The vetting of allegations of misconduct at the Hawaii State Hospital by the state Senate Special Investigative Committee continued on Wednesday with the questioning of a nursing office clerk whose job is to fill vacancies when staff call in sick and two psychiatric technicians who have been assaulted by patients.

The committee, which has subpoena power, has been holding briefings to hear from witnesses to try to discern whether supervisors have knowingly put hospital workers at risk of being assaulted by patients, which happens at a rate of about once every three days, according to the Department of Health.

Using a calendar propped up on an easel, nursing office clerk Debbie Ono demonstrated for senators how employees "game the system" by taking overtime shifts on their days off and calling in sick on scheduled work days.

The six workers with the most overtime hours, however, are not abusing the sick-leave procedure, Ono said. She said they are able to work so much overtime because too many people call in sick. Ono said workers get 14 hours of sick leave per month that can accumulate over time.

Lawmakers have expressed concern that safety has been an issue at the hospital because it’s short-staffed. 

"Safeguards need to be put in place to prevent employees from gaming the system," Sen. Clayton Hee, chairman of the Senate Judiciary Committee and co-chairman of the investigation committee, said after the hearing. "Now if this is being done with the knowledge and consent of the administration, then we have bigger issues."

Ono, testifying under oath, also described "frequent" cases — two to three times per week — in which workers seem to game the system in pairs. A worker will call in asking to work overtime, she explained, followed by another worker calling in sick.

"And then person No. 1 will call back not too long after that and say, ‘Oh, do you have something now?’" she added.

When Hee asked Ono whether she has brought her concerns to the attention of her supervisor, she told the committee she has, but that she hasn’t seen any permanent changes in behavior. She estimated between 20 to 25 workers seemingly abuse sick leave.

Health Director Dr. Linda Rosen took detailed notes during the hearing.

"I’m definitely concerned about employee safety and I’m trying to, as the new director, learn as much as I can about what is going on and what we can do to improve safety for employees," she said afterward in a phone interview. 

Hee estimated the committee is more than halfway through its investigation, and that next on its agenda will be to further examine concerns regarding the workers compensation system. He said he anticipates ultimately recommending structural changes at the hospital, such as a shift to being a forensic facility — "a facility for the most dangerous mentally ill population."

"To get to that we need to gather more information, but I think it’s a no-brainer at this point," he said.

The committee also heard from two psychiatric technicians who were injured by patients — one of whom might have been retaliated against for raising concerns regarding hospital working conditions.

Kalford Keanu told senators under oath that he was investigated by the state attorney general’s office for two incidents he had with a violent patient in October 2013. Keanu said he was reprimanded by his supervisors and told to attend an anger management workshop despite being exonerated in the attorney general’s report, which he obtained about four months after he was reprimanded and transferred to another unit.

"I feel that I was lied to," he told senators.

Hee suggested in January when the investigation began that based on the evidence he had seen, there is a "hostile workplace environment" at the hospital.

The state Ethics Commission has also agreed to open an investigation into nepotism at the hospital.