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This legislation authorizes the State of Rhode Island to provide up to $18 million to create a debt service reserve fund for CharterCARE Health. This financial support is intended to help CharterCARE secure bond financing to purchase and operate Roger Williams Medical Center and Our Lady of Fatima Hospital, both of which are currently in bankruptcy proceedings. The funds will be transferred from the state's supplemental budget reserve. If the bond sale to purchase the hospitals does not close by May 8, 2026, this legislation will not take effect.
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Analysis

Pros for Progressives

  • Preserves essential healthcare access for the communities served by Roger Williams Medical Center and Our Lady of Fatima Hospital, preventing the creation of "medical deserts" in urban areas.
  • Protects approximately 2,700 jobs at these facilities, preventing mass unemployment and the associated economic instability for workers and their families.
  • Ensures continued service to vulnerable populations, including uninsured and governmentally insured patients, who rely on these community hospitals for emergency and inpatient care.

Cons for Progressives

  • Allocates $18 million in public funds to support a private entity's acquisition of assets, which some may view as a corporate bailout rather than a direct investment in public infrastructure.
  • Diverts money from the supplemental state budget reserve that could potentially be used for other pressing social needs, such as housing or education.
  • Relies on a private healthcare model to solve a public health crisis, potentially perpetuating systemic issues regarding profit-driven healthcare rather than moving toward a fully public system.

Pros for Conservatives

  • Prevents the economic shock of losing 2,700 jobs, which would have a negative ripple effect on the local economy and tax base.
  • Utilizes existing reserve funds to facilitate a private market transaction rather than creating a permanent government-run hospital system or raising new taxes.
  • Stabilizes the healthcare market to ensure competition remains, rather than allowing a total collapse that might require more drastic and expensive government intervention later.

Cons for Conservatives

  • Represents government intervention in the free market by using taxpayer funds to prop up a specific business transaction, picking winners and losers.
  • Risks $18 million of state funds on a business venture that has already faced bankruptcy, potentially wasting taxpayer money if the new management fails.
  • Sets a precedent that the state will step in with financial guarantees when private businesses fail, potentially encouraging moral hazard in other sectors.

Constitutional Concerns

None Likely

Impact Overview

Groups Affected

  • Hospital Employees
  • Patients of Roger Williams Medical Center
  • Patients of Our Lady of Fatima Hospital
  • CharterCARE Health of Rhode Island Inc
  • Rhode Island Taxpayers

Towns Affected

Providence, North Providence

Cost to Taxpayers

$11.56

Revenue Generated

None

BillBuddy Impact Ratings

Importance

65

Measures population affected and overall level of impact.

Freedom Impact

0

Level of individual freedom impacted by the bill.

Public Services

80

How much the bill is likely to impact one or more public services.

Regulatory

5

Estimated regulatory burden imposed on the subject(s) of the bill.

Clarity of Bill Language

95

How clear the language of the bill is. Higher ambiguity equals a lower score.

Enforcement Provisions

100

Measures enforcement provisions and penalties for non-compliance (if applicable).

Environmental Impact

0

Impact the bill will have on the environment, positive or negative.

Privacy Impact

0

Impact the bill is likely to have on the privacy of individuals.

Bill Status

Current Status

Held
Comm Passed
Floor Passed
Law

History

• 01/29/2026 Introduced, referred to House Finance
• 01/30/2026 Scheduled for hearing (02/03/2026)
• 02/03/2026 Committee recommended measure be held for further study
• 02/04/2026 Scheduled for consideration (02/06/2026)
• 02/05/2026 Proposed Substitute
• 02/06/2026 Committee recommends passage of Sub A
• 02/06/2026 Placed on House Calendar (02/10/2026)
• 02/10/2026 House passed Sub A as amended (floor amendment)
• 02/10/2026 Senate passed Sub A as amended in concurrence
• 02/10/2026 Transmitted to Governor
• 02/11/2026 Signed by Governor

Bill Text

SECTION 1. This article shall serve as the joint resolution and authorization required pursuant to Rhode Island General Laws § 35-18-1, et seq (the “Rhode Island Public Corporation Debt Management Act”) and other applicable law.

SECTION 2. CharterCARE Health of Rhode Island, Inc. Debt Service Reserve Fund
WHEREAS, The General Assembly has historically adopted laws and provided various levels of support for the benefit of hospitals and healthcare facilities in the state for the health, safety and welfare of the Rhode Island people; and
WHEREAS, Certain community hospitals act as the sole source of immediate access to hospital care for residents of the areas they serve and are essential to the maintenance of public health and safety; and
WHEREAS, The diversity of services provided by these essential community hospitals are necessary for the overall health and safety of the community, but the costs of such services result in financial distress for the hospitals that must serve large uninsured or governmentally insured populations;
WHEREAS, Because of the important medical services provided by such hospitals, restoring and ensuring the continued financial viability of these essential community hospitals is necessary for the public health and safety; and
WHEREAS, Roger William Medical Center located in Providence, Rhode Island and Our Lady of Fatima Hospital, located in North Providence, Rhode Island (the “Hospitals”) are distressed essential community hospitals, currently under the supervision of the United States Bankruptcy Court for the Northern District of Texas Dallas Division Case No 25-80002 (SGJ) and are currently in the process of being sold to CharterCARE Health of Rhode Island, Inc. pursuant to an order of the Bankruptcy Court and state approvals pursuant to the Hospital Conversions Act Rhode Island General Laws § 23-17.14-1 et seq. and the Licensing of Healthcare Facilities Act Rhode Island General Laws § 23-17-1 et seq.; and
WHEREAS, In fiscal year 2024, Roger Williams Medical Center provided care for nearly 31,500 emergency room patients, 55,000 inpatient cases and 84,000 outpatient visits, demonstrating that the financial viability of Roger Williams Medical Center is vital to the public health and safety of the community it serves; and
WHEREAS, In fiscal year 2024, Our Lady of Fatima Hospital provided care for nearly 25,500 emergency room patients, 4,857 inpatient cases and 124,000 outpatient visits, demonstrating that the financial viability of Our Lady of Fatima Hospital is vital to the public health LC004723 - Page 2 of 7 and safety of the community it serves; and
WHEREAS, Ensuring the financial viability of the Hospitals is expected to preserve two thousand seven hundred (2,700) jobs and benefit the State of Rhode Island; and
WHEREAS, To preserve the viability of the Hospitals, it is necessary to provide financing support to assist the sale of the Hospitals to CharterCARE Health of Rhode Island, Inc.; and
WHEREAS, CharterCARE Health of Rhode Island, Inc., itself or acting through its affiliate or a special purpose entity created for such purpose, as borrower, intends to finance the acquisition of the Hospitals and all or a portion of the related costs through the issuance of limited obligations of the Rhode Island Health and Educational Building Corporation (the “Corporation”) under its hospital revenue bond program; and
WHEREAS, Due to market conditions and to enhance the creditworthiness of the borrower, it is critical to the sale of the bonds that the state provide no greater than eighteen million dollars ($18,000,000) to fund a debt service reserve fund as credit support for the bonds; and
WHEREAS, The state from time to time may fund the debt service reserve fund from available monies as set forth in Article 3 herein or by paying the costs to obtain a letter of credit, surety or other credit support for the bonds (the “Credit Facility”), or any combination of the foregoing; and
WHEREAS, That the state’s obligations under any Credit Facility will be subject to appropriation therefor by the General Assembly in each budget year; and
WHEREAS, The maximum obligation of the state under any Credit Facility shall be $18,000,000 not including interest on any amounts drawn and fees; and
WHEREAS, The Rhode Island Public Corporation Debt Management Act requires the General Assembly to provide its consent to the issuance or incurring by the State of Rhode Island of certain obligations, including financing guarantees or other credit support agreements.
NOW THEREFORE, It is enacted and resolved by the General Assembly as follows:
RESOLVED, That this General Assembly hereby approves the creation of a debt service reserve fund for the bonds in a principal amount funded by the state not to exceed $18,000,000 in accordance with Article 3 hereof, or, at the option of the state, in lieu of cash funding of the debt service reserve fund, the establishment of a Credit Facility to fund the debt service reserve fund for the bonds in a principal amount of not to exceed $18,000,000; and be it further
RESOLVED, That the state shall have no obligation to replenish the debt service reserve fund, however, nothing contained herein shall prohibit the state by act of the General Assembly from doing so in the event the debt service reserve fund is drawn upon; and be it further
RESOLVED, That any funds remaining in the debt service reserve fund either upon LC004723 - Page 3 of 7 payment in full of the bonds or upon the substitution of cash funding with a Credit Facility shall revert to the supplemental state budget reserve account established pursuant to Rhode Island General Laws § 35-3-20.2; and be it further
RESOLVED, That the interest rate on any Credit Facility shall not exceed the maximum rate permitted by law; and be it further
RESOLVED, That the state, acting through the general treasurer shall execute agreements in connection with the establishment of a Credit Facility as contemplated herein and any other agreements necessary to effectuate the purposes of this act; and be it further
RESOLVED, That bonds issued by the Corporation will be special obligations of the Corporation payable from funds received by the Corporation under the bond documents and other revenues received by the Corporation, in any combination or priority as may be designated in the proceedings of the Corporation authorizing the issuance of such debt; and be it further
RESOLVED, That the Credit Facility will not constitute indebtedness of the state or any of its subdivisions or a debt for which the full faith and credit of the state or any of its subdivisions is pledged; and be it further
RESOLVED, That the state’s authority to incur the obligations set forth herein is contingent upon the sale and issuance of the bonds to provide funds for the purchase of the Hospitals and all or a portion of the costs associated therewith. The authority hereunder shall become effective upon the sale of the bonds and shall remain in effect as long the bonds remain outstanding.
RESOLVED, That this joint resolution shall take effect upon passage.

SECTION 3. This article shall take effect upon passage ARTICLE 2 RELATING TO THE SUPPLEMENTAL STATE BUDGET RESERVE ACCOUNT

SECTION 1. Section 35-3-20.2 of the General Laws in Chapter 35-3 entitled "State Budget" is hereby amended to read as follows:
35-3-20.2. Supplemental state budget reserve account.
(a) There is hereby created within the general fund a supplemental state budget reserve account, which shall be administered by the state controller and which shall be used solely for the purpose of providing such sums as may be appropriated to fund any unanticipated general revenue deficit caused by a general revenue shortfall.
(b) At any time after the third quarter of a fiscal year that it is indicated that total resources which are defined to be the aggregate of estimated general revenue, general revenue receivables, and available free surplus in the general fund will be less than the estimates upon which current appropriations were based, the general assembly may make appropriations from the supplemental state budget reserve account for the difference between the estimated total resources and the original estimates upon which enacted appropriations were based, but only in the amount of the difference based upon the revenues projected at the latest state revenue estimating conference pursuant to chapter 16 of this title as reported by the chairperson of that conference.
(c) Whenever a transfer has been made pursuant to subsection (b), that transfer shall be considered as estimated general revenues for the purposes of determining the amount to be transferred to the Rhode Island capital plan fund for the purposes of § 35-3-20.1(b).
(d) The supplemental state budget reserve account shall consist of: (1) Such sums as the state may from time to time directly transfer to the account as authorized in law; and (2) Any amounts transferred pursuant to § 35-6-1(e).
(e) Notwithstanding the provisions of this section or any other law to the contrary, for the fiscal year ending June 30, 2026, the state controller shall transfer the sum of eighteen million dollars ($18,000,000) from the supplemental state budget reserve account to general revenue. LC004723 - Page 5 of 7 ARTICLE 3 RELATING TO MAKING REVISED APPROPRIATIONS IN SUPPORT OF FY 2026

SECTION 1. Section 1 of Article 1 of Chapter 278 of the Public Laws of 2025 is hereby amended as follows:
Increase general revenue by $18,000,000 by adding a new line item within the general program of the department of administration by inserting the following text after the line “Library Construction Aid 2,115,628”:
Hospital Financing Support Debt Service Reserve $18,000,000
Provided that, in order to provide credit enhancement to the proposed Hospital Financing Revenue Bonds (CharterCARE Health of Rhode Island, Inc. Issue) to be issued by the Rhode Island Health and Educational Building Corporation, $18,000,000 be allocated to the Rhode Island Health and Educational Building Corporation to be used to fund a debt service reserve fund for the bonds LC004723 - Page 6 of 7 ARTICLE 4 RELATING TO EFFECTIVE DATE

SECTION 1. Except as otherwise provided herein, this act shall take effect upon the sale of the proposed Hospital Financing Revenue Bonds (CharterCARE Health of Rhode Island, Inc. Issue) to be issued by the Rhode Island Health and Educational Building Corporation, and further provided that if the bond issue does not close by May 8, 2026 this act shall not take effect.

SECTION 2. The article shall take effect upon passage.
SECTION 1. CharterCARE Health of Rhode Island, Inc. Debt Service Reserve Fund.
WHEREAS, The General Assembly has historically adopted laws and provided various levels of support for the benefit of hospitals and healthcare facilities in the state for the health, safety and welfare of the Rhode Island people; and
WHEREAS, Certain community hospitals act as the sole source of immediate access to hospital care for residents of the areas they serve and are essential to the maintenance of public health and safety; and
WHEREAS, The diversity of services provided by these essential community hospitals are necessary for the overall health and safety of the community, but the costs of such services result in financial distress for the hospitals that must serve large uninsured or governmentally insured populations;
WHEREAS, Because of the important medical services provided by such hospitals, restoring and ensuring the continued financial viability of these essential community hospitals is necessary for the public health and safety; and
WHEREAS, Roger Williams Medical Center located in Providence, Rhode Island and Our Lady of Fatima Hospital, located in North Providence, Rhode Island (the “Hospitals”) are distressed essential community hospitals, currently under the supervision of the United States Bankruptcy Court for the Northern District of Texas Dallas Division Case No 25-80002 (SGJ) and are currently in the process of being sold to CharterCARE Health of Rhode Island, Inc. pursuant to an order of the Bankruptcy Court and state approvals pursuant to the Hospital Conversions Act Rhode Island General Laws § 23-17.14-1 et seq. and the Licensing of Healthcare Facilities Act Rhode Island General Laws § 23-17-1 et seq.; and
WHEREAS, In fiscal year 2024, Roger Williams Medical Center provided care for nearly 31,500 emergency room patients, 55,000 inpatient cases and 84,000 outpatient visits, demonstrating that the financial viability of Roger Williams Medical Center is vital to the public health and safety of the community it serves; and
WHEREAS, In fiscal year 2024, Our Lady of Fatima Hospital provided care for nearly 25,500 emergency room patients, 4,857 inpatient cases and 124,000 outpatient visits, demonstrating that the financial viability of Our Lady of Fatima Hospital is vital to the public health LC004723/SUB A - Page 2 of 5 and safety of the community it serves; and
WHEREAS, Ensuring the financial viability of the Hospitals is expected to preserve two thousand seven hundred (2,700) jobs and benefit the State of Rhode Island; and
WHEREAS, To preserve the viability of the Hospitals, it is necessary to provide financing support to assist the sale of the Hospitals to CharterCARE Health of Rhode Island, Inc.; and
WHEREAS, CharterCARE Health of Rhode Island, Inc., itself or acting through its affiliate or a special purpose entity created for such purpose, as borrower, intends to finance the acquisition of the Hospitals and all or a portion of the related costs through the issuance of limited obligations of the Rhode Island Health and Educational Building Corporation (the “Corporation”) under its hospital revenue bond program; and
WHEREAS, Due to market conditions and to enhance the creditworthiness of the borrower, it is critical to the sale of the bonds that the state provide no greater than eighteen million dollars ($18,000,000) to fund a debt service reserve fund as credit support for the bonds; and
WHEREAS, The state from time to time may fund the debt service reserve fund from available monies as set forth in Section 3 herein.
NOW THEREFORE, It is enacted and resolved by the General Assembly as follows:
RESOLVED, That this General Assembly hereby approves the creation of a debt service reserve fund for the bonds in a principal amount funded by the state not to exceed $18,000,000 in accordance with Section 3 hereof; and be it further
RESOLVED, That the state shall have no obligation to replenish the debt service reserve fund, however, nothing contained herein shall prohibit the state by act of the General Assembly from doing so in the event the debt service reserve fund is drawn upon; and be it further
RESOLVED, That any funds remaining in the debt service reserve fund upon payment in full of the bonds shall revert to the supplemental state budget reserve account established pursuant to Rhode Island General Laws § 35-3-20.2; and be it further
RESOLVED, That bonds issued by the Corporation will be special obligations of the Corporation payable from funds received by the Corporation under the bond documents and other revenues received by the Corporation, in any combination or priority as may be designated in the proceedings of the Corporation authorizing the issuance of such debt; and be it further
RESOLVED, That the bonds will not constitute indebtedness of the state or any of its subdivisions or a debt for which the full faith and credit of the state or any of its subdivisions is pledged; and be it further
RESOLVED, That the state’s authority to incur the obligations set forth herein is contingent upon the sale and issuance of the bonds to provide funds for the purchase of the LC004723/SUB A - Page 3 of 5 Hospitals and all or a portion of the costs associated therewith. The authority hereunder shall become effective upon the sale of the bonds and shall remain in effect as long the bonds remain outstanding.
RESOLVED, That this joint resolution shall take effect upon passage.

SECTION 2. Section 35-3-20.2 of the General Laws in Chapter 35-3 entitled "State Budget" is hereby amended to read as follows:
35-3-20.2. Supplemental state budget reserve account.
(a) There is hereby created within the general fund a supplemental state budget reserve account, which shall be administered by the state controller and which shall be used solely for the purpose of providing such sums as may be appropriated to fund any unanticipated general revenue deficit caused by a general revenue shortfall.
(b) At any time after the third quarter of a fiscal year that it is indicated that total resources which are defined to be the aggregate of estimated general revenue, general revenue receivables, and available free surplus in the general fund will be less than the estimates upon which current appropriations were based, the general assembly may make appropriations from the supplemental state budget reserve account for the difference between the estimated total resources and the original estimates upon which enacted appropriations were based, but only in the amount of the difference based upon the revenues projected at the latest state revenue estimating conference pursuant to chapter 16 of this title as reported by the chairperson of that conference.
(c) Whenever a transfer has been made pursuant to subsection (b), that transfer shall be considered as estimated general revenues for the purposes of determining the amount to be transferred to the Rhode Island capital plan fund for the purposes of § 35-3-20.1(b).
(d) The supplemental state budget reserve account shall consist of: (1) Such sums as the state may from time to time directly transfer to the account as authorized in law; and (2) Any amounts transferred pursuant to § 35-6-1(e).
(e) Notwithstanding the provisions of this section or any other law to the contrary, for the fiscal year ending June 30, 2026, the state controller shall transfer the sum of eighteen million dollars ($18,000,000) from the supplemental state budget reserve account to general revenue.

SECTION 3. Section 1 of Article 1 of Chapter 278 of the Public Laws of 2025 is hereby amended as follows:
Increase general revenue by $18,000,000 by adding a new line item within the general program of the department of administration by inserting the following text after the line “Library Construction Aid 2,115,628”:
Hospital Financing Support Debt Service Reserve $18,000,000 LC004723/SUB A - Page 4 of 5
Provided that, in order to provide credit enhancement to the proposed Hospital Financing Revenue Bonds (CharterCARE Health of Rhode Island, Inc. Issue) to be issued by the Rhode Island Health and Educational Building Corporation, $18,000,000 be allocated to the Rhode Island Health and Educational Building Corporation to be used to fund a debt service reserve fund for the bonds.
Increase the department of administration grand total as follows:
Grand Total - Administration 430,628,941 448,628,941
Increase statewide totals general revenues as follows:
Statewide Totals
General Revenues 5,809,363,121 5,827,363,121
Increase statewide grand total as follows:
Statewide Grand Total 14,336,378,593 14,354,378,593

SECTION 4. Except as otherwise provided herein, this act shall take effect upon the sale of the proposed Hospital Financing Revenue Bonds (CharterCARE Health of Rhode Island, Inc. Issue) to be issued by the Rhode Island Health and Educational Building Corporation, and further provided that if the bond issue does not close by May 8, 2026 this act shall not take effect.

SECTION 5. The article shall take effect upon passage.
Changes from H7408A:
The amended bill removes the option for the state to use a "Credit Facility" (such as a letter of credit) to fund the debt service reserve, requiring cash funding instead. Additionally, it updates the appropriations section to include specific dollar amount adjustments to agency and statewide budget totals reflecting the $18 million increase.
- Removed all references and authorizations regarding the use of a "Credit Facility" (letter of credit, surety, etc.) in lieu of cash funding for the debt service reserve fund.
- Deleted resolutions setting interest rate limits on Credit Facilities and authorizing the general treasurer to execute Credit Facility agreements.
- Updated the appropriations section to specifically list the increased "Grand Total - Administration" ($448,628,941), "Statewide Totals General Revenues" ($5,827,363,121), and "Statewide Grand Total" ($14,354,378,593).
- Renumbered the structure from distinct "Articles" (Article 2, 3, 4) to sequential "Sections" (Section 2, 3, 4, 5).
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