State Hospital paid
$3.8 million in OT

Record-keeping was faulted also,
despite improvements

Star-Bulletin staff

In 1996, Hawaii State Hospital paid $2.3 million in staff overtime and $1.5 million for contract nursing overtime.

Three workers at the hospital earned 40 or more hours of overtime per week while 4 percent of the staff received 30 hours of overtime and 11 percent received 20 hours.

A follow-up audit of the hospital, released yesterday, states that while management at the facility improved since an audit was conducted in December 1995, excessive overtime and abuse of sick leave were still problems. The follow-up audit covered January 1996 to March 1997.

Of the 626 staff members at the psychiatric facility, 250 receive overtime payments during a typical pay period, the audit says.

"Working large amounts of overtime negatively affects patient care and reduces efficiency," the report says.

"Reportedly staff who work many overtime shifts in addition to their regular shifts become exhausted. Some staff are found sleeping on duty after working several overtime shifts. Abuse or neglect of patients after staff worked several shifts without resting has also been reported."

The report says high overtime earners also receive large amounts or premium payments for reporting back to work with less than 10 hours of rest, reporting to a new shift with less than 12 hours' rest, or working for six days without 24 hours' rest.

The audit says high employee absenteeism results in high overtime costs.

According to the audit, union contracts and a Department of Justice consent agreement setting minimum staffing requirements limit efforts to cut down on overtime.

The audit says hospital management has improved and the hospital has attained accreditation.

The report also says:

Progress in financial management has been mixed. Cost control and improved record-keeping are needed.

Staff meal prices of $1.50 a meal cover less than one-fourth of the cost of the meals, and there are inadequate controls over the number of takeout meals.

The inventory system for food supplies has improved, but further improvements are needed to account for gasoline and housekeeping items. Controls were insufficient to account for gasoline from the hospital gas pump and from a commercial gas station, and record-keeping is inadequate.

The problem of those committed by court order remains. The hospital has sought to provide transitional services and return patients to the community. But its large court-ordered patient population requires security costs and limits admission of other patients.

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