It’s Time to Give Local Communities a Greater Voice When Their Hospitals Want to Close or Downsize!

Why New Yorkers Need the Local Input for Community Healthcare (LICH) Bill (S.8843-A/A.1633-B, Rivera/Simon) to Become Law
 

Across our state, hospitals are moving to close essential units, such as maternity or emergency, or close the hospital entirely. More than 40 hospitals have closed over the last 20 years and 10 hospitals have closed maternity services over the last decade, including in Columbia, Franklin, Lewis, New York, Niagara, Ontario, Otsego, St. Lawrence and Wyoming counties. A number of psychiatric services closed during the pandemic, and some still have not reopened.

Such closures can have serious negative consequences for patients who rely on the hospital, especially people with disabilities, pregnant people, elderly people, people of color, and people who are uninsured or have public insurance. Residents of rural areas and low-income urban neighborhoods are disproportionately affected.

However, all too often, the directly affected community residents are given little or no advance notice, and not consulted about how such a closing would affect their continued access to timely, affordable health care. It is vital that communities are notified and consulted about such proposed changes. Moreover, such closures should receive the highest level of state review and be subject to health equity impact assessments.

• The bill requires earlier notice to affected communities and their elected officials, and meaningful engagement of stakeholders.  The current practice of 90 days’ advance notice of their intent to close, under state Department of Health guidance issued in August 2023, is not enough time for communities and their representatives to respond and seek ways to either avoid the closure or secure a meaningful mitigation plan to help affected patients obtain care elsewhere. The LICH bill requires 270 days advance notice for full hospital closures, and 210 days for closures of an essential hospital unit, such as maternity, emergency or psychiatric care. It also requires a public hearing at which affected local residents can comment on how their access to care would be affected, in order to influence the hospital’s proposed closure and mitigation plans.
• The bill also proposes that closures of entire hospitals receive independent health equity impact assessments. Currently, hospital closures are carried out through “notice” to the State Department of Health, rather than through a Certificate of Need (CON) application.  Because the State’s new health equity impact assessment law amended the CON process, closures of entire hospitals were left out. Closure of an entire hospital can have a devastating effect on local residents, especially those who are medically underserved, and therefore, should undergo a health equity assessment to determine potential ways to mitigate the negative consequences.
• The bill further requires that both closures of entire hospitals and closures of key hospital units be considered through submission of “full review” CON applications. Both the “notice” process used for hospital closures and the “limited review” CON process being used for proposed closures of hospital units omit any review by the State’s Public Health and Health Planning Council (PHHPC). Instead, decisions on these proposed closures are made behind closed doors by Department of Health officials. Bringing proposed hospital and unit closures before the PHHPC has the benefit of allowing discussion of the CON application in a public forum, at which affected residents can make comments. Expert members of the PHHPC (including its two consumer representatives and those with public health and medical knowledge) can ask questions of the applicant, scrutinize the proposed mitigation plan developed through the health equity assessment process and vote on an official recommendation to the State Health Commissioner.  The bill gives affected people a voice in a decision that can result in lack of medical care in their community and region.

Please write or call the Governor and ask her to sign the bill.  

You may use this form to email her, or if you prefer, call her office at 518-474-8390. If you wish, you can do so through our automated platform using the button below.  Tell the Governor your story, and please include some version of this message: "Our community must have a say if our hospital wants to close! Please sign the Local Input for Community Healthcare Act (S.8843-A/A.1633-B) into law."

We are grateful to you for standing with your fellow New Yorkers on this critical issue.