SUNY Downstate’s University Hospital would have more than two-thirds of its beds cut under an early proposal mapping out the future of the struggling facility, according to a copy of the proposal obtained by Crain’s.
The plan, put forth by advisory board member and former attending physician at New York-Presbyterian’s Brooklyn Methodist Hospital Dr. Donald Moore, suggests building a downsized hospital with 100 beds connected to a 10-story ambulatory surgery center, the proposal shows. It reduces the size of the 342-bed inpatient hospital, eliminates the emergency room and builds up ambulatory care at the East Flatbush medical center. Though the plan sets out to reduce hospital beds, the state could expand the bed count to 200 over time by building onto the facility, it says.
The plan was sent to the Downstate Community Advisory Board, a nine-member panel formed under state law last year to make recommendations to modernize the safety-net hospital and help it stay afloat. It was devised by a single member of the board and is not an official proposal, according to a representative from Downstate. The board expects to review additional plans, but the current proposal provides an early look at what could be on the table as the board prepares to submit formal recommendations to the state by June 1.
“As the process of developing a long term plan for SUNY Downstate progresses, the community advisory board will continue to consider all input and proposals from the community,” said Kara Fesolovich, spokeswoman for Gov. Kathy Hochul.
The plan to shrink hospital beds builds on a state-sanctioned proposal released last year that aimed to reduce Downstate’s operating deficit by closing the main hospital building and building an outpatient hub. The state has since reversed its position and said it would preserve some level of inpatient care, giving the board a $750 million capital budget to determine how to construct the facility. The board is considering what mix of hospital and outpatient services will help Downstate stay up and running.
The early proposal includes a brand new outpatient building across the street from University Hospital, including two floors of underground parking and eight stories of medical services including oncology, radiology, surgery, endoscopy, cardiology and women’s health services.
The ambulatory building would have a bridge connecting to a downsized, five-story hospital with somewhere between 100 to 200 beds. The new hospital should be built “as small as possible initially, with possible vertical expansion if needed,” according to the plan.
The cornerstone of the proposal is for the state to implement a regional planning body that could study how hospitals including Maimonides, One Brooklyn Health, Kings County Hospital and Downstate could more efficiently use their resources and coordinate care for residents in Brooklyn, Queens, Staten Island and even parts of Long Island, Moore, who was appointed to the advisory board by House Speaker Carl Heastie and does not have an affiliation with Downstate, told Crain’s.
“It has become clear to us that the problems are way beyond an aging building,” Moore said. “It’s a lack of regional planning and a changing health care landscape. Yet the hospital has not changed.”
Moore’s plan omits an emergency room at Downstate, which he said is not needed because the public medical center Kings County Hospital has a sophisticated emergency department across the street. The emergency room at Kings County is one of the most overcrowded in the public hospital system, Dr. Mitchell Katz said in a budget hearing last year, raising concerns that it will not be able to take an influx of patients from Downstate.
The proposal preserves transplant services at Downstate, which houses the only kidney transplant center in Brooklyn, and also maintains services for high-risk pregnancies.
During construction, the main hospital building would stay up and running, according to the plan.
The document does not outline how much Moore’s proposal would cost, and he said that consulting firms will estimate a budget for whatever plan the board agrees on. The proposal that he put forth could reach an estimated $1.5 billion, Moore said.
The advisory board has not publicly released any proposals it is considering ahead of its June 1 deadline, nor has it reached a consensus on a plan. But the panel has received at least one other proposal that aims to preserve more hospital beds, which was released in December by the community coalition Brooklyn for Downstate. The organization, which formed in opposition to state efforts to close inpatient services, has proposed to reduce hospital beds to 250 and expand the emergency room at Downstate, which currently sees 50,000 patients a year.
