RICHMOND — A Virginia House subcommittee on health on Tuesday advanced a series of bills aimed at maternal safety, rural hospital approval processes, nursing-home oversight, water-system reporting and drug testing — including a measure requiring emergency departments to include fentanyl in urine drug screening when a drug panel is ordered. Several bills passed unanimously; one measure on a $1 sewage-reporting fee failed.

The most immediate action came on maternal-health legislation. Delegate Hayes presented House Bill 2753, which — as substituted — directs hospitals with emergency departments that handle labor and delivery, freestanding emergency departments and birthing centers to adopt standardized protocols and training for recognizing and responding to obstetric emergencies. The substitute requires collaboration with the Virginia Neonatal Perinatal Collaborative and participation in the Alliance for Innovation on Maternal Health (AIM) patient-safety bundles. "All hospitals with an emergency department for labor and delivery, freestanding emergency departments, and birthing centers shall participate in and submit data to the Alliance for Innovation in Maternal Health Patient Safety Bundle," Hayes said during his presentation.

Why it matters: Subcommittee members and several health-care groups told the panel that standard protocols, training and shared quality metrics are crucial to reduce preventable maternal morbidity and address racial disparities in maternal outcomes. Julie Deim of the Virginia Hospital and Healthcare Association and representatives of midwives and the Virginia Neonatal Perinatal Collaborative testified in support. The substitute passed on a roll call reported 8-0.

Other health-care bills advanced

- Malcolm's Law (House Bill 2742): The panel voted unanimously (8-0) to recommend the amended bill, which would require that when an emergency department orders a urine drug screen and a patient consents, fentanyl be included in that screening panel. Therea Kent, whose son Malcolm died after a suspected fentanyl exposure, urged passage: "For less than a cup of ramen, we could be giving families and clinicians the tools they need to make informed decisions about follow-on care," she said. Dr. Ronit Lev, an emergency and addiction physician who helped push similar laws in other states, told the panel that adding the fentanyl reagent is inexpensive and that other states (California, Maryland, Pennsylvania) have enacted comparable measures.

- COPN/Expedited review (House Bill 2119): Delegate Walker's substituted bill directs the State Health Services Plan Task Force to recommend an expedited Certificate of Public Need (COPN) review process for projects in areas lacking nearby hospitals or with low provider density or high poverty. The substitute passed on an 8-0 roll call after testimony from rural-health advocates and medical societies.

- Maternal-data task force (House Bill 2109): The subcommittee recommended reestablishing a legislative task force to evaluate maternal health data collection and quality measures; the motion to report the bill included a referral to appropriations and passed on a recorded vote (referred to appropriations).

Nursing-home oversight and inspection funding

Two related bills aimed at nursing-home quality and the agency resources to inspect facilities moved forward. Delegate Waxman presented House Bill 2253, which would give the Virginia Department of Health (VDH) new intermediate enforcement options short of license revocation or admission bans (for example, probation, mandated training or monetary penalties) when federal action does not follow from cited deficiencies. The bill drew strong support from the state long-term care ombudsman and advocacy groups, and opposition from industry representatives who warned about double jeopardy and urged guardrails; the subcommittee voted to report and refer the bill to appropriations (8-0).

Delegate Waxman also presented House Bill 2255 to allow VDH to set inspection and licensure fees by regulation and to use fee revenue to fund additional inspector positions. VDH testified this change would permit hiring of additional inspectors (the department cited a plan to fund seven new nursing-home inspectors to help close an inspection backlog). Supporters, including AARP Virginia and the Virginia Poverty Law Center, said the change is needed after years of flat fees. The substitute to that bill passed and the subcommittee recommended referral to appropriations (8-0).

Water systems and reporting (House Bill 2749)

A substitute to HB 2749 was reported favorably (8-0). The bill strengthens reporting and definitions for public water systems, adds defined terms for equipment malfunctions and requires monthly reporting to the VDH Office of Drinking Water, including prompt notice of critical equipment failures. Duane Roadcap of VDH's Office of Drinking Water said the office maintains after-hours coverage for emergency reports. Orange County Supervisor Brian Nicole described a 2024 water emergency that left many residents under a "do not use" advisory and urged passage.

Other measures

- House Bill 2319 (drug-checking products): The subcommittee approved a technical change to extend the existing exception for fentanyl test devices to drug-checking products for other contaminants and opioids; the bill passed on an 8-0 roll.

- House Bill 2473 (correctional facility drug stock): The subcommittee approved allowing correctional facilities to register with the board of pharmacy to keep floor stock of long-acting injectable or extended‑release medications for mental illness and substance-use disorder, with perpetual inventory and monthly reconciliation requirements; it passed 8-0.

- House Bill 2082 (DMAS provider appeals): A clarification bill to align provider appeal procedures in the Code with existing DMAS (Department of Medical Assistance Services) practice passed on an 8-0 roll.

Failed item

- House Bill 2031 (remove $1 reporting fee for alternate on-site sewage): The subcommittee voted and the bill failed on a 3-5 vote. Supporters, including Delegate Orrock and VDH, said the $1 fee is costly to administer relative to revenue; opponents raised procedural and substitution issues during the roll call and the motion did not carry.

What happened next and what's pending

Several bills were referred to appropriations for funding consideration (including the nursing-home sanction/inspection bills and the maternal-data task force bill). The subcommittee scheduled an additional meeting to finish remaining docket items.

Speakers quoted in this report spoke at the subcommittee session: Delegate Hayes (patron, HB 2753), Therea Kent (family member testifying on HB 2742), Dr. Ronit Lev (physician/advocate on HB 2742), Julie Deim (Virginia Hospital and Healthcare Association), Delegate Walker (HB 2119), Delegate Waxman (HBs 2253 and 2255), Kim Beasley and Duane Roadcap (VDH offices), Brian Nicole (Orange County supervisor).