S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9421
 
                           I N  A S S E M B L Y
 
                              March 14, 2024
                                ___________
 
 Introduced  by  M.  of  A.  CUNNINGHAM  -- 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-C
 to read as follows:
 
                               ARTICLE 49-C
    COMMISSION FOR THE MODERNIZATION AND REVITALIZATION OF SUNY DOWNSTATE
                              MEDICAL CENTER
 SECTION 996. LEGISLATIVE INTENT.
         996-A. COMMISSION FOR THE MODERNIZATION  AND  REVITALIZATION  OF
                SUNY DOWNSTATE MEDICAL CENTER.
         996-B. SEVERABILITY.
   §  996.  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
 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD14727-01-4
 A. 9421                             2
 
 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-SIX-A OF THIS
 ARTICLE,  TO AN OUTPATIENT SETTING, EXPANDING SERVICES TO INCLUDE ACCESS
 TO PRIMARY CARE THROUGH CLINICS, URGENT CARE OR  OTHER  HOSPITAL  AFFIL-
 IATED 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.
   § 996-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
 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
 A. 9421                             3
 
 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
 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;
 A. 9421                             4
 
   (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-
 TALS  IN  THE  COUNTY OF KINGS, NO LATER THAN DECEMBER THIRTY-FIRST, TWO
 THOUSAND TWENTY-FOUR. SUCH RECOMMENDATIONS SHALL INCLUDE:
   (A) RECOMMENDED DATES BY WHICH SUCH LEGISLATIVE OR  EXECUTIVE  ACTIONS
 SHOULD OCCUR;
 A. 9421                             5
 
   (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-FIVE. 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-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  ACT, 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) 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.
   § 996-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.