NY State Senate Bill 2025-S1226

Senate Bill S1226

2025-2026 Legislative Session

Requires public notice and public engagement when a general hospital seeks to close entirely or a unit that provides maternity, mental health or substance use care

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Current Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Jan 08, 2025	referred to health

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2025-S1226 (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §2801-g, Pub Health L
Versions Introduced in 2023-2024 Legislative Session:: S8843

2025-S1226 (ACTIVE) - Summary

Requires public notice and public engagement when a general hospital seeks to close entirely or a unit that provides maternity, mental health or substance use care.

2025-S1226 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S1226

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the public health law, in relation to providing public
notice and public engagement when a general hospital seeks to close
entirely or a unit that provides maternity, mental health or substance
use care

 
PURPOSE OR GENERAL OF BILL:

Requires public notice and public engagement when a general hospital
seeks to either close entirely or close a unit that provides emergency,
maternity, mental health, or substance use care.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section one names the act as the "Local Input in Community Healthcare
Act"

Section two amends section 2801-g of the public health law (PHL) as it

relates to a community forum on hospital closure, to set forth a process
for closure of a general hospital or unit of a general hospital.

Subdivision 1 defines unit and reduction for purposes of this section.

Subdivision 2 is amended to set forth the process for the closure of a
general hospital. General hospitals must provide written notification of
proposed closure of a general hospital to the Department of Health (DOH)
no later than 270 days before the proposed closure date, and allows
hospitals to confer with DOH prior to giving written notice.  The
closure application will require review from the Public Health and
Health Planning Council (PHHPC), which includes the health equity impact
assessment. The application would be submitted at least 210 days before
the proposed closure. No cessation, transfer, pause, or limitation of
service may be carried out without prior written approval by the Commis-
sioner of Health (COH).

*Paragraph (c) is added to extend the period that the COH is required to
hold a public community forum to obtain public input concerning the
anticipated impact of the hospital closure from no later than 30 days
after to 150 days before the proposed closure. Additionally, requires
the commissioner to make the following information publicly available no
later than 30 days prior to a community forum: the proposed closure plan
submitted by the health facility, the impact on access to health care
services to the surrounding community and information on specific meas-
ures DOH will take, and any other recommendations to address the impact
of the closure on health care services, including but not limited to
ensuring services being eliminated are still accessible to medicaid
recipients or individuals insured by publicly subsidized plans, and
uninsured residents in the surrounding facilities. The COH must announce
the date and location of the community forum on the proposed closure of
a hospital 14 days prior, instead of 10 days prior, to be held and must
ensure the forum is held at a proper time and accessible to the impacted
community virtually and physically.

*Paragraphs (d)-(e) require hospitals to submit a revised plan address-
ing community concerns no later than 30 days after the community forum
and make it publicly available within 45 days after the forum. PHHPC
must meet to review the application with the revised plan no later than
90 days after the forum and must make a recommendation to the commis-
sioner within two weeks after meeting.

Subdivision 3 sets forth the process for unit reductions or closures
that affect emergency, maternity, mental health, substance use, or any
other licensed services in the operating certificate including specialty
care. Requires written notification no later than 210 days prior and
provides for exemptions from the required process for a reduction or
closure of a unit. The community forum is required to be held no later
than 90 days prior to the proposed closure date. At least 14 days before
the forum, the hospital must notify the community stakeholders of the
date and location of the forum and the COH must make the proposed
closure plan publicly available.

*Paragraph (d)-(e) requires hospitals to submit a revised unit closure
plan addressing community concerns no later than 30 days after the
community forum and make it publicly available within 45 days after the
forum. PHHPC must meet to review the application with the revised plan
no later than 90 days after the forum and must make a recommendation to
the commissioner within two weeks after meeting.

Subdivision 4 requires the COH to make a decision to either approve or
deny a closure plan within 30 days following receipt of a PHHPC recom-
mendation.

Former subdivision 4 is now new subdivision 5

Adds a new subdivision 6 requiring an annual report to the legislature
by the DOH on a list of general hospitals or units of general hospitals
that notify the department of their intent to close.

Adds a new subdivision 7 to require a hospital to submit a revised
closure plan to DOH addressing concerns raised during the community
forum no later than 30 days after the forum and requires DOH to make the
revised plan publicly available on their website no later than 45 days
after the community forum.

Section three provides an effective date.

 
JUSTIFICATION:

Across New York State, there have been several incidents when hospitals
summarily announce planned closures of maternity services, emergency
departments, mental health, and substance use services, and even entire
hospitals, without any prior communication or meaningful engagement with
the local communities they serve. Over the last decade, 10 hospitals in
New York State closed their maternity services (in Columbia, Franklin,
Lewis, New York, Niagara, Ontario, Otsego, St. Lawrence, and Wyoming
counties).  So far in 2024, two more maternity service closures are
pending in Rensselaer and Suffolk counties. Two major closings of entire
hospitals are under consideration and facing community opposition in
lower Manhattan and in Central Brooklyn, after last year's closures of
another. Brooklyn hospital and a hospital in Eastern Niagara County.
More closures are likely; a recent study by the Center for Healthcare
Quality and Payment Reform found that there are 27 rural hospitals in

New York State at risk of closing, amounting to 53 percent of all rural
hospitals in the state.

(source:https://vwvw.beckershospitalreview.com/finance/646-hospitals-at-r
isk-of-closure-rankedby-state.html)

Closures of any of these services, or of the entire hospital, can have a
devastating impact on the communities that have depended on these facil-
ities for care. When the COVID-19 pandemic hit New York City in early
2020, one of the boroughs most affected (Queens) was ill-prepared
because of hospital closings in that borough. Elmhurst Hospital, a
public hospital, was forced to shoulder more than its fair share of
COVID-19 cases because of the closures of St. John's Queens Hospital,
Mary Immaculate Hospital, and Parkway Hospital in 2009.

(source: https://qns.com/2020/03/demise-
of-three-queens-hospitals-11-vears-ago-ad ds-to-Dain-of-borouq hs-coro-
navirus-tragedies/)

Closures of hospital maternity services are leaving entire counties
without any nearby access to labor and delivery, causing pregnant
patients to have to travel long distances to the nearest hospital with
maternal health services. The proposed closure of the Burdett Birth
Center in Troy, for example, would leave Rensselaer County as the larg-
est county in the state without maternity care, and also affect pregnant
people in adjacent rural Washington and Columbia counties, which lack
their own maternity services. The March of Dimes warns that the further
a pregnant person has to travel to obtain maternity care, the greater
the chances that there will be a negative outcome. There is a higher
risk for complications and death for both mothers and babies in communi-
ties that do not have maternity care services, according to the Center
for Healthcare Quality and Payment Reform.

Closures of hospital psychiatric services were numerous during the
pandemic, with more than two dozen hospitals closing more than 500
psychiatric beds. The Hochul administration has been working to bring
those back into service, citing a severe shortage of short-term beds for
patients suffering psychiatric crises.

(Source:
https://www.nytimes.com/2023/10/12/nyregion/hospitals-hochul-mental-heal
th,html)

Despite the serious impact of such closures on communities, especially
those where people are already medically-underserved and not easily able
to travel elsewhere for care, New York State Public Health Law does not
adequately require hospitals to engage the public and work to address
their concerns. Too little (if any) advance notice is given to the
community and key stakeholders, and under the law, a public hearing is
not required until 30 days after a hospital closes (although recent
state Department of Health guidance to hospitals has required an advance
hearing).

While the state's new Health Equity Impact Assessment law is helping to
improve community engagement, it does not apply to closings of entire
hospitals because those are carried out through simple notice to the
Department and a closure plan, not a Certificate of Need application.
Moreover, none of these types of dosures (the entire hospital, or mater-
nity, emergency or mental health services) requires a full Certificate
of Need review process that would go before the state Public Health and
Health Planning Council for review in a public meeting at which communi-
ty members could make comments.

This proposed legislation will address these gaps in the state's review
of proposed hospital and hospital unit closures by ensuring adequate
advance notice to the public, public disclosure of hospital closing
plans, a community forum held well in advance of the closure date to
allow public comment on the proposed dosure plan, and preparation of a
final closure plan that addresses concerns raised at the community
forum.

 
PRIOR LEGISLATIVE STORY:

2024: S8834-A Rivera/A1633-B Simon - Vetoed Memo 108

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:.
Effective on the sixtieth day after it shall have become law, and shall
not apply to any matter subject to section 2801-g of the PHL that is
pending on the date it shall take effect.

2025-S1226 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1226
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                              January 8, 2025
                                ___________
 
 Introduced  by  Sens.  RIVERA, KAVANAGH, GONZALEZ, MYRIE, HINCHEY, WEBB,
   KRUEGER, ASHBY,  BAILEY,  BRISPORT,  HARCKHAM,  HOYLMAN-SIGAL,  RAMOS,
   SALAZAR, SCARCELLA-SPANTON -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN  ACT  to amend the public health law, in relation to providing public
   notice and public engagement when a general hospital  seeks  to  close
   entirely or a unit that provides maternity, mental health or substance
   use care
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1.  Short title. This act shall be known and may be  cited  as
 the "local input in community healthcare act".
   § 2.  Section 2801-g of the public health law, as added by chapter 541
 of  the  laws  of 2010, subdivision 4 as added by section 3 of part E of
 chapter 57 of the laws of 2023, is amended to read as follows:
   § 2801-g. Community [forum] NOTICE AND ENGAGEMENT on hospital closure.
 1. PROCESS FOR THE CLOSURE OF A GENERAL HOSPITAL OR A UNIT OF A  GENERAL
 HOSPITAL.  (A)  THIS  SECTION  SETS FORTH A PROCESS FOR THE CLOSURE OF A
 GENERAL HOSPITAL OR A UNIT OF  A  GENERAL  HOSPITAL.  AS  USED  IN  THIS
 SECTION,  "UNIT"  MEANS  A  PORTION  OF  A  GENERAL HOSPITAL THAT OFFERS
 LICENSED EMERGENCY, MATERNITY, MENTAL HEALTH OR SUBSTANCE USE  SERVICES,
 INCLUDING ANY SPECIALTY CARE OR ANY OTHER HOSPITAL SERVICE IN AN OPERAT-
 ING  CERTIFICATE  AS APPROVED UNDER SECTION TWENTY-EIGHT HUNDRED FIVE OF
 THIS ARTICLE. FOR THE PURPOSES OF THIS SECTION, THE CLOSURE OF A UNIT OF
 A GENERAL HOSPITAL SHALL INCLUDE A REDUCTION  OF SUCH SERVICES.  AS USED
 IN THIS SECTION, "REDUCTION" MEANS A REDUCTION IN SERVICES THAT  RESULTS
 IN:
   (I)  MORE THAN FIFTEEN PERCENT OF A REDUCTION IN PATIENT CAPACITY OF A
 UNIT WITHIN TWELVE MONTHS; OR
   (II) A TWENTY-FIVE PERCENT OR MORE REDUCTION IN  PATIENT  CAPACITY  IN
 AGGREGATE WITHIN A TWENTY-FOUR MONTH PERIOD; OR
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD03821-01-5

 S. 1226                             2
 
   (III)  A  THIRTY-FIVE PERCENT OR MORE REDUCTION IN PATIENT CAPACITY IN
 AGGREGATE WITHIN A THIRTY-SIX MONTH PERIOD.
   2.  CLOSURE  OF  A  GENERAL  HOSPITAL.  (A)  WRITTEN NOTIFICATION OF A
 PROPOSED CLOSURE OF A GENERAL HOSPITAL MUST BE PROVIDED TO  THE  DEPART-
 MENT  AND  ALL  PARTIES  LISTED IN SUBPARAGRAPH (II) OF PARAGRAPH (C) OF
 THIS SUBDIVISION NO LATER THAN TWO HUNDRED SEVENTY  DAYS  PRIOR  TO  THE
 PROPOSED CLOSURE DATE.  NOTHING IN THIS SECTION SHALL PROHIBIT A GENERAL
 HOSPITAL  FROM  CONFERRING  WITH THE DEPARTMENT PRIOR TO SUBMITTING SUCH
 WRITTEN NOTIFICATION TO GIVE INFORMAL NOTICE AND SEEK GUIDANCE.
   (B) APPLICATION.   A GENERAL HOSPITAL THAT  SEEKS  TO  CLOSE  ENTIRELY
 SHALL  SUBMIT  AN  APPLICATION THAT REQUIRES REVIEW BY THE PUBLIC HEALTH
 AND HEALTH PLANNING COUNCIL, OR ANY SUCCESSOR  ENTITY.  THE  APPLICATION
 FOR  THE  CLOSURE  SHALL  INCLUDE  A HEALTH EQUITY IMPACT ASSESSMENT, AS
 DEFINED BY SECTION TWENTY-EIGHT HUNDRED TWO-B OF  THIS  ARTICLE,  AND  A
 PROPOSED  CLOSURE  PLAN. THE APPLICATION SHALL BE SUBMITTED AT LEAST TWO
 HUNDRED TEN DAYS BEFORE  THE  PROPOSED  CLOSURE.  NO  CESSATION,  PAUSE,
 TRANSFER,  OR LIMITATION OF SERVICE MAY BE CARRIED OUT WHILE THE CLOSURE
 APPLICATION IS PENDING WITHOUT PRIOR WRITTEN APPROVAL BY THE COMMISSION-
 ER OR THE COMMISSIONER'S DESIGNEE, WHO MAY TAKE INTO  CONSIDERATION  THE
 IMPACTS  ON  QUALITY OF CARE AND PATIENT SAFETY STEMMING FROM CHANGES IN
 PATIENT VOLUME OR SERVICES.  AS  USED  IN  THIS  SECTION,  "TRANSFER  OF
 SERVICES"  SHALL INCLUDE CONVERSION OF SERVICES FROM INPATIENT TO OUTPA-
 TIENT SERVICES, THE MOVING OF  SERVICES  TO  OTHER  FACILITIES,  OR  THE
 TRANSFER OF PERSONNEL THAT WOULD CONSTITUTE A REDUCTION OR UNAVAILABILI-
 TY OF SERVICES.
   (C)  PUBLIC  COMMUNITY  FORUM.  (I) No later than [thirty] ONE HUNDRED
 FIFTY days [after] PRIOR TO the PROPOSED closure of a general  hospital,
 the  commissioner shall hold a public community forum for the purpose of
 obtaining public input concerning the anticipated impact of the  general
 hospital's  closure  on access to health care services by members of the
 surrounding community,  including  but  not  limited  to  recipients  of
 medical  assistance  for  needy  persons,  the  uninsured, and MEDICALLY
 underserved populations AS DEFINED IN PARAGRAPH (D) OF  SUBDIVISION  ONE
 OF  SECTION  TWENTY-EIGHT HUNDRED TWO-B OF THIS ARTICLE, and options and
 proposals to ameliorate such anticipated impact. The commissioner  shall
 afford  community  members, health care providers, labor unions, payers,
 businesses and consumers a reasonable opportunity to speak  about  rele-
 vant matters at such community forum.
   [2.]  (II)  No later than [sixty] THIRTY days [after] BEFORE holding a
 community forum pursuant to [subdivision one of this section] THIS PARA-
 GRAPH, the commissioner shall  make  available  to  the  public  on  the
 department's website information regarding:
   [(a)] (A) THE PROPOSED CLOSURE PLAN SUBMITTED BY THE GENERAL HOSPITAL;
   (B) the anticipated impact of the general hospital's closure on access
 to health care services by members of the surrounding community, includ-
 ing  but  not  limited  to  recipients  of  medical assistance for needy
 persons, the uninsured, and underserved populations;
   [(b)] (C) specific measures the  department  and  other  parties  have
 taken  or  will take to ameliorate such anticipated impact INCLUDING BUT
 NOT LIMITED TO ENSURING THAT THE SERVICES  TO  BE  ELIMINATED  WOULD  BE
 AVAILABLE  TO  MEDICAID,  OR INDIVIDUALS THAT ARE INSURED BY A PUBLICLY-
 SUBSIDIZED PLAN AND UNINSURED PATIENTS AT THE SURROUNDING  AREA  FACILI-
 TIES THAT ARE TAKING NEW PATIENTS; and
   [(c)]  (D) any further recommendations regarding access to health care
 services in communities impacted by the general hospital's closure.
 S. 1226                             3
 
   [3.] (III) A community forum conducted pursuant to this section  shall
 be  held  at  a  location  within  a reasonable proximity to the general
 hospital OR UNIT subject to THE PROPOSED closure, and shall be announced
 no less than [ten] FOURTEEN days prior to the  date  of  such  community
 forum.  SUCH  FORUM  SHALL BE HELD AT A PROPER TIME AND BE ACCESSIBLE TO
 THE IMPACTED COMMUNITY VIRTUALLY AND PHYSICALLY.
   [4.  At least thirty days prior to a general hospital applying to  the
 federal  centers  for  medicare  and medicaid services to convert from a
 general hospital with inpatients to a rural emergency hospital under  42
 USC  1395x(kkk),  or  successor  provisions,  such hospital shall hold a
 public community  forum  for  the  purpose  of  obtaining  public  input
 concerning the anticipated impact of the hospital's closure of inpatient
 units, including but not limited to, the impact on recipients of medical
 assistance  for  needy persons, the uninsured, people with disabilities,
 and medically underserved populations,  and  options  and  proposals  to
 ameliorate such anticipated impact.
   The]  (IV)  NO LATER THAN THIRTY DAYS PRIOR TO A COMMUNITY FORUM UNDER
 THIS SECTION, THE GENERAL hospital shall notify health  care  providers,
 labor  unions, the [congressional] LOCAL, STATE, AND FEDERAL LEGISLATIVE
 representative, THE OFFICE OF THE ATTORNEY GENERAL,  THE  COUNTY  EXECU-
 TIVE,  MAYOR,  TOWN SUPERVISOR, AND IN THE CASE OF THE CITY OF NEW YORK,
 THE BOROUGH PRESIDENT, AND COMMUNITY BOARD for [the] EVERY  district  in
 which  the [facility] GENERAL HOSPITAL is located, [the county executive
 of the county in which the facility is located, and  the  state  senator
 and  assembly  member representing the area within which the facility is
 located] of the date, time, and location of  the  community  forum.  The
 GENERAL  hospital  shall  afford  all  public  participants a reasonable
 opportunity to speak about relevant matters  at  such  community  forum.
 Prior to [any] A community forum and as soon as practicable, the GENERAL
 hospital shall be required to:
   [(a)] (A) notify the office of mental health and the local director of
 community  services  in  the event such general hospital has psychiatric
 inpatient beds licensed under article thirty-one of the  mental  hygiene
 law  or  designated  pursuant to section 9.39 of the mental hygiene law,
 and
   [(b)] (B) notify the office of addiction services and supports in  the
 event  such general hospital has inpatient substance use disorder treat-
 ment  programs  or  inpatient  chemical  dependence  treatment  programs
 licensed under article thirty-two of the mental hygiene law. The commis-
 sioner  shall  also  accept comments submitted in writing at such public
 forum and by mail OR ELECTRONIC MAIL within at least two weeks following
 the community forum.
   (V) THE COMMISSIONER SHALL ALSO ACCEPT COMMENTS SUBMITTED  IN  WRITING
 AT  SUCH PUBLIC FORUM AND BY MAIL OR ELECTRONIC MAIL WITHIN AT LEAST TWO
 WEEKS FOLLOWING THE COMMUNITY FORUM.
   (D) REVISED CLOSURE PLAN. NO LATER THAN THIRTY DAYS AFTER THE COMMUNI-
 TY FORUM, THE GENERAL HOSPITAL SHALL SUBMIT A REVISED  CLOSURE  PLAN  TO
 THE  DEPARTMENT  ADDRESSING  CONCERNS  RAISED  BY COMMUNITY STAKEHOLDERS
 DURING THE COMMUNITY FORUM. THE  GENERAL  HOSPITAL  AND  THE  DEPARTMENT
 SHALL MAKE THE REVISED CLOSURE PLAN PUBLICLY AVAILABLE ON THEIR WEBSITES
 NO LATER THAN FORTY-FIVE DAYS AFTER THE COMMUNITY FORUM.
   (E)  PUBLIC  HEALTH  AND HEALTH PLANNING COUNCIL REVIEW. NO LATER THAN
 NINETY DAYS PRIOR TO THE PROPOSED CLOSURE, THE PUBLIC HEALTH AND  HEALTH
 PLANNING  COUNCIL,  OR ANY SUCCESSOR ENTITY, SHALL HOLD A PUBLIC MEETING
 BEFORE THE COUNCIL TO REVIEW THE APPLICATION, INCLUDING THE HEALTH EQUI-
 TY IMPACT ASSESSMENT AND REVISED CLOSURE PLAN. WITHIN  TWO  WEEKS  AFTER
 S. 1226                             4
 
 SUCH MEETING, THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL SHALL MAKE A
 RECOMMENDATION TO THE COMMISSIONER FOR THE COMMISSIONER'S CONSIDERATION.
   3.  CLOSURE  OF A UNIT OF A GENERAL HOSPITAL. (A)(I) WRITTEN NOTIFICA-
 TION OF A PROPOSED CLOSURE OF A UNIT OF A GENERAL HOSPITAL,  AS  DEFINED
 IN  SUBDIVISION  ONE OF THIS SECTION, MUST BE PROVIDED TO THE DEPARTMENT
 AND ALL PARTIES LISTED IN SUBPARAGRAPH (IV) OF PARAGRAPH (C) OF SUBDIVI-
 SION TWO OF THIS SECTION NO LATER THAN TWO HUNDRED TEN DAYS PRIOR TO THE
 PROPOSED CLOSURE DATE. NOTHING IN THIS SECTION SHALL PROHIBIT A  GENERAL
 HOSPITAL  FROM  CONFERRING  WITH THE DEPARTMENT PRIOR TO SUBMITTING SUCH
 WRITTEN NOTIFICATION TO GIVE INFORMAL NOTICE AND SEEK GUIDANCE.
   (II) A REDUCTION IN SERVICES OR CLOSURE OF A UNIT IN A GENERAL  HOSPI-
 TAL  SHALL  NOT  BE  REQUIRED  TO  UNDERGO THE PROCESS SET FORTH IN THIS
 SECTION IF THE GENERAL HOSPITAL DEMONSTRATES TO THE  DEPARTMENT  A  GOOD
 CAUSE  FOR  SUCH REDUCTION OR CLOSURE OF A UNIT, WHICH SHALL INCLUDE ONE
 OR MORE OF THE FOLLOWING:
   (A) WHETHER SUCH CLOSURE OR REDUCTION IS TEMPORARY IN ORDER TO MODERN-
 IZE A FACILITY;
   (B) WHETHER SUCH CLOSURE ADDRESSES THE  CURRENT  HEALTH  CARE  DEMAND,
 SUCH  AS  PATIENT VOLUME AND THE OVERALL AVAILABILITY OF SERVICES IN THE
 FACILITY'S HEALTH SERVICE AREA OR COUNTY SERVED;
   (C) THERE ARE ACUTE LABOR SHORTAGES OUTSIDE  OF  THE  CONTROL  OF  THE
 GENERAL HOSPITAL THAT IMPACTS PATIENT SAFETY; OR
   (D) AN ACUTE FINANCIAL EMERGENCY OUTSIDE OF THE CONTROL OF THE GENERAL
 HOSPITAL.
   (B)  APPLICATION.  A GENERAL HOSPITAL THAT SEEKS THE CLOSURE OF A UNIT
 SHALL SUBMIT AN APPLICATION TO THE DEPARTMENT OF  HEALTH  THAT  REQUIRES
 REVIEW  BY THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL, OR ANY SUCCES-
 SOR ENTITY IN ADDITION TO APPROVAL BY THE COMMISSIONER. THE  APPLICATION
 FOR  THE  CLOSURE  SHALL  INCLUDE  A HEALTH EQUITY IMPACT ASSESSMENT, AS
 DEFINED BY SECTION TWENTY-EIGHT HUNDRED TWO-B OF  THIS  ARTICLE,  AND  A
 PROPOSED  CLOSURE  PLAN. THE APPLICATION SHALL BE SUBMITTED AT LEAST ONE
 HUNDRED FIFTY DAYS BEFORE THE PROPOSED  CLOSURE.  NO  CESSATION,  PAUSE,
 TRANSFER,  OR LIMITATION OF SERVICE MAY BE CARRIED OUT WHILE THE CLOSURE
 APPLICATION IS PENDING WITHOUT PRIOR WRITTEN APPROVAL BY THE COMMISSION-
 ER OR THE COMMISSIONER'S DESIGNEE, WHO SHALL TAKE INTO CONSIDERATION THE
 IMPACTS ON QUALITY OF CARE AND PATIENT SAFETY STEMMING FROM  CHANGES  IN
 PATIENT  VOLUME  OR  SERVICES.  AS  USED  IN  THIS SECTION, "TRANSFER OF
 SERVICES" SHALL INCLUDE CONVERSION OF SERVICES FROM INPATIENT TO  OUTPA-
 TIENT  SERVICES,  THE  MOVING  OF  SERVICES  TO OTHER FACILITIES, OR THE
 TRANSFER OF PERSONNEL THAT WOULD CONSTITUTE A REDUCTION OR UNAVAILABILI-
 TY OF SERVICES.
   (C) COMMUNITY PUBLIC FORUM. (I) NO LATER THAN NINETY DAYS PRIOR TO THE
 PROPOSED CLOSURE OF A UNIT OF A GENERAL HOSPITAL, THE COMMISSIONER SHALL
 HOLD A PUBLIC COMMUNITY FORUM FOR THE PURPOSE OF OBTAINING PUBLIC  INPUT
 CONCERNING  THE  ANTICIPATED IMPACT OF THE UNIT'S CLOSURE ON QUALITY AND
 ACCESS TO HEALTH CARE SERVICES BY MEMBERS OF THE SURROUNDING  COMMUNITY,
 INCLUDING  BUT NOT LIMITED TO RECIPIENTS OF MEDICAL ASSISTANCE FOR NEEDY
 PERSONS, THE UNINSURED, AND MEDICALLY UNDERSERVED POPULATIONS AS DEFINED
 IN PARAGRAPH (D) OF SUBDIVISION  ONE  OF  SECTION  TWENTY-EIGHT  HUNDRED
 TWO-B  OF  THIS  ARTICLE,  AND  OPTIONS AND PROPOSALS TO AMELIORATE SUCH
 ANTICIPATED IMPACT. THE COMMISSIONER  SHALL  AFFORD  COMMUNITY  MEMBERS,
 HEALTH  CARE  PROVIDERS,  LABOR  UNIONS,  PAYERS,  BUSINESSES, AND OTHER
 PARTICIPANTS A REASONABLE OPPORTUNITY TO SPEAK ABOUT RELEVANT MATTERS AT
 SUCH COMMUNITY FORUM.
   (II) NO LATER THAN TWO WEEKS BEFORE HOLDING A COMMUNITY FORUM PURSUANT
 TO THIS PARAGRAPH, THE COMMISSIONER SHALL MAKE AVAILABLE TO  THE  PUBLIC
 S. 1226                             5
 
 ON  THE  DEPARTMENT'S  WEBSITE  INFORMATION  REGARDING: (A) THE PROPOSED
 CLOSURE PLAN SUBMITTED BY THE  GENERAL  HOSPITAL;  (B)  THE  ANTICIPATED
 IMPACT  OF  THE CLOSURE ON QUALITY AND ACCESS TO HEALTH CARE SERVICES BY
 MEMBERS  OF  THE  SURROUNDING  COMMUNITY,  INCLUDING  BUT NOT LIMITED TO
 RECIPIENTS OF MEDICAL ASSISTANCE FOR NEEDY PERSONS, THE  UNINSURED,  AND
 UNDERSERVED  POPULATIONS; (C) SPECIFIC MEASURES THE DEPARTMENT AND OTHER
 PARTIES HAVE TAKEN OR WILL TAKE TO AMELIORATE  SUCH  ANTICIPATED  IMPACT
 INCLUDING BUT NOT LIMITED TO ENSURING THAT THE SERVICES TO BE ELIMINATED
 WOULD  BE  AVAILABLE  TO  MEDICAID, OR INDIVIDUALS THAT ARE INSURED BY A
 PUBLICLY-SUBSIDIZED PLAN AND UNINSURED PATIENTS AT THE SURROUNDING  AREA
 FACILITIES THAT ARE TAKING NEW PATIENTS; AND (D) ANY FURTHER RECOMMENDA-
 TIONS  REGARDING  QUALITY AND ACCESS TO HEALTH CARE SERVICES IN COMMUNI-
 TIES IMPACTED BY THE CLOSURE.
   (III) A COMMUNITY FORUM CONDUCTED PURSUANT TO THIS PARAGRAPH SHALL  BE
 HELD  AT A LOCATION WITHIN A REASONABLE PROXIMITY TO THE UNIT SUBJECT TO
 THE PROPOSED CLOSURE AND SHALL BE ANNOUNCED NO LESS THAN  FOURTEEN  DAYS
 PRIOR TO THE DATE OF SUCH COMMUNITY FORUM. SUCH FORUM SHALL BE HELD AT A
 PROPER  TIME  AND  BE ACCESSIBLE TO THE IMPACTED COMMUNITY VIRTUALLY AND
 PHYSICALLY.
   (IV) NO LATER THAN TWO WEEKS PRIOR TO THE COMMUNITY FORUM  UNDER  THIS
 SECTION,  THE  GENERAL  HOSPITAL  SEEKING  TO  CLOSE A UNIT SHALL NOTIFY
 HEALTH CARE PROVIDERS, LABOR  UNIONS,  THE  LOCAL,  STATE,  AND  FEDERAL
 LEGISLATIVE  REPRESENTATIVE,  THE  OFFICE  OF  THE ATTORNEY GENERAL, THE
 COUNTY EXECUTIVE, MAYOR, TOWN SUPERVISOR, AND IN THE CASE OF THE CITY OF
 NEW YORK, THE BOROUGH PRESIDENT, AND COMMUNITY BOARD FOR EVERY  DISTRICT
 IN  WHICH  THE  GENERAL  HOSPITAL  IS  LOCATED,  OF  THE DATE, TIME, AND
 LOCATION OF THE COMMUNITY FORUM. PRIOR TO THE  COMMUNITY  FORUM  AND  AS
 SOON  AS  PRACTICABLE,  THE  GENERAL  HOSPITAL SHALL BE REQUIRED TO: (A)
 NOTIFY THE OFFICE OF MENTAL HEALTH AND THE LOCAL DIRECTOR  OF  COMMUNITY
 SERVICES IN THE EVENT SUCH GENERAL HOSPITAL IS SEEKING TO CLOSE AN INPA-
 TIENT  PSYCHIATRIC  UNIT LICENSED UNDER ARTICLE THIRTY-ONE OF THE MENTAL
 HYGIENE LAW OR DESIGNATED PURSUANT TO SECTION 9.39 OF THE MENTAL HYGIENE
 LAW, AND (B) NOTIFY THE OFFICE OF ADDICTION SERVICES AND SUPPORTS IN THE
 EVENT THE GENERAL HOSPITAL IS SEEKING TO CLOSE  AN  INPATIENT  SUBSTANCE
 USE  DISORDER TREATMENT PROGRAMS OR INPATIENT CHEMICAL DEPENDENCE TREAT-
 MENT PROGRAMS LICENSED UNDER ARTICLE THIRTY-TWO OF  THE  MENTAL  HYGIENE
 LAW.
   (V)  THE  COMMISSIONER SHALL ALSO ACCEPT COMMENTS SUBMITTED IN WRITING
 AT SUCH PUBLIC FORUM AND BY MAIL OR ELECTRONIC MAIL WITHIN AT LEAST  TWO
 WEEKS FOLLOWING THE COMMUNITY FORUM.
   (D) REVISED CLOSURE PLAN. NO LATER THAN THIRTY DAYS AFTER THE COMMUNI-
 TY  FORUM,  THE  GENERAL HOSPITAL SHALL SUBMIT A REVISED CLOSURE PLAN TO
 THE DEPARTMENT ADDRESSING  CONCERNS  RAISED  BY  COMMUNITY  STAKEHOLDERS
 DURING  THE  COMMUNITY  FORUM.  THE  GENERAL HOSPITAL AND THE DEPARTMENT
 SHALL MAKE THE REVISED CLOSURE PLAN PUBLICLY AVAILABLE ON THEIR WEBSITES
 NO LATER THAN FORTY-FIVE DAYS AFTER THE COMMUNITY FORUM.
   (E) PUBLIC HEALTH AND HEALTH PLANNING COUNCIL REVIEW.  NO  LATER  THAN
 THIRTY  DAYS PRIOR TO THE PROPOSED CLOSURE, THE PUBLIC HEALTH AND HEALTH
 PLANNING COUNCIL, OR ANY SUCCESSOR ENTITY, SHALL HOLD A  PUBLIC  MEETING
 TO REVIEW THE APPLICATION, INCLUDING THE HEALTH EQUITY IMPACT ASSESSMENT
 AND  REVISED  CLOSURE  PLAN.  WITHIN  TWO  WEEKS AFTER SUCH MEETING, THE
 PUBLIC HEALTH AND HEALTH PLANNING COUNCIL SHALL MAKE A RECOMMENDATION TO
 THE COMMISSIONER FOR THE COMMISSIONER'S CONSIDERATION.
   4. THE COMMISSIONER SHALL MAKE THEIR DECISION  TO  EITHER  APPROVE  OR
 DENY THE CLOSURE PLAN WITHIN THIRTY DAYS FOLLOWING RECEIPT OF THE RECOM-
 MENDATION FROM THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL.
 S. 1226                             6
 
   5.  AT LEAST THIRTY DAYS PRIOR TO A GENERAL HOSPITAL  APPLYING  TO THE
 FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES  TO  CONVERT  FROM  A
 GENERAL  HOSPITAL WITH INPATIENTS TO A RURAL EMERGENCY HOSPITAL UNDER 42
 USC  1395X(KKK),  OR SUCCESSOR PROVISIONS,   SUCH GENERAL HOSPITAL SHALL
 HOLD  A PUBLIC COMMUNITY FORUM FOR THE PURPOSE OF OBTAINING PUBLIC INPUT
 CONCERNING  THE ANTICIPATED IMPACT OF THE GENERAL HOSPITAL'S  CLOSURE OF
 INPATIENT  UNITS, INCLUDING BUT NOT LIMITED TO, THE IMPACT ON RECIPIENTS
 OF MEDICAL ASSISTANCE FOR NEEDY  PERSONS,  THE  UNINSURED,  PEOPLE  WITH
 DISABILITIES,  AND  MEDICALLY  UNDERSERVED  POPULATIONS, AND OPTIONS AND
 PROPOSALS TO AMELIORATE SUCH ANTICIPATED IMPACT.
   6.  NO LATER THAN JANUARY FIRST, TWO THOUSAND TWENTY-SIX AND  ANNUALLY
 THEREAFTER, THE COMMISSIONER SHALL PROVIDE A REPORT TO THE  LEGISLATURE,
 INCLUDING  BUT  NOT LIMITED TO, IDENTIFYING THE GENERAL HOSPITAL OR UNIT
 OF A GENERAL HOSPITAL THAT HAS PROVIDED WRITTEN NOTICE OF A CLOSURE, THE
 PROPOSED CLOSURE DATE AND THE SERVICES IMPACTED BY THE PROPOSED CLOSURE.
 SUCH REPORT SHALL BE PROVIDED IN ELECTRONIC FORMAT AND SHALL BE DISTRIB-
 UTED TO THE TEMPORARY PRESIDENT AND MINORITY LEADER OF THE  SENATE,  THE
 SPEAKER  AND  MINORITY  LEADER  OF THE ASSEMBLY, THE CHAIR OF THE SENATE
 STANDING COMMITTEE ON HEALTH, AND  THE  CHAIR  OF  THE  ASSEMBLY  HEALTH
 COMMITTEE.
   7.  NO PROVISION OF THIS SECTION SHALL MODIFY ANY OTHER REQUIREMENT OR
 PROCESS FOR THE CLOSURE OF A GENERAL HOSPITAL OR A  UNIT  OF  A  GENERAL
 HOSPITAL  THAT  IS  REQUIRED PURSUANT TO THIS CHAPTER OR THE REGULATIONS
 PROMULGATED PURSUANT TO IT, INCLUDING BUT NOT LIMITED TO ANY  DEPARTMENT
 OR PUBLIC HEALTH AND HEALTH PLANNING COUNCIL REVIEW OR APPROVAL PROCESS.
   §  3.  This  act  shall take effect on the sixtieth day after it shall
 have become a law, and shall not  apply  to  any  proposed  closures  on
 notice to the department as of the date it shall take effect.

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