BILL NUMBER: S8843A
SPONSOR: RIVERA
 
TITLE OF BILL:
An act to amend the public health law, in relation to providing public
notice and public engagement when a general hospital seeks to close
entirely or a unit that provides maternity, mental health or substance
use care
 
PURPOSE OR GENERAL OF BILL:
Requires public notice and public engagement when a general hospital
seeks to either close entirely or close a unit that provides emergency,
maternity, mental health, or substance use care.
 
SUMMARY OF SPECIFIC PROVISIONS:
Section one names the act as the "Local Input in Community Healthcare
Act"
Section two amends section 2801-g of the public health law (PHL) as it
relates to a community forum on hospital closure, to set forth a process
for closure of a general hospital or unit of a general hospital.
Subdivision 1 defines unit and reduction for purposes of this section.
Subdivision 2 is amended to set forth the process for the closure of a
general hospital. General hospitals must provide written notification of
proposed closure of a general hospital to the Department of Health (DOH)
no later than 270 days before the proposed closure date, and allows
hospitals to confer with DOH prior to giving written notice. The
closure application will require review from the Public Health and
Health Planning Council (PHHPC), which includes the health equity impact
assessment. The application would be submitted at least 210 days before
the proposed closure. No cessation, transfer, pause, or limitation of
service may be carried out without prior written approval by the Commis-
sioner of Health (COH).
*Paragraph (c) is added to extend the period that the COH is required to
hold a public community forum to obtain public input concerning the
anticipated impact of the hospital closure from no later than 30 days
after to 150 days before the proposed closure. Additionally, requires
the commissioner to make the following information publicly available no
later than 30 days prior to a community forum: the proposed closure plan
submitted by the health facility, the impact on access to health care
services to the surrounding community and information on specific meas-
ures DOH will take, and any other recommendations to address the impact
of the closure on health care services, including but not limited to
ensuring services being eliminated are still accessible to medicaid
recipients or individuals insured by publicly subsidized plans, and
uninsured residents in the surrounding facilities. The COH must announce
the date and location the community forum on the proposed closure of a
hospital 14 days prior, instead of 10 days prior, to be held and must
ensure the forum is held at a proper time and accessible to the impacted
community virtually and physically.
*Paragraphs (d)-(e) require hospitals to submit a revised plan address-
ing community concerns no later than 30 days after the community forum
and make it publicly available within 45 days after the forum. PHHPC
must meet to review the application with the revised plan no later than
90 days after the forum and must make a recommendation to the commis-
sioner within two weeks after meeting.
Subdivision 3 sets forth the process for unit reductions or closures
that affect emergency, maternity, mental health, substance use, or any
other licensed services in the operating certificate including specialty
care. Requires written notification no later than 210 days prior and
provides for exemptions from the required process for a reduction or
closure of a unit. The community forum is required to be held no later
than 90 days prior to the proposed closure date. At least 14 days before
the forum, the hospital must notify the community stakeholders of the
date and location of the forum and the COH must make the proposed
closure plan publicly available.
*Paragraph (d)-(e) requires hospitals to submit a revised unit closure
plan addressing community concerns no later than 30 days after the
community forum and make it publicly available within 45 days after the
forum. PHHPC must meet to review the application with the revised plan
no later than 90 days after the forum and must make a recommendation to
the commissioner within two weeks after meeting.
Subdivision 4 requires the COH to make a decision to either approve or
deny a closure plan within 30 days following receipt of a PHHPC recom-
mendation.
Former subdivision 4 is now new subdivision 5
Adds a new subdivision 6 requiring an annual report to the legislature
by the DOH on a list of general hospitals or units of general hospitals
that notify the department of their intent to close.
Adds a new subdivision 7 to require a hospital to submit a revised
closure plan to DOH addressing concerns raised during the community
forum no later than 30 days after the forum and requires DOH to make the
revised plan publicly available on their website no later than 45 days
after the community forum.
Section three provides an effective date.
 
JUSTIFICATION:
Across New York State, there have been several incidents when hospitals
summarily announce planned closures of maternity services, emergency
departments, mental health, and substance use services, and even entire
hospitals, without any prior communication or meaningful engagement with
the local communities they serve. Over the last decade, 10 hospitals in
New York State closed their maternity services (in Columbia, Franklin,
Lewis, New York, Niagara, Ontario, Otsego, St. Lawrence, and Wyoming
counties). So far in 2024, two more maternity service closures are pend-
ing in Rensselaer and Suffolk counties. Two major closings of entire
hospitals are under consideration and facing community opposition in
lower Manhattan and in Central Brooklyn, after last year's closures of
another Brooklyn hospital and a hospital in Eastern Niagara County. More
closures are likely; a recent study by the Center for Healthcare Quality
and Payment Reform found that there are 27 rural hospitals in New York
State at risk of closing, amounting to 53 percent of all rural hospitals
in the state.
(source:https://r.,.beckershospitaireview.com/financei646-hospitals-at-ri
sk-of-closure-ranked-by-state.html)
Closures of any of these services, or of the entire hospital, can have a
devastating impact on the communities that have depended on these facil-
ities for care. When the COVID-19 pandemic hit New York City in early
2020, one of the boroughs most affected (Queens) was ill-prepared
because of hospital closings in that borough. Elmhurst Hospital, a
public hospital, was forced to shoulder more than its fair share of
COVID-19 cases because of the closures of St. John's Queens Hospital,
Mary Immaculate Hospital, and Parkway Hospital in 2009.
(source:https://gns.com/2020/03/demise-of-three-
gueens-hosoitals-11-years-ago-adds-to- pain-ofboroughs- coronae irus-
tragedies/)
Closures of hospital maternity services are leaving entire counties
without any nearby access to labor and delivery, causing pregnant
patients to have to travel long distances to the nearest hospital with
maternal health services. The proposed closure of the Burdett Birth
Center in Troy, for example, would leave Rensselaer County as the larg-
est county in the state without maternity care, and also affect pregnant
people in adjacent rural Washington and Columbia counties, which lack
their own maternity services. The March of Dimes warns that the further
a pregnant person has to travel to obtain maternity care, the greater
the chances that there will be a negative outcome. There is a higher
risk for complications and death for both mothers and babies in communi-
ties that do not have maternity care services, according to the Center
for Healthcare Quality and Payment Reform.
Closures of hospital psychiatric services were numerous during the
pandemic, with more than two dozen hospitals closing more than 500
psychiatric beds. The Hochul administration has been working to bring
those back into service, citing a severe shortage of short-term beds for
patients suffering psychiatric crises.
(Source: https://www.nytimes.com/2023/10/1
2/nyregiortihospita;s-hochul-rnental-he th.html)
Despite the serious impact of such closures on communities, especially
those where people are already medically-underserved and not easily able
to travel elsewhere for care, New York State Public Health Law does not
adequately require hospitals to engage the public and work to address
their concerns. Too little (if any) advance notice is given to the
community and key stakeholders, and under the law, a public hearing is
not required until 30 days after a hospital closes
(although recent state Department of Health guidance to hospitals has
required an advance hearing).
While the states new Health Equity Impact Assessment law is helping to
improve community engagement, it does not apply to closings of entire
hospitals because those are carried out through simple notice to the
Department and a closure plan, not a Certificate of Need application.
Moreover, none of these types of closures (the entire hospital, or
maternity, emergency or mental health services) requires a full Certif-
icate of Need review process that would go before the state Public
Health and Health Planning Council for review in a public meeting at
which community members could make comments.
This proposed legislation will address these gaps in the state's review
of proposed hospital and hospital unit closures by ensuring adequate
advance notice to the public, public disclosure of hospital closing
plans, a community forum held well in advance of the closure date to
allow public comment on the proposed closure plan, and preparation of a
final closure plan that addresses concerns raised at the community
forum.
 
PRIOR LEGISLATIVE STORY:
New bill.
 
FISCAL IMPLICAT:
None.
 
EFFECTIVE DATE:
Effective on the sixtieth day after it shall have become law, and shall
not apply to any matter subject to section 2801-g of the PHL that is
pending on the date it shall take effect.