S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4558
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 4, 2025
                                ___________
 
 Introduced  by  M.  of  A.  CUNNINGHAM -- Multi-Sponsored by -- M. of A.
   CHANDLER-WATERMAN, COLTON, DAVILA, FORREST,  GONZALEZ-ROJAS,  MAMDANI,
   MEEKS,  RIVERA,  SEAWRIGHT, SHRESTHA, WEPRIN -- read once and referred
   to the Committee on Health
 
 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
 life-saving care to the sickest New Yorkers without  any  state  funding

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05737-01-5
              

 A. 4558                             2
 
 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-
 mine whether providing such health care services at the state university
 A. 4558                             3
 
 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, 2025. The sustainability plan shall serve to  inform
 the   governor   in   preparation  of  the  2026-2027  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.