ALBANY — After allowing a state panel’s recommendations for shrinking New York’s troubled hospital industry to become law, legislative leaders are now seeking to undo parts of the plan by passing a new law that could save a number of hospitals from closure.

The leaders of the Assembly and the Senate said yesterday that the state was not wedded to the final report of the Commission on Health Care Facilities in the 21st Century, whose ambitious plan that included closing 10 hospitals in the state was endorsed by governors Pataki and Spitzer and Mayor Bloomberg and became law on January 1.

The commission’s report “should not be the end all and be all,” the Democratic speaker of the Assembly, Sheldon Silver, said.

The attack on the commission’s report presents a fresh challenge to Mr. Spitzer and his health care agenda. Lawmakers who successfully rolled back many of the hospital cuts proposed by Mr. Spitzer in his budget are now seeking changes that could threaten the administration’s efforts to streamline and restructure the state’s hospital industry.

Mr. Spitzer yesterday said it was unlikely that any of the 10 hospitals recommended for closure by the commission would be granted a reprieve. “I don’t think the Berger Commission recommendations will be reversed or revised,” he said, referring to the chairman of the panel, Stephen Berger.

Spitzer officials warned yesterday that the state would risk losing $1.5 billion in federal grants by tampering with the recommendations.
A prominent budget analyst, E.J. McMahon, the director of the Empire Center for New York State Policy, said Mr. Spitzer’s response to the Legislature’s attack on the recommendations “will be a test of the governor’s commitment to a patients-first agenda.

The leaders said some of the closures advocated by the commission were unnecessary and also criticized the report’s support for privatizing State University of New York teaching hospitals located in Brooklyn, Syracuse, and Stony Brook.

SUNY’s faculty union, which is affiliated with New York State United Teachers, one of the most powerful interest groups in Albany, has lobbied aggressively against the privatization plans, saying they would hurt the hospitals. Union members came to Albany this week to protest the commission’s report.

The report said privatizing the hospitals would promote “more effective long-term planning” and fiscal stability and would save the state millions of dollars. It noted that “leading academic medical centers operate their medical schools and principal teaching hospitals under separate ownership without deleterious effects on their research enterprise. Prominent examples include Harvard, Yale, Cornell, Columbia and Washington Universities, all of which own no hospitals yet remain leaders in research funding.”

The Republican majority leader of the Senate, Joseph Bruno, said his conference was considering legislation that would reverse closures of upstate hospitals, including Bellevue Woman’s Hospital, a 55-bed facility in Schenectady.

The report said, “The hospital’s financial situation is dire and its future viability is in serious jeopardy. It has a substantial debt load and its business model is dependent on the provision of poorly-reimbursed obstetrical services.”

“We have to look at the ramifications of what we did and the Berger Commission and correct,” Mr. Bruno said.

Mr. Silver said he doesn’t think lawmakers should be deterred from amending the commission’s report based on fear that the state would be losing the $1.5 billion in Federal-State Health Reform Partnership grants. “I’m not convinced the federal funds that were so-called promised are actually there,” Mr. Silver said.

“The dollars are most definitely coming,” Mr. Spitzer’s deputy secretary for health, Dennis Whalen, said.

The Commission on Health Care Facilities in the 21st Century recommended the closure of six hospitals in New York City (St. Vincent’s Midtown Hospital, Cabrini Medical Center, Manhattan Eye, Ear and Throat Hospital in Manhattan; Victory Memorial in Brooklyn; New York Westchester Square Medical Center in the Bronx, and Parkway Hospital in Queens) and four hospitals upstate. It also recommended reconfiguration, merger, and conversion plans involving an additional 48 hospitals.

The commission said its plan would save the state about $1.5 billion a year and reduce about 4,200 hospital beds statewide, helping to bring stability to a system lacking in primary care services and burdened by spiraling debt, inefficiency, and rising health care costs.

Commission members said they targeted hospitals that were on the brink of extinction and sought to cushion their fall by recommending that federal funds be used to help those hospitals pay off debts and to help displaced employees find jobs elsewhere in the system.

Three of the New York City hospitals slated for closure, Cabrini, Parkway, and Westchester Square, have refused to shut down and are waging legal battles to try to overturn the recommendations.

By law, Mr. Spitzer’s health commissioner, Richard Daines, has a deadline of June 2008 to implement the commission’s recommendations. Hospitals that are on the chopping block must develop closing plans by September 30.