Bill Text: NY S08843 | 2023-2024 | General Assembly | Amended

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Bill Title: 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.

Spectrum: Strong Partisan Bill (Democrat 15-1)

Status: (Engrossed) 2024-06-06 - returned to senate [S08843 Detail]

Download: New_York-2023-S08843-Amended.html

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                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.