Vetoes Bill to Require Community Input on Hospital Closures; Urges Court to Expedite Beth Israel Closure

By Arthur Schwartz

Governor Kathy Hochul ended 2024 by escalating her attack on local input into hospital closures, and then having her Health Department push to get the Beth Israel Hospital closure expedited. The hospital lobby sure has her under their thumb.

On December 13 Hochul vetoed a bill that would have required local community input before a hospital closes a facility or certain units. The bill, which the Senate and Assembly approved in June, would have laid out a timeline and procedures for any closure, with the hospital which wanted to close being required to do a Community Health Impact Assessment, show proof of the ability of other facilities to absorb the hospital’s existing patient population, and hold a public forum, and not close any services down until the closure was approved by the Department of Health. In 2023 a similar law was adopted for all health facilities except for hospitals, and the subsequent effort to close Beth Israel and SUNY Downstate Hospital spurred legislators to include hospitals. In August 2023, the DOH imposed similar guidelines on hospitals, guidelines which have helped preserve a Temporary Restraining Order keeping Beth Israel open since February 2024.

But in her veto message, Hochul said the bill didn’t properly take into account the “realities on the ground.” Instead, the Governor said she would direct the state Department of Health to come up with reforms to its existing closure procedures. But the Beth Israel case has shown that “guidelines,” as opposed to a law, are a precarious basis for a lawsuit.

“Greater transparency in the closure process would be beneficial, but this bill does not appropriately balance that goal against the financial realities that struggling hospitals face and changes in health care services delivery,” Hochul wrote.

The bill is known as the Local Input for Community Hospitals Act — or LICH Act, a sly nod to the Long Island College Hospital in Brooklyn that closed despite community opposition in 2014.

But lobbying organizations representing New York’s hospitals pushed back, arguing that the bill is too onerous for facilities buffeted by financial troubles. The bill would have required hospital leaders to notify the State at least 270 days before closing an entire hospital, or 210 days if they are planning to close or reduce an emergency, maternity, mental health or substance use unit. Current DOH guidance calls for 120 days’ notice, and in the Beth Israel case, its parent, Mount Sinai, argued that 120 days’ notice was unconstitutional. In fact, the NY State Constitution requires the State to ensure “quality health care.”

“Establishing another lengthy and duplicative approval process will only further distress an institution facing difficult decisions in a financial crisis and will bind the hands of others trying to make service changes that meet identified community needs,” reads an opposition memo from the Suburban Hospital Alliance of New York State, which represents hospitals in the Hudson Valley and on Long Island.

Senator Gustavo Rivera, the LICH Act sponsor, responded: “We can’t have institutions that are the place where people get care, from one day to the next, just close or change what kind of services they offer without community involvement.”

Hochul wasn’t through. The day after Christmas she had the lawyers representing the Department of Health in the Beth Israel case write to the Judge deciding the case that he was taking too long, and that the delay, given the $150 million per year losses at Beth Israel, could sink the entire Mount Sinai system. That system grossed $23 BILLION in revenue in 2023. Crains reported a revenue increase in the first quarter of 2024. Hochul knows that the land Beth Israel sits on is worth $1.2 billion with the new City of Yes zoning law. But Hochul’s minions have decided not only to approve the closure, but now are pushing it to happen faster. To Hochul, the $150 million per year “loss” (which the State could fund in a snap) is more important than the health care of 650,000 who live in the Beth Israel service area.