S T A T E O F N E W Y O R K
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8732
I N S E N A T E
March 5, 2024
___________
Introduced by Sen. MYRIE -- read twice and ordered printed, and when
printed to be committed to the Committee on Finance
AN ACT to amend the executive law, in relation to establishing the
commission for the modernization and revitalization of downstate
medical center
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The executive law is amended by adding a new article 49-C
to read as follows:
ARTICLE 49-C
COMMISSION FOR THE MODERNIZATION AND REVITALIZATION
OF DOWNSTATE MEDICAL CENTER
SECTION 996. COMMISSION FOR THE MODERNIZATION AND REVITALIZATION OF
DOWNSTATE MEDICAL CENTER.
§ 996. COMMISSION FOR THE MODERNIZATION AND REVITALIZATION OF DOWN-
STATE MEDICAL CENTER. 1. LEGISLATIVE INTENT. THE LEGISLATURE HEREBY
FINDS AND DECLARES THAT THE STATE UNIVERSITY DOWNSTATE MEDICAL CENTER
("DOWNSTATE") AS ESTABLISHED PURSUANT TO SECTION THREE HUNDRED FIFTY-TWO
OF THE EDUCATION LAW, IS A VITAL COMPONENT OF OUR STATE'S HEALTH CARE
SYSTEM. AS ONE OF THREE STATE HOSPITALS AND THE ONLY STATE HOSPITAL IN
THE CITY OF NEW YORK, IT IS INCUMBENT UPON THE STATE TO ENSURE THAT THIS
HOSPITAL REMAINS FISCALLY VIABLE TO CONTINUE TO PROVIDE THE HEALTH CARE
SERVICES THAT THE RESIDENTS OF CENTRAL BROOKLYN DESERVE AND DEPEND ON.
THE STATE UNIVERSITY DOWNSTATE MEDICAL CENTER IS ONE OF THE STATE'S
LARGEST SAFETY-NET HOSPITALS, WHICH CARES FOR ALL PATIENTS, REGARDLESS
OF THEIR ABILITY TO PAY. IT PREDOMINANTLY SERVES PEOPLE OF COLOR, LOW
INCOME, UNINSURED, UNDERINSURED, UNDOCUMENTED AND AT-RISK INDIVIDUALS
WHO HAVE LIMITED ACCESS TO AFFORDABLE HEALTH CARE AND WHO ARE MORE PRONE
TO SUFFER FROM SERIOUS DISEASE AND FACE HIGHER MORBIDITY RATES THAN
OTHER PATIENTS ACROSS OUR CITY AND STATE. IN TWO THOUSAND TWENTY-TWO,
THE HOSPITAL HAD OVER THREE HUNDRED THOUSAND OUTPATIENT VISITS AND HAS
AN AVERAGE OF FOURTEEN THOUSAND INPATIENTS EACH YEAR. IT ALSO PROVIDES
SEVEN THOUSAND FOUR HUNDRED FREE HEALTH SCREENINGS A YEAR AND SPONSORS
OVER ONE HUNDRED COMMUNITY SERVICE PROJECTS ANNUALLY.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD14768-01-4
S. 8732 2
PROVIDED FURTHER, DOWNSTATE IS IN THE HEART OF CENTRAL BROOKLYN AND
HAS THE LARGEST MEDICAL SCHOOL IN NEW YORK CITY, WHICH OFFERS TRAINING
IN FIFTY-SIX SPECIALTIES ACROSS FIVE SCHOOLS AND COLLEGES AND ANNUALLY
EDUCATES AND TRAINS NEARLY ONE THOUSAND NINE HUNDRED STUDENTS. THE
MEDICAL SCHOOL STUDENT POPULATION IS MADE UP OF NEARLY SIXTY PERCENT
STUDENTS OF COLOR, PRODUCES THE MOST PHYSICIANS OF COLOR IN THE STATE OF
NEW YORK, AND NEARLY SEVENTY PERCENT OF TWO THOUSAND TWENTY-TWO GRADU-
ATES REMAINED IN NEW YORK FOR THEIR RESIDENCY. HAVING A HOSPITAL AFFIL-
IATED WITH THE MEDICAL SCHOOL IS BOTH CRITICAL FOR THE TRAINING OF
MEDICAL STUDENTS AND IS AN ESSENTIAL PART IN PRODUCING THE NEXT GENER-
ATION OF HEALTH CARE PROFESSIONALS, WHICH ARE DESPERATELY NEEDED TO
ENHANCE THE ACCESS TO VITAL HEALTH CARE IN OUR COMMUNITIES.
THE LEGISLATURE FURTHER FINDS THAT THE ENTIRE BROOKLYN HEALTH CARE
DELIVERY SYSTEM REMAINS IN NEED OF A CONTINUED GLOBAL EXAMINATION,
ASSESSING THE NEEDS OF EACH OF ITS DIVERSE COMMUNITIES, THE ACCESS TO
HIGH QUALITY OF CARE THROUGHOUT BROOKLYN, THE DEMOGRAPHICS, HEALTH CARE
EQUITIES AND DISPARITIES OF EACH COMMUNITY, THE AVAILABILITY OF SPECIAL-
TY SERVICES FOR LOW INCOME POPULATIONS, AND THE INTERCONNECTIVITY
BETWEEN THE VARIOUS HEALTH CARE SYSTEMS TO ENSURE THE LONG TERM FINAN-
CIAL SUSTAINABILITY OF EACH OF THE VARIOUS DELIVERY SYSTEMS IN THE
BOROUGH. SUCH FURTHER EXAMINATION CAN BEGIN WITH THE MODERNIZATION AND
REVITALIZATION OF DOWNSTATE CONTINUING AS A HOSPITAL OFFERING CRITICAL
HOSPITAL SPECIALTY SERVICES FOR THE COMMUNITY, BECOMING A CORE SPECIALTY
HOSPITAL CENTER OF EXCELLENCE FOR THOSE CRITICAL SPECIALTY SERVICES, BUT
SIMULTANEOUSLY UNDERTAKING AN EXAMINATION OF THE APPROPRIATENESS OF
CONVERTING CERTAIN DESIGNATED INPATIENT BEDS THAT ARE NOT UTILIZED FOR
THE SPECIALTY HOSPITAL CENTER OF EXCELLENCE (PROVIDING SPECIALTY
SERVICES PURSUANT TO SUBDIVISION THREE OF THIS SECTION), TO AN OUTPA-
TIENT SETTING, EXPANDING SERVICES TO INCLUDE ACCESS TO PRIMARY CARE THRU
CLINICS, URGENT CARE OR OTHER HOSPITAL AFFILIATED MEDICAL PRACTICES.
THE LEGISLATURE FURTHER FINDS THAT THE CONTINUED OPERATION OF THE
STATE UNIVERSITY DOWNSTATE MEDICAL CENTER AS A FREE-STANDING STATE-OPER-
ATED PUBLIC HOSPITAL, STAFFED WITH PUBLIC EMPLOYEES, AT ITS CURRENT
LOCATION, WITHIN AND UNDER THE APPOINTING AUTHORITY OF THE STATE UNIVER-
SITY OF NEW YORK IN A MODERNIZED AND REVITALIZED FORM, IS VITAL AND
NECESSARY, AND THE STATE SHOULD DEVELOP A PLAN TO ENSURE ITS FUTURE
SUSTAINABILITY AND SHALL PROVIDE STATE FUNDING AND OTHER RESOURCES
NECESSARY TO IMPLEMENT AND EXECUTE SUCH PLAN. SUCH PLAN SHALL BE BASED
ON THE RECOMMENDATIONS OF THE COMMISSION FOR THE MODERNIZATION AND REVI-
TALIZATION OF DOWNSTATE MEDICAL CENTER. THE COMMISSION FOR THE MODERN-
IZATION AND REVITALIZATION OF DOWNSTATE MEDICAL CENTER SHALL EXAMINE
THOSE SERVICES THAT ARE NECESSARY TO BE PROVIDED AT DOWNSTATE, ALTERNA-
TIVE SERVICES WHICH ARE MORE SUITABLE FOR THE COMMUNITY AND WHICH ARE IN
ADDITION TO THE CORE CENTER OF EXCELLENCE SPECIALTY SERVICES WHICH SHALL
CONTINUE TO BE OFFERED AT DOWNSTATE.
2. DEFINITIONS. FOR THE PURPOSES OF THIS SECTION, THE FOLLOWING TERMS
SHALL HAVE THE FOLLOWING MEANINGS:
(A) "COMMISSION" SHALL MEAN THE COMMISSION FOR THE MODERNIZATION AND
REVITALIZATION OF DOWNSTATE MEDICAL CENTER.
(B) "DOWNSTATE" SHALL MEAN THE DOWNSTATE MEDICAL CENTER.
(C) "CORE SPECIALTY CENTER OF EXCELLENCE SERVICES" SHALL INCLUDE THE
FOLLOWING SERVICES WHICH SHALL CONTINUE TO BE OFFERED IN A HOSPITAL
SETTING AT DOWNSTATE, NOTWITHSTANDING THE RECOMMENDATIONS OF THE COMMIS-
SION:
(I) LEVEL II TRAUMA CARE AND RELATED SERVICES;
(II) TRANSPLANT CARE AND RELATED SERVICES;
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(III) CARDIOLOGY CARE AND RELATED SERVICES;
(IV) MATERNITY AND PEDIATRIC CARE FOR LOW INCOME AND ETHNICALLY
DIVERSE POPULATIONS; AND
(V) EMERGENCY SERVICES. PROVIDED, HOWEVER, THE COMMISSION SHALL BE
AUTHORIZED TO EXAMINE THE SIZE, SCOPE AND OTHER APPROPRIATE FEATURES
NECESSARY IN PROVIDING EMERGENCY SERVICES AT DOWNSTATE.
3. COMMISSION FOR THE MODERNIZATION AND REVITALIZATION OF DOWNSTATE
MEDICAL CENTER. (A) THERE IS HEREBY CREATED WITHIN THE EXECUTIVE DEPART-
MENT THE COMMISSION FOR THE MODERNIZATION AND REVITALIZATION OF DOWN-
STATE MEDICAL CENTER.
(B) THE COMMISSION SHALL EXAMINE THOSE SERVICES THAT SHOULD BE OFFERED
AT DOWNSTATE, OR A DOWNSTATE AFFILIATE, WHICH ARE IN ADDITION TO THE
CORE SPECIALTY CENTER OF EXCELLENCE SERVICES WHICH SHALL CONTINUE TO BE
OFFERED AT DOWNSTATE. IN DETERMINING ITS RECOMMENDATIONS, THE COMMISSION
SHALL CONSIDER THE FOLLOWING FACTORS: (I) THE FINANCIAL SUSTAINABILITY
OF DOWNSTATE CONSIDERING MANAGEMENT OPERATIONS, BILLING PRACTICES,
CURRENT HEALTH CARE SERVICES AND DELIVERY MODEL; (II) THE PATIENT MIX
AND DEMOGRAPHICS, INCLUDING BUT NOT LIMITED TO, THE FINANCIAL CHALLENGES
POSED BY THE PROVISION OF SAFETY NET SERVICES TO LOW INCOME, UNINSURED,
UNDERINSURED, UNDOCUMENTED AND AT-RISK INDIVIDUALS; (III) THE SERVICES
AVAILABLE AND READILY ACCESSIBLE AT OTHER HEALTH CARE SYSTEMS OR PROVID-
ERS IN BROOKLYN AND ACCESS TO THOSE SERVICES BY RESIDENTS OF CENTRAL
BROOKLYN; (IV) THE HEALTH CARE DISPARITIES IN CENTRAL BROOKLYN; (V)
ACCESS TO PRIMARY CARE, OUTPATIENT SERVICES, AND EMERGENCY SERVICES FOR
RESIDENTS OF THE DOWNSTATE COMMUNITY AND THE FEASIBILITY OF DOWNSTATE
OFFERING EXPANDED SERVICES TO ADDRESS THESE NEEDS; (VI) THOSE SERVICES
WHICH ARE NECESSARY FOR THE TRAINING AND EDUCATION OF STUDENTS AND GRAD-
UATES OF THE DOWNSTATE MEDICAL SCHOOL; AND (VII) OTHER SERVICES THE
COMMISSION DEEMS APPROPRIATE IN MAKING ITS RECOMMENDATIONS. THE COMMIS-
SION SHALL ALSO DETERMINE WHAT CAPITAL PROJECT IMPROVEMENTS ARE REQUIRED
AT DOWNSTATE TO BOTH MAINTAIN THE CORE SPECIALTY CENTER OF EXCELLENCE
SERVICES AND ALSO ENABLE THE HOSPITAL TO ADEQUATELY MEET CURRENT AND
FUTURE HEALTH CARE NEEDS OF THE COMMUNITY AS IDENTIFIED BY THE COMMIS-
SION. THE COMMISSION SHALL ALSO PROVIDE AN ANALYSIS OF CURRENT EMERGENCY
ROOM OPERATIONS, WHICH SHALL INCLUDE, BUT SHALL NOT BE LIMITED TO,
PATIENT CARE AND SERVICE CAPACITY AS WELL AS IMPROVEMENTS NEEDED TO
ADEQUATELY ADDRESS PATIENT SERVICE DEMANDS AND THE TECHNOLOGY, EQUIPMENT
AND CAPITAL INFRASTRUCTURE IMPROVEMENTS THAT ARE REQUIRED TO IMPROVE
PATIENT SERVICES AND TO IMPROVE THE FINANCIAL POSITION OF DOWNSTATE.
(C) THE COMMISSION SHALL NOT BE AUTHORIZED TO MAKE RECOMMENDATIONS
WHICH REDUCE, LIMIT OR ANY IN WAY ALTER THE CORE SPECIALTY CENTER OF
EXCELLENCE SERVICES OFFERED IN A HOSPITAL SETTING AT DOWNSTATE.
4. COMMISSION APPOINTMENTS. THE COMMISSION SHALL CONSIST OF THE
FOLLOWING MEMBERS: (A) THE COMMISSIONER OF HEALTH, WHO SHALL SERVE AS
THE EX-OFFICIO CHAIR THE COMMISSION; (B) A REPRESENTATIVE OF ORGANIZED
LABOR REPRESENTING EMPLOYEES AT THE STATE UNIVERSITY OF NEW YORK PURSU-
ANT TO ARTICLE FOURTEEN OF THE CIVIL SERVICE LAW; (C) ONE MEMBER
APPOINTED BY THE TEMPORARY PRESIDENT OF THE SENATE; (D) ONE MEMBER
APPOINTED BY THE SPEAKER OF THE ASSEMBLY; (E) ONE MEMBER APPOINTED BY
THE MINORITY LEADER OF THE SENATE; (F) ONE MEMBER APPOINTED BY THE
MINORITY LEADER OF THE ASSEMBLY; (G) TWO MEMBERS APPOINTED BY THE LOCAL
COMMUNITY BOARDS; (H) TWO MEMBERS APPOINTED BY THE GOVERNOR; AND (I) THE
CHANCELLOR OF THE STATE UNIVERSITY OF NEW YORK.
5. COMPENSATION. THE MEMBERS OF THE COMMISSION SHALL RECEIVE NO
COMPENSATION FOR THEIR SERVICE AS MEMBERS, BUT SHALL BE ALLOWED THEIR
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ACTUAL AND NECESSARY EXPENSES INCURRED IN THE PERFORMANCE OF THEIR
DUTIES.
6. COMMISSION COMMENCEMENT. (A) THE COMMISSION AND ITS DELIBERATIONS
SHALL BE SUBJECT TO ARTICLE SEVEN OF THE PUBLIC OFFICERS LAW.
(B) THE COMMISSION SHALL ADOPT ITS BYLAWS ON OR BY ITS SECOND MEETING.
(C) THE COMMISSION SHALL BEGIN TO ACT FORTY-FIVE DAYS AFTER THIS ARTI-
CLE SHALL HAVE BECOME A LAW.
7. DEPARTMENT OF HEALTH ASSISTANCE. (A) THE COMMISSIONER OF HEALTH
SHALL DESIGNATE SUCH EMPLOYEES OF THE DEPARTMENT OF HEALTH AS ARE
REASONABLY NECESSARY TO PROVIDE SUPPORT SERVICES TO THE COMMISSION.
(B) THE COMMISSIONER OF HEALTH SHALL ALSO SUBMIT TO THE COMMISSION
SUCH INFORMATION AS MAY BE AVAILABLE FROM THE DEPARTMENT OF HEALTH ON
GENERAL HOSPITAL AND NURSING HOME CAPACITY, SERVICES AND BEDS, AVAIL-
ABILITY OF PRIMARY AND AMBULATORY CARE SERVICES, AND CURRENT NUMBER OF
BEDS IN SUCH FACILITIES, INCLUDING, BUT NOT LIMITED TO, INFORMATION
FROM:
(I) OPERATING CERTIFICATE FILES;
(II) INSTITUTIONAL COST REPORTS;
(III) FACILITY OCCUPANCY REPORTS;
(IV) ANNUAL REPORTS OF THE CERTIFICATE OF NEED PROGRAM;
(V) THE STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM; AND
(VI) ANY OTHER DOCUMENTATION REQUESTED BY THE COMMISSION.
8. DORMITORY AUTHORITY REPRESENTATION. THE DIRECTOR OF THE DORMITORY
AUTHORITY OF THE STATE OF NEW YORK SHALL APPOINT ONE OR MORE REPRESEN-
TATIVES TO BE A LIAISON BETWEEN THE COMMISSION AND THE AUTHORITY.
9. OTHER REQUIRED RECOMMENDATIONS. IN CARRYING OUT ITS TASK, THE
COMMISSION SHALL ALSO FORMALLY SOLICIT RECOMMENDATIONS FROM HEALTH CARE
EXPERTS, COUNTY HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS, STATE
AND REGIONAL HEALTH CARE INDUSTRY ASSOCIATIONS, LABOR UNIONS AND OTHER
INTERESTED PARTIES AS BROADLY AS IT CONSIDERS IT NECESSARY AND PROPER,
AND IT SHALL TAKE INTO ACCOUNT SUCH RECOMMENDATIONS AND THE RECOMMENDA-
TIONS OF THE KINGS COUNTY HEALTH CARE STAKEHOLDERS COUNCIL DURING ITS
DELIBERATIONS. IN DEVELOPING ITS RECOMMENDATIONS, THE COMMISSION SHALL
AS FAR AS PRACTICABLE ESTIMATE THE IMPROVEMENT IN QUALITY OF CARE,
FINANCIAL STATUS OF THE HOSPITALS, AND ALL OTHER EFFICIENCIES THAT MAY
BE DERIVED FROM RECONFIGURATION OF THE KINGS COUNTY HEALTH CARE SYSTEM.
10. REPORT OF COMMISSION. (A) THE COMMISSION SHALL BE FINISHED WITH
ITS STUDY AND ANALYSIS AND PROVIDE ITS WRITTEN RECOMMENDATIONS TO THE
LEGISLATURE AND THE GOVERNOR, ALONG WITH SUGGESTED LEGISLATIVE AND EXEC-
UTIVE ACTION, INCLUDING BUT NOT LIMITED TO INFRASTRUCTURE INVESTMENTS,
AND REFINANCING OF EXISTING DEBT OF GENERAL HOSPITALS IN KINGS COUNTY,
BY DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY-FOUR.
(B) SUCH RECOMMENDATIONS SHALL INCLUDE, BUT NOT BE LIMITED TO:
(I) RECOMMENDED DATES BY WHICH SUCH ACTIONS SHOULD OCCUR;
(II) NECESSARY INVESTMENTS, IF ANY, THAT SHOULD BE MADE IN EACH CASE
TO CARRY OUT THE COMMISSION'S RECOMMENDATIONS, INCLUDING ANY NECESSARY
WORKFORCE, TRAINING, OR OTHER INVESTMENTS TO ENSURE THAT REMAINING
FACILITIES ARE ABLE TO ADEQUATELY PROVIDE SERVICES WITHIN THE CONTEXT OF
A RESTRUCTURED INSTITUTIONAL PROVIDER HEALTH CARE SYSTEM; AND
(III) THE COMMISSION'S JUSTIFICATION FOR ITS RECOMMENDATIONS.
11. IMPLEMENTATION OF RECOMMENDATIONS. (A) NOTWITHSTANDING ANY CONTRA-
RY PROVISION OF LAW, RULE OR REGULATION RELATED TO THE ESTABLISHMENT,
CONSTRUCTION, APPROVAL, OR REVISIONS TO THE OPERATING CERTIFICATES,
RESIZING, CONSOLIDATION, CONVERSION OR RESTRUCTURING OF HEALTH CARE
FACILITIES IDENTIFIED IN THE COMMISSION'S RECOMMENDATIONS, INCLUDING BUT
NOT LIMITED TO SECTIONS TWENTY-EIGHT HUNDRED ONE-A, TWENTY-EIGHT HUNDRED
S. 8732 5
TWO, TWENTY-EIGHT HUNDRED FIVE, TWENTY-EIGHT HUNDRED SIX, AND TWENTY-
EIGHT HUNDRED SIX-B OF THE PUBLIC HEALTH LAW, THE COMMISSIONER OF HEALTH
SHALL TAKE ALL ACTIONS NECESSARY TO IMPLEMENT, IN A REASONABLE, COST-EF-
FICIENT MANNER, THE RECOMMENDATIONS OF THE COMMISSION PURSUANT TO THIS
SECTION.
(B) THE PROVISIONS OF PARAGRAPH (A) OF THIS SUBDIVISION SHALL NOT
APPLY IF A MAJORITY OF THE MEMBERS OF EACH HOUSE OF THE LEGISLATURE VOTE
TO ADOPT A CONCURRENT RESOLUTION REJECTING THE RECOMMENDATIONS OF THE
COMMISSION IN THEIR ENTIRETY BY FEBRUARY FIRST, TWO THOUSAND TWENTY-
FIVE. IN NO EVENT SHALL THE COMMISSIONER OF HEALTH BEGIN TO IMPLEMENT
THE RECOMMENDATIONS OF THE COMMISSION PRIOR TO FEBRUARY FIRST, TWO THOU-
SAND TWENTY-FIVE. PROVIDED, FURTHER, THE COMMISSIONER OF HEALTH SHALL BE
PRECLUDED FROM ACTING UPON ANY CERTIFICATE OF NEED APPLICATION, OR ANY
OTHER SUBMISSION OR CLOSURE PLAN WHICH LIMITS OR IN ANY WAY ALTERS THE
SERVICES PROVIDED BY DOWNSTATE, ON OR AFTER THE EFFECTIVE DATE OF THIS
SECTION, UNTIL AFTER FEBRUARY FIRST, TWO THOUSAND TWENTY-FIVE. PROVIDED,
HOWEVER, THAT NOTHING HEREIN SHALL BE CONSTRUED AS: (I) LIMITING THE
AUTHORITY OF THE COMMISSIONER OF HEALTH TO ENFORCE OR IMPLEMENT ANY
PROVISION OF THE PUBLIC HEALTH LAW RELATING TO THE HEALTH OR SAFETY OF
THE PATIENTS AT DOWNSTATE; OR (II) FROM APPROVING AN APPLICATION RELAT-
ING TO CAPITAL AND INFRASTRUCTURE IMPROVEMENTS AT DOWNSTATE THAT DO NOT
IMPACT THE SCOPE OR LEVEL OF SERVICES OFFERED AT DOWNSTATE.
12. SEVERABILITY CLAUSE. IF ANY CLAUSE, SENTENCE, PARAGRAPH, SUBDIVI-
SION, SECTION OR PART OF THIS SECTION SHALL BE ADJUDGED BY ANY COURT OF
COMPETENT JURISDICTION TO BE INVALID, SUCH JUDGMENT SHALL NOT AFFECT,
IMPAIR, OR INVALIDATE THE REMAINDER THEREOF, BUT SHALL BE CONFINED IN
ITS OPERATION TO THE CLAUSE, SENTENCE, PARAGRAPH, SUBDIVISION, SECTION
OR PART THEREOF DIRECTLY INVOLVED IN THE CONTROVERSY IN WHICH SUCH JUDG-
MENT SHALL HAVE BEEN RENDERED. IT IS HEREBY DECLARED TO BE THE INTENT OF
THE LEGISLATURE THAT THIS SECTION WOULD HAVE BEEN ENACTED EVEN IF SUCH
INVALID PROVISIONS HAD NOT BEEN INCLUDED HEREIN.
§ 2. This act shall take effect immediately.
