Hawai’i State Hospital Employees Game Overtime System

by Andrew Walden, Heartland Foundation, December 5, 2014 

A federal court order is being ignored so union members at the Hawai’i State Hospital can manipulate work rules to boost their pay, according to Hawai’i State Senate investigative committee report released in October.

The report also cites hospital management for nepotism and retaliation and points to unsafe working conditions resulting in employees being assaulted by psychiatric patients—almost all of whom are criminals ordered there by the courts.

With a debt load amongst the nation’s highest, Hawai’i can ill-afford this kind of profligacy, said Keli'i Akina, president of the Grassroot Institute of Hawai’i.

“The mismanagement of Hawai’i State Hospital is a critical problem for patients, hospital employees, and taxpayers,” Akina explained. “The situation reflects a lack of best practices in managing public worker benefits and collective bargaining agreements.”

The hospital employs over 600 union members and numerous additional contract workers, costing over $52 million out of the state’s general fund to look after an average of 200 patients.

The average cost per patient per day is $657.97 compared to $304 to $425 per day at a South Carolina facility to which Hawai’i has sent especially difficult cases.

Work Rules Abused

Hawai’i government employees have lower pay scales than their private health care sector counterparts—yet cost more to employ. The report explains paradox as being due to the manipulation of overtime and sick leave benefits, describing several schemes used by employees.

In one scenario, a worker scheduled for a 40-hour work week with two days off takes sick leave benefits during two regularly scheduled shifts and works during the two regularly scheduled days off. The employee has worked 40 hours, but will receive overtime pay for the two shifts they were not originally scheduled to work.

In another scenario, an employee scheduled to work 40 hours in a week with two days off takes sick leave benefits during the five regularly scheduled shifts and works overtime shifts during the two regularly scheduled days off. For working 16 hours, the employee will be paid five days of sick leave and two days of overtime.

The committee report also notes the five days of paid sick leave create five additional opportunities for other employees to work overtime.

Employees Coordinate Manipulation

Debbie Ono, a staffer at the Hawai’i State Hospital who schedules staff, testified to the state legislature she sees concerted efforts to game the overtime system about two to three times per week, and that it contributes to understaffing which in turn endangers staff. Several employees of the hospital have suffered serious injuries from assaults by patients where staff shortages played a role.

Ono said she suspects some workers are taking advantage of the system by coordinating with colleagues to have one call in sick and the other work the shift to get overtime pay. “The reason our overtime is so great is that the people hired do not want to work,” Ono told the committee.

The report found that six employees amassed nearly 7,400 overtime hours between them in 2013, earning more than $200,000 in additional wages.

Court Order Ignored

The overtime practices at Hawai’i State Hospital were supposed to be changed after a 1996 federal court ruling, but the order has been ignored.

According to the report, “the Hospital was ordered… to ‘adopt and implement a policy that no [Hospital] employee works voluntary overtime on consecutive days and that limits the number of voluntary overtime shifts for each employee to a maximum of three shifts per week.’ …[But] [t]he Hospital was not successful in obtaining consent from the United Public Workers union and accordingly, the overtime policies prescribed under the order were not implemented.”

“The waste and incentive to ‘game the system’ demonstrates the need for broad reforms that will improve the work environment of state hospitals and stop the draining of the state budget,” Akina of the Grassroot Institute said.

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Related: Hospital Crisis: How to Use Union Work Rules for Fun and Profit