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A01633 Summary:

COSPNSRCruz, Reyes, Glick, Weprin, Burdick, Jacobson, Otis, Cunningham, Seawright, Santabarbara, Mitaynes, Gonzalez-Rojas, Colton, Forrest, Pheffer Amato, Barrett, Shrestha, Levenberg, Ardila, Mamdani, Dinowitz, Tapia, Lee, McDonald, Kelles, Taylor
MLTSPNSRCarroll, Cook, Davila, Epstein, Hevesi, Paulin, Steck, Walker
Amd §2801-g, Pub Health L
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.
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A01633 Memo:

submitted in accordance with Assembly Rule III, Sec 1(f)
  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: To allow for improved public notice and public engagement when hospital and certain unit closures are threatened, and to strengthen state review of such closings.   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 have community notice and engagement on hospital closures and require general hospitals to provide written notification of proposed closure of a general hospi- tal or unit that offers emergency, maternity, mental health, or substance use services to the Department of Health (DOH) no later than 270 days before the proposed closure date, if the proposed closure will result in the reduction or unavailability of such services in the the hospital's service area or county. Subdivision two is amended to require a general hospital that seeks to close entirely or seeks to close one or more units must submit an appli- cation that requires review and approval by the Public Health and Health Planning Council, or successor entity. The application would be submit- ted at least 210 days before the proposed closure. No cessation, trans- fer, pause, or limitation of service may be carried out without prior written approval by the Commissioner of Health (COH). A new subdivision three 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 or unit's closure from no later than 30 days after to 150 days before the proposed closure. Subdivision four, is amended to require the commissioner to make public- ly 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 informa- tion on specific measures 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, or individuals insured by publicly subsidized plans, and uninsured residents in the surrounding facilities. Subdivision 3, now re-numbered to five, amends the announcement of the community forum on the proposed closure of a hospital or unit to 14 days prior, instead of 10 days prior, to the date that the community forum will be held and ensures the forum is held at a proper time and accessi- ble to the impacted community virtually and physically. Subdivision 4 is re-numbered to subsection 6. Adds a new subdivision 7 to require hospitals to notify health care providers, labor unions, local, state, and federal legislative represen- tatives, the office of the attorney general, their county executive, mayor, town supervisor, and in NYC, the borough president and community board for every district that the hospital is located in, no later than thirty days prior to the community forum. Adds a new subdivision 8 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 ensure DOH makes the revised plan publicly available on their website no later than 45 days after the community forum. Adds a new subdivision 9 requiring an annual report to the legislature by the department on a list of general hospitals or units of general hospitals that notify the department of their intent to close. Section three provides an effective date.   JUSTIFICATION: The proposed closure of Long Island College Hospital (LICH), formerly operated by the State University of New York-Downstate, ended up in court for nearly two years, during which a court said that the current regulation governing hospital closures is "unconstitutionally vague." The court proceeding made clear that there was no process for determin- ing the healthcare impact of the hospital's closure on Cobble Hill and surrounding communities or Brooklyn. In addition, there was no role for real community input or transparency. Throughout the multi-year fight to save a full-service hospital in Cobble Hill, the community's needs were repeatedly ignored. This is happening across New York State. There have been several inci- dents 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 mater- nity 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 pending in Rensselaer and Suffolk coun- ties. Two major closings of entire hospitals are moving forward 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://WWW.BECKERSHOSPITALREVIEW.CORN/FINANCE/ 646-HOSPI- TALS-AT-RISK-OF-CLOSURERANKED-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://QNS.COM/2020/03/DEMISE-OF-THREE-QUEENS-HO SPITALS-11 -YEARS-AGO-ADDS-TO-PAIN-OFBOROUGHS- CORONAVIRUS-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, and 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/2023/10/12/NYREGION/ HOSPITALS-HO- CHUL-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 review Certificate of Need that would go before the state Public Health and Health Planning Council for review in a public meeting at which communi- ty 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: 2023: A.1633 Simon - passed assembly 2022: A.2251a Simon - passed assembly 2020-19: A.2986 Simon - referred to health 2018-17: A.1015 Simon - referred to health   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.
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