The closing of hospitals in New York, like the Lakeshore-TLC Health Center in Irving, could take a lot longer in the future.

The state Assembly recently passed the Local Input In Community Healthcare Act (A.2251) that would implement a lengthy process once a hospital’s closure is announced. The legislation passed 110-36, with Assembylmen Andrew Goodell, R-Jamestown, and Joe Giglio, R-Gowanda, voting against.

Companion legislation in the state Senate, S.3131, hasn’t moved out of the Senate Health Committee.

Assemblywoman Joann Simon, D-Brooklyn, introduced the bill after the closure of Long Island College Hospital, formerly operated by the State University of New York-Downstate. That closure ended up in court for nearly two years, during which a court said the current regulation governing hospital closures is “unconstitutionally vague.”

“I will say that as part of the impact which we weren’t able to assess because we didn’t have adequate information a the time, although we tried very hard and this did go to litigation,” Simon said. “One of the things that was clear, the court found that in fact it wasn’t a process by which New York state had to provide people with the information they needed. Unfortunately people died because ambulances couldn’t understand where the addresses were in the local public housing because the addresses were all linked to a courtyard. The familiarity with the area was really critical to the provision of emergency care and it really was a very difficult situation for our community.”

She wrote in her legislative justification the court proceeding made clear that there was no process for determining the health care impact of the hospital’s closure on Cobble Hill and surrounding communities or Brooklyn. Current law, she said, requires a community forum to be held after a hospital has already been closed and does not require the commissioner of the state Department of Health to consider the health care needs of the community, including emergency medical care or transitional care, as part of the commissioner’s decision to approve a hospital closure.

Simon’s legislation adds a new Section 2801-i of the state Public Health law to give explicit authority for closure of hospitals to the state health commissioner and requires the commissioner to issue a report within 30 days of an application for closure, including that includes the anticipated impact of closure on the surrounding communities’ access to care, including the uninsured and underserved; measures the state Health Department and others have taken or plan to take to lessen any negative impact; recommendations regarding access to health care services in the impacted communities and why the state cannot assume financial. responsibility for the hospital or identify an alternate operator.

The state Health Department would also be required to hold a community forum to give community members and local elected officials the chance to raise questions, voice concerns, and offer alternatives, both in person and via written comment. At least 10 days before the public hearing the state will be required to post a copy of a report related to the proposed closure that includes measures the Health Department is taking to lessen any negative impact from the hospital’s closure, recommendations about access to health care services in the region and options for medical services in the area.

“We could not go wrong if we had better information,” Simon said. “With information we would have been able to determine the continuum of care which retained the contract for the billing after SUNY came in. It wasn’t actually sending bills because they didn’t want to send bills because they wanted to close the hospital. That was their main goal was closure of the hospital. It was the community’s main goal to keep health care in the community for the people in our community. This legislation would allow that to happen.”

While the state would be asked to give reasons why it can’t assume financial responsibility to keep a hospital operating, Goodell said the bill’s biggest flaw is that it doesn’t attach funding to allow the public process to play out. He said passing the bill should require a line item in the state budget.

“It’s a great idea that hospitals give us months and months of notice and the Department of Health takes months and months to review it,” Goodell said. “But there’s nothing in this bill that addresses what happens when the hospital runs out of money and can’t pay its employees. There’s nothing in this bill that addresses what happens when a hospital runs out of staff and can’t provide the level of care that we in this legislature are demanding with minimum staffing levels. There’s nothing in this legislation that deals with the fact that a hospital that is going into bankruptcy isn’t going to continue to get supplies. I applaud the desire to have as much notice as possible. The reality is if we’re serious about providing this process in a timely manner we have to be serious about providing the state funding that enables it to happen. There’s no money tree growing behind hospitals they can shake while the state takes its time reviewing an application.”

The closure of the TLC-Lakeshore Health Center in Irving was a shock even though the hospital had faced financial issues for six years before its 2019 closure. It emerged from a 2013 bankruptcy in 2017 after years of deficits and a recommendation by the state’s Berger Commission to close the facility in 2006. The state had been propping up both TLC-Lakeshore and Brooks Memorial Hospital to the tune of roughly $25 million at the time.

“This isn’t just a hypothetical,” Goodell said. “I’ve lived it and I bet many of my other colleagues have actually lived it. I had a hospital company, I had two hospitals in my district. And they were forced to shut one of the two hospitals down or it would have bankrupted the entire facility. Both hospitals would have been closed down.”