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.
STATE OF NEW YORK
________________________________________________________________________
1633--B
Cal. No. 47
2023-2024 Regular Sessions
IN ASSEMBLY
January 17, 2023
___________
Introduced by M. of A. SIMON, CRUZ, REYES, GLICK, WEPRIN, BURDICK,
JACOBSON, OTIS, CUNNINGHAM, SEAWRIGHT, SANTABARBARA, MITAYNES, GONZA-
LEZ-ROJAS, COLTON, FORREST, PHEFFER AMATO, BARRETT, SHRESTHA, LEVEN-
BERG, ARDILA, MAMDANI, DINOWITZ, TAPIA, LEE, McDONALD, KELLES, TAYLOR,
BORES -- Multi-Sponsored by -- M. of A. CARROLL, COOK, DAVILA,
EPSTEIN, HEVESI, PAULIN, STECK, WALKER -- read once and referred to
the Committee on Health -- ordered to a third reading, amended and
ordered reprinted, retaining its place on the order of third reading
-- passed by Assembly and delivered to the Senate, recalled from the
Senate, vote reconsidered, bill amended, ordered reprinted, retaining
its place on the special order of third reading
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. (a) This section sets forth a process for the closure of a
9 general hospital or a unit of a general hospital. As used in this
10 section, "unit" means a portion of a general hospital that offers
11 licensed emergency, maternity, mental health or substance use services,
12 including any specialty care or any other hospital service in an operat-
13 ing certificate as approved under section twenty-eight hundred five of
14 this article. For the purposes of this section, the closure of a unit of
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD02692-08-4
A. 1633--B 2
1 a general hospital shall include a reduction of such services. As used
2 in this section, "reduction" means a reduction in services that results
3 in:
4 (i) more than fifteen percent of a reduction in patient capacity of a
5 unit within twelve months; or
6 (ii) a twenty-five percent or more reduction in patient capacity in
7 aggregate within a twenty-four month period; or
8 (iii) a thirty-five percent or more reduction in patient capacity in
9 aggregate within a thirty-six month period.
10 2. Closure of a general hospital. (a) Written notification of a
11 proposed closure of a general hospital must be provided to the depart-
12 ment and all parties listed in subparagraph (ii) of paragraph (c) of
13 this subdivision no later than two hundred seventy days prior to the
14 proposed closure date. Nothing in this section shall prohibit a general
15 hospital from conferring with the department prior to submitting such
16 written notification to give informal notice and seek guidance.
17 (b) Application. A general hospital that seeks to close entirely
18 shall submit an application that requires review by the public health
19 and health planning council, or any successor entity. The application
20 for the closure shall include a health equity impact assessment, as
21 defined by section twenty-eight hundred two-b of this article, and a
22 proposed closure plan. The application shall be submitted at least two
23 hundred ten days before the proposed closure. No cessation, pause,
24 transfer, or limitation of service may be carried out while the closure
25 application is pending without prior written approval by the commission-
26 er or the commissioner's designee, who may take into consideration the
27 impacts on quality of care and patient safety stemming from changes in
28 patient volume or services. As used in this section, "transfer of
29 services" shall include conversion of services from inpatient to outpa-
30 tient services, the moving of services to other facilities, or the
31 transfer of personnel that would constitute a reduction or unavailabili-
32 ty of services.
33 (c) Public community forum. (i) No later than [thirty] one hundred
34 fifty days [after] prior to the proposed closure of a general hospital,
35 the commissioner shall hold a public community forum for the purpose of
36 obtaining public input concerning the anticipated impact of the general
37 hospital's closure on access to health care services by members of the
38 surrounding community, including but not limited to recipients of
39 medical assistance for needy persons, the uninsured, and medically
40 underserved populations as defined in paragraph (d) of subdivision one
41 of section twenty-eight hundred two-b of this article, and options and
42 proposals to ameliorate such anticipated impact. The commissioner shall
43 afford community members, health care providers, labor unions, payers,
44 businesses and consumers a reasonable opportunity to speak about rele-
45 vant matters at such community forum.
46 [2.] (ii) No later than [sixty] thirty days [after] before holding a
47 community forum pursuant to [subdivision one of this section] this para-
48 graph, the commissioner shall make available to the public on the
49 department's website information regarding:
50 [(a)] (A) the proposed closure plan submitted by the general hospital;
51 (B) the anticipated impact of the general hospital's closure on access
52 to health care services by members of the surrounding community, includ-
53 ing but not limited to recipients of medical assistance for needy
54 persons, the uninsured, and underserved populations;
55 [(b)] (C) specific measures the department and other parties have
56 taken or will take to ameliorate such anticipated impact including but
A. 1633--B 3
1 not limited to ensuring that the services to be eliminated would be
2 available to Medicaid, or individuals that are insured by a publicly-
3 subsidized plan and uninsured patients at the surrounding area facili-
4 ties that are taking new patients; and
5 [(c)] (D) any further recommendations regarding access to health care
6 services in communities impacted by the general hospital's closure.
7 [3.] (iii) A community forum conducted pursuant to this section shall
8 be held at a location within a reasonable proximity to the general
9 hospital or unit subject to the proposed closure, and shall be announced
10 no less than [ten] fourteen days prior to the date of such community
11 forum. Such forum shall be held at a proper time and be accessible to
12 the impacted community virtually and physically.
13 [4. At least thirty days prior to a general hospital applying to the
14 federal centers for medicare and medicaid services to convert from a
15 general hospital with inpatients to a rural emergency hospital under 42
16 USC 1395x(kkk), or successor provisions, such hospital shall hold a
17 public community forum for the purpose of obtaining public input
18 concerning the anticipated impact of the hospital's closure of inpatient
19 units, including but not limited to, the impact on recipients of medical
20 assistance for needy persons, the uninsured, people with disabilities,
21 and medically underserved populations, and options and proposals to
22 ameliorate such anticipated impact.
23 The] (iv) No later than thirty days prior to a community forum under
24 this section, the general hospital shall notify health care providers,
25 labor unions, the [congressional] local, state, and federal legislative
26 representative, the office of the attorney general, the county execu-
27 tive, mayor, town supervisor, and in the case of the city of New York,
28 the borough president, and community board for [the] every district in
29 which the [facility] general hospital is located, [the county executive
30 of the county in which the facility is located, and the state senator
31 and assembly member representing the area within which the facility is
32 located] of the date, time, and location of the community forum. The
33 general hospital shall afford all public participants a reasonable
34 opportunity to speak about relevant matters at such community forum.
35 Prior to [any] a community forum and as soon as practicable, the general
36 hospital shall be required to:
37 [(a)] (A) notify the office of mental health and the local director of
38 community services in the event such general hospital has psychiatric
39 inpatient beds licensed under article thirty-one of the mental hygiene
40 law or designated pursuant to section 9.39 of the mental hygiene law,
41 and
42 [(b)] (B) notify the office of addiction services and supports in the
43 event such general hospital has inpatient substance use disorder treat-
44 ment programs or inpatient chemical dependence treatment programs
45 licensed under article thirty-two of the mental hygiene law. The commis-
46 sioner shall also accept comments submitted in writing at such public
47 forum and by mail or electronic mail within at least two weeks following
48 the community forum.
49 (v) The commissioner shall also accept comments submitted in writing
50 at such public forum and by mail or electronic mail within at least two
51 weeks following the community forum.
52 (d) Revised closure plan. No later than thirty days after the communi-
53 ty forum, the general hospital shall submit a revised closure plan to
54 the department addressing concerns raised by community stakeholders
55 during the community forum. The general hospital and the department
A. 1633--B 4
1 shall make the revised closure plan publicly available on their websites
2 no later than forty-five days after the community forum.
3 (e) Public health and health planning council review. No later than
4 ninety days prior to the proposed closure, the public health and health
5 planning council, or any successor entity, shall hold a public meeting
6 before the council to review the application, including the health equi-
7 ty impact assessment and revised closure plan. Within two weeks after
8 such meeting, the public health and health planning council shall make a
9 recommendation to the commissioner for the commissioner's consideration.
10 3. Closure of a unit of a general hospital. (a)(i) Written notifica-
11 tion of a proposed closure of a unit of a general hospital, as defined
12 in subdivision one of this section, must be provided to the department
13 and all parties listed in subparagraph (iv) of paragraph (c) of subdivi-
14 sion two of this section no later than two hundred ten days prior to the
15 proposed closure date. Nothing in this section shall prohibit a general
16 hospital from conferring with the department prior to submitting such
17 written notification to give informal notice and seek guidance.
18 (ii) A reduction in services or closure of a unit in a general hospi-
19 tal shall not be required to undergo the process set forth in this
20 section if the general hospital demonstrates to the department a good
21 cause for such reduction or closure of a unit, which shall include one
22 or more of the following:
23 (A) whether such closure or reduction is temporary in order to modern-
24 ize a facility;
25 (B) whether such closure addresses the current health care demand,
26 such as patient volume and the overall availability of services in the
27 facility's health service area or county served;
28 (C) there are acute labor shortages outside of the control of the
29 general hospital that impacts patient safety; or
30 (D) an acute financial emergency outside of the control of the general
31 hospital.
32 (b) Application. A general hospital that seeks the closure of a unit
33 shall submit an application to the department of health that requires
34 review by the public health and health planning council, or any succes-
35 sor entity in addition to approval by the commissioner. The application
36 for the closure shall include a health equity impact assessment, as
37 defined by section twenty-eight hundred two-b of this article, and a
38 proposed closure plan. The application shall be submitted at least one
39 hundred fifty days before the proposed closure. No cessation, pause,
40 transfer, or limitation of service may be carried out while the closure
41 application is pending without prior written approval by the commission-
42 er or the commissioner's designee, who shall take into consideration the
43 impacts on quality of care and patient safety stemming from changes in
44 patient volume or services. As used in this section, "transfer of
45 services" shall include conversion of services from inpatient to outpa-
46 tient services, the moving of services to other facilities, or the
47 transfer of personnel that would constitute a reduction or unavailabili-
48 ty of services.
49 (c) Community public forum. (i) No later than ninety days prior to the
50 proposed closure of a unit of a general hospital, the commissioner shall
51 hold a public community forum for the purpose of obtaining public input
52 concerning the anticipated impact of the unit's closure on quality and
53 access to health care services by members of the surrounding community,
54 including but not limited to recipients of medical assistance for needy
55 persons, the uninsured, and medically underserved populations as defined
56 in paragraph (d) of subdivision one of section twenty-eight hundred
A. 1633--B 5
1 two-b of this article, and options and proposals to ameliorate such
2 anticipated impact. The commissioner shall afford community members,
3 health care providers, labor unions, payers, businesses, and other
4 participants a reasonable opportunity to speak about relevant matters at
5 such community forum.
6 (ii) No later than two weeks before holding a community forum pursuant
7 to this paragraph, the commissioner shall make available to the public
8 on the department's website information regarding: (A) the proposed
9 closure plan submitted by the general hospital; (B) the anticipated
10 impact of the closure on quality and access to health care services by
11 members of the surrounding community, including but not limited to
12 recipients of medical assistance for needy persons, the uninsured, and
13 underserved populations; (C) specific measures the department and other
14 parties have taken or will take to ameliorate such anticipated impact
15 including but not limited to ensuring that the services to be eliminated
16 would be available to Medicaid, or individuals that are insured by a
17 publicly-subsidized plan and uninsured patients at the surrounding area
18 facilities that are taking new patients; and (D) any further recommenda-
19 tions regarding quality and access to health care services in communi-
20 ties impacted by the closure.
21 (iii) A community forum conducted pursuant to this paragraph shall be
22 held at a location within a reasonable proximity to the unit subject to
23 the proposed closure and shall be announced no less than fourteen days
24 prior to the date of such community forum. Such forum shall be held at a
25 proper time and be accessible to the impacted community virtually and
26 physically.
27 (iv) No later than two weeks prior to the community forum under this
28 section, the general hospital seeking to close a unit shall notify
29 health care providers, labor unions, the local, state, and federal
30 legislative representative, the office of the attorney general, the
31 county executive, mayor, town supervisor, and in the case of the city of
32 New York, the borough president, and community board for every district
33 in which the general hospital is located, of the date, time, and
34 location of the community forum. Prior to the community forum and as
35 soon as practicable, the general hospital shall be required to: (A)
36 notify the office of mental health and the local director of community
37 services in the event such general hospital is seeking to close an inpa-
38 tient psychiatric unit licensed under article thirty-one of the mental
39 hygiene law or designated pursuant to section 9.39 of the mental hygiene
40 law, and (B) notify the office of addiction services and supports in the
41 event the general hospital is seeking to close an inpatient substance
42 use disorder treatment programs or inpatient chemical dependence treat-
43 ment programs licensed under article thirty-two of the mental hygiene
44 law.
45 (v) The commissioner shall also accept comments submitted in writing
46 at such public forum and by mail or electronic mail within at least two
47 weeks following the community forum.
48 (d) Revised closure plan. No later than thirty days after the communi-
49 ty forum, the general hospital shall submit a revised closure plan to
50 the department addressing concerns raised by community stakeholders
51 during the community forum. The general hospital and the department
52 shall make the revised closure plan publicly available on their websites
53 no later than forty-five days after the community forum.
54 (e) Public health and health planning council review. No later than
55 thirty days prior to the proposed closure, the public health and health
56 planning council, or any successor entity, shall hold a public meeting
A. 1633--B 6
1 to review the application, including the health equity impact assessment
2 and revised closure plan. Within two weeks after such meeting, the
3 public health and health planning council shall make a recommendation to
4 the commissioner for the commissioner's consideration.
5 4. The commissioner shall make their decision to either approve or
6 deny the closure plan within thirty days following receipt of the recom-
7 mendation from the public health and health planning council.
8 5. At least thirty days prior to a general hospital applying to the
9 federal centers for medicare and medicaid services to convert from a
10 general hospital with inpatients to a rural emergency hospital under 42
11 USC 1395x(kkk), or successor provisions, such general hospital shall
12 hold a public community forum for the purpose of obtaining public input
13 concerning the anticipated impact of the general hospital's closure of
14 inpatient units, including but not limited to, the impact on recipients
15 of medical assistance for needy persons, the uninsured, people with
16 disabilities, and medically underserved populations, and options and
17 proposals to ameliorate such anticipated impact.
18 6. No later than January first, two thousand twenty-five and annually
19 thereafter, the commissioner shall provide a report to the legislature,
20 including but not limited to, identifying the general hospital or unit
21 of a general hospital that has provided written notice of a closure, the
22 proposed closure date and the services impacted by the proposed closure.
23 Such report shall be provided in electronic format and shall be distrib-
24 uted to the temporary president and minority leader of the senate, the
25 speaker and minority leader of the assembly, the chair of the senate
26 standing committee on health, and the chair of the assembly health
27 committee.
28 7. No provision of this section shall modify any other requirement or
29 process for the closure of a general hospital or a unit of a general
30 hospital that is required pursuant to this chapter or the regulations
31 promulgated pursuant to it, including but not limited to any department
32 or public health and health planning council review or approval process.
33 § 3. This act shall take effect on the sixtieth day after it shall
34 have become a law, and shall not apply to any proposed closures on
35 notice to the department as of the date it shall take effect.
