Lawmakers are backing a new effort to reform hospital closure laws as the pending shutdown of several local institutions has left New Yorkers in the dark about their access to care.
Legislators introduced a bill Wednesday that sets clear guidelines for hospitals seeking to close entirely or shut down their emergency departments, labor and delivery units or mental health and substance use services. The bill would impose timelines for public disclosure of a hospital shutdown and implement more oversight of closure plans.
The calls for reform come as the shutdown of Mount Sinai Beth Israel, SUNY Downstate and Samaritan Hospital’s Burdett Birthing Center in Troy threatens to reduce access to critical health care services. Lawmakers say their proposal is an attempt to alter a closure process that’s long been criticized as murky, leaving out community members who could face consequences from disruptions in care. The bill would require hospitals to present their closure plans to regulators and the public nine months in advance and host a town hall five months before closure.
The bill would also require hospitals to submit a Health Equity Impact Assessment for potential closures outlining how the plan would impact communities’ access to care. Hospital closure plans would be submitted for review to the Public Health and Health Planning Council, an advisory panel that makes recommendations on certificate-of-need applications but has not previously reviewed hospital closures.
After announcing their plans to scale back or entirely closer services, SUNY Downstate and Mount Sinai Beth Israel have implemented community input processes, which are required under current Health Department closure rules. But it’s unclear how that feedback will be incorporated into closure plans submitted by both facilities.
SUNY Downstate, which is expected to receive $300 million in capital funds to restructure its campus in the upcoming state budget, has implemented a community engagement process to get feedback from employees, local faith leaders and patients on a potential closure of the hospital. So far SUNY has held three community input sessions, all of which were closed to the public. The academic medical center is planning two additional focus groups to inform its restructuring process.
SUNY Downstate has not submitted a closure plan to the Health Department, but is working with the Health Department to determine what that process will look like once the institution decides which health services will remain on campus, SUNY Chancellor John King told Crain’s.
“Our approach here has been to share principles tied to the level of available dollars, and then to gather lots of community feedback,” King said. “I think that’s the right approach.”
Increased transparency also has the potential to backfire. Disclosing a hospital closure too far in advance could adversely impact the facility’s financial status and spur employees to look for other work, threatening patient care, according to a source familiar with the regulatory landscape.
Previous guidelines for hospital closures precluded health systems from disclosing their plans to the public in an attempt to keep services running while the hospital transitioned to shutting down. The state has struggled to balance the fact that hospitals have to run a business, but also provide an asset to the community – health care, the source added.
“The law doesn’t recognize health care as a public good,” they said, noting for example that there are no requirements for geographic regions to have full-service hospitals. “That’s really the conundrum.”
The impacts of public discussion of hospital closures are evident in the case of Mount Sinai Beth Israel. Although the hospital proposed to close this upcoming July, it said it had to begin scaling back services eight months earlier than planned because of staff resignations and a decline in volume. The Health Department issued an order to halt the hospital from shuttering services without its approval, but the hospital has repeatedly cited patient safety concerns and has continued to scale back care and staffing, according to a lawsuit filed in February.
Danielle DeSouza, a spokeswoman for the Health Department, said that the agency cannot comment on specific closure plans.
Amanda D'Ambrosio , 2024-03-21 10:33:09
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