Bill
SB 6101
Washington creates a state framework to allow licensed acute hospitals to provide inpatient-level care at home, continuing CMS waivers and DOH rules by 12/31/2025.
Status and procedural history
- Introduced: January 9, 2024.
- Passed the Senate (third reading) Feb 7, 2024 (yeas 49, nays 0). Returned to Senate Rules Committee for third reading by resolution March 7, 2024.
- Bill includes an emergency declaration.
Purpose and legislative intent
- Authorize and create a Washington regulatory framework allowing licensed acute care hospitals to provide "hospital at‑home" services — acute inpatient‑level care delivered in a patient’s home or other patient‑chosen location — and to preserve continuity of programs that began under the federal CMS “acute hospital care at‑home” waivers launched during the COVID‑19 pandemic.
Key provisions
- Immediate continuation for waivered programs: Hospitals that hold an active federal program waiver (CMS acute hospital care at‑home program) before the Department of Health (DOH) adopts state rules may provide hospital at‑home services and must notify DOH within 30 days of the bill’s effective date.
- Rulemaking deadline: DOH must adopt rules by December 31, 2025, to add hospital at‑home services as an approved acute care hospital service line and to establish program standards. In setting initial standards DOH must consider and endeavor to make them substantially similar to the federal program; required topics include environment of care, admission/transfer/discharge/referral processes, inclusion/exclusion criteria, geographic criteria, and data reporting. The department may adopt additional standards to promote safe care.
- Continuity if federal program ends: If the federal program expires before state rules are adopted, hospitals must continue to follow the federal requirements in effect at that time; DOH will enforce those requirements until state rules are in place.
- Application and fees: After rules are established, hospitals must apply to DOH to add hospital at‑home as a service line. Hospitals with pre‑rule federal waivers may operate while applying. DOH must approve applications meeting rule standards. The department may set a one‑time application fee not to exceed the actual staff review cost. Program administration is to be funded by hospital licensing fees (per cited RCWs).
- Regulatory scope and definitions:
- “Hospital at‑home services” are defined as acute care delivered by a licensed acute care hospital outside its licensed facility, in a patient’s home or other patient‑determined location.
- Hospital at‑home services are expressly made not subject to chapters 70.126 or 70.127 RCW (state home care/hospice/home health statutes) and do not count as increases in a hospital’s licensed bed count nor fall under chapter 70.38 RCW (bed‑related provisions).
Who is affected
- Acute care hospitals licensed under chapter 70.41 RCW (hospitals) that obtained or seek CMS at‑home waivers.
- Patients who may receive acute inpatient‑level care at home (potentially fewer readmissions, shorter treatment periods per legislative findings).
- Department of Health — responsible for rulemaking, approvals, and enforcement.
- Potentially affects the regulatory coverage and oversight previously associated with state home care statutes for services delivered under hospital at‑home programs.
Potential impacts and considerations
- Preserves and legitimizes hospital‑based at‑home acute care programs launched during the federal waiver period and clarifies state oversight.
- May expand access to inpatient‑level care outside hospitals without increasing licensed bed counts or triggering certificate‑of‑need/bed‑increase processes.
- Shifts regulatory oversight for these services into hospital licensing rules rather than into home care/home health statutory regimes (chapters 70.126 and 70.127).
- DOH rule choices between now and December 31, 2025 will determine operational details, patient protections, and reporting requirements.
Compiled from official sources — confirm details with the bill’s official record.
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