Answering to the concerns of Nassau County residents and watchdog groups, Jerald C. Newman, president and CEO of the Nassau Health Care Corporation, said that rather than interfere with the hospital's mission to provide healthcare to the poor and uninsured, Nassau County Medical Center's new public benefit corporation status would improve services.

"Actions speak louder than words," said Newman. "The facts are that we are actually providing a higher level of medical care than was provided in the past for the poor, and the more profitable we become, the better we will be able to take care of the indigent population."

The Nassau Health Care Corp. purchased the 615-bed facility last year by raising $259 million in a triple-rated bond issue, $82 million of which was given to the county, with the balance kept as working capital. Since then, improvements have been made to the seven community health centers, formerly county-run Department of Health clinics, which have won over most skeptics. The centers now deliver primary care, providing communities with access to internal medicine, pediatric and prenatal care, ob-gyn services, and dental services.

Hours of operation are being extended to include nights and weekends, dental capabilities are in the process of being expanded, and the centers are currently being staffed by full-time doctors, rather than on a rotating basis. Newman was recently in Washington, lobbying Congress for money for minibuses to transport patients between health centers and the hospital. Moreover, successful efforts are being made on the hospital's behalf to uphold a sounding board and improve relations in communities, such as New Cassel.

"Sometimes when there is a changing of the guard, a dialogue that was previously established is lost," said Jamal Abdul-Karim, member of the New Cassel/Westbury Health Advisory Board. "Hospital Board Chairman Eric Rosenblum seems very open to our suggestions."

The New Cassel/Westbury Health Advisory Board was formed three years ago in order to provide a link between concerned citizens and health care professionals in the community, and the decision-makers operating the New Cassel facility. Ongoing meetings with hospital board members have reassured Abdul-Karim, and other members of the advisory board, that they will be able to play a participatory role in changes being made.

Currently, Nassau Heath Care Corp. receives an $18 million subsidy from the county, $13 million of which is intended to provide care for the uninsured, and $5 million to take over the preventative medicine programs of the health centers. However, according to Newman, uncompensated care of $30 million is provided each year, with Medicaid and Medicare recipients, and third-party insurance payers, including HMOs, making up the deficit.

Crucial to provision of services to those who cannot afford them, is the hospital's ability to capitalize on those who can. "The more middle-class people we service, the more money will go to attracting and hiring more doctors, buying better equipment, and continuing to provide healthcare to poor people in better ways," said Newman.

To remain competitive in a difficult market, the medical center is currently expanding its kidney dialysis unit from 13 beds to 28, upgrading its cardiology capabilities to handle open-heart surgery, implementing a state-of-the-art hand surgery department, and offering a weight-loss program that includes surgical stomach-stapling.

The hospital also boasts one of the only major burn units in the metropolitan area, and a Level 1 trauma center that receives more than half of all trauma cases in Nassau County, and is designated to provide emergency care to the president of the United States, should he require it.

The corporation also runs the highly-rated Holly Patterson Home. With 889 beds, it is the largest long-term nursing residence in the state.

A recent collaborative effort between the hospital and the Nassau County Correctional Center has overhauled the jail's ailing healthcare system by expanding medical services staff, and restructuring the health-care delivery system. Improvements at the jail will ultimately bring new patients into the system, as inmates who are treated for diseases such as diabetes or tuberculosis are referred to one of the community health centers for follow-up care upon their release.

While Abdul-Karim said he is generally pleased with changes being made, both at the community health center in New Cassel and at the hospital itself, he expressed concern on behalf of the advisory board about incidents such as the hospital's impending name change, which was prematurely listed in the December Yellow Pages. "It's nice when people are informed that these changes are going to come down, not after the fact, but before."