Security System at Hospitals Draws Scrutiny
NY Times , 2004-04-22 10:55

New York City's 11 public hospitals have no common security system, no uniform method of screening visitors or restricting their access to certain wards of a hospital building. Background checks on new employees can vary widely from one institution to another.

In fact, despite the employment of its own 850-member police force, and even after years of sporadic, sometimes deadly violence across the city's sprawling public health care network, the municipal hospitals have put in place relatively few systemwide security measures.

Hospital officials say the hospitals and the more than 100 community clinics, diagnostic centers and nursing homes in the system share security concerns every other month, at meetings of the major facilities' security directors. But the officials acknowledge that the system leaves to each institution the decision on how and whether to disclose its problems.

The holes in hospital security have been painfully evident this month, first when a 13-year-old girl was raped in the pediatric ward of Bellevue Hospital Center, in Manhattan, then days later when a Bellevue patient-care assistant with a criminal record was arrested on charges of selling cocaine and guns at the hospital.

Over the years, such problems have not been restricted to Bellevue or to public hospitals. In 1999, a visitor to Victory Memorial Hospital, a private institution in Dyker Heights, Brooklyn, slashed his father's throat and beat another patient to death with a hammer. And in 1998, a surgeon at Lutheran Medical Center, in Sunset Park, Brooklyn, was stabbed four times in an elevator soon after he withdrew money from an automated teller machine.

But officials at the Health and Hospitals Corporation, which runs the city system, acknowledge that because their institutions are often in neighborhoods where crime is more prevalent and because they serve a clientele that includes inmates from city jails and patients with severe mental illnesses, they are more likely to have to contend with crime.

Dr. Benjamin K. Chu, the president of the Health and Hospitals Corporation, defended the system's security procedures. "I think we do a very good job, considering the challenge," he said. But he added that the agency has waged a constant struggle to find the right balance between the need of the public and a vast array of medical professionals to have access to its centers and the desire to keep the hospital hallways secure.

"If we wanted to lock down the facilities, it would be a much easier job,'' Dr. Chu said in an interview last week. "But you can't really do that in a hospital setting. And you wouldn't want to.''

Mayor Michael R. Bloomberg agrees. "There's a limit to how much security you can provide," Mr. Bloomberg said at a press conference yesterday. "You just can't have a security guard every two feet on every floor of every hospital. I think we clearly can do a better job.'' He added that Dr. Chu "is working with the Police Department to try to find ways to do a better job."

Public hospitals in New York City are already like small cities. Roughly 100,000 patients come through their doors each week for outpatient procedures, and 20,000 more visit their emergency rooms, often in the company of family members or friends. The system employs some 35,000 people. About 5,500 patients occupy hospital beds throughout the system each day, with thousands more people coming to visit those patients.

Corporate offices or government buildings can install metal detectors or have armed guards patrolling the premises. But medical professionals say a hospital needs to preserve its fundamental sense of refuge and care.

"The challenge is we have to let you in, and we want to control where you go, and we want to do this without making you feel like you're in a prison,'' said Frank Taormina, the president of the Metropolitan Healthcare Security and Safety Directors Association, a group of security officials from private and municipal hospitals.

The majority of violent or disruptive incidents occur in the city's emergency rooms, and the New York Police Department is frequently called to assist hospital security officers. In 2003, the department was called about 434 occurrences at Jacobi Medical Center, in the Pelham Gardens section of the Bronx. Eighteen of those involved criminal activity, including two that were serious. The police similarly responded to 894 calls last year at Kings County Hospital Center in Prospect-Lefferts Gardens, Brooklyn, including 21 for crimes, eight of them serious. In the last 12 months, police officers were called to Bellevue 522 times, 12 for criminal activity.

But city hospitals do not merely wait until there is an attack or other crime to put new security measures into place, Dr. Chu said. Well before the most recent instances at Bellevue, officials at Lincoln Medical and Mental Health Center in the South Bronx began testing a system that takes a picture of every visitor receiving a pass that gives access to patient wards.

"If the cameras work at Lincoln, I think we'll apply that across the system,'' Dr. Chu said.

After the 9/11 attack, most city hospitals increased the use of surveillance cameras in and around their facilities. Similarly, some increased their use of key cards - special identification cards that are needed to unlock doors providing access from one area of the hospital to another. And some put in place color-coded visitor passes, which should, in theory, make it easier to spot visitors who wander into areas where they don't belong.

The problem with those systems is that patients and visitors frequently have to go to many different wards, said Susan C. Waltman, a senior vice president of the Greater New York Hospital Association. "They need to be able to move around,'' she said, "and if you slow that down, you create a big complication for us as well as for the people who need care.''

Other security measures are applied inconsistently across the city's public health care system. Background checks of new employees are supposed to be conducted by human resource directors at each hospital, but no one in the central administration verifies that they have been done.

After the arrest this month of the Bellevue employee with a criminal record, Dr. Chu ordered administrators to begin reviewing the background checks on employees hired in 2002 or earlier. He also appointed a new security overseer at Bellevue last week and hired an outside consultant to review procedures there.

But there is no central administrator focused solely on security across the entire city system, a policy that Dr. Chu defended in an interview. He acknowledged that decisions about even the most basic practices, like how to screen hospital visitors, are left to each facility. "The practices are probably variable,'' Dr. Chu said. But he added that there is a reason to decentralize decisions about security procedures. "Each facility has local relationships with the N.Y.P.D. and local relations with the community that they have to pay attention to,'' he said.

Some of the hospital security officers are less certain of that. At a press conference at Bellevue yesterday, officials of Teamsters Local 237, the union representing hospital security officers, called for the hiring of more officers and better training.

Four years ago, the Giuliani administration sought to replace the hospital police force with private security guards, a move it claimed would save the Health and Hospitals Corporation $10 million annually. The plan was dropped in 2001 after stiff opposition from the union and the City Council.

The hospital officers have previously pushed legislators in Albany for the right to carry weapons, a measure that is opposed by the hospital administration.

More basic reforms of the hospital police system have also been rejected. Having its own security force is not unique to the city hospital system; the Department of Education also employs a dedicated force of school safety officers.

But since 1999, the school officers have been part of the New York Police Department. Unlike the school officers, hospital safety officers are hired individually by each institution, and there is no coordination among them in the deployment or oversight of the officers.

Since the recent incidents at Bellevue, the Police Department has begun "a very, very labor-intensive job'' assessing Bellevue's security efforts, said Raymond W. Kelly, the police commissioner. Some preliminary recommendations have already been made, including improving the deployment of guards, ensuring that construction workers are properly identified and employing measures as simple as making sure that locks work.

The department will also conduct preliminary reviews at all of the other city hospitals to determine if more comprehensive assessments are needed. However, Dr. Chu said he doubted that all of them needed the top-to-bottom review being undertaken by Bellevue.