Health care facilities seeking state approval of significant changes now have to file independent reports on how their project would affect health outcomes and access to care among medically underserved groups — such as people with disabilities, immigrants, LGBTQ patients, and racial and ethnic minority communities. The newly required health equity impact assessments must detail how a given project would positively and negatively affect the health needs of medically underserved groups in the area. Supporters say the new law will help prevent hospitals and other health care facilities from making substantial changes that could curtail access for patients who already struggle to obtain services. “These new requirements are long overdue in New York, where hospitals and health systems have been merging, downsizing and cutting services at a rapid pace over the last 20 years,” Lois Uttley, founder of the advocacy group Community Voices for Health System Accountability, said in a statement. “Communities have had little or no say when their local health facilities seek state approval to carry out changes that make it difficult for people to get needed health care close to home,” Uttley added. No other state has such an extensive health equity assessment requirement, according to a June presentation on the regulation by the state Department of Health. However, the law has a couple of notable loopholes. Under New York’s state-mandated process, the establishment, construction, renovation and ownership changes of health care facilities typically require a certificate of need, which involves a Health Department review and a vote by the state’s Public Health and Health Planning Council. The health equity assessment law says health care facilities must file one with any certificate-of-need application that involves a substantial expansion or reduction of services. But hospital closures don’t go through the state’s certificate-of-need process, which exempts them from the equity assessment requirement, the Department of Health confirmed. Instead, hospitals planning to discontinue operations need only provide 90 days’ notice to the Health Department and obtain the health commissioner’s approval of a closure plan. “The Department must act to ensure that communities facing proposed closures of their hospitals are also meaningfully engaged and given an opportunity to spell out the likely consequences for their access to care,” the New York Civil Liberties Union wrote in a public comment last month. “Since closures have the most dramatic impact on communities, they should also undergo a required health equity assessment.” An assessment also wouldn't be required if a hospital reduces beds in a particular unit by "relocating" them elsewhere in the same facility, unless they were being converted to a new bed category, a Health Department spokesperson said. GOT TIPS? Send story ideas and feedback to Maya Kaufman at mkaufman@politico.com. Want to receive this newsletter every weekday? Subscribe to POLITICO Pro. You’ll also receive daily policy news and other intelligence you need to act on the day’s biggest stories.
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