«CALL TO ORDER Ms. Emily A. Youssouf Adoption of Minutes December 4, 2014 Ms. Emily A. Youssouf • INFORMATION ITEMS Audits Update Mr. Chris A. ...»
Mr. Sweeney responded that one of the issues we are consistently trying to address is mandatory overtime for my staff. I want people to want to stay at the hospital. The difference between somebody who wants to stay and somebody who is told they have to stay is quite stark. In an effort to reduce mandatory overtime, we had to set up a system that we can get folks from other facilities who are interested in working overtime to cover these posts. It has been an effective program – it helps, especially on weekends, fill some slots that would normally have to keep somebody from going home. The way the process was being set up, I worked with Payroll and Finance to figure out how we can do these charge backs and we keep separate time sheets. We keep overtime sheets and we send all the documentation to the facility where the person comes from and that facility then pays that person and is supposed to charge us back. One of the findings in the audit was that Bellevue did not always know what needed to be collected because the burden is supposed to be on the facility that pays that employee. We are now going to give copies of what we collect as far as overtime hours and pay that directly to our client so that they know what bill is coming. The part of getting the people paid from their facility was working. It is that facility charging Bellevue back for that overtime was the lag in how long they let that slide.
Mrs. Bolus asked if they would rather have 17 full time employees as opposed to paying overtime equivalent to 17 full time employees.
Mr. Sweeney responded yes, absolutely. That is a complicated answer because the process of hiring a special officer is a cumbersome one. It is a civil service position and they have to take a test. We have to have hiring pools and there is a lengthy process to vet those who are on the list that would eventually be candidates in the approval for the facility to actually choose their candidate that they want to hire and some point they have to do to the academy.
Mrs. Bolus asked how many vacancies are there at this point.
Mr. Alexander answered that we opened ten positions for hire about year ago and in the course of vetting individuals to bring them on board, some of the people leave, so we are trying to stay ahead of that. We opened another ten positions recently, anticipating that it is a bit of a protracted process to get people through to make sure we have the right qualified hospital police that can perform appropriately; we are basically going with an understanding that this is going to take nine months. I need to float the positions well in advance so that I always have a flow of people coming in. In order to get ahead of it, we had to advance that process a little more than we had in the past. For example, this last year those ten positions that we were successful in getting, they just finished the academy a couple of weeks ago and since then we lost an additional six. This is the kind of attrition we are dealing with. I guarantee that those few people that just came out of the academy who will for a variety of reasons will not be here in six months.
Mrs. Bolus asked if he knew why? Mr. Sweeney said that some of it is they go to other City agencies, Corrections, NYPD or they are interested in law enforcement. Most of them leave for greener pastures or something.
Mrs. Bolus asked if you ask them to exit? Mr. Sweeney responded yes, that some of them do not work out. There is a probationary period and we want to weed that out at the front end rather than call in sick and have a problem on your hands.
Mrs. Bolus pointed out that this should be on our list of vacancies. It is very important, we should ask about the police department too.
Mr. Martin stated that he thinks that is a great point. When they talk about the protracted time it takes to bring somebody on. The academy only operates three times a year, so if you select somebody, you have to wait for the next academy session to put them in. It is not just HHC, it is other agencies, and you need a full list of a certain number of people for the academy to actually occur. It is difficult, but we will put it on the QA.
Mr. Page stated that it is a test, but it is a training period that you provide. Mr. Sweeney explained that after you go through the test process and you are selected as a candidate and Bellevue hires you, and so do the other facilities, they go through the same process. Then at some point, when there is enough vacancies filled, they go into an academy class, which is six weeks, plus an additional week for specific HHC training.
Mr. Page added that the training has a certain value to other employers. Mr. Sweeny said yes.
Mr. Page asked if you can get some kind of commitment from candidates for whom you provide training that they continue working for you for a year or something? Mr. Sweeney said that they all say they will.
Mr. Page asked if you can make it stick? Mr. Russo responded that they are collectively bargained, and any additional requirements we have to pose, we have to bargain with the unions.
Mr. Leon said that it should be noted that we have our own specific test for HHC, and there is also a citywide exam as well so we prefer those who are taking our test remain with us, but unfortunately, as Mr. Sweeney said that does not always happen, so we have to bargain, deal with other agencies.
Mr. Bolus asked how much does academy cost? To which Mr. Leon answered that prices varies depending on the number of candidates that we have. They do a per-person per number of days and then a proposal is sent. The proposal is looked at very carefully based on a number we have, it is anywhere from $50,000 to $80,000 per class.
Mr. Page asked what the cost of one of those positions is. Mr. Sweeny said that is somewhere in the high $30s, after a few years it goes up to $42.
Mr. Martin said that we have found is that the training they receive at the academy is very generic because they want to make it really applicable to all City agencies so Mr. Leon has added HHC-specific training because we have some unique situations within HHC that our hospital police have to refer to.
Mrs. Bolus asked if they are on salary from day one. To which Mr. Sweeny responded that as soon as they step into the academy. Bellevue folks are paid by Bellevue. Some of the directors and I have talked about perhaps maybe doing more of our own type of academy so we could have that HHC influence from the very beginning.
Mrs. Bolus asked if they would be certified and will this education then go from whatever hospital to hospital? Mr.
Sweeney responded yes. Then Mr. Bolus asked if they would be paid a different salary at some places or the same salary? Mr. Sweeny said that within HHC it is all the same. People do transfer from different facilities.
Mr. Page asked if they would see value in trying to run this resource more broadly than just hospital to hospital. Mr.
Sweeney responded yes.
Mrs. Bolus asked if there is any value in centralizing it. Mr. Alexander answered that there are some differences from facility to facility, there are some cultural things. Some of the basics of how you approach a patient and things like that would be the same, but there is a little bit of a learning going from Kings to Bellevue to Elmhurst.
Mr. Telano stated that he had additional comments related to Bellevue. There was licenses and certifications that we could not locate, and as a result we could not confirm that the security officers, the special officers and the watch persons, were properly trained or that they were authorized to perform the job that they were in.
Mr. Sweeney stated that they used to have a notification process and is not sure where that fell off. Locally it was not part of our responsibility to keep track of that, but the issue came up when the auditors were there and frankly I did not know the answer, so we started looking into it. The special officers are 100% compliant. It took us a while to track down the certification for about 11 of them, we verified they had certification. The watch persons’ licensing, we had one person who was not up to date and they were previously relieved of duty until they get their certification back, so that is 99% personnel compliance. I think it was more of a bookkeeping error than actually certification.
Mr. Telano moved on to page six. We found confiscated patient items that are deemed harmful to patients or others that were not being properly disposed of in a proper period of time. There were no guns, but there were knives and screwdrivers.
Mr. Sweeney said that that is a challenge for us. We have had some historical issues with what is valuable to me might be different to you. The patients come in with items that we do not want them to have, and typically it is when they enter our CPEP. We do not want to give it back to them because it is something that they can hurt themselves with or somebody else regardless of whether they have been treated and released. In doing that they ended up with a collection, we revamped that process; we have a couple of things to iron out as well with the sharp objects. A lot of the stuff we will discard if it is obvious it is just garbage and dangerous, but the stuff that is dangerous and may not be garbage maybe somebody’s personal property we hang on to. We are going to transfer that stuff over to our property office for disposal so that it is all documented. Some of the stuff we had around is because we do use it for training purposes to show new coming officers what they might see out there as far as taking stuff off, but we sort of cleaned that up as well.
Mr. Telano continued by stating that during the course of the audit there was the lack of use of the HHC custom-built Hospital Police Incident Reporting system and asked them if they were now utilizing it.
Mr. Sweeney responded yes, that that was bad timing. We had just gotten it and there was a bit of a learning curve. A lot of folks were not used to using the Group-wise, so we have been training them and it is working much better.
Mr. Telano moved on to the next audit regarding nursing employment agencies at Coler and Bellevue and stated that it should be noted that this was not an audit as much as it was a request by the Chief Financial Officers at both sites. He
asked the representatives to approach the table and introduce themselves. They introduced themselves as follows:
Aaron Cohen, Chief Financial Officer of the South Manhattan Network; Robert Hughes, Senor Executive Director of Coler and Henry J. Carter; Manuela Brito, Chief Financial Officer of Coler and Carter; Leah Matias, Chief Nurse of Coler and Carter.
Mr. Telano stated that the objective of this audit was to ascertain if nurses who work for both HHC and employment agencies, they are called recycled nurses, were not being paid by both parties for the same hours worked. At Coler we tested 12 recycled nurses and we found that 10 were paid for overlapping hours, and at Bellevue we reviewed about 50% of the sample. There were over 80 recycled nurses, we reviewed 43 and there were only 6 in which they were double paid. We also found some issues in which log sheets were missing and one or two instances in which people were overpaid for a certain number of hours.
Mr. Cohen said that we became aware that there problems and we called Mr. Telano and his folks to come in and they did a very thorough review. Some of the problems that we had discovered they obviously agreed with, and they made a series of recommendations and we agreed with all of the recommendations that they made and we are in the process of implementing all the recommendations. We are very pleased, if one can be pleased about something like this, in terms of them coming in and sort of reinforcing what we saw was happening and coming up with a very useful, helpful report, and we also appreciate the comment at the very end of the audit that the Nursing Director has been very helpful in making changes to make sure that this does not happen. We should mention that this is a consolidated function. Payroll is a consolidated function in the South Manhattan Network. We are physically located at Bellevue for all of the facilities in the network. The timekeepers are at the individual facilities.
Mr. Hughes commented that Mr. Cohen summed it up as far as how this unfolded and Mr. Telano’s office had been requested to come in. We have locally at Coler and Carter put a moratorium on using recycled nurses to do overtime.
They are not able to do agency, as a way to prevent this from recurring again until we can take the time and put into place a process, a system that will give us the safeguards to prevent this type of abuse from happening again.
Mrs. Bolus said that the one I have the most problem with was the Bellevue nurse who was suspended without pay and yet actually worked that day – could not understand that one.
Mr. Cohen said that it is a significant problem, and we have put things in place with Nursing so that it cannot happen again.
Mr. Telano continued with the last audit which is at Coler, Employee Salary Changes. Overall the findings have to do with record-keeping deficiencies and a lack of a verification process, and as a result, employees were sometimes overpaid or underpaid and sometimes when they were doubled paid, it was not reversed on a timely basis. We also found some inefficiencies in the manner in which they enter items into PeopleSoft, and we also noted that personnel requisition forms were not always fully approved by the required individuals.
Mr. Cohen stated that the first finding has to do with duplicate payments of employees and it is a little bit misleading.
When an employee first comes on to the payroll system, sometimes it takes a few payroll cycles, and as a result, we issue advanced checks. What is supposed to happen is once a person gets on payroll, you are supposed to eventually deduct what they have already been paid. In this case that was not happening as timely as it should have been happening. Eventually it was, it is not that it does not get done. It just should be done sooner as opposed to later. The other issue relates to the fact that there were some errors made, and the recommendation by Internal Audits is that we use a scanner; we have a scanner at Bellevue, but not at Coler. Three years ago we requested from the Contract Review Committee that we wanted additional scanners and we were turned down twice. We will bring Mr.