During an investigative committee hearing Wednesday, the senators peppered the hospital’s acting administrator William Elliott with questions about hiring practices and employee relationships at the facility.
What they found, according to Green, was both unethical and “disturbing.”
“I learned that there is a significant nepotism problem over at the State Hospital,” Green said after the hearing. “I think they need to get their house in order.”
Green and Hee began their investigation after hospital workers came forward saying they were the victims of severe patient assaults, and that the state was ignoring their concerns.
The workers also brought forth allegations of nepotism, retaliation and overtime abuse.
Senators on Wednesday asked whether Elliott knew exactly how many in-laws and family members of employees had been hired to work inside the mental health hospital and if procedures meant to stop favoritism had been followed.
The senators compiled employment data from the Department of Health that showed that at least eight staffers — some in supervisory roles — had anywhere from three to six family members who were also employed at the facility.
If the senators are correct, there are between 24 and 48 employees from eight families working at a hospital with about 600 employees.
During the hearing, Hee specifically homed in on Emma Evans, an associate chief nurse with several family members as hospital colleagues. Evans also helped pick selection committees for hiring.
Employees are expected to recuse themselves from the hiring process when it involves relatives, but Hee asked Elliott whether she would be surprised to hear that wasn’t always the case.
“If I said to you that she (Emma Evans) did in fact have a role in hiring one or more of those individuals would you be surprised?” Hee asked.
“Given what I’ve found since we started looking, nothing would surprise me,” Elliott responded. “But I would be a little surprised, yes sir, because I expect people in upper level positions to recuse themselves.”
It wasn’t the only time during his testimony that Elliott conceded that he’s no longer astonished by what he’s uncovered since the Senate launched its investigation into the State Hospital.
He reiterated the point during similar questioning about the recusal process, adding that he would also be “disappointed.”
If someone is caught violating the hospital’s hiring policies, Elliott said, that person would be put through the proper disciplinary procedures.
The names of many of the employees were kept confidential during Wednesday’s hearing because of interference from the Hawaii Attorney General’s Office.
Supervising Deputy Attorney General Jim Halvorson, who’s representing Elliott, interrupted the acting administrator’s testimony to say he was barred from talking about specific employee matters because certain personnel information is protected under the state’s public records law.
“If you want this information we’re more than glad to share that with the committee, but I think that should be done in executive session,” Halvorson said, suggesting that senators go behind close doors to continue the discussion.
“The committee is still entitled to the information. You’re a duly appointed Senate committee, you’re entitled to that information. We just don’t want to (release the information) in public.”
This seemed to surprise Hee, who said he fully intended to release the names of hospital employees who were related to one another.
Hee also said after the hearing that Senate attorney Richard Wada disagreed with Halvorson’s interpretation of the matter and that he plans to get clarification from the Office of Information Practices.
“Regardless of the attorney general’s objections we’ll still be pursuing this thing,” Hee said after the hearing. “The public has a right know.”
Hee added that there’s “no question” in his mind that nepotism is a problem at the State Hospital, saying workers continue to highlight the issue while administrators fail to acknowledge it.
“It appears nobody is taking responsibility for the actions of those being hired at the Hawaii State Hospital,” Hee said. “We’ll get to the bottom of it. We’re still setting the table, so to speak.”
DOH Director Linda Rosen defended the State Hospital’s procedures after the hearing, saying she doesn’t find the number of family members working at the State Hospital to be particularly alarming and that she hasn’t found any evidence to indicate wrongdoing.
Kaneohe is a small community, she said, so there’s a smaller pool of candidates to pull from who live nearby. Rosen also noted that it’s not illegal for family members to work in the same facility.
In fact, she said it’s quite normal for someone’s son or daughter to follow in the footsteps of a parent or other relative when it comes to choosing a career.
“Just because people are related doesn’t mean there was favoritism or preferential treatment,” Rosen said.
The DOH director also addressed concerns raised by senators that heavy reliance on overtime may have resulted in violence at the State Hospital due to employees being so worn out that they weren’t fully responsive to threatening situations.
The investigative panel pounced on the overtime issue during a March 28 hearing. At that time, officials said the hospital spent more than $2 million a year on overtime and that some employees worked in excess of 1,000 hours of overtime a year.
But Rosen defended the hospital’s overtime rate, saying it’s needed to provide adequate floor staff at the hospital, which operates 24 hours a day and has a large number of patients who are admitted through the criminal justice system.
Overtime also doesn’t appear to a contributing factor to the violence that’s been taking place at the hospital, Rosen said.
She explained that she analyzed the top 10 overtime users at the hospital and discovered that they were working an average of 20 extra hours per week, which she noted was less than the 80 hours per week that some residency programs are capped at.
“I see the overtime as a necessity to maintain staff safety,” she said.
Wednesday’s hearing also brought another revelation: The man who has been in charge of the hospital since March 2013 does not have some formal qualifications required for the job.
Elliott was appointed as the acting administrator by Mark Fridovich, the adult mental health administrator for DOH, who is also Elliott’s predecessor. But Elliott acknowledged Wednesday that he did not meet the minimum qualifications for the job, at least as they related to education.
According to the job description, the state hospital’s acting administrator should have a masters or doctorate degree in an area such as psychology, nursing, social work or hospital administration.
Elliott, who spent 28 years in submarine service in the Navy, has a bachelors degree in management. He also has nearly 20 years experience working as the associate director for administrative and support services at the hospital, a job he still performs today.
Although Hee questioned Elliott extensively about his qualifications for the job, Elliott said he was probably chosen for the position based on his experience at the hospital.
“It didn’t dawn on me that I did not meet the minimum qualifications,” Elliott told the panel. “I also had been looking to apply for the position… I had been interviewed by somebody (who must have) determined I had met the minimum qualifications.”
The Senate panel plans to reconvene on April 30, with Fridovich scheduled to testify under oath.
Hee has publicly admonished Fridovich for downplaying the severity of assaults on hospital staffers.
The senator even addressed Fridovich, who was looking on Wednesday, telling him he should soon be prepared to respond to many of the same questions Elliott faced and that the panel will expect clear answers.
“If there are ways we can sharpen up the answers it would be appreciated,” Hee told Fridovich. ”We’re trying to unravel a lot of what appears to be issues that have been … problematic.”