A nine-member advisory board designing the renovation of SUNY Downstate’s University Hospital has submitted its plan to modestly reduce hospital beds and build a new ambulatory surgery center at the struggling medical facility, Gov. Kathy Hochul said Thursday.
The Downstate Community Advisory Board, established under a state law passed last year, submitted its final proposal for the renovation of the East Flatbush teaching hospital to the Hochul administration on Wednesday, concluding seven months of deliberations on how to revamp the cash-strapped facility. The final report recommends that the state refurbish the existing 693,000 square-foot hospital building and construct an annex across the street to bolster ambulatory care, in hopes of reversing the hospital’s financial woes.
The proposal released Thursday is closely aligned with a draft version of the recommendations reported by Crain’s.
The final proposal outlines a higher number of inpatient beds at Downstate than the board previously recommended. Under the proposal, the renovated inpatient hospital would have 225 beds in private rooms and preserve all existing inpatient services, including maternity care and kidney transplants. The 342-bed hospital currently only operates 286 of its beds, and an average of 165 patients occupy those beds each day – a number that the hospital should aim to increase, according to the board’s report. The plan also recommends that the hospital expand its emergency room capacity by 10% to include 45 treatment stations, part of an effort to ease emergency wait times in central Brooklyn.
The cost is projected at $1.1 billion, higher than both the $750 million allocated for the project in the recently passed state budget and the $928 million price tag in the draft proposal. SUNY will funnel seven years of capital funding – amounting to $350 million – to cover the remaining costs of the renovation, according to the governor’s office.
The board also proposed building a new annex on the site of an abandoned parking lot across the street that includes a four-story ambulatory surgery center focused on cancer and heart disease – the leading causes of death for patients in Brooklyn, according to the report.
The proposal comes more than a year after the governor proposed to reduce debts at Downstate by eliminating all of its inpatient services and building an outpatient hub on campus. The plan was scrapped in budget negotiations last year after health care workers, elected officials and community members raised concerns about the erosion of health care in central Brooklyn. That pushback led the state to appoint an advisory board to determine how to renovate the hospital and maintain access to care while ensuring it remained fiscally sustainable.
Downstate has faced deficits up to $100 million in recent years, according to SUNY. Though the proposed renovation – and specifically, the emphasis on more lucrative outpatient cardiology and oncology services – could help the hospital reduce that deficit, it’s still unlikely that the project will help Downstate break even, according to a fiscal analysis included in the board’s report.
The board’s proposal anticipates that construction for the proposed plan will start during the fall of 2026, according to Nicolette Simmonds, a spokeswoman for the governor. She said Hochul is currently reviewing the recommendations, but did not provide an estimate of when the governor expects to make a decision.
June 5, 2025: This story has been updated with a statement from the governor’s office.
