STATE OF NEW YORK ________________________________________________________________________ 6956--A 2023-2024 Regular Sessions IN SENATE May 16, 2023 ___________ Introduced by Sens. MYRIE, JACKSON, MAY, SALAZAR -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- recommitted to the Committee on Health in accordance with Senate Rule 6, sec. 8 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT in relation to requiring the commissioner of health to develop a sustainability plan for 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: 1 Section 1. Legislative intent. The legislature hereby finds and 2 declares that the state university downstate medical center is a vital 3 component of our state's health care system. As one of three state 4 hospitals and the only state hospital in the city of New York, it is 5 incumbent upon the state to ensure that this hospital remains fiscally 6 viable to continue to provide the health care services that the resi- 7 dents of central Brooklyn deserve and depend on. The state university 8 downstate medical center is one of the state's largest safety-net hospi- 9 tals, which cares for all patients, regardless of their ability to pay. 10 It predominantly serves people of color, low income, uninsured, underin- 11 sured, undocumented and at-risk individuals who have limited access to 12 affordable health care and who are more prone to suffer from serious 13 disease and face higher morbidity rates than other patients across our 14 city and state. Last year, the hospital had over three hundred thousand 15 outpatient visits and has an average of fourteen thousand inpatients 16 each year. It also provides seven thousand four hundred free health 17 screenings a year and sponsors over one hundred community service 18 projects annually. 19 The legislature further finds that at the height of the pandemic, when 20 the city of New York was at the epicenter, the state university down- 21 state medical center stepped up as a COVID-only hospital and provided EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD11427-02-4
S. 6956--A 2 1 life-saving care to the sickest New Yorkers without any state funding 2 support. Serving COVID-only patients exacerbated the existing untenable 3 financial situation of the hospital, which in large part, is due to 4 years of state financial neglect and unequitable treatment. Provided 5 further, the state university downstate medical center is a major part 6 of the Brooklyn economy and is one of the ten largest employers in 7 Brooklyn, providing employment to four thousand two hundred people. It's 8 also responsible for nearly nine hundred million dollars in economic 9 activity, generating nearly two hundred million dollars in tax revenue. 10 The hospital is the heart of central Brooklyn and has the largest 11 medical school in New York city, which offers training in fifty-six 12 specialties across five schools and colleges and annually educates and 13 trains nearly one thousand nine hundred students. The medical school 14 student population is made up of nearly sixty percent students of color, 15 produces the most physicians of color in the state of New York, and 16 nearly seventy percent of two thousand twenty-two graduates remained in 17 New York for their residency. This institution is an essential part in 18 producing the next generation of health care professionals, which are 19 desperately needed to sustain our state health care system. 20 The legislature further finds that the continued operation of the 21 state university downstate medical center is vital and necessary, and 22 the state should develop a plan to ensure its future sustainability and 23 shall provide state funding and other resources necessary to implement 24 and execute such plan. 25 § 2. The commissioner of health, in consultation with the chancellor 26 of the state university of New York and the employee organizations 27 representing employees at the state university of New York pursuant to 28 article 14 of the civil service law, shall develop a sustainability plan 29 for the state university of New York downstate medical center as estab- 30 lished pursuant to section 352 of the education law to ensure the hospi- 31 tal's continued operation in serving the public health care needs of the 32 Brooklyn community. Such plan shall maintain the state university down- 33 state medical center as a public state-operated hospital, staffed with 34 public employees within and under the appointing authority of the state 35 university of New York. In developing such sustainability plan, the 36 commissioner shall examine the state university downstate medical 37 center's finances, management operations, billing practices, current 38 health care services and delivery model, and any other records, metrics, 39 or aspects of the hospital the commissioner deems necessary and appro- 40 priate to adequately assess their direct or indirect effects on the 41 financial health and viability of the hospital and to determine what 42 modifications are needed to make the state university downstate medical 43 center financially sustainable. In assessing the financial health and 44 viability of the state university downstate medical center, the commis- 45 sioner shall also examine patient mix demographics, including but not 46 limited to, the financial challenges posed by the provision of safety 47 net services to low income, uninsured, underinsured, undocumented and 48 at-risk individuals. The commissioner shall also assess the current and 49 potential economic impact of the state university downstate medical 50 center in Brooklyn and identify any new potential health care service 51 areas not currently being provided at the state university downstate 52 medical center, which if provided, would better serve patients and help 53 ameliorate the hospital's current and future financial situation. 54 Provided further, the commissioner shall also identify current gaps in 55 health care services throughout Brooklyn, especially for low income, 56 uninsured, underinsured, undocumented and at-risk individuals and deter-
S. 6956--A 3 1 mine whether providing such health care services at the state university 2 downstate medical center would be beneficial to the future financial 3 sustainability of the hospital. In making such determination, the 4 commissioner shall delineate any costs associated with the hospital 5 providing such services, including but not limited to, personal service 6 costs, costs for equipment, management costs and capital funding needs. 7 Provided further, in identifying gaps in current health care services, 8 the commissioner shall examine, among other health care services, the 9 feasibility and public health value of establishing and operating a 10 center for maternal and children's health services at the state univer- 11 sity downstate medical center to address high rates of maternal morbidi- 12 ty in Brooklyn and shall delineate all projected costs associated with 13 the establishment and operation of such center. 14 The commissioner shall also determine what capital project improve- 15 ments are required at the state university downstate medical center to 16 enable the hospital to adequately meet current and future health care 17 service needs identified as part of the sustainability plan. The commis- 18 sioner shall also provide an analysis of current emergency room oper- 19 ations as part of such sustainability plan, which shall include, but 20 shall not be limited to, patient care and service capacity as well as 21 improvements needed to adequately address patient service demands and 22 the technology, equipment and capital infrastructure improvements that 23 are required to improve patient services and to improve the financial 24 position of the hospital. 25 The commissioner shall submit such sustainability plan to the gover- 26 nor, the temporary president of the senate and the speaker of the assem- 27 bly by December 31, 2024. The sustainability plan shall serve to inform 28 the governor in preparation of the 2025-26 executive budget submission. 29 § 3. Notwithstanding any provision of law to the contrary, all rights 30 and benefits, including terms and conditions of employment and 31 protection of civil service and collective bargaining status of all 32 existing public employees shall be preserved and protected. Nothing in 33 the sustainability plan required by this act or any provision of this 34 act shall limit the rights of employees pursuant to a collective 35 bargaining agreement or alter the existing representational relation- 36 ships among collective bargaining representatives or the bargaining 37 relationships between the state university downstate medical center and 38 any employee organization. Employees of the state university downstate 39 medical center serving in any new positions or titles resulting from the 40 implementation of the commissioner's sustainability plan, or any part 41 thereof, pursuant to this act shall be assigned to the appropriate 42 existing bargaining units. Prior to the implementation of such sustain- 43 ability plan, or any part thereof, developed by the commissioner pursu- 44 ant to this act, the state university of New York shall inform affected 45 employee organizations of any potential impact on its members or collec- 46 tive bargaining unit as a result of such implementation. 47 § 4. This act shall take effect immediately.