HB 832 — An Act providing for hospital closure procedure requirements, for notice of proposed general hospital closure or significant impact closure, for health equity impact assessments, for closure plans and for enforcement actions.

PRINTER'S NO.   1192

                   THE GENERAL ASSEMBLY OF PENNSYLVANIA



                        HOUSE BILL
                        No. 832
                                               Session of
                                                 2025

     INTRODUCED BY O'MARA, PASHINSKI, WAXMAN, KHAN, GUENST, MADDEN,
        GIRAL, PIELLI, HILL-EVANS, HANBIDGE, OTTEN, HOWARD, MAYES,
        SANCHEZ, HADDOCK, DALEY, DONAHUE, KENYATTA, FREEMAN,
        DAVIDSON, CIRESI AND CERRATO, APRIL 1, 2025

     REFERRED TO COMMITTEE ON HEALTH, APRIL 1, 2025


                                   AN ACT
 1   Providing for hospital closure procedure requirements, for
 2      notice of proposed general hospital closure or significant
 3      impact closure, for health equity impact assessments, for
 4      closure plans and for enforcement actions.
 5      The General Assembly of the Commonwealth of Pennsylvania
 6   hereby enacts as follows:
 7   Section 1.   Short title.
 8      This act shall be known and may be cited as the Hospital
 9   Closure Procedure and Notification Act.
10   Section 2.   Definitions.
11      The following words and phrases when used in this act shall
12   have the meanings given to them in this section unless the
13   context clearly indicates otherwise:
14      "Closure plan."   A detailed plan for a general hospital
15   closure or a significant impact unit closure as required under
16   this act.
17      "Department."   The Department of Health of the Commonwealth.
18      "General hospital closure."   The closure of all or a majority
 1   of the units or departments of a hospital.
 2      "Health equity impact assessment."        A report that provides
 3   data metrics on a hospital as required under section 7.
 4      "Hospital."     As defined in 28 Pa. Code § 101.4 (relating to
 5   definitions).
 6      "Hospital authority."     A hospital's parent company or
 7   governing body or a similar authority that oversees the
 8   hospital's operations and a closure plan.
 9      "Significant impact closure."        The closure of an emergency
10   treatment unit or department of a hospital, a labor and delivery
11   unit or department of a hospital or any other type of unit or
12   department of a hospital, that the department determines, by
13   regulation under section 10, significantly impacts the health
14   and welfare of an affected community.
15   Section 3.     Hospital closure procedure requirements.
16      (a)   Prohibition.--A hospital authority may not engage in a
17   general hospital closure or significant impact closure unless
18   the hospital has adopted a closure plan that has been approved
19   by the Office of Attorney General and either the department or
20   the health department of the county or municipality where the
21   hospital is located.
22      (b)   Approval process.--
23            (1)   The Office of Attorney General and either the
24      department or the health department of the county or
25      municipality where the hospital is located may not approve a
26      closure plan unless the Office of Attorney General and either
27      the department or the health department of the county or
28      municipality where the hospital is located determine that
29      continuity of patient care and the health and safety needs of
30      the affected community have been adequately addressed in the

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 1      closure plan.
 2            (2)   The Office of Attorney General and either the
 3      department or the health department of the county or
 4      municipality where the hospital is located may provide a
 5      conditional approval of the closure plan based on the
 6      hospital authority entering into an agreement with the Office
 7      of Attorney General and either the department or the health
 8      department of the county or municipality where the hospital
 9      is located to meet the requirements under this act.
10   Section 4.     Notice of proposed general hospital closure or
11                  significant impact closure.
12      No later than 180 days before engaging in a general hospital
13   closure or significant impact closure, a hospital authority
14   shall submit a notice of the closure plan to the Office of
15   Attorney General and either the department or the health
16   department of the county or municipality where the hospital is
17   located.
18   Section 5.     Public hearings.
19      (a)     Duty of hospital authority.--Before engaging in a
20   general hospital closure or significant impact closure, a
21   hospital authority shall hold a minimum of two public hearings
22   in the affected community. The hospital authority shall hold one
23   public hearing no later than 60 days after submitting the notice
24   under section 4. The hospital authority shall hold a second
25   public hearing no later than 120 days after submitting the
26   notice under section 4.
27      (b)     Advertisements.--The hospital authority shall provide a
28   notice of each public hearing under subsection (a) by
29   advertising each public hearing in a newspaper of general
30   circulation within the impacted county, including the time and

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 1   place of each public hearing and other relevant information. The
 2   hospital authority shall advertise each public hearing no
 3   earlier than 60 days before the date of the public hearing and
 4   no later than 10 days before the date of the public hearing.
 5      (c)   Hearing information.--No later than 10 days before the
 6   date of each public hearing under subsection (a), the hospital
 7   authority shall make any relevant information, including
 8   handouts, about each public hearing available via a publicly
 9   accessible Internet website.
10      (d)   Attendance.--The Office of Attorney General and either
11   the department or the health department of the county or
12   municipality where the hospital is located may require hospital
13   executive staff and administrators to attend a public hearing
14   under subsection (a) and engage in discussions at the public
15   hearing, including discussions regarding relevant information
16   and documents, the closure plan and compliance with the closure
17   plan.
18   Section 6.     Public comment period.
19      (a)   Comments.--In each advertisement under section 5(b), the
20   hospital authority shall include contact information for the
21   solicitation of public comments on the closure plan, including
22   the following:
23            (1)   A toll-free telephone number for sharing public
24      comments.
25            (2)   A publicly accessible Internet website for sharing
26      public comments.
27      (b)   Review.--The hospital authority shall collect and
28   transcribe the public comments received under subsection (a),
29   make the public comments available on the publicly accessible
30   Internet website under subsection (a)(2) and provide a

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 1   transcript of the public comments to the Office of Attorney
 2   General and either the department or the health department of
 3   the county or municipality where the hospital is located no
 4   later than 30 days before engaging a general hospital closure or
 5   significant impact closure.
 6      (c)   Comment period.--The hospital authority shall provide a
 7   public comment period on the closure plan of no less than 60
 8   days before engaging in a general hospital closure or
 9   significant impact closure.
10   Section 7.     Health equity impact assessments.
11      (a)   Submission.--No later than 80 days before engaging in a
12   general hospital closure or significant impact closure, a
13   hospital authority shall submit a health equity impact
14   assessment to the Office of Attorney General and either the
15   department or the health department of the county or
16   municipality where the hospital is located. The hospital
17   authority shall include all of the following information in the
18   health equity impact assessment:
19            (1)   The estimated number of patients gaining or losing
20      access to health care services at the hospital due to the
21      general hospital closure or significant impact closure.
22            (2)   The estimated number of low-income, senior, minority
23      and Medicare and medical assistance eligible patients gaining
24      or losing access to health care services due to the general
25      hospital closure or significant impact closure.
26            (3)   The names and addresses of the three nearest
27      hospitals that provide comparable services, including whether
28      or not each hospital is a medical assistance provider.
29            (4)   A summary of the public and private transit options
30      to the hospitals specified under paragraph (3), including

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 1      estimated drive times.
 2            (5)   The number of hospital beds gained or eliminated due
 3      to the general hospital closure or significant impact
 4      closure.
 5            (6)   A summary of the gained or eliminated health care
 6      services due to the general hospital closure or significant
 7      impact closure.
 8            (7)   The number of jobs that will be created or lost due
 9      to the general hospital closure or significant impact
10      closure.
11            (8)   The estimated fiscal impact on the affected
12      community due to the general hospital closure or significant
13      impact closure.
14            (9)   The estimated fiscal impact on the hospital
15      authority due to the general hospital closure or significant
16      impact closure.
17      (b)     Forms.--The department shall develop a standardized form
18   for use by a hospital authority to complete and submit a health
19   equity impact assessment under subsection (a) and make the form
20   available on the department's publicly accessible Internet
21   website.
22   Section 8.     Closure plans.
23      (a)     Initial plan.--No later than 120 days before engaging in
24   a general hospital closure or significant impact closure, a
25   hospital authority shall submit an initial closure plan to the
26   Office of Attorney General and either the department or the
27   health department of the county or municipality where the
28   hospital is located.
29      (b)     Updates.--After submitting the initial closure plan
30   under subsection (a), the hospital authority shall provide

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 1   updates on the implementation of the closure plan to the Office
 2   of Attorney General and either the department or the health
 3   department of the county or municipality where the hospital is
 4   located every 14 days until the date when the general hospital
 5   closure or significant impact closure is completed.
 6      (c)   Contents.--The hospital authority shall include all of
 7   the following information in a closure plan:
 8            (1)   The reason for the general hospital closure or
 9      significant impact closure.
10            (2)   Strategies regarding the continuity of patient care
11      in each department and unit of the hospital and the transfer
12      of patients to other health care facilities.
13            (3)   Strategies regarding specialized programs or groups
14      of patients particularly vulnerable to interruptions in
15      medical care, including cancer chemotherapy or prenatal care.
16            (4)   Strategies for the closure of the emergency
17      department of the hospital, including diversion to other
18      hospital emergency departments and the interface with
19      emergency medical services.
20            (5)   Written agreements with other health care providers
21      to accept responsibility for continuing the care of patients
22      receiving ongoing care at the hospital.
23            (6)   Strategies for how all medical records, including
24      paper and electronic records, will be maintained throughout
25      and after the general hospital closure or significant impact
26      closure, and how the medical records will be made available
27      to former patients and the physicians who provide care for
28      the patients.
29            (7)   Strategies for the maintenance, transfer and
30      disposal of pharmaceuticals, chemicals, hazardous substances

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 1      and other similar materials located at the hospital.
 2            (8)    The anticipated timeline for the closing of each
 3      department or unit of the hospital.
 4            (9)    A communications and engagement plan regarding the
 5      affected community, including holding public meetings in the
 6      affected community.
 7            (10)    Any change to the administration and medical staff
 8      of the hospital authority during the implementation of the
 9      closure plan.
10            (11)    Strategies regarding the hospital authority's
11      efforts to assist affected employees and students with
12      finding suitable employment and educational opportunities.
13            (12)    Strategies regarding the hospital authority's
14      efforts to assist affected employees with maintaining health
15      insurance and to address the impact of collective bargaining
16      for represented employees.
17            (13)    Strategies for maintaining hospital security.
18            (14)    Strategies for supervising compliance with the
19      closure plan, including updates to the closure plan under
20      subsection (b).
21   Section 9.      Enforcement actions.
22      (a)   Actions.--If the Office of Attorney General or either
23   the department or the health department of the county or
24   municipality where the hospital is located determines that a
25   hospital has violated the provisions of this act, the Attorney
26   General or a district attorney may initiate a civil action to
27   enforce the provisions of this act.
28      (b)   Remedies.--If a court of competent jurisdiction finds
29   that a hospital has failed to comply with this act, the court
30   may:

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 1          (1)     enjoin the hospital authority from taking any
 2      measure to engage a general hospital closure or significant
 3      impact closure until the hospital authority complies with
 4      this act;
 5          (2)     appoint a special master or temporary manager to
 6      ensure that the hospital authority complies with this act; or
 7          (3)     grant any other remedy as the court deems just,
 8      proper and equitable under the circumstances.
 9   Section 10.    Regulations.
10      The Office of Attorney General and the department shall
11   jointly promulgate regulations necessary to effectuate this act.
12   Section 11.    Construction.
13      Nothing in this act shall be construed to require the
14   Commonwealth or a municipality, including an official or
15   employee of the Commonwealth or municipality, to relieve,
16   discharge, perform, indemnify or assume liability for an
17   obligation or duty belonging to a hospital or the hospital's
18   officers, directors or affiliates.
19   Section 12.    Effective date.
20      This act shall take effect in 30 days.




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