsured patients. Hospitals choose whether to join. This option starts July 1, 2029.

Nursing home safety checks and cannabis oil

Nursing homes must check before admission if a new resident must register as a sex offender when a stay is expected to be over three days, or does go over three days. Staff who can give medicines may store and give cannabis oil to residents with a valid written certification. Both changes take effect July 1, 2029.

Organ donation and clotting-factor tracking

Starting July 1, 2029, each hospital must follow a federal‑compliant organ donation protocol and keep agreements with an organ procurement group, a tissue bank, and an eye bank. The protocol is followed unless the family has opposed donation and no donor document is found. Facilities that treat hemophiliacs and stock clotting factors must record lot numbers and alert the attending physician if a contaminated lot is identified.

Patient visits and device access rules

Starting July 1, 2029, hospitals must give patients a written policy on rights and responsibilities that follows federal rules. Hospitals and nursing facilities must allow visits from clergy during declared communicable‑disease emergencies, consistent with safety guidance. During a COVID‑19 public health emergency, nursing homes must offer in‑person or virtual visits at least every 10 days unless the patient or representative limits or waives visits. Facilities must also let inpatients use personal smart assistants under HIPAA‑safe policies.

Safer surgeries and rehab planning

Starting July 1, 2029, hospitals must use smoke‑evacuation systems for planned surgeries that create surgical smoke. If you are having elective surgery and will likely need outpatient physical therapy, the hospital must tell you and have you choose a therapy provider before discharge.

Hospital workplace violence rules timeline

The Board of Health must issue workplace violence rules by July 1, 2027. No penalties apply before July 1, 2029. The rules are enforceable starting July 1, 2029.

Sponsors & Cosponsors

Sponsor

  • Rodney T. Willett

    Democratic • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 218 • No: 0

Senate vote 3/2/2026

Passed Senate Block Vote

Yes: 40 • No: 0

Senate vote 2/27/2026

Passed by for the day Block Vote (Voice Vote)

Yes: 0 • No: 0

Senate vote 2/27/2026

Constitutional reading dispensed Block Vote (on 2nd reading)

Yes: 37 • No: 0

Senate vote 2/26/2026

Reported from Education and Health

Yes: 15 • No: 0

House vote 2/17/2026

Read third time and passed House Block Vote

Yes: 97 • No: 0

House vote 2/12/2026

Reported from Health and Human Services with amendment(s)

Yes: 21 • No: 0

House vote 2/10/2026

Subcommittee recommends reporting with amendment(s)

Yes: 8 • No: 0

Actions Timeline

  1. Acts of Assembly Chapter text (CHAP0145)

    4/6/2026Governor
  2. Approved by Governor-Chapter 145 (effective 7/1/2026)

    4/6/2026Governor
  3. Governor's Action Deadline 11:59 p.m., April 13, 2026

    3/10/2026Governor
  4. Enrolled Bill communicated to Governor on March 10, 2026

    3/10/2026House
  5. Fiscal Impact Statement from Department of Planning and Budget (HB456)

    3/5/2026House
  6. Bill text as passed House and Senate (HB456ER)

    3/5/2026House
  7. Enrolled

    3/5/2026House
  8. Signed by President

    3/5/2026Senate
  9. Signed by Speaker

    3/5/2026House
  10. Passed Senate Block Vote (40-Y 0-N 0-A)

    3/2/2026Senate
  11. Read third time

    3/2/2026Senate
  12. Passed by for the day Block Vote (Voice Vote)

    2/27/2026Senate
  13. Constitutional reading dispensed Block Vote (on 2nd reading) (37-Y 0-N 0-A)

    2/27/2026Senate
  14. Rules suspended

    2/27/2026Senate
  15. Reported from Education and Health (15-Y 0-N)

    2/26/2026Senate
  16. Fiscal Impact Statement from Department of Planning and Budget (HB456)

    2/19/2026House
  17. Referred to Committee on Education and Health

    2/18/2026Senate
  18. Constitutional reading dispensed (on 1st reading)

    2/18/2026Senate
  19. Read third time and passed House Block Vote (97-Y 0-N 0-A)

    2/17/2026House
  20. Engrossed by House as amended

    2/16/2026House
  21. committee amendments agreed to

    2/16/2026House
  22. Read second time

    2/16/2026House
  23. Read first time

    2/15/2026House
  24. Reported from Health and Human Services with amendment(s) (21-Y 0-N)

    2/12/2026House
  25. House subcommittee offered

    2/10/2026House

Bill Text

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