Carol Pittman, NYC Community Affairs Representative, has announced that the Department of Health is beginning their implementation of the Berger Recommendations.

DOH Begins Process to Implement Commission Recommendations

The Department of Health (DOH) is beginning the process to implement the recommendations of the Commission on Health Care Facilities in the 21st Century, including imposing restrictions on granting Certificate of Need (CON) approvals, licenses, grants, or permits for many of the 57 facilities named in the Commission report.

Despite ongoing legal challenges to the Commission's recommendations, DOH has its advised staff that the recommendations became legally binding January 1 and that implementation activities must begin. The restrictions being imposed apply to 21 facilities that are required to take certain actions to implement the recommendations, such as joining with other facilities in new governance arrangements, and facilities recommended for closure. DOH has said it would make exceptions to these restrictions and move forward with activities involving the affected facilities only where necessary to protect the life, health, safety, or welfare of patients.

DOH's action is based on language contained in the section of the Commission report titled, "Preface to Recommendations," which gives the Commissioner of Health authority to "take any action necessary to compel" the affected facilities to comply with the restructuring recommendations. The Commission report specifically states the Commissioner may refuse to act on any application from the subjected facilities, and may go so far as to suspend, limit, or modify their operating certificates.

DOH is expected to send a letter next week to all 57 facilities describing the steps they need to take to initiate implementation of the recommendations.

DOH officials described the implementation activities at a meeting Thursday of the Planning Committee of the State Hospital Review and Planning Council (SHRPC). Committee members and DOH officials discussed the extent to which the recommendations could be carried out through administrative actions and which aspects of the Commission plan would require action by the SHRPC or Public Health Council. Many of those procedural questions have not yet been answered.

Also at Thursday's SHRPC committee meetings, the Project Review Committee recommended approval of the first CON related to a Commission recommendation. Plans for a new 374-bed hospital in Wallkill, Orange County, to replace two existing hospitals of Orange Regional Medical Center in Goshen and Middletown, were unanimously recommended for approval. The current capacity of the two hospitals is 450 beds.

The $323 million proposal would be paid for with a combination of proceeds from the sale of the existing properties, fundraising, a Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) grant, and tax-exempt financing from the Dormitory Authority of the State of New York. The full SHRPC is scheduled to vote on the proposal at its February 1 meeting.

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