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
________________________________________________________________________
8843--A
Cal. No. 837
IN SENATE
March 20, 2024
___________
Introduced by Sens. RIVERA, KAVANAGH, GONZALEZ, MYRIE, HINCHEY, WEBB,
KRUEGER, BAILEY, BRESLIN, BRISPORT, HARCKHAM, HOYLMAN-SIGAL, RAMOS,
SALAZAR, SCARCELLA-SPANTON -- read twice and ordered printed, and when
printed to be committed to the Committee on Health -- reported favora-
bly from said committee, ordered to first and second report, ordered
to a third reading, amended and ordered reprinted, retaining its place
in the 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
15 a general hospital shall include a reduction of such services. As used
16 in this section, "reduction" means a reduction in services that results
17 in:
18 (i) more than fifteen percent of a reduction in patient capacity of a
19 unit within twelve months; or
20 (ii) a twenty-five percent or more reduction in patient capacity in
21 aggregate within a twenty-four month period; or
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD14019-11-4
S. 8843--A 2
1 (iii) a thirty-five percent or more reduction in patient capacity in
2 aggregate within a thirty-six month period.
3 2. Closure of a general hospital. (a) Written notification of a
4 proposed closure of a general hospital must be provided to the depart-
5 ment and all parties listed in subparagraph (ii) of paragraph (c) of
6 this subdivision no later than two hundred seventy days prior to the
7 proposed closure date. Nothing in this section shall prohibit a general
8 hospital from conferring with the department prior to submitting such
9 written notification to give informal notice and seek guidance.
10 (b) Application. A general hospital that seeks to close entirely
11 shall submit an application that requires review by the public health
12 and health planning council, or any successor entity. The application
13 for the closure shall include a health equity impact assessment, as
14 defined by section twenty-eight hundred two-b of this article, and a
15 proposed closure plan. The application shall be submitted at least two
16 hundred ten days before the proposed closure. No cessation, pause,
17 transfer, or limitation of service may be carried out while the closure
18 application is pending without prior written approval by the commission-
19 er or the commissioner's designee, who may take into consideration the
20 impacts on quality of care and patient safety stemming from changes in
21 patient volume or services. As used in this section, "transfer of
22 services" shall include conversion of services from inpatient to outpa-
23 tient services, the moving of services to other facilities, or the
24 transfer of personnel that would constitute a reduction or unavailabili-
25 ty of services.
26 (c) Public community forum. (i) No later than [thirty] one hundred
27 fifty days [after] prior to the proposed closure of a general hospital,
28 the commissioner shall hold a public community forum for the purpose of
29 obtaining public input concerning the anticipated impact of the general
30 hospital's closure on access to health care services by members of the
31 surrounding community, including but not limited to recipients of
32 medical assistance for needy persons, the uninsured, and medically
33 underserved populations as defined in paragraph (d) of subdivision one
34 of section twenty-eight hundred two-b of this article, and options and
35 proposals to ameliorate such anticipated impact. The commissioner shall
36 afford community members, health care providers, labor unions, payers,
37 businesses and consumers a reasonable opportunity to speak about rele-
38 vant matters at such community forum.
39 [2.] (ii) No later than [sixty] thirty days [after] before holding a
40 community forum pursuant to [subdivision one of this section] this para-
41 graph, the commissioner shall make available to the public on the
42 department's website information regarding:
43 [(a)] (A) the proposed closure plan submitted by the general hospital;
44 (B) the anticipated impact of the general hospital's closure on access
45 to health care services by members of the surrounding community, includ-
46 ing but not limited to recipients of medical assistance for needy
47 persons, the uninsured, and underserved populations;
48 [(b)] (C) specific measures the department and other parties have
49 taken or will take to ameliorate such anticipated impact including but
50 not limited to ensuring that the services to be eliminated would be
51 available to Medicaid, or individuals that are insured by a publicly-
52 subsidized plan and uninsured patients at the surrounding area facili-
53 ties that are taking new patients; and
54 [(c)] (D) any further recommendations regarding access to health care
55 services in communities impacted by the general hospital's closure.
S. 8843--A 3
1 [3.] (iii) A community forum conducted pursuant to this section shall
2 be held at a location within a reasonable proximity to the general
3 hospital or unit subject to the proposed closure, and shall be announced
4 no less than [ten] fourteen days prior to the date of such community
5 forum. Such forum shall be held at a proper time and be accessible to
6 the impacted community virtually and physically.
7 [4. At least thirty days prior to a general hospital applying to the
8 federal centers for medicare and medicaid services to convert from a
9 general hospital with inpatients to a rural emergency hospital under 42
10 USC 1395x(kkk), or successor provisions, such hospital shall hold a
11 public community forum for the purpose of obtaining public input
12 concerning the anticipated impact of the hospital's closure of inpatient
13 units, including but not limited to, the impact on recipients of medical
14 assistance for needy persons, the uninsured, people with disabilities,
15 and medically underserved populations, and options and proposals to
16 ameliorate such anticipated impact.
17 The] (iv) No later than thirty days prior to a community forum under
18 this section, the general hospital shall notify health care providers,
19 labor unions, the [congressional] local, state, and federal legislative
20 representative, the office of the attorney general, the county execu-
21 tive, mayor, town supervisor, and in the case of the city of New York,
22 the borough president, and community board for [the] every district in
23 which the [facility] general hospital is located, [the county executive
24 of the county in which the facility is located, and the state senator
25 and assembly member representing the area within which the facility is
26 located] of the date, time, and location of the community forum. The
27 general hospital shall afford all public participants a reasonable
28 opportunity to speak about relevant matters at such community forum.
29 Prior to [any] a community forum and as soon as practicable, the general
30 hospital shall be required to:
31 [(a)] (A) notify the office of mental health and the local director of
32 community services in the event such general hospital has psychiatric
33 inpatient beds licensed under article thirty-one of the mental hygiene
34 law or designated pursuant to section 9.39 of the mental hygiene law,
35 and
36 [(b)] (B) notify the office of addiction services and supports in the
37 event such general hospital has inpatient substance use disorder treat-
38 ment programs or inpatient chemical dependence treatment programs
39 licensed under article thirty-two of the mental hygiene law. The commis-
40 sioner shall also accept comments submitted in writing at such public
41 forum and by mail or electronic mail within at least two weeks following
42 the community forum.
43 (v) The commissioner shall also accept comments submitted in writing
44 at such public forum and by mail or electronic mail within at least two
45 weeks following the community forum.
46 (d) Revised closure plan. No later than thirty days after the communi-
47 ty forum, the general hospital shall submit a revised closure plan to
48 the department addressing concerns raised by community stakeholders
49 during the community forum. The general hospital and the department
50 shall make the revised closure plan publicly available on their websites
51 no later than forty-five days after the community forum.
52 (e) Public health and health planning council review. No later than
53 ninety days prior to the proposed closure, the public health and health
54 planning council, or any successor entity, shall hold a public meeting
55 before the council to review the application, including the health equi-
56 ty impact assessment and revised closure plan. Within two weeks after
S. 8843--A 4
1 such meeting, the public health and health planning council shall make a
2 recommendation to the commissioner for the commissioner's consideration.
3 3. Closure of a unit of a general hospital. (a)(i) Written notifica-
4 tion of a proposed closure of a unit of a general hospital, as defined
5 in subdivision one of this section, must be provided to the department
6 and all parties listed in subparagraph (iv) of paragraph (c) of subdivi-
7 sion two of this section no later than two hundred ten days prior to the
8 proposed closure date. Nothing in this section shall prohibit a general
9 hospital from conferring with the department prior to submitting such
10 written notification to give informal notice and seek guidance.
11 (ii) A reduction in services or closure of a unit in a general hospi-
12 tal shall not be required to undergo the process set forth in this
13 section if the general hospital demonstrates to the department a good
14 cause for such reduction or closure of a unit, which shall include one
15 or more of the following:
16 (A) whether such closure or reduction is temporary in order to modern-
17 ize a facility;
18 (B) whether such closure addresses the current health care demand,
19 such as patient volume and the overall availability of services in the
20 facility's health service area or county served;
21 (C) there are acute labor shortages outside of the control of the
22 general hospital that impacts patient safety; or
23 (D) an acute financial emergency outside of the control of the general
24 hospital.
25 (b) Application. A general hospital that seeks the closure of a unit
26 shall submit an application to the department of health that requires
27 review by the public health and health planning council, or any succes-
28 sor entity in addition to approval by the commissioner. The application
29 for the closure shall include a health equity impact assessment, as
30 defined by section twenty-eight hundred two-b of this article, and a
31 proposed closure plan. The application shall be submitted at least one
32 hundred fifty days before the proposed closure. No cessation, pause,
33 transfer, or limitation of service may be carried out while the closure
34 application is pending without prior written approval by the commission-
35 er or the commissioner's designee, who shall take into consideration the
36 impacts on quality of care and patient safety stemming from changes in
37 patient volume or services. As used in this section, "transfer of
38 services" shall include conversion of services from inpatient to outpa-
39 tient services, the moving of services to other facilities, or the
40 transfer of personnel that would constitute a reduction or unavailabili-
41 ty of services.
42 (c) Community public forum. (i) No later than ninety days prior to the
43 proposed closure of a unit of a general hospital, the commissioner shall
44 hold a public community forum for the purpose of obtaining public input
45 concerning the anticipated impact of the unit's closure on quality and
46 access to health care services by members of the surrounding community,
47 including but not limited to recipients of medical assistance for needy
48 persons, the uninsured, and medically underserved populations as defined
49 in paragraph (d) of subdivision one of section twenty-eight hundred
50 two-b of this article, and options and proposals to ameliorate such
51 anticipated impact. The commissioner shall afford community members,
52 health care providers, labor unions, payers, businesses, and other
53 participants a reasonable opportunity to speak about relevant matters at
54 such community forum.
55 (ii) No later than two weeks before holding a community forum pursuant
56 to this paragraph, the commissioner shall make available to the public
S. 8843--A 5
1 on the department's website information regarding: (A) the proposed
2 closure plan submitted by the general hospital; (B) the anticipated
3 impact of the closure on quality and access to health care services by
4 members of the surrounding community, including but not limited to
5 recipients of medical assistance for needy persons, the uninsured, and
6 underserved populations; (C) specific measures the department and other
7 parties have taken or will take to ameliorate such anticipated impact
8 including but not limited to ensuring that the services to be eliminated
9 would be available to Medicaid, or individuals that are insured by a
10 publicly-subsidized plan and uninsured patients at the surrounding area
11 facilities that are taking new patients; and (D) any further recommenda-
12 tions regarding quality and access to health care services in communi-
13 ties impacted by the closure.
14 (iii) A community forum conducted pursuant to this paragraph shall be
15 held at a location within a reasonable proximity to the unit subject to
16 the proposed closure and shall be announced no less than fourteen days
17 prior to the date of such community forum. Such forum shall be held at a
18 proper time and be accessible to the impacted community virtually and
19 physically.
20 (iv) No later than two weeks prior to the community forum under this
21 section, the general hospital seeking to close a unit shall notify
22 health care providers, labor unions, the local, state, and federal
23 legislative representative, the office of the attorney general, the
24 county executive, mayor, town supervisor, and in the case of the city of
25 New York, the borough president, and community board for every district
26 in which the general hospital is located, of the date, time, and
27 location of the community forum. Prior to the community forum and as
28 soon as practicable, the general hospital shall be required to: (A)
29 notify the office of mental health and the local director of community
30 services in the event such general hospital is seeking to close an inpa-
31 tient psychiatric unit licensed under article thirty-one of the mental
32 hygiene law or designated pursuant to section 9.39 of the mental hygiene
33 law, and (B) notify the office of addiction services and supports in the
34 event the general hospital is seeking to close an inpatient substance
35 use disorder treatment programs or inpatient chemical dependence treat-
36 ment programs licensed under article thirty-two of the mental hygiene
37 law.
38 (v) The commissioner shall also accept comments submitted in writing
39 at such public forum and by mail or electronic mail within at least two
40 weeks following the community forum.
41 (d) Revised closure plan. No later than thirty days after the communi-
42 ty forum, the general hospital shall submit a revised closure plan to
43 the department addressing concerns raised by community stakeholders
44 during the community forum. The general hospital and the department
45 shall make the revised closure plan publicly available on their websites
46 no later than forty-five days after the community forum.
47 (e) Public health and health planning council review. No later than
48 thirty days prior to the proposed closure, the public health and health
49 planning council, or any successor entity, shall hold a public meeting
50 to review the application, including the health equity impact assessment
51 and revised closure plan. Within two weeks after such meeting, the
52 public health and health planning council shall make a recommendation to
53 the commissioner for the commissioner's consideration.
54 4. The commissioner shall make their decision to either approve or
55 deny the closure plan within thirty days following receipt of the recom-
56 mendation from the public health and health planning council.
S. 8843--A 6
1 5. 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 general hospital shall
5 hold a public community forum for the purpose of obtaining public input
6 concerning the anticipated impact of the general hospital's closure of
7 inpatient units, including but not limited to, the impact on recipients
8 of medical assistance for needy persons, the uninsured, people with
9 disabilities, and medically underserved populations, and options and
10 proposals to ameliorate such anticipated impact.
11 6. No later than January first, two thousand twenty-five and annually
12 thereafter, the commissioner shall provide a report to the legislature,
13 including but not limited to, identifying the general hospital or unit
14 of a general hospital that has provided written notice of a closure, the
15 proposed closure date and the services impacted by the proposed closure.
16 Such report shall be provided in electronic format and shall be distrib-
17 uted to the temporary president and minority leader of the senate, the
18 speaker and minority leader of the assembly, the chair of the senate
19 standing committee on health, and the chair of the assembly health
20 committee.
21 7. No provision of this section shall modify any other requirement or
22 process for the closure of a general hospital or a unit of a general
23 hospital that is required pursuant to this chapter or the regulations
24 promulgated pursuant to it, including but not limited to any department
25 or public health and health planning council review or approval process.
26 § 3. This act shall take effect on the sixtieth day after it shall
27 have become a law, and shall not apply to any proposed closures on
28 notice to the department as of the date it shall take effect.