In a report released today, State Auditor Marion Higa was critical of the Emergency Medical Services and Injury Prevention System Branch, which is responsible for overseeing $30 million worth of state contracted services for ambulance service in each county.

Higa said the branch, which is part of the state Department of Health, failed to adequately administer the contracts and that led to the inappropriate use of state money and the possibility that services were not provided effectively or efficiently.

Higa also said a single individual in the 12-person staff had created so much stress among co-workers that several were taking unpaid leave to avoid working with the individual.

"We did observe what we would consider unprofessional behavior, what some could consider fearsome behavior," Higa said today. "And a great deal of tension."

Workers told her investigators that they felt their fears were not being taken seriously by health department officials. She said they had complained about "a near physical altercation" between two workers, arguments and repeated shoving of furniture.

"It's been an ongoing thing," she said.

State health director Bruce Anderson said the audit raised several legitimate issues, but stressed that none of the complaints had affected ambulance service to victims of emergencies.

"The problems the auditor identified have to do with fiscal accountability and not with the quality of ambulance service provided to the public," he said today. "I think we have one of best and most responsive ambulance services anywhere."

Improved contract management is warranted, he said.

Anderson said concerns for workplace violence have been and will continue to be addressed. Since audit investigators spent time with the program in the spring, mediators from the University of Hawai'i Program for Conflict Resolution have worked with the staff and everyone had completed an anger management program, Anderson said.

"We have done all we can to address the issue," he said. "I believe there is no continuing threat of workplace violence in the program."

Higa said that nearly $1.4 million went uncollected by the state during Fiscal Year 2000-01 because of lax controls on billing for emergency services.

"This loss is directly related to the branch's failure to adequately monitor or enforce its contracts for ambulance services, failure to follow proper billing and collection procedures and failure to monitor the work performance of some branch personnel," Higa said in her audit.

Anderson said that conclusion was not based on "verifiable data."

"The fact is, the program manager does monitor the billings and I think the problem here was more of documentation," Anderson said. "The program manager didn't document this. Perhaps she needs to sign off on the bills or somehow document better what the process is."