By Penny Mintz
In September, I reported that State Senator Hoylman and State Assembly Member Harvey Epstein had met in August with members of the Community Coalition to Save Beth Israel (“CCSBI”). Hoylman and Epstein promised to take two affirmative actions to help make the process of review of hospital closures more transparent and responsive to community needs. The first action was to write a letter to Governor Cuomo asking him to appoint consumer advocates to fill the two vacancies that now exist on the New York State Department of Health’s (DOH) Public Health and Health Planning Council (“PHHPC”).
PHHPC is a powerful player in the state’s oversight of hospital closures. Under New York law, hospitals must file a certificate of need (“CON”) for any proposed change of a hospital service. The CON triggers either a full or a partial review of the proposal by DOH. But DOH does not itself process the review. That’s done by PHHPC, which then makes a recommendation to DOH, and PHHPC’s recommendations to approve or deny the hospital’s proposal are inevitably adopted.
By law, PHHPC must have at least one consumer advocate on its board. For more than a year, however, the council has been limited to representatives of hospitals, health systems, and nursing homes. The consumer advocate position has been vacant. During that time, the CONs for closures of the maternity, neonatal care, pediatric intensive care, and adult cardiac surgery units of Beth Israel were approved by DOH after a limited review, which does not require any public hearings. The fact that a limited review was performed for such major closures is the subject of a legal challenge by attorney Arthur Schwartz.
While the legal challenge goes forward, the quest to change the makeup of PHHPC is also going forward. On October 26, 2018, Hoylman and Epstein sent their letter to the governor “respectfully requesting” that the two currently vacant PHHPC positions be filled by consumer advocates in order to “provide consumers a voice in the major decisions that affect them [and] to ensure the system appropriately meets their needs.”
“Given the enormous power wielded by PHHPC,” says Senator Hoylman, “public accountability and trust demand that the vacant seats on PHHPC be filled with consumer advocates.” Hoylman and Epstein were joined by 15 other elected officials, including State Assembly Member Dick Gottfried and State Senator Gustavo Rivera. Assembly Member Gottfried has promised to go beyond asking the governor to take action. He said that he will be introducing legislation with Senator Hoylman “to expand PHHPC’s membership to include additional representation for consumers and healthcare workers.”
For 32 years, Dick Gottfried has led a battle in Albany for the adoption of the New York Health Act, which would provide single-payer healthcare for all New Yorkers. Harvey Epstein says that he will be cosponsoring that bill in the Assembly this session. Senator Rivera has been the leader of the effort to get the Health Act through the State Senate. With the State Senate under Republican control for the last 12 years, that has been a fruitless pursuit. Last month’s election dramatically changed the Senate landscape.
I will be following those efforts and reporting back.
The second promise that Hoylman and Epstein made at their meeting with CCSBI in August was to introduce legislation that would require an examination by the state health commissioner of the impact of any hospital closure on access to health care services before the closure can be approved, thus ending limited reviews of CONs for closures of hospital units. This legislation, called the Local Input in Community Healthcare Act (LICH), is being carried by Senator Brian Kavanagh in 2019.
With a Democratic-controlled Senate, LICH will hopefully become law this session. And hopefully LICH and PHHPC changes will be accomplished in time to assure that Beth Israel remains a full-service hospital.
