Cook County officials have long promised to rein in runaway overtime costs, but payroll records show that more than 100 county workers were each paid $50,000 or more in overtime last year, with one industrious nurse pulling down $187,500 in extra pay.
Oak Forest Hospital nurse Usha Patel, who earned the overtime on top of her regular $92,700 salary, also led county employees in overtime pay in 1996, when the Tribune last totaled up the tab.
Since then, the annual county government bill for worker overtime has ballooned from $32 million to $76.7 million.
Patel's total pay package meant she earned more last year than most doctors who work for county medical facilities. Her paycheck also was a lot fatter than the one for her ultimate boss, Cook County Board President John Stroger, whose annual salary is $170,000.
When she wasn't on vacation or taking personal days, according to hospital officials, Patel, 57, was working 16-hour shifts.
Patel declined to comment.
Stroger, who learned Friday about Patel's 2,746 hours of overtime in 2004, said he was concerned about her grueling workload.
"It's not legally criminal, but it's criminal," said Stroger, referring to Patel's double shifts. "She loses her effectiveness at some point."
Stroger said no nurse should work 16 hours a day continuously, and he has instructed the chief of the Bureau of Health Services to make changes and to curb overtime.
Two of Patel's fellow nurses at Oak Forest Hospital also made more than $100,000 in overtime in 2004, according to county payroll records.
The records show that 57 county workers, most but not all in health service jobs, doubled their salaries thanks to overtime pay, including six security guards and two ward clerks at Stroger Hospital, and a janitor at Provident Hospital whose total income reached $80,000.
County government officials for years have bemoaned the amount they pay out in overtime, yet they have failed to get the spending under control.
Excessive and unexpected overtime costs strain the county's budget because employees are typically paid 1 1/2 times their normal hourly rate.
The overtime expenses are highest in the Bureau of Health Services. The county's medical system, which serves as a safety net for the poor and uninsured, runs Stroger, Oak Forest and Provident Hospitals, a network of neighborhood clinics and the Department of Public Health.
Last year, overtime accounted for more than 10 percent of the more than $500 million in wages earned by workers in the health bureau.
Nursing shortage blamed
Officials often pin some of the blame for high overtime costs on the nation's chronic nursing shortage. At the same time, the county spends more than $9 million a year on temporary workers to supplement its staff.
The county has struggled in recent years to stave off budget deficits, adding to pressure to rein in overtime pay. In 2004, overtime expenses accounted for 6 percent of the county's total $1.35 billion payroll for its 26,000 employees.
"The numbers themselves point to a real need for the county government to develop and publish a policy related to overtime and how it's awarded," said Laurence Msall, president of the Civic Federation, a local government watchdog group.
The county routinely underbudgets for overtime, only to later transfer money earmarked for thousands of unfilled jobs, Msall said. "It raises questions about the county's staffing practices. Either they are not appropriately budgeting for positions ... or there's some technical shortage in that field and they're overworking the people they do have."
Frankie Nelson, a custodian supervisor at Provident Hospital, makes a little more than $35,000 a year in regular pay. But 2004, she said, was a good year. Records show Nelson supplemented her salary with almost $45,000 in overtime.
"I worked around the clock--16 hours a day, 7 days a week," Nelson said. "My husband was getting really upset. I was spending more time at the hospital than with him. He said I should have married the hospital."
Nelson said a chronic shortage of janitorial supervisors in 2004, when one supervisor was off because of major surgery and two others had extended illnesses, led to the huge amount of overtime she racked up. But the previous year, she made almost as much in overtime, $44,587.
Six figures for security officer
One security officer at Stroger Hospital, Edwin Hernandez, made more than $123,000 last year, including more than $76,000 in overtime, payroll records show.
"Why the interest in me and my overtime?" Hernandez asked. "Why don't you go after the doctors? They make twice what I make."
In 1996, only 13 county workers made more than $50,000 in overtime pay, compared with 103 workers last year.
Oak Forest Hospital nurse Patel was the overtime leader in 1996, too, raking in an extra $73,000 above her regular pay.
Patel declined to comment about her 2004 workload. But when asked eight years ago about her hours, she replied: "I don't keep track of the time I work. I have the stamina to work, and I love my work."
John Karebian, associate executive director of the Illinois Nurses Association, said there are no federal or state regulations limiting the hours nurses can voluntarily work.
Though unfamiliar with Patel's specific circumstances, Karebian said that generally nurses work extra hours because they are concerned about patient care and because of frequent nursing shortages.
"They're not doing it for the money, they're doing it because somebody has to pick up those chips," Karebian said. He said his organization supports placing guidelines on overtime when mandated by employers, adding that nurses know best when they are fatigued.
`Clearly there's a problem'
Cook County Commissioner Gregg Goslin (R-Glenview) said he understands staffing problems caused by the nursing shortage. Still, Goslin said in some cases the overtime paid by the county last year was excessive, especially considering the high number of workers who more than doubled their wages.
"Clearly there's a problem," he said. "There's only so many hours in a day somebody can work. I think those kinds of cases are at the extreme end of the spectrum, but that's troublesome."
Commissioner Larry Suffredin (D-Evanston) said that overtime payments are a continuing financial challenge confronting the county.
"There are significant abuses of overtime because we do not have good management controls to alert managers when they're violating, significantly, their budgets with overtime," Suffredin said.
Suffredin predicted that budget troubles would worsen next year, saying county politicians have failed to break the financial cycle of an inefficient government.
"To survive in the future, we're going to have to be extremely efficient," he said. "The standard of county work has not been about efficiencies, but rather to carry on as in prior generations."
Overtime costs have not been the only challenge for county officials as taxpayers beg for tax relief. Earlier this year, the Tribune reported that 1 1/2 years after Stroger ordered a hiring freeze--exempting only critical public health and safety jobs--the county added 2,700 workers, or about 10 percent of the payroll.
Many of the new hires were doctors, nurses and jail guards, but county officials also found jobs for their relatives and the politically connected. Stroger hired two administrative assistants, a $59,000-a-year human resources aide and a $78,000-a-year special events coordinator, among others.
OT cost jumps at jail
Though the health bureau accounted for about 70 percent of all overtime dollars paid to county workers last year, records show that other departments have significant overtime costs.
Overtime at the Cook County Jail grew from $2.4 million in 2002 to $7.4 million last year. According to payroll records, 25 correctional officers made at least $25,000 each in overtime in 2004.
Sheriff Michael Sheahan has complained for years that the jail is understaffed, a problem officials are addressing in the current budget.
Stroger said overtime expenses, particularly at the health bureau, have long been a concern for him.
In fact, Stroger said one of the first things he discussed with Dr. Daniel Winship, who replaced Ruth Rothstein as the bureau's chief last year, was controlling overtime costs.
Stroger said the county was working to cut overtime expenses, in part, by recruiting additional nurses. The county last year entered into an agreement with City Colleges to help train nurses who would then work for the county.
Winship agreed that the nursing shortage must be alleviated but said nurses like Patel, an advanced practice nurse, should be applauded for their dedication.
Patel is a highly skilled nurse "who is always willing to step up and take another shift when the requirement is there, frequently at the last minute when no one else wants to do it," Winship said.
Limiting the hours a nurse may voluntarily work is an issue that would be subject to union negotiations. Winship said he has spoken with county labor negotiators about raising the issue during contract bargaining.
In the last 30 days, the health bureau has put in place stringent new rules designed to reduce overtime hours, Winship said. While those rules are being refined, each institution must now stay within its budgeted overtime amount, he said.
"We're working real hard on it," Winship said. "We're making some progress here."