News From Assembly Member Richard N. Gottfried

(Assembly Member Richard Gottfried) December 28, 2021

CONTACT: Mischa Sogut, (518) 455-4941sog…

Improving Health Equity:  Gov. Hochul Signs Gottfried Bill Into LawStatement by Assembly Health Committee

Chair Richard Gottfried:

Governor Kathy Hochul has signed a bill I sponsored in the Assembly expanding the certificate of need (CoN) process to require “health equity assessments” as part of CoN applications. Bill A.191-A/S.1451-A was sponsored in the Senate by Senate Health Committee Chair Gustavo Rivera.

When a big hospital takes over a smaller one, often it pulls lucrative services out of the smaller hospital, leaving communities badly underserved. When hospitals form networks, this can also mean loss of services in a community. With this new law, the Health Department will consider those impacts before allowing this kind of action.
CoN applications are required of inpatient hospitals and other health care facilities when they merge, reduce or expand or relocate facilities or services, or make other substantial changes to operations or ownership. The process can require financial filings, architectural plans, or other documentation. However, patient advocates have long raised concerns that nothing in the CoN process requires that providers analyze the impact of proposed changes on medically underserved communities. There are huge geographic disparities in access to care, such as New York City ranging from 6.4 hospital beds per 1,000 residents in Manhattan to just 1.5 beds per 1,000 in Queens.   

This landmark legislation will require that for most CoN applications, the applicant must include a health equity assessment that documents whether, and if so how, a project will improve or reduce access to health care and reduce or worsen health disparities, with particular focus on members of medically underserved groups. The health equity assessment must be prepared by an independent entity and include meaningful engagement with interested parties such as community leaders and employees. The assessment will be part of the applicant’s CoN application and is required to be posted on both the applicant’s website and the NYS Health Department’s. (The bill exempts a narrow category of outpatient providers, like many community health centers and family planning clinics, that serve mostly underserved populations, for whom the requirement might be burdensome.)

There is widespread recognition among advocates, public health analysts, and others that consolidation in health care goes hand in hand with disparities in access. The CoN process is central to how New York organizes health care delivery. This bill is a critical step toward ensuring health equity when facilities expand, contract, or merge. A.191-A has the support of numerous organizationsand was drafted in consultation with leading public health and community advocates. Governor Hochul has taken a great step for health equity in signing this bill. I thank her, Assembly Speaker Carl Heastie, Senate sponsor Gustavo Rivera, and the many others whose assistance helped make this law.