BROOKLYN EAGLE: Since SUNY announced its plans for Downstate in January, critics of the move have said that your intention is to close Downstate, eliminating health care services for Brooklynites while putting the jobs of Downstate’s employees at risk. How do you respond to that?

SUNY CHANCELLOR JOHN KING: First of all, no one is talking about closing Downstate. Downstate is an essential institution not only for Brooklyn but for our entire city and state. We provide vital health care to the surrounding community, but the hospital building is one part of a larger academic medical center that is providing both in-patient and out-patient care and educating at the health sciences university diverse, excellent doctors, nurses, and other health care professionals who often come from New York and go right back to work in the neighborhoods they grew up in.

Right now, the hospital building is running an annual $100 million deficit, even with over $120 million in disproportionate share hospital payments received, and its physical structure is rapidly deteriorating, putting the entire hospital at risk of catastrophic failure. So, allowing the status quo to continue is not a viable option — neither is building a new hospital or completely renovating the current one, which would cost billions of dollars and take more than a decade to complete.

We are extremely grateful that Governor Hochul has committed to a historic $300 million capital investment to help us implement a plan — developed in collaboration with our local community in Brooklyn — that preserves the services our hospital currently provides while securing the entire university’s future. The Governor is also proposing to cover Downstate’s $100 million operating deficit for the next two years while the plan is implemented. Community participation is essential to building this plan.

BE: So if you’re not able to build a new hospital or repair the existing one, what exactly is this plan going to look like?

CHANCELLOR KING: We’re in the process of a community engagement process that is going to inform the final shape of our plan, but because of the Governor’s $300 million investment, we’re able to commit to some guiding principles. Our plan will preserve the current levels and quality of inpatient care and specialty services — such as our renowned kidney transplant services — now available at Downstate through stronger partnerships with neighboring hospitals, including Kings County, right across the street. Additionally, we anticipate the historic $300 million investment from the state of New York will expand the number of patient-centered services being delivered to the Brooklyn community, with the expansion of desperately needed outpatient and ambulatory care resources, providing those services on campus. And critically, we’ll upgrade our health sciences university with state-of-the-art research and training facilities and a Brooklyn Center for Health Equity operated in collaboration with leading community-based organizations.

BE: When you say the plan will be developed in collaboration with Downstate’s surrounding community in Central Brooklyn, what does that look like?

CHANCELLOR KING: SUNY has launched a community engagement process, which includes a survey and focus groups that will inform the plan we submit to the Governor. SUNY’s survey already has over 1,000 total responses and remains open at www.AStrongerDownstate.org for Downstate students, alumni, faculty, staff, patients and community stakeholders to share their concerns and aspirations.

We are also holding five focus groups that will engage community leaders, patients, students, leading health care experts, faculty and staff across the university and Central Brooklyn. The process began with a needs assessment to better understand stakeholders’ perspectives on the current state of affairs at SUNY Downstate, followed by a visioning process to ensure that community-sourced ideas inform SUNY’s plan for a stronger Downstate at all levels. SUNY will publish a report detailing findings and recommendations.

That said, we are committed to ongoing community input informing the future of SUNY Downstate and continue to discuss with elected officials and other stakeholders what forms that could take.  

BE: And how do you respond to concerns from Downstate hospital employees — most of whom are union members — about losing their jobs?

CHANCELLOR KING: The staff at Downstate does tremendous work and is on the front lines of tackling the health disparities that Brooklyn residents face on a daily basis. The greatest threat to their jobs is the status quo. If the hospital’s physical condition and fiscal crisis cause it to fail, our staff — not only in the hospital but across the university — would see their jobs at risk. The hospital is currently borrowing money from the health sciences university in order to continue to operate.

There are four main unions with members at SUNY Downstate. We can commit that three of the four would see all of their jobs preserved. Overall, 90-95% of the jobs would be preserved. For the employees affected, we’re confident we can help place them in similar jobs at other SUNY hospitals or elsewhere, given the current health care worker shortage that New York is experiencing.

BE: With Kings County Hospital being a major partner in this plan, will they have the capacity and resources to handle the services you’re currently providing at Downstate? Can you provide more details on what this partnership looks like? 

CHANCELLOR KING: As part of SUNY’s plan for a stronger Downstate, SUNY is committed to ensuring Downstate health care professionals have a dedicated, state-of-the-art facility to continue providing the quality care Downstate is known for. Core to this vision is Kings County Hospital, where Downstate doctors, nurses and staff will provide the same services their patients currently receive — just at a better-equipped facility across the street. This will be a multi-year transition process, allowing us to minimize any disruption of services and make necessary capital upgrades.

BE: What does this mean for the medical school? What will happen to students who are currently able to secure clerkships and residencies at Downstate?

CHANCELLOR KING: SUNY Downstate Health Sciences University is critical to the community, training a diverse workforce that primarily remains in-state upon graduation. The status quo only puts the future of our medical school at catastrophic risk. Downstate is a gem of our SUNY system, and this proposal will ensure medical students are able to successfully continue their studies throughout this transition. SUNY Downstate already collaborates with nearby hospitals to support its mission. Right now, approximately two-thirds of Downstate clerkships and residency placements are with surrounding hospitals and health care providers. With the Governor’s proposed $300 million capital investment, Downstate students will have new, cutting-edge research, training, and outpatient facilities where they can hone their craft.

BE: Community members are pointing to the Department of Health’s report on Brooklyn health care inequities — particularly around maternal health care — to reiterate the need for Downstate. How does this plan respond to the DOH’s report? 

CHANCELLOR KING: At Downstate, we currently deliver about two babies a day, or approximately 3% of all births in Brooklyn. People are generally not choosing Downstate as the place to have their baby. Kings County Hospital delivers almost double the number of babies as Downstate does daily. Maimonides, NYU Langone in Brooklyn, and NY Presbyterian in Brooklyn together birth 2/3 of all babies born in Brooklyn.

With the $300 million investment, we could play a substantial role in improving maternal care and addressing maternal health care disparities. With our new outpatient facility, we can expand pre-natal and post-natal care resources to help tackle maternal health disparities on the ground while using our new Health Equity Institute to mobilize our doctors and researchers at the Health Sciences University to get at the root causes of the inequities we see in this space. We could also potentially expand the Downstate Health Sciences University midwifery program and explore the addition of a training program for doulas.

A major driver of health disparities in Brooklyn is the unmet need for primary and urgent care, and our proposal seeks to continue and expand those services as future demand for outpatient services is expected to continue trending upward in Brooklyn and nationwide.