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SB 445

relative to adjudicative proceedings where there is a council or board with jurisdiction.

2026 Regular Session Introduced by Bill Gannon and 3 co-sponsors

Automatically align NC hospital rules with federal 1135/1812(f) waivers during emergencies, enabling faster capacity expansion, with DHSR oversight and safety safeguards.

Signed by the Governor on 06/19/2026; Chapter 185; Effective 08/18/2026
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Bill Summary · SB 445

SB 445 — Regulatory Relief for Hospitals in Disaster Zones

Status: Reptd Favorable (committee) | Introduced: Feb 18, 2025
Primary sponsor: Sen. Jarvis (NC); bill text reflects North Carolina G.S. 131E‑84 amendments

Purpose / intent

To ensure that state hospital licensing and regulatory requirements immediately align with temporary federal emergency flexibilities during declared emergencies, so hospitals can expand capacity and alter operations quickly and lawfully when emergencies threaten public health and safety.

Key provisions

  • Amends G.S. 131E‑84 (Waiver of rules and increase in bed capacity during an emergency) to add automatic state adoption of certain federal emergency waivers:
    • If the U.S. Secretary of Health and Human Services (HHS) or CMS issues a temporary waiver or modification under the Social Security Act (section 1135 or section 1812(f)), the corresponding state hospital rule(s) are automatically modified or waived to the extent necessary to be consistent with the federal action.
    • Those automatic state modifications remain in effect at least until the federal waiver/ modification expires.
  • Confirms the Division of Health Service Regulation (DHSR) authority to:
    • Temporarily waive state hospital rules during state, national, or federal public health emergencies, or when DHSR determines an emergency exists that poses risks to patient health or safety.
    • Allow temporary increases in hospital bed capacity notwithstanding other statutory limits (G.S. 131E‑183) during emergencies.
    • Further waive or modify rules beyond the federal action, provided changes remain consistent with federal law.
  • Retains procedural safeguards:
    • DHSR may pre-identify rules subject to waiver and may rescind a waiver if it finds an unreasonable risk to patient health, safety, or welfare.
    • Emergency management agencies must notify DHSR within 72 hours when preapproved waivers are deemed applicable (in existing subsection language).

Who is affected

  • Hospitals (acute care and other licensed facilities) — operational flexibility during declared emergencies (e.g., pandemics, natural disasters).
  • Division of Health Service Regulation / state health oversight bodies — responsibility to recognize and implement federal waivers and to supervise rescission where necessary.
  • Emergency management agencies — coordination and notification responsibilities.
  • Patients and the public — access to expanded or altered hospital services during emergencies; oversight and safety protections continue via DHSR.

Procedural / timeline notes

  • Effective immediately upon enactment (“this act is effective when it becomes law”).
  • Automatic state adjustments track the duration of any applicable federal 1135 / 1812(f) waiver; DHSR may act more broadly or narrowly as circumstances require.
  • The bill was refined in committee (committee substitute) to emphasize that only the corresponding rule(s) or portions necessary for consistency with federal waivers are automatically modified or waived.

Potential impacts

  • Expected benefits: faster operational response by hospitals, reduced regulatory friction when implementing federally authorized emergency measures, and clearer state–federal alignment.
  • Considerations/risks: automatic waivers may reduce certain state-level protections temporarily; DHSR retains authority to rescind waivers if patient safety is jeopardized. Stakeholders may seek clarity on which rules are “corresponding” and on oversight/ reporting requirements during implementation.

Compiled from official sources — confirm details with the bill’s official record.

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