Nassau wants state to foot near $2M bill that covers costs for county's financial watchdog group

Nassau's comptroller is demanding state officials reimburse the county $1.75 million to partly cover yearly expenses of a fiscal watchdog group that monitors Nassau University Medical Center's spending.

The Nassau Interim Finance Authority, which oversees budgets for the county and the hospital’s parent company, is funded by Nassau taxpayer dollars. In a letter sent last week, Comptroller Elaine Phillips said that since the hospital is now run by state-appointed officials rather than county leaders, Nassau residents should no longer foot the bill for its fiscal oversight.

"On behalf of the taxpayers of Nassau County, and as their duly elected Comptroller and fiscal watchdog, I intend to stop the practice of having our residents and businesses paying millions of dollars for a New York State control board to oversee a New York State-run hospital," Phillips wrote in a statement.

Phillips billed the state Division of Budget for half of NIFA’s charges for the past 16 months. Moving forward, she will invoice state officials every quarter for half of the group’s operating expenses, she said.

NIFA’s $3.5 million in operating costs from May 2025 to August 2026 were funded through Nassau’s sales tax revenue, according to Phillips.

Tim Ruffinen, director of communications at the New York Division of Budget, said state law dictates NIFA is paid for using local sales tax revenue. "This law has been in place for more than a quarter century," he wrote in a statement. "The county should simply follow the law rather than send out a press release notifying the media of their symbolic efforts."

In May 2025, state officials restructured NUMC, its parent company and the A. Holly Patterson Extended Care Facility, shifting a majority of control from county to state appointees. At the time, seven of the hospital’s board seats were appointed by state Democrats and Nassau Republicans refused to appoint their four board seats.

Asked what prompted Phillips to send the invoice last week, spokeswoman Wendy Goldstein said the decision simply came a little over a year since NUMC's leadership changeover.

Tensions between NIFA and the county have intensified recently. In July, NIFA sounded the alarm that Nassau was not complying with an audit of its tax assessment system. In 2024, the group did not approve the county budget — a first in six years — calling Nassau’s accounting approach "illegal."

For its part, NUMC, Nassau’s only public hospital, has had its own fiscal woes. Last year, the hospital reported more than $1.4 billion in debt, and last month, officials announced another $110 million shortfall. Newsday reported last week that it would be cheaper to replace the hospital altogether than to upgrade its aging infrastructure, according to NUMC CEO Thomas Stokes.