Requires 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.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A10736
SPONSOR: Simon 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 proc-
ess 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 Plan-
ning Council (PHHPC), which includes the health equity impact assess-
ment. 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 COH 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 of 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, materni-
ty, mental health, substance use, or any other licensed services in the
operating certificate including specialty care. Requires written notifi-
cation 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 noti-
fy 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 depart-
ment 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://wwvv.beckershospitalreview.com/ finance/ 646-hospitals-
at-risk-of-closure-rankedby-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://qns.corn/2020/03/
demise-of-three-oueenshospitals-11-years-ago-adds-to-pain-ofborouchs-
coronavirus-tracedies/)
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://wvvw.nytimes.com/2023/
10/12/nyregion/hospitals-hochul-mental-health.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 state's 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:
2024: S8834-A Rivera/A1633-B Simon - Vetoed Memo 108
2025: S1226 Rivera/A6004 Simon - Vetoed memo 137
FISCAL IMPLICATIONS:
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.
STATE OF NEW YORK
________________________________________________________________________
10736
IN ASSEMBLY
March 27, 2026
___________
Introduced by M. of A. SIMON -- read once and referred to the Committee
on Health
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
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Short title. This act shall be known and may be cited as
2 the "local input in community healthcare act".
3 § 2. Section 2801-g of the public health law, as added by chapter 541
4 of the laws of 2010, subdivision 4 as added by section 3 of part E of
5 chapter 57 of the laws of 2023, is amended to read as follows:
6 § 2801-g. Community [forum] notice and engagement on hospital closure.
7 1. Process for the closure of a general hospital or a unit of a general
8 hospital. This section sets forth a process for the closure of a general
9 hospital or a unit of a general hospital. As used in this section,
10 "unit" means a portion of a general hospital that offers licensed emer-
11 gency, maternity, mental health or substance use services, including any
12 specialty care or any other hospital service in an operating certificate
13 as approved under section twenty-eight hundred five of this article. For
14 the purposes of this section, the closure of a unit of a general hospi-
15 tal shall include a reduction of such services. As used in this
16 section, "reduction" means a reduction in services that results in:
17 (a) more than fifteen percent of a reduction in patient capacity of a
18 unit within twelve months; or
19 (b) a twenty-five percent or more reduction in patient capacity in
20 aggregate within a twenty-four month period; or
21 (c) a thirty-five percent or more reduction in patient capacity in
22 aggregate within a thirty-six month period.
23 2. Closure of a general hospital. (a) Written notification of a
24 proposed closure of a general hospital must be provided to the depart-
25 ment and all parties listed in subparagraph (ii) of paragraph (c) of
26 this subdivision no later than two hundred seventy days prior to the
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD03821-03-6
A. 10736 2
1 proposed closure date. Nothing in this section shall prohibit a general
2 hospital from conferring with the department prior to submitting such
3 written notification to give informal notice and seek guidance.
4 (b) Application. A general hospital that seeks to close entirely
5 shall submit an application that requires review by the public health
6 and health planning council, or any successor entity. The application
7 for the closure shall include a health equity impact assessment, as
8 defined by section twenty-eight hundred two-b of this article, and a
9 proposed closure plan. The application shall be submitted at least two
10 hundred ten days before the proposed closure. No cessation, pause,
11 transfer, or limitation of service may be carried out while the closure
12 application is pending without prior written approval by the commission-
13 er or the commissioner's designee, who may take into consideration the
14 impacts on quality of care and patient safety stemming from changes in
15 patient volume or services. As used in this section, "transfer of
16 services" shall include conversion of services from inpatient to outpa-
17 tient services, the moving of services to other facilities, or the
18 transfer of personnel that would constitute a reduction or unavailabili-
19 ty of services.
20 (c) Public community forum. (i) No later than [thirty] one hundred
21 fifty days [after] prior to the proposed closure of a general hospital,
22 the commissioner shall hold a public community forum for the purpose of
23 obtaining public input concerning the anticipated impact of the general
24 hospital's closure on access to health care services by members of the
25 surrounding community, including but not limited to recipients of
26 medical assistance for needy persons, the uninsured, and medically
27 underserved populations as defined in paragraph (d) of subdivision one
28 of section twenty-eight hundred two-b of this article, and options and
29 proposals to ameliorate such anticipated impact. The commissioner shall
30 afford community members, health care providers, labor unions, payers,
31 businesses and consumers a reasonable opportunity to speak about rele-
32 vant matters at such community forum.
33 [2.] (ii) No later than [sixty] thirty days [after] before holding a
34 community forum pursuant to [subdivision one of this section] this para-
35 graph, the commissioner shall make available to the public on the
36 department's website information regarding:
37 [(a)] (A) the proposed closure plan submitted by the general hospital;
38 (B) the anticipated impact of the general hospital's closure on access
39 to health care services by members of the surrounding community, includ-
40 ing but not limited to recipients of medical assistance for needy
41 persons, the uninsured, and underserved populations;
42 [(b)] (C) specific measures the department and other parties have
43 taken or will take to ameliorate such anticipated impact including but
44 not limited to ensuring that the services to be eliminated would be
45 available to Medicaid, or individuals that are insured by a publicly-
46 subsidized plan and uninsured patients at the surrounding area facili-
47 ties that are taking new patients; and
48 [(c)] (D) any further recommendations regarding access to health care
49 services in communities impacted by the general hospital's closure.
50 [3.] (iii) A community forum conducted pursuant to this section shall
51 be held at a location within a reasonable proximity to the general
52 hospital or unit subject to the proposed closure, and shall be announced
53 no less than [ten] fourteen days prior to the date of such community
54 forum. Such forum shall be held at a proper time and be accessible to
55 the impacted community virtually and physically.
A. 10736 3
1 [4. At least thirty days prior to a general hospital applying to the
2 federal centers for medicare and medicaid services to convert from a
3 general hospital with inpatients to a rural emergency hospital under 42
4 USC 1395x(kkk), or successor provisions, such hospital shall hold a
5 public community forum for the purpose of obtaining public input
6 concerning the anticipated impact of the hospital's closure of inpatient
7 units, including but not limited to, the impact on recipients of medical
8 assistance for needy persons, the uninsured, people with disabilities,
9 and medically underserved populations, and options and proposals to
10 ameliorate such anticipated impact.
11 The] (iv) No later than thirty days prior to a community forum under
12 this section, the general hospital shall notify health care providers,
13 labor unions, the [congressional] local, state, and federal legislative
14 representative, the office of the attorney general, the county execu-
15 tive, mayor, town supervisor, and in the case of the city of New York,
16 the borough president, and community board for [the] every district in
17 which the [facility] general hospital is located, [the county executive
18 of the county in which the facility is located, and the state senator
19 and assembly member representing the area within which the facility is
20 located] of the date, time, and location of the community forum. The
21 general hospital shall afford all public participants a reasonable
22 opportunity to speak about relevant matters at such community forum.
23 Prior to [any] a community forum and as soon as practicable, the general
24 hospital shall be required to:
25 [(a)] (A) notify the office of mental health and the local director of
26 community services in the event such general hospital has psychiatric
27 inpatient beds licensed under article thirty-one of the mental hygiene
28 law or designated pursuant to section 9.39 of the mental hygiene law,
29 and
30 [(b)] (B) notify the office of addiction services and supports in the
31 event such general hospital has inpatient substance use disorder treat-
32 ment programs or inpatient chemical dependence treatment programs
33 licensed under article thirty-two of the mental hygiene law. The commis-
34 sioner shall also accept comments submitted in writing at such public
35 forum and by mail or electronic mail within at least two weeks following
36 the community forum.
37 (v) The commissioner shall also accept comments submitted in writing
38 at such public forum and by mail or electronic mail within at least two
39 weeks following the community forum.
40 (d) Revised closure plan. No later than thirty days after the communi-
41 ty forum, the general hospital shall submit a revised closure plan to
42 the department addressing concerns raised by community stakeholders
43 during the community forum. The general hospital and the department
44 shall make the revised closure plan publicly available on their websites
45 no later than forty-five days after the community forum.
46 (e) Public health and health planning council review. No later than
47 ninety days prior to the proposed closure, the public health and health
48 planning council, or any successor entity, shall hold a public meeting
49 before the council to review the application, including the health equi-
50 ty impact assessment and revised closure plan. Within two weeks after
51 such meeting, the public health and health planning council shall make a
52 recommendation to the commissioner for the commissioner's consideration.
53 3. Closure of a unit of a general hospital. (a)(i) Written notifica-
54 tion of a proposed closure of a unit of a general hospital, as defined
55 in subdivision one of this section, must be provided to the department
56 and all parties listed in subparagraph (iv) of paragraph (c) of subdivi-
A. 10736 4
1 sion two of this section no later than two hundred ten days prior to the
2 proposed closure date. Nothing in this section shall prohibit a general
3 hospital from conferring with the department prior to submitting such
4 written notification to give informal notice and seek guidance.
5 (ii) A reduction in services or closure of a unit in a general hospi-
6 tal shall not be required to undergo the process set forth in this
7 section if the general hospital demonstrates to the department a good
8 cause for such reduction or closure of a unit, which shall include one
9 or more of the following:
10 (A) whether such closure or reduction is temporary in order to modern-
11 ize a facility;
12 (B) whether such closure addresses the current health care demand,
13 such as patient volume and the overall availability of services in the
14 facility's health service area or county served;
15 (C) there are acute labor shortages outside of the control of the
16 general hospital that impacts patient safety; or
17 (D) an acute financial emergency outside of the control of the general
18 hospital.
19 (b) Application. A general hospital that seeks the closure of a unit
20 shall submit an application to the department of health that requires
21 review by the public health and health planning council, or any succes-
22 sor entity in addition to approval by the commissioner. The application
23 for the closure shall include a health equity impact assessment, as
24 defined by section twenty-eight hundred two-b of this article, and a
25 proposed closure plan. The application shall be submitted at least one
26 hundred fifty days before the proposed closure. No cessation, pause,
27 transfer, or limitation of service may be carried out while the closure
28 application is pending without prior written approval by the commission-
29 er or the commissioner's designee, who shall take into consideration the
30 impacts on quality of care and patient safety stemming from changes in
31 patient volume or services. As used in this section, "transfer of
32 services" shall include conversion of services from inpatient to outpa-
33 tient services, the moving of services to other facilities, or the
34 transfer of personnel that would constitute a reduction or unavailabili-
35 ty of services.
36 (c) Community public forum. (i) No later than ninety days prior to the
37 proposed closure of a unit of a general hospital, the commissioner shall
38 hold a public community forum for the purpose of obtaining public input
39 concerning the anticipated impact of the unit's closure on quality and
40 access to health care services by members of the surrounding community,
41 including but not limited to recipients of medical assistance for needy
42 persons, the uninsured, and medically underserved populations as defined
43 in paragraph (d) of subdivision one of section twenty-eight hundred
44 two-b of this article, and options and proposals to ameliorate such
45 anticipated impact. The commissioner shall afford community members,
46 health care providers, labor unions, payers, businesses, and other
47 participants a reasonable opportunity to speak about relevant matters at
48 such community forum.
49 (ii) No later than two weeks before holding a community forum pursuant
50 to this paragraph, the commissioner shall make available to the public
51 on the department's website information regarding: (A) the proposed
52 closure plan submitted by the general hospital; (B) the anticipated
53 impact of the closure on quality and access to health care services by
54 members of the surrounding community, including but not limited to
55 recipients of medical assistance for needy persons, the uninsured, and
56 underserved populations; (C) specific measures the department and other
A. 10736 5
1 parties have taken or will take to ameliorate such anticipated impact
2 including but not limited to ensuring that the services to be eliminated
3 would be available to Medicaid, or individuals that are insured by a
4 publicly-subsidized plan and uninsured patients at the surrounding area
5 facilities that are taking new patients; and (D) any further recommenda-
6 tions regarding quality and access to health care services in communi-
7 ties impacted by the closure.
8 (iii) A community forum conducted pursuant to this paragraph shall be
9 held at a location within a reasonable proximity to the unit subject to
10 the proposed closure and shall be announced no less than fourteen days
11 prior to the date of such community forum. Such forum shall be held at a
12 proper time and be accessible to the impacted community virtually and
13 physically.
14 (iv) No later than two weeks prior to the community forum under this
15 section, the general hospital seeking to close a unit shall notify
16 health care providers, labor unions, the local, state, and federal
17 legislative representative, the office of the attorney general, the
18 county executive, mayor, town supervisor, and in the case of the city of
19 New York, the borough president, and community board for every district
20 in which the general hospital is located, of the date, time, and
21 location of the community forum. Prior to the community forum and as
22 soon as practicable, the general hospital shall be required to: (A)
23 notify the office of mental health and the local director of community
24 services in the event such general hospital is seeking to close an inpa-
25 tient psychiatric unit licensed under article thirty-one of the mental
26 hygiene law or designated pursuant to section 9.39 of the mental hygiene
27 law, and (B) notify the office of addiction services and supports in the
28 event the general hospital is seeking to close an inpatient substance
29 use disorder treatment programs or inpatient chemical dependence treat-
30 ment programs licensed under article thirty-two of the mental hygiene
31 law.
32 (v) The commissioner shall also accept comments submitted in writing
33 at such public forum and by mail or electronic mail within at least two
34 weeks following the community forum.
35 (d) Revised closure plan. No later than thirty days after the communi-
36 ty forum, the general hospital shall submit a revised closure plan to
37 the department addressing concerns raised by community stakeholders
38 during the community forum. The general hospital and the department
39 shall make the revised closure plan publicly available on their websites
40 no later than forty-five days after the community forum.
41 (e) Public health and health planning council review. No later than
42 thirty days prior to the proposed closure, the public health and health
43 planning council, or any successor entity, shall hold a public meeting
44 to review the application, including the health equity impact assessment
45 and revised closure plan. Within two weeks after such meeting, the
46 public health and health planning council shall make a recommendation to
47 the commissioner for the commissioner's consideration.
48 4. The commissioner shall make their decision to either approve or
49 deny the closure plan within thirty days following receipt of the recom-
50 mendation from the public health and health planning council.
51 5. At least thirty days prior to a general hospital applying to the
52 federal centers for medicare and medicaid services to convert from a
53 general hospital with inpatients to a rural emergency hospital under 42
54 USC 1395x(kkk), or successor provisions, such general hospital shall
55 hold a public community forum for the purpose of obtaining public input
56 concerning the anticipated impact of the general hospital's closure of
A. 10736 6
1 inpatient units, including but not limited to, the impact on recipients
2 of medical assistance for needy persons, the uninsured, people with
3 disabilities, and medically underserved populations, and options and
4 proposals to ameliorate such anticipated impact.
5 6. No later than January first, two thousand twenty-seven and annually
6 thereafter, the commissioner shall provide a report to the legislature,
7 including but not limited to, identifying the general hospital or unit
8 of a general hospital that has provided written notice of a closure, the
9 proposed closure date and the services impacted by the proposed closure.
10 Such report shall be provided in electronic format and shall be distrib-
11 uted to the temporary president and minority leader of the senate, the
12 speaker and minority leader of the assembly, the chair of the senate
13 standing committee on health, and the chair of the assembly health
14 committee.
15 7. No provision of this section shall modify any other requirement or
16 process for the closure of a general hospital or a unit of a general
17 hospital that is required pursuant to this chapter or the regulations
18 promulgated pursuant to it, including but not limited to any department
19 or public health and health planning council review or approval process.
20 § 3. This act shall take effect on the sixtieth day after it shall
21 have become a law, and shall not apply to any proposed closures on
22 notice to the department as of the date it shall take effect.
