Requires the commissioner of health to develop a sustainability plan for the state university of New York downstate medical center; provides that such sustainability plan shall not limit or alter the rights of employees pursuant to a collective bargaining agreement.
STATE OF NEW YORK
________________________________________________________________________
4558
2025-2026 Regular Sessions
IN ASSEMBLY
February 4, 2025
___________
Introduced by M. of A. CUNNINGHAM -- Multi-Sponsored by -- M. of A.
CHANDLER-WATERMAN, COLTON, DAVILA, FORREST, GONZALEZ-ROJAS, MAMDANI,
MEEKS, RIVERA, SEAWRIGHT, SHRESTHA, WEPRIN -- read once and referred
to the Committee on Health
AN ACT in relation to requiring the commissioner of health to develop a
sustainability plan for the state university of New York downstate
medical center
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Legislative intent. The legislature hereby finds and
2 declares that the state university downstate medical center is a vital
3 component of our state's health care system. As one of three state
4 hospitals and the only state hospital in the city of New York, it is
5 incumbent upon the state to ensure that this hospital remains fiscally
6 viable to continue to provide the health care services that the resi-
7 dents of central Brooklyn deserve and depend on. The state university
8 downstate medical center is one of the state's largest safety-net hospi-
9 tals, which cares for all patients, regardless of their ability to pay.
10 It predominantly serves people of color, low income, uninsured, underin-
11 sured, undocumented and at-risk individuals who have limited access to
12 affordable health care and who are more prone to suffer from serious
13 disease and face higher morbidity rates than other patients across our
14 city and state. Last year, the hospital had over three hundred thousand
15 outpatient visits and has an average of fourteen thousand inpatients
16 each year. It also provides seven thousand four hundred free health
17 screenings a year and sponsors over one hundred community service
18 projects annually.
19 The legislature further finds that at the height of the pandemic, when
20 the city of New York was at the epicenter, the state university down-
21 state medical center stepped up as a COVID-only hospital and provided
22 life-saving care to the sickest New Yorkers without any state funding
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD05737-01-5
A. 4558 2
1 support. Serving COVID-only patients exacerbated the existing untenable
2 financial situation of the hospital, which in large part, is due to
3 years of state financial neglect and unequitable treatment. Provided
4 further, the state university downstate medical center is a major part
5 of the Brooklyn economy and is one of the ten largest employers in
6 Brooklyn, providing employment to four thousand two hundred people. It's
7 also responsible for nearly nine hundred million dollars in economic
8 activity, generating nearly two hundred million dollars in tax revenue.
9 The hospital is the heart of central Brooklyn and has the largest
10 medical school in New York city, which offers training in fifty-six
11 specialties across five schools and colleges and annually educates and
12 trains nearly one thousand nine hundred students. The medical school
13 student population is made up of nearly sixty percent students of color,
14 produces the most physicians of color in the state of New York, and
15 nearly seventy percent of two thousand twenty-two graduates remained in
16 New York for their residency. This institution is an essential part in
17 producing the next generation of health care professionals, which are
18 desperately needed to sustain our state health care system.
19 The legislature further finds that the continued operation of the
20 state university downstate medical center is vital and necessary, and
21 the state should develop a plan to ensure its future sustainability and
22 shall provide state funding and other resources necessary to implement
23 and execute such plan.
24 § 2. The commissioner of health, in consultation with the chancellor
25 of the state university of New York and the employee organizations
26 representing employees at the state university of New York pursuant to
27 article 14 of the civil service law, shall develop a sustainability plan
28 for the state university of New York downstate medical center as estab-
29 lished pursuant to section 352 of the education law to ensure the hospi-
30 tal's continued operation in serving the public health care needs of the
31 Brooklyn community. Such plan shall maintain the state university down-
32 state medical center as a public state-operated hospital, staffed with
33 public employees within and under the appointing authority of the state
34 university of New York. In developing such sustainability plan, the
35 commissioner shall examine the state university downstate medical
36 center's finances, management operations, billing practices, current
37 health care services and delivery model, and any other records, metrics,
38 or aspects of the hospital the commissioner deems necessary and appro-
39 priate to adequately assess their direct or indirect effects on the
40 financial health and viability of the hospital and to determine what
41 modifications are needed to make the state university downstate medical
42 center financially sustainable. In assessing the financial health and
43 viability of the state university downstate medical center, the commis-
44 sioner shall also examine patient mix demographics, including but not
45 limited to, the financial challenges posed by the provision of safety
46 net services to low income, uninsured, underinsured, undocumented and
47 at-risk individuals. The commissioner shall also assess the current and
48 potential economic impact of the state university downstate medical
49 center in Brooklyn and identify any new potential health care service
50 areas not currently being provided at the state university downstate
51 medical center, which if provided, would better serve patients and help
52 ameliorate the hospital's current and future financial situation.
53 Provided further, the commissioner shall also identify current gaps in
54 health care services throughout Brooklyn, especially for low income,
55 uninsured, underinsured, undocumented and at-risk individuals and deter-
56 mine whether providing such health care services at the state university
A. 4558 3
1 downstate medical center would be beneficial to the future financial
2 sustainability of the hospital. In making such determination, the
3 commissioner shall delineate any costs associated with the hospital
4 providing such services, including but not limited to, personal service
5 costs, costs for equipment, management costs and capital funding needs.
6 Provided further, in identifying gaps in current health care services,
7 the commissioner shall examine, among other health care services, the
8 feasibility and public health value of establishing and operating a
9 center for maternal and children's health services at the state univer-
10 sity downstate medical center to address high rates of maternal morbidi-
11 ty in Brooklyn and shall delineate all projected costs associated with
12 the establishment and operation of such center.
13 The commissioner shall also determine what capital project improve-
14 ments are required at the state university downstate medical center to
15 enable the hospital to adequately meet current and future health care
16 service needs identified as part of the sustainability plan. The commis-
17 sioner shall also provide an analysis of current emergency room oper-
18 ations as part of such sustainability plan, which shall include, but
19 shall not be limited to, patient care and service capacity as well as
20 improvements needed to adequately address patient service demands and
21 the technology, equipment and capital infrastructure improvements that
22 are required to improve patient services and to improve the financial
23 position of the hospital.
24 The commissioner shall submit such sustainability plan to the gover-
25 nor, the temporary president of the senate and the speaker of the assem-
26 bly by December 31, 2025. The sustainability plan shall serve to inform
27 the governor in preparation of the 2026-2027 executive budget
28 submission.
29 § 3. Notwithstanding any provision of law to the contrary, all rights
30 and benefits, including terms and conditions of employment and
31 protection of civil service and collective bargaining status of all
32 existing public employees shall be preserved and protected. Nothing in
33 the sustainability plan required by this act or any provision of this
34 act shall limit the rights of employees pursuant to a collective
35 bargaining agreement or alter the existing representational relation-
36 ships among collective bargaining representatives or the bargaining
37 relationships between the state university downstate medical center and
38 any employee organization. Employees of the state university downstate
39 medical center serving in any new positions or titles resulting from the
40 implementation of the commissioner's sustainability plan, or any part
41 thereof, pursuant to this act shall be assigned to the appropriate
42 existing bargaining units. Prior to the implementation of such sustain-
43 ability plan, or any part thereof, developed by the commissioner pursu-
44 ant to this act, the state university of New York shall inform affected
45 employee organizations of any potential impact on its members or collec-
46 tive bargaining unit as a result of such implementation.
47 § 4. This act shall take effect immediately.
