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A08205 Summary:

BILL NOA08205A
 
SAME ASSAME AS S07740-A
 
SPONSORMcDonald
 
COSPNSRBurdick, Fahy, Shimsky, Buttenschon, Cunningham, O'Donnell, Thiele, Santabarbara, Stirpe, Levenberg, Lunsford, Bendett, McDonough, Brabenec, Slater, Woerner, Lavine, Seawright, Ardila, Paulin, Davila, McMahon, Simone, Dinowitz, Epstein, Tapia
 
MLTSPNSR
 
Amd §2803, Pub Health L
 
Requires the commissioner of health to promulgate regulations requiring that the addition of, decertification of, or changes in the method of delivery of perinatal services by a general hospital be subject to an application under article 28 of the public health law that requires review and approval by the council.
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A08205 Actions:

BILL NOA08205A
 
10/27/2023referred to health
01/03/2024referred to health
01/09/2024amend and recommit to health
01/09/2024print number 8205a
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A08205 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A8205A
 
SPONSOR: McDonald
  TITLE OF BILL: An act to amend the public health law, in relation to review of projects affecting the availability of maternity services   PURPOSE OR GENERAL IDEA OF BILL: The purpose of this legislation is to require the public health and health planning council (PHHPC) to regulate any changes in perinatal services offered by general hospitals in New York State.   SUMMARY OF SPECIFIC PROVISIONS: Section 1 amends Paragraph v of subdivision 2 of section 2803 of the public health law to require the commissioner to promulgate regulations related to requiring general hospitals to submit an application for review and approval to add, decertify, or change the method of delivery of perinatal services. Section 2 establishes the effective date.   JUSTIFICATION: The United States is experiencing a growing maternal health crisis, a recent study showed maternal deaths have more than doubled over the last 20 years for every racial group in every state but continue to dispro- portionally impact Black women when compared to their white counter- parts.(1) Our state is not an exception to this alarming reality, in 2018 the pregnancy-related mortality ratio in New York was 18.2 per 100,000 live births, and 78% of those deaths were preventable according to a report by the New York State Department of Health.(2) The report showed the pregnancy related mortality rate for Black women was five times higher than White women in 2018, highlighting the ongoing racial disparity in New York.(3) Access to quality maternity care is essential to preventing adverse health outcomes related to pregnancy and eliminating health disparities. Unfortunately, maternal health will only further decline as delivery units continue to shut down across the country, particularly in rural areas where at least 89 obstetric units were closed between 2015 and 2019 according to the American Hospital Association.(4) Ongoing closures intensify the already inequitable access to maternity care we see nationally and in our home state. Since 2008, 28 hospitals across the state have closed or reduced obstetric care.(5) Moreover, as of 2022, more than four percent of women in New York did not have a birthing hospital within 30 minutes of their homes; this problem is more acute in rural areas across the state where over 47% of women lived more than 30 minutes from a birthing center.(6) Hospitals are obligated by law to submit a Certificate of Need for the establishment, construction, renovation, acquisitions of major medical equipment, adding or removing services, and change of ownership for approval by the Department of Health and/or PHHPC, depending on the type of review required by regulation. However, there is no requirement that major changes to maternity care undergo a full review before the PHHPC. Thus, significant changes in availability of labor and delivery services in a community can be advanced with limited community input or PHHPC oversight and engagement. In June 2023, St. Peter's Health Partners announced plans to close Troy's Burdett Birth Center, the only birthing facility left in Rensse- laer County, New York and one of the only providers of low-intervention, midwifery led birth care in the Capital Region.(7) In 2022, there were 881 births at Burdett, and more than half of the patients are insured by Medicaid.(8) Eliminating an access point to quality maternity care will further deepen the already unacceptable health disparities we see in this state related to maternal health outcomes. St. Peter's provided notice of intended closure just prior to the effective date of a new law that requires a health equity impact assessment be done on Certificate 'of Need Applications. Ultimately, St. Peters agreed to conduct an assessment after intense criticism from the local community.(9) In addition to completing a health equity impact assessment, general hospitals should also be required to undergo a full review when seeking to close maternity services. This proposed legislation would stipulate a process for PHHPC to oversee the provision of perinatal services. The reality is that closure of maternity units will have impact on not only patients but also other components of the health care system. The PHHPC is a diverse council that represents the provider, labor, and patient community and therefore is well positioned to weigh in on impacts of discontinuation of services. It is essential that communities across the state maintain access to quality perinatal care services, and that attempts to reduce access through a closure of services is transparent and has strong oversight to protect and advance the health and wellbeing of those impacted.   PRIOR LEGISLATIVE HISTORY: New bill   FISCAL IMPLICATIONS: To be determined.   EFFECTIVE DATE: This act shall take effect immediately. 1 Fleszar LG, Bryant AS, Johnson CO, et al., JAMA, "Trends in State-Lev- el Maternal Mortality by Racial and Ethnic Group in the United States." https://jamanetwork.com/journals/jama/article-abstract/ 2806661?resultClick-1 (July 3, 2023) 2 NYS Department of Health, "New York State Report on Pregnancy Associ- ated Deaths in 2018" https://www.health.ny.govicommunity/adults/women/docs/maternal mortality review 2018.pdf (April-2022) 3 Ibid. 4 American Hospital Association, "Obstetrics U.S. Rural Hospitals" https://www.aha.org/system/files/mediefile/2022/04/Infographic-r ural-health-obstetrics-15ap22.pdf (2022) 5 Silberstein, R., Times Union "Maternity wards continue to close across New York" httOs://www.timQSUnion.com/health/article/maternity-wards- continue-close-across-new-york18376042.php?utm campaign=CMS%20Sharing%20Tools%20(Premium)&utm source= share-byemail&utm medium=email (October 8, 2023) 6 Fontenot, J, Lucas, R, Stoneburner, A, Brigance, C, Hubbard, K, Jones, E, Mishkin, K., March of Dimes "Where You Live Matters: Maternity Care Deserts and the Crisis of Access and Equity in New York." (Updated July 2023) https://www.marchofdimes.org/peristats/reports/new- york/maternityca re-deserts• 7 Save Burdett Birth Center, "About" https://www.saveburdettbirthcenter.com/who-we-are (2023) 8 Qi, Lyan, Wall Street Journal, "Fight to Save a New York Birth Center Tests State Law" https://www.wsj.com/heal h/healthcare/fight-to-save-a-n ew-york-birth-center-tests-state- law-9cd5be3b (September 27, 2023_ 9 Silberstein, R., Times Union "St. Peter's agrees to conduct impact study for birth center closure" https://www.timesunion.com/health/article/st-peter-s-agrees- conductim- pac t-study-birth-18185553.0hp (July 9, 2023)
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A08205 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         8205--A
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                    October 27, 2023
                                       ___________
 
        Introduced  by  M.  of A. McDONALD, BURDICK, FAHY, SHIMSKY, BUTTENSCHON,
          CUNNINGHAM, O'DONNELL, THIELE, SANTABARBARA, STIRPE, LEVENBERG,  LUNS-
          FORD,   BENDETT,   McDONOUGH,   BRABENEC,   SLATER,  WOERNER,  LAVINE,
          SEAWRIGHT, ARDILA, PAULIN, DAVILA -- read once  and  referred  to  the
          Committee  on  Health  --  recommitted  to  the Committee on Health in
          accordance with Assembly Rule 3, sec. 2 -- committee discharged,  bill
          amended,  ordered reprinted as amended and recommitted to said commit-
          tee
 
        AN ACT to amend the public health law, in relation to review of projects
          affecting the availability of maternity services
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  Subparagraph  (v)  of  paragraph  (a) of subdivision 2 of
     2  section 2803 of the public health law, as added by chapter  807  of  the
     3  laws of 1985, is amended to read as follows:
     4    (v)  standards  and  procedures relating to hospital operating certif-
     5  icates, provided however,  that  the  council  shall  establish  minimum
     6  acceptable  standards  and  procedures equal to the standards and proce-
     7  dures which federal law and regulation require for hospitals to  qualify
     8  as  providers  pursuant  to  titles  XVIII and XIX of the federal social
     9  security act. The existing state standards and procedures in  effect  on
    10  the  date  that  this  subdivision  becomes effective shall be deemed to
    11  constitute maximum standards and procedures  for  purposes  of  limiting
    12  medical  assistance  reimbursement  pursuant to the social services law.
    13  Such standards and procedures may thereafter be changed or added  to  by
    14  the  council  only  upon the recommendation of the commissioner. For the
    15  purposes of ensuring that the health and  safety  of  the  residents  of
    16  hospitals  are not endangered, the council may promulgate changes in the
    17  minimum acceptable standards and  procedures  referred  to  herein  upon
    18  recommendation of the commissioner.  Provided, however, the commissioner
    19  shall  promulgate  regulations requiring that the addition of, decertif-
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13442-02-4

        A. 8205--A                          2
 
     1  ication of, or changes in the method of delivery of  perinatal  services
     2  by  a  general  hospital  shall  be subject to an application under this
     3  article that requires review and approval by the council, and
     4    § 2.  This act shall take effect immediately.
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