The architecture firm NBBJ partnered with local leaders to envision a modernized SUNY Downstate, only a year after the hospital was slated for closure.
Graphics courtesy of Brooklyn for Downstate
By JACK DELANEY | jdelaney@queensledger.com
This past year has been a rollercoaster ride for SUNY Downstate, the only state-run hospital in New York City.
In January 2024, Governor Kathy Hochul announced plans to either shrink or fully close the teaching hospital, relocating its outpatient and urgent care units to a new building in a nearby parking lot. The mood at the time was grim, with SUNY Chancellor John King rattling off a laundry list of problems: “We do have a $100 million deficit at [Downstate],” he said, “and we will run out of cash this summer, and the building is in disrepair and at risk of catastrophic failure.”
But community advocates pushed back, calling the move rushed and arguing that it lacked buy-in from residents. “If everything is dire, if everything is falling apart, come to us and show it,” said State Senator Zellnor Myrie, in whose district Downstate falls.
The response was overwhelming. Most tellingly, a poll released in March showed that approximately 70% of those in the neighborhood opposed a closure. And local politicians and hospital employees alike rebuked the state for only allocating $300 million in capital funding for the smaller facility across the street, claiming that a sustainable solution to the issues plaguing Downstate — which had suffered from decades of shortfalls — would require an injection on the order of $1 billion.
By April 2024, officials had clarified that they would not be closing Downstate in the “near-term,” a win for activists. Yet another twist came in December, when the hospital’s CEO since 2020, Dr. David Berger, resigned amid allegations of financial misconduct. But the tides shifted decisively in January 2025, with Hochul pivoting to allocate an additional $550 million to address Downstate’s woes, for a total of $950 million (the previous funding had included $100 million for operations). The governor then passed the baton, for now at least, to a community advisory board (CAB) she had formed last November, whose recommendations will be due this upcoming April. Karl-Henry Cesar, chair of Brooklyn Community Board 14, said he hoped the board would be “fully empowered and supported to take as much time as needed to talk with the community and faithfully execute its mission” — the group held its first hearing in January, after months of inactivity, and the next is scheduled for February 27 at Medgar Evers College.
It was in this context, of an averted closure and stalled conversations in the aftermath, that the local coalition Brooklyn for Downstate (BfD) partnered with an architecture firm to envision a next-generation hospital. Last week, they unveiled the fruits of that collaboration: glitzy renderings of what SUNY Downstate could look like if lawmakers deliver enough funding for a full revamp. During an online presentation, members of BfD criticized the state’s approach to gathering community input, with many singling out delays around the CAB as particularly frustrating. “From our position, 8 months were wasted,” said Redetha Abraham-Nichols, DNP, MRA, RN. “We think it’s unfair for the commission to take the work of 12 months and have to do it in 3 months.” Yet they were taking matters into their own hands, the coalition’s leaders stated, and the renderings were an attempt to chart a course for the hospital that would have broad appeal.
In drawing up a modern iteration of SUNY Downstate, architects from the firm NBBJ pulled heavily from a report BfD commissioned in December that brainstormed practical alternatives to closing the hospital. Such a tack could prove disastrous, “deepening disparities and straining neighboring hospitals” the report concluded, offering a counterproposal. “Retaining core services, while optimizing capacity and modernizing infrastructure, is the most effective path forward to sustain equitable healthcare access for Brooklyn’s most vulnerable residents.” Specifically, the report laid out four demands: first, to streamline service by reducing the number of beds from 342 to 250. Second, to upgrade technology and facilities for departments like emergency care, while adding rooms for maternal and OBGYN treatment. Third, to create urgent care and ambulatory surgery centers, with the goal of reducing ER visits. And fourth, to funnel resources into outpatient preventative care centers, heading off major health issues before they occur.
During the presentation, the architects placed special emphasis on transplants, noting that SUNY Downstate is the only licensed organ transplant provider in the county. “Patients may be waiting on a transplant list for an extended period of time,” said Christina Grimes, who leads NBBJ’s global healthcare practice, “and it can be a very multi-disciplinary team.” With that in mind, the renderings leaned into a biophilic approach to make long waits more tolerable
Joan Rosegreen, who represents the nurses at SUNY Downstate, asked how the new design would deal with patient overflow, to which the architects responded that they were still working out the details, and that this was just a starting point. Rosegreen also outlined a brief wish list for future schematics: “We have a small oncology unit,” she commented, “so it would be great if we could expand that.”
Downstate has a storied history that can be traced back to 1856, when a handful of physicians opened a free clinic to care for poor German immigrants. The next year, its name changed from the German General Dispensary to The St. John’s Hospital; it was renamed again in 1858, with administrators settling on the Long Island College Hospital. As of 1860, it was one of only 11 medical schools nationwide to admit Black students, and it was among the earliest to admit women, too, in the early 20th century. Today, Central Brooklyn has one of the greatest concentrations of Caribbean people in the country, which is why some critics of the governor’s initial plan cast it as another case of chronic disinvestment in Black communities.
As the MC of the BfD presentation, Abraham-Nichols was adamant that the state support a grander vision for the hospital. “We cannot, and we will not, go backward,” she said. “Only forward.”
