S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  7546--A
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               May 25, 2023
                                ___________
 
 Introduced  by M. of A. CUNNINGHAM, CHANDLER-WATERMAN, MAMDANI, FORREST,
   SHRESTHA, DAVILA -- read once and referred to the Committee on  Health
   --  recommitted to the Committee on Health in accordance with Assembly
   Rule  3,  sec.  2  --  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:
 
   Section 1.  Legislative  intent.  The  legislature  hereby  finds  and
 declares  that  the state university downstate medical center 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 resi-
 dents of central Brooklyn deserve and depend on.  The  state  university
 downstate medical center is one of the state's largest safety-net hospi-
 tals,  which cares for all patients, regardless of their ability to pay.
 It predominantly serves people of color, low income, uninsured, underin-
 sured, 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. Last year, 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.
   The legislature further finds that at the height of the pandemic, when
 the  city  of  New York was at the epicenter, the state university down-
 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.
                                                            LBD11427-03-4
              

 A. 7546--A                          2
 
 life-saving  care  to  the sickest New Yorkers without any state funding
 support. Serving COVID-only patients exacerbated the existing  untenable
 financial  situation  of  the  hospital,  which in large part, is due to
 years  of  state  financial  neglect and unequitable treatment. Provided
 further, the state university downstate medical center is a  major  part
 of  the  Brooklyn  economy  and  is  one of the ten largest employers in
 Brooklyn, providing employment to four thousand two hundred people. It's
 also responsible for nearly nine hundred  million  dollars  in  economic
 activity,  generating nearly two hundred million dollars in tax revenue.
 The hospital is 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 graduates remained in
 New York for their residency. This institution is an essential  part  in
 producing  the  next  generation of health care professionals, which are
 desperately needed to sustain our state health care system.
   The legislature further finds that  the  continued  operation  of  the
 state  university  downstate  medical center 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.
   § 2. The commissioner of health, in consultation with  the  chancellor
 of  the  state  university  of  New  York and the employee organizations
 representing employees at the state university of New York  pursuant  to
 article 14 of the civil service law, shall develop a sustainability plan
 for  the state university of New York downstate medical center as estab-
 lished pursuant to section 352 of the education law to ensure the hospi-
 tal's continued operation in serving the public health care needs of the
 Brooklyn community. Such plan shall maintain the state university  down-
 state  medical  center as a public state-operated hospital, staffed with
 public employees within and under the appointing authority of the  state
 university  of  New  York.  In  developing such sustainability plan, the
 commissioner  shall  examine  the  state  university  downstate  medical
 center's  finances,  management  operations,  billing practices, current
 health care services and delivery model, and any other records, metrics,
 or aspects of the hospital the commissioner deems necessary  and  appro-
 priate  to  adequately  assess  their  direct or indirect effects on the
 financial health and viability of the hospital  and  to  determine  what
 modifications  are needed to make the state university downstate medical
 center financially sustainable. In assessing the  financial  health  and
 viability  of the state university downstate medical center, the commis-
 sioner shall also examine patient mix 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. The commissioner shall also assess the current and
 potential economic impact of  the  state  university  downstate  medical
 center  in  Brooklyn  and identify any new potential health care service
 areas not currently being provided at  the  state  university  downstate
 medical  center, which if provided, would better serve patients and help
 ameliorate  the  hospital's  current  and  future  financial  situation.
 Provided  further,  the commissioner shall also identify current gaps in
 health care services throughout Brooklyn,  especially  for  low  income,
 uninsured, underinsured, undocumented and at-risk individuals and deter-
 A. 7546--A                          3
 
 mine whether providing such health care services at the state university
 downstate  medical  center  would  be beneficial to the future financial
 sustainability of  the  hospital.  In  making  such  determination,  the
 commissioner  shall  delineate  any  costs  associated with the hospital
 providing such services, including but not limited to, personal  service
 costs,  costs for equipment, management costs and capital funding needs.
 Provided further, in identifying gaps in current health  care  services,
 the  commissioner  shall  examine, among other health care services, the
 feasibility and public health value  of  establishing  and  operating  a
 center  for maternal and children's health services at the state univer-
 sity downstate medical center to address high rates of maternal morbidi-
 ty in Brooklyn and shall delineate all projected costs  associated  with
 the establishment and operation of such center.
   The  commissioner  shall  also determine what capital project improve-
 ments are required at the state university downstate medical  center  to
 enable  the  hospital  to adequately meet current and future health care
 service needs identified as part of the sustainability plan. The commis-
 sioner shall also provide an analysis of current  emergency  room  oper-
 ations  as  part  of  such sustainability plan, 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 the hospital.
   The commissioner shall submit such sustainability plan to  the  gover-
 nor, the temporary president of the senate and the speaker of the assem-
 bly  by December 31, 2024. The sustainability plan shall serve to inform
 the governor in preparation of the 2025-26 executive budget submission.
   § 3. Notwithstanding any provision of law to the contrary, all  rights
 and   benefits,   including  terms  and  conditions  of  employment  and
 protection of civil service and  collective  bargaining  status  of  all
 existing  public  employees shall be preserved and protected. Nothing in
 the sustainability plan required by this act or any  provision  of  this
 act  shall  limit  the  rights  of  employees  pursuant  to a collective
 bargaining agreement or alter the  existing  representational  relation-
 ships  among  collective  bargaining  representatives  or the bargaining
 relationships between the state university downstate medical center  and
 any  employee organization.  Employees of the state university downstate
 medical center serving in any new positions or titles resulting from the
 implementation of the commissioner's sustainability plan,  or  any  part
 thereof,  pursuant  to  this  act  shall  be assigned to the appropriate
 existing bargaining units.  Prior to the implementation of such sustain-
 ability plan, or any part thereof, developed by the commissioner  pursu-
 ant  to this act, the state university of New York shall inform affected
 employee organizations of any potential impact on its members or collec-
 tive bargaining unit as a result of such implementation.
   § 4. This act shall take effect immediately.