S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4560
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 4, 2025
                                ___________
 
 Introduced  by  M.  of A. CUNNINGHAM, GONZALEZ-ROJAS, CHANDLER-WATERMAN,
   BEEPHAN, CHANG, DeSTEFANO, SIMON -- read  once  and  referred  to  the
   Committee on Health
 
 AN  ACT  to  amend  the  executive  law, in relation to establishing the
   commission for the  modernization  and  revitalization  of  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:
 
   Section 1. The executive law is amended by adding a new  article  49-D
 to read as follows:
 
                               ARTICLE 49-D
    COMMISSION FOR THE MODERNIZATION AND REVITALIZATION OF SUNY DOWNSTATE
                              MEDICAL CENTER
 SECTION 997. LEGISLATIVE INTENT.
         997-A.  COMMISSION  FOR  THE MODERNIZATION AND REVITALIZATION OF
                SUNY DOWNSTATE MEDICAL CENTER.
         997-B. SEVERABILITY.
   § 997.  LEGISLATIVE  INTENT.  1.  THE  LEGISLATURE  HEREBY  FINDS  AND
 DECLARES THAT THE STATE UNIVERSITY DOWNSTATE MEDICAL CENTER (HEREINAFTER
 REFERRED  TO  AS  "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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD06578-01-5
              

 A. 4560                             2
 
 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 OUTPA-
 TIENT  VISITS  AND  HAS  AN AVERAGE OF FOURTEEN THOUSAND INPATIENTS EACH
 YEAR. IT ALSO PROVIDES SEVEN THOUSAND FOUR HUNDRED FREE  HEALTH  SCREEN-
 INGS  A  YEAR  AND  SPONSORS OVER ONE HUNDRED COMMUNITY SERVICE PROJECTS
 ANNUALLY.
   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.
   3.  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 TWO OF SECTION NINE  HUNDRED  NINETY-SEVEN-A  OF
 THIS  ARTICLE,  TO  AN OUTPATIENT SETTING, EXPANDING SERVICES TO INCLUDE
 ACCESS TO PRIMARY CARE THROUGH CLINICS, URGENT CARE  OR  OTHER  HOSPITAL
 AFFILIATED PRACTICES.
   4.  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  SUNY  DOWNSTATE  MEDICAL  CENTER ("THE COMMISSION"). THE
 COMMISSION SHALL  EXAMINE  THOSE  SERVICES  THAT  ARE  NECESSARY  TO  BE
 PROVIDED  AT DOWNSTATE, ALTERNATIVE SERVICES WHICH ARE MORE SUITABLE FOR
 THE COMMUNITY, AND WHICH ARE IN ADDITION TO THE CORE  CENTER  OF  EXCEL-
 LENCE  SPECIALTY  SERVICES  WHICH  SHALL CONTINUE TO BE OFFERED AT DOWN-
 STATE.
   § 997-A. COMMISSION FOR THE MODERNIZATION AND REVITALIZATION  OF  SUNY
 DOWNSTATE  MEDICAL CENTER. 1. COMMISSION ESTABLISHED. (A) THERE SHALL BE
 ESTABLISHED THE COMMISSION FOR THE MODERNIZATION AND  REVITALIZATION  OF
 A. 4560                             3

 SUNY  DOWNSTATE  MEDICAL CENTER (HEREINAFTER REFERRED TO AS "THE COMMIS-
 SION"). THE COMMISSION SHALL CONDUCT A STUDY TO EXAMINE  THOSE  SERVICES
 THAT  SHOULD  BE  OFFERED  AT SUNY DOWNSTATE MEDICAL CENTER (HEREINAFTER
 REFERRED TO AS "DOWNSTATE"), OR A DOWNSTATE AFFILIATE, WHICH SHALL BE IN
 ADDITION TO THE CORE SPECIALTY CENTER OF EXCELLENCE SERVICES WHICH SHALL
 CONTINUE  TO  BE  OFFERED  AT DOWNSTATE, AND MAKE RECOMMENDATIONS TO THE
 LEGISLATURE AND THE EXECUTIVE. IN CONDUCTING ITS STUDY  AND  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 SAFE-
 TY NET SERVICES TO LOW INCOME, UNINSURED, UNDERINSURED, UNDOCUMENTED AND
 AT-RISK INDIVIDUALS; (III) SERVICES AVAILABLE AND READILY ACCESSIBLE, AT
 OTHER HEALTH CARE SYSTEMS OR PROVIDERS IN BROOKLYN, AND ACCESS TO  THOSE
 SERVICES BY RESIDENTS OF CENTRAL BROOKLYN; (IV) THE HEALTH CARE DISPARI-
 TIES  IN  CENTRAL  BROOKLYN;  (V)  ACCESS  TO  PRIMARY  CARE, OUTPATIENT
 SERVICES, AND EMERGENCY SERVICES FOR RESIDENTS OF  THE  COMMUNITY  WHERE
 DOWNSTATE  IS LOCATED AND THE FEASIBILITY OF DOWNSTATE OFFERING EXPANDED
 SERVICES TO ADDRESS SUCH NEEDS; (VI) THOSE SERVICES WHICH ARE  NECESSARY
 FOR  THE  TRAINING  AND EDUCATION OF STUDENTS AND GRADUATES OF THE DOWN-
 STATE MEDICAL SCHOOL; AND (VII)  OTHER  SERVICES  THE  COMMISSION  DEEMS
 APPROPRIATE IN MAKING ITS RECOMMENDATIONS.
   (B)  THE  COMMISSIONER  SHALL  ALSO  DETERMINE  WHAT  CAPITAL  PROJECT
 IMPROVEMENTS ARE REQUIRED AT DOWNSTATE MEDICAL CENTER TO  BOTH  MAINTAIN
 THE  CORE  SPECIALTY CENTER OF EXCELLENCE SERVICES AND ALSO ENABLE DOWN-
 STATE TO ADEQUATELY MEET CURRENT AND FUTURE HEALTH  CARE  NEEDS  OF  THE
 COMMUNITY  AS  IDENTIFIED  BY  THE COMMISSION. 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  IMPROVE-
 MENT OF THE FINANCIAL POSITION OF DOWNSTATE.
   2.  DEFINITIONS.  (A)  FOR  PURPOSES  OF THIS ARTICLE, "CORE SPECIALTY
 CENTER OF EXCELLENCE SERVICES" SHALL MEAN THE FOLLOWING  SERVICES  WHICH
 SHALL  CONTINUE  TO  BE  OFFERED  IN  A  HOSPITAL  SETTING AT DOWNSTATE,
 NOTWITHSTANDING THE RECOMMENDATIONS OF THE COMMISSION:
   (I) LEVEL II TRAUMA CARE AND RELATED SERVICES;
   (II) TRANSPLANT CARE AND RELATED SERVICES;
   (III) CARDIOLOGIC 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.
   (B)  THE  COMMISSION  SHALL  NOT BE AUTHORIZED TO MAKE RECOMMENDATIONS
 WHICH REDUCE, LIMIT OR IN ANY WAY ALTER THE  CORE  SPECIALTY  CENTER  OF
 EXCELLENCE SERVICES OFFERED IN A HOSPITAL SETTING AT DOWNSTATE.
   3.  COMMISSION  MEMBERS. THE COMMISSION SHALL CONSIST OF THE FOLLOWING
 MEMBERS:
   (A) THE COMMISSIONER OF HEALTH, WHO  SHALL  SERVE  AS  THE  EX-OFFICIO
 CHAIR OF THE COMMISSION;
   (B) A REPRESENTATIVE OF EACH ORGANIZED LABOR REPRESENTING EMPLOYEES AT
 THE  STATE  UNIVERSITY  OF  NEW YORK PURSUANT TO ARTICLE FOURTEEN OF THE
 CIVIL SERVICE LAW, WHICH SHALL INCLUDE THE UNITED UNIVERSITY PROFESSIONS
 A. 4560                             4
 
 UNION, CIVIL SERVICE EMPLOYEES ASSOCIATION, PUBLIC EMPLOYEES  FEDERATION
 AND  NEW  YORK STATE CORRECTIONAL OFFICERS AND POLICE BENEVOLENT ASSOCI-
 ATION;
   (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) ONE MEMBER APPOINTED BY THE KINGS COUNTY BOROUGH PRESIDENT;
   (H) TWO MEMBERS APPOINTED BY LOCAL COMMUNITY BOARDS;
   (I) ONE MEMBER APPOINTED BY THE MAYOR OF THE CITY OF NEW YORK;
   (J) ONE MEMBER APPOINTED BY THE GOVERNOR; AND
   (K) THE CHANCELLOR OF THE STATE UNIVERSITY OF NEW YORK.
   4.  COMPENSATION.  THE  MEMBERS  OF  THE  COMMISSION  SHALL RECEIVE NO
 COMPENSATION FOR THEIR SERVICE AS MEMBERS, BUT SHALL  BE  ALLOWED  THEIR
 ACTUAL  AND  NECESSARY  EXPENSES  INCURRED  IN  THE PERFORMANCE OF THEIR
 DUTIES.
   5. COMMISSION DELIBERATIONS AND BYLAWS. (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  BEFORE  ITS  SECOND
 MEETING.
   6.  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 THE 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 REQUEST BY THE COMMISSION.
   7. LIAISON. THE DIRECTOR OF THE DORMITORY AUTHORITY OF  THE  STATE  OF
 NEW  YORK  SHALL  APPOINT  ONE  OR  MORE REPRESENTATIVES TO BE A LIAISON
 BETWEEN THE COMMISSION AND THE DORMITORY AUTHORITY.
   8. OTHER REQUIRED RECOMMENDATIONS.  IN  CARRYING  OUT  ITS  TASKS  AND
 DUTIES,  THE COMMISSION SHALL ALSO FORMALLY SOLICIT RECOMMENDATIONS FROM
 HEALTH CARE EXPERTS, COUNTY HEALTH DEPARTMENTS,  COMMUNITY-BASED  ORGAN-
 IZATIONS,  STATE  AND  REGIONAL HEALTH CARE INDUSTRY ASSOCIATIONS, LABOR
 UNIONS AND OTHER INTERESTED PARTIES AS BROADLY AS IT CONSIDERS IT NECES-
 SARY AND PROPER, AND IT SHALL TAKE INTO ACCOUNT SUCH RECOMMENDATIONS AND
 THE RECOMMENDATIONS OF THE KINGS COUNTY HEALTH CARE STAKEHOLDERS COUNCIL
 DURING ITS DELIBERATIONS. IN DEVELOPING ITS RECOMMENDATIONS, THE COMMIS-
 SION 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.
   9. REPORT OF COMMISSION. THE COMMISSION SHALL COMPLETE ITS  STUDY  AND
 PROVIDE  A  REPORT  OF  ITS WRITTEN RECOMMENDATIONS ALONG WITH SUGGESTED
 LEGISLATIVE AND EXECUTIVE ACTION, INCLUDING BUT NOT LIMITED  TO  INFRAS-
 TRUCTURE INVESTMENTS, AND REFINANCING OF EXISTING DEBT OF GENERAL HOSPI-
 A. 4560                             5
 
 TALS  IN  THE  COUNTY OF KINGS, NO LATER THAN DECEMBER THIRTY-FIRST, TWO
 THOUSAND TWENTY-FIVE. SUCH RECOMMENDATIONS SHALL INCLUDE:
   (A)  RECOMMENDED  DATES BY WHICH SUCH LEGISLATIVE OR EXECUTIVE ACTIONS
 SHOULD OCCUR;
   (B) 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
   (C) THE COMMISSION'S JUSTIFICATION FOR SUCH RECOMMENDATIONS.
   10.  IMPLEMENTATION  OF  RECOMMENDATIONS.  (A)   NOTWITHSTANDING   ANY
 PROVISION  OF  LAW,  RULE  OR  REGULATION TO THE CONTRARY RELATED TO THE
 ESTABLISHMENT, CONSTRUCTION, APPROVAL, OR  REVISIONS  TO  THE  OPERATING
 CERTIFICATES,  RESIZING,  CONSOLIDATION,  CONVERSION  OR  RELATED TO THE
 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  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-EFFICIENT MANNER, THE RECOMMENDA-
 TIONS OF THE COMMISSION PURSUANT TO SUBDIVISION NINE OF 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 PURSUANT TO SUBDIVISION NINE OF THIS SECTION IN THEIR ENTIRE-
 TY BY FEBRUARY FIRST, TWO THOUSAND TWENTY-SIX. IN  NO  EVENT  SHALL  THE
 COMMISSIONER  OF  HEALTH  BEGIN  TO IMPLEMENT THE RECOMMENDATIONS OF THE
 COMMISSION PURSUANT TO SUBDIVISION NINE OF THIS SECTION PRIOR TO  FEBRU-
 ARY  FIRST, TWO THOUSAND TWENTY-SIX. 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  ACT, UNTIL AFTER FEBRUARY FIRST, TWO THOUSAND
 TWENTY-SIX. 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) PROHIBITING THE APPROVAL OF AN APPLICATION  RELATING  TO  CAPITAL
 AND  INFRASTRUCTURE  IMPROVEMENTS  AT  DOWNSTATE  THAT DO NOT IMPACT THE
 SCOPE OR LEVEL OF SERVICES OFFERED AT DOWNSTATE.
   § 997-B. SEVERABILITY. IF ANY CLAUSE,  SENTENCE,  PARAGRAPH,  SUBDIVI-
 SION,  SECTION OR PART OF THIS ARTICLE 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 ARTICLE WOULD HAVE BEEN ENACTED EVEN IF SUCH
 INVALID PROVISIONS HAD NOT BEEN INCLUDED HEREIN.
   § 2. This act shall take effect immediately.