Assemblymember Simon Passes Bill Reforming NYS’s Hospital Closure Process

Bill to strengthen NYS oversight and ensure public input passes Assembly with bipartisan support as closings threaten facilities across NYS from SUNY Downstate to Beth Israel & the Burdett Birth Center

Albany, NY – Assemblymember Jo Anne Simon (AD-52) announced that her Local Input in Community Healthcare (LICH) Act, A1633A, passed the Assembly today with bipartisan support. This significant piece of legislation requires public notice and public engagement when a hospital seeks to either close entirely or close a unit that provides emergency, maternity, mental health, or substance use care. The bill would also strengthen state review of the proposed closings.

Assemblymember Jo Anne Simon, who passed the bill in the Assembly several times before and recently updated it, said, “I’m thrilled that the Assembly passed my bill to strengthen the state’s oversight of hospital closures – and to ensure that the community can give meaningful input into this process. For far too long, there has been little to no transparency, planning, or public engagement in the hospital closure process, and thus no real assessment of impacts to the community’s health. The public is entitled to be fully informed. Since the closure of LICH a decade ago, more than 40 hospitals have closed across New York and 10 hospitals have closed maternity services. We are seeing history repeat itself now with the closure or possible closures at SUNY Downstate, Beth Israel, and St. Catherine of Siena Hospital.” She continued, “This bill reforms the process to ensure stronger state oversight and real community engagement that protects the public’s health.”

"I am grateful that the Assembly has passed Assemblymember Simon and my LICH bill. Our communities deserve transparency and engagement when they might lose access to their closest maternity unit or emergency department, or even the entire facility," said State Senator Gustavo Rivera, Chair of the Senate Health Committee and Senate sponsor. "New Yorkers are already facing major health disparities so this bill will make them a key stakeholder in a critical decision-making process that can have serious impacts on their health care. I will continue to work with my colleagues to pass this bill in the Senate."

"Today's action in the Assembly to approve the LICH bill is a major step forward in ensuring that affected communities get a say when their hospitals are proposing to close entirely or eliminate such vital services as maternity, emergency and mental health care," said Lois Uttley, co-founder of Community Voices for Health System Accountability, a statewide health advocacy network. "All across the state, communities are faced with these proposed closures, but often get little or no advance notice and are not meaningfully engaged in discussions about how to protect their access to care. We applaud Assemblymember Simon for her leadership in moving this important measure forward."

“We are excited that the Assembly has reaffirmed its commitment to improving New York’s oversight of hospital closure proposals and putting the community’s concerns at the center of the discussion from the beginning of the process, something that’s been long overdue,” said Mark Hannay, Coordinator of the Save Beth Israel and New York Eye and Ear Campaign. “We salute our Lower Manhattan Assemblymembers Epstein, Glick, Lee, and Simone for helping to lead the charge on this bill being passed, and look forward to working with Senators Gonzalez, Hoylman-Sigal, Kavanagh, and Krueger to get it through the Senate and onto Governor Hochul’s desk.”

When SUNY Downstate closed Long Island College Hospital (LICH) in 2013, for which this bill is named, the health department didn’t notify or seek input from the communities that LICH had served for 156 years. This included low-income communities of color that had been designated as lacking health care services by the federal government. Since that time, more than 40 hospitals have closed across New York and 10 hospitals have closed maternity services, including in Columbia, Franklin, Lewis, New York, Niagara, Ontario, Otsego, St. Lawrence and Wyoming counties. A number of psychiatric services closed during the pandemic and some still have not reopened. A recent study by the Center for Healthcare Quality and Payment Reform found that there are 27 rural hospitals in the state at risk of closing, amounting to 53 percent of all state rural hospitals.

Currently, New York State Public Health Law does not require hospitals to give adequate advance notice to key stakeholders like local officials or the potentially impacted community about a planned closure. A public hearing is not required until 30 days after a hospital closure is approved by the state under current statute, although a recent guidance to hospitals by the State Department of Health has changed that, and now requires an advance hearing.

While the new Health Equity Impact Assessment (HEIA) law that Senator Rivera passed into law in 2021 has helped to improve community engagement, it does not apply to closures of entire hospitals. Currently, hospital closures are carried out through a simple notice to the NYS Department of Health and an overall closure plan, not through a Certificate of Need (CON) application. Moreover, these closures are not subjected to a full CON review, which would go before the state Public Health and Health Planning Council for review in a public meeting at which community members could make comments.

The legislation will address these gaps in the state’s review of proposed hospital and critical unit closures by requiring adequate advance notice to local officials and the public, a community forum held 150 days in advance of the proposed closure date to allow public comment on the hospital’s plan, a final closure plan that addresses concerns raised at the community forum, and public disclosure of all submitted plans by the Department of Health.

“Closures of hospitals and hospital units can be devastating to affected communities, especially medically underserved people such as people with disabilities, pregnant people, people of color and people who are uninsured or underinsured,” said Elisabeth Ryden Benjamin, Vice President for Health Initiatives of the Community Service Society of NY, which coordinates the Health Care for All New York (HCFANY) statewide coalition. “It is vital that such proposed changes receive the highest level of state review and are subject to health equity impact assessments.”

Lara Kassel, coordinator of Medicaid Matters New York, commented that "People who have Medicaid for their health insurance coverage often live-in marginalized communities and underserved areas. Medicaid Matters believes in community involvement and input when it comes to changes to the health care services people rely on. Whether the closing of a hospital or hospital services takes place in urban neighborhoods in our state's cities or rural areas where health care can often be far from home, people deserve to know and have the chance to weigh in on what the changes would mean to them. Thank you to the bill sponsors and all of our partners for raising awareness about this important issue and to the state Assembly for passing this bill today.”

Mbacke Thiam, Health and Housing Community Organizer at the Center for Independence of the Disabled, NY (CIDNY), said: “Community members, especially people with disabilities, should have the right to be included in the conversation when their hospital is in jeopardy. Closure of health care facilities can be detrimental to people with disabilities and their families; they bear the brunt of these closures. So, their opinion must be taken into consideration. CIDNY strongly supports this legislation and thanks the Assembly for passing it.”

Maria Alvarez, Executive Director of the New York StateWide Senior Action Council, commented that: “Senior citizens are the largest consumers of acute and primary care in New York State and the closure of community hospitals like Beth Israel can have a devastating effect on limiting their access to critical care in a timely manner. This bill, if given final passage in the Senate and signed into law by Governor Hochul, would require that the concerns of older New Yorkers are addressed whenever hospital closures are proposed.”

“As the pandemic came to a close, we talked about building back better, building more robust and equitable systems. The loss of healthcare services in a community not only disrupts the continuity of care for patients, especially critical during pregnancy, but it also places an additional burden on providers at receiving facilities, exacerbating the strain on the system,” emphasized Kathryn Mitchell, National Director of Maternal and Infant Health & Collective Impact for March of Dimes. “The far-reaching impacts of unit or whole hospital closures underscore the necessity of engaging communities and conducting a comprehensive review of any proposed changes."