same the way with three modalities and then medical ste ste stenographers. those classifications that have the additional skills and modalities that we need, we emphasize those. we have a list right now of 25 people on the eligible list for their rad tech. so, again, we don't have a problem recruiting those and we do like to promote from within. so that's the structure that we've proposed. >> sheehy: so at the very bottom you have 40% that are registry, right? what is the cost of a registry person verses the cost of somebody who is on staff? per hour? >> so if you can remember when i started i talked about the fmla and all that. so we do have x-ray techs. unfortunately several of those x-ray techs are actually out on some type of family medical leave. last week

i got the green light to go ahead because we have a couple that are on ada. so i will be able to fill those positions. it's not -- like i mentioned, it's not that we don't have the bodies, it's what we are bringing in to supplement during that time when we do not have the body at work. so that body comes in the form of registry. so i just want to clarify that. when we think about it we don't have the amount of staffing but when you look at it collectively, you look at, well, i do have a lot of people on my staffing grid but they're not at work, they're off so 20% of my staff is out on fmla or some type of leave. so how do i get to take care of my patients with

20% of the staff not being there? then i bring in registry. the other pieces that working with ron and karen is how do i get a category to supplement that time. a lot of the times we don't know that people are going to go out on fmla. we have people on intermitten fmla out there. they can call out twice a week and they're not a part of my workforce. so those are the things that i don't think we factor into our discussions but this is the reality of the department operational needs. we do have people that are on my book so to speak but not present in any department. >> so she's going to answer the specific question on the cost. the advantage of promoting from within is that it gives our staff and the union members

opportunities. it does create sort of a continual churn rate at the bottom. susan has the numbers on the registry. >> it actually is less expensive for us to have registry. it comes out to $91 an hour versus $115 and some change for our own employees. of course that's not the direction we want to go. we want permanent civil service positions. it's a little more expensive for us because, you know, of the benefit structure that we have and the costs that are not salary. so it's -- so it's $115 for a city employee, $91 for a registry. >> sheehy: you pay the register $91 an hour per employee? >> this is ultrasound. >> so that's not for t the tecs that we were talking about? >> the techs only get half of

that. the company makes a profit off the top. >> sheehy: i've asked a ton of questions and i have my colleague and we need to hear from loretta johnson. >> supervisor stefani: there is a great presentation. i've learned a lot. i ran the city department for two years so i understand. i had different employees at those levels and i had, you know, situations where people were on fmla and positions that i can't fill because i have savings in my budget. i know that all city departments have that. i'm wondering too is this something that -- you know, we are in budget season right now, supervisor sheehy and i both sit on the large budget committee. is this something that's being discussed radio it -- right now

with the mayor's budget office. >> we are in a no new positions budget. so we have the staffing model to give additional money to those with the modalities to give us more flexibility but we are not adding staffing. >> supervisor stefani: what are the classifications? what are the classifications so i can take a look? >> i don't have those off memory. >> i do. so we have 2467s, 2468s, 2470s, we have 2424 which are lab aids. >> supervisor stefani: do you have new you couldn't feel? >> no, i would say -- you want to speak? >> we have five permanent

vacancies and we have a list so we can hire those. that dollar amount was 102 for a rad tech city employee and $75 for a registry. >> supervisor stefani: if you dent have the limitation of no new ft he saes, we are looking $139 million deficit that we are trying to solve for, what do you think would solve of those staffing issues in terms of the classifications? i know on cat 16, 17, it's not a permanent position, people don't get the same benefits. in your perfect world what would that solution look like to you and then realistically and everything? >> thank you for that question. my ideal world to be to get my staff on fmla back to work. >> how many?

>> i don't know all the numbers off the top. it worked out to be 19.7% of my staff. so if -- to get them back into work and then i would have a good staff as far as numbers are concerned, to continue with training and having that upward mobility in the department which is good because i think that is a wonderful thing as far as workforce development is concerned. then to make sure that our staffing grid is accurate. so one of the things that we weren't operating on when i started was a staffing grid. understanding at what time are your peak levels and things of that nature. so we've been able to with the input of all the leaders to look at that wholistically from above and below and then -- and to work through that. we have a really

phenomenal ehr system, that would be awesome. we are moving to epic. i'm still looking forward to that. a lot of the work that goes on behind the scenes i think epic will definitely be a cure or a remedy for that. so i think when i look at my ideal world that's what it would look like. i would have my team all present and accounted for. i would have upward mobility of training. i would have an ehr system that works really well, you know, from the time that a provider puts the consult in to the time the patient gets their scheduled appointment and come in for that. right now we have several different systems that don't work together. there's a lot of inefficiencies that are build in. so i would look at it that

way. i promise you once you have that and have all that in place it would look like when you call and you get your appointment the next day. you know, you have -- people can look at your labs so i would be able to see it all to know that, you know, this is the way to proceed. so that's how it would work well. then, again, working with finance and the hr team, you know, that when i know that there's an upcoming -- if someone tells me they're pregnant i know 9 or 10 months from now they will be out of my department. i would start to look ahead as to how i'm going to remedy that during that time. so, yeah, that would be it. >> supervisor stefani: i just have one more question. in the materials i reviewed the city's classification system has not stayed current with the changes in the industry and i'm wondering if you can walk me

through that. that's why i asked for the classifications just to understand what that looks like. >> say that again. >> supervisor stefani: the classification has not stayed current with the changes in the industry. >> isn't the industry. -- in the industry. so i came from the mercy industry from the midwest. there's a lot of things that -- how it works in the private sector does not go over into the public health sector. so it's not apples to apples. i had to learn that quickly. so where i see where there's some comparison, as far as a national standard we need to have a good ehr system. so we start with that. staffing -- a staffing model is what i

brought to my team and where i got that from was quite frankly my experience but also the advisory board that i used. the other pieces that we really didn't really pay attention to our data so if i have a staffing model that i have three people coming in at 7:00 or 7:30 but the height of my population is not coming in until later on in the day but now those people are going home so we had to look at our data more diligently. so that's one of the things that we've done here. go ahead. >> i'm sorry. the proposal that i mentioned that would provide for the 5 to 15% increasing wages that's been sitting on the table for a year does have new class backs.

>> supervisor stefani: okay. thanks. >> sheehy: should i hear from loretta johnson first? >> yes, please. >> sheehy: i just want to note that i get the 2.5% cut but these are jobs that make money. this is not the same as if you hired somebody and it comes out of the budget. you hire somebody, more money comes in. loretta, please. we are going to -- thank you. i appreciate your patience and your hard work as well. >> good afternoon, supervisors. i think we are getting a brief powerpoint presentation pulled up. my name is loretta johnson. i'm currently the lead technologist at san francisco general hospital. today we are going to talk about a little bit about our role at the hospital. you've been hearing some about understaffing, patient wait

times and talk about some solutions for recruitment and retention. you will hear today from my coworkers who are ste stenographsten stenographers and x-ray technologis technologists. i myself have been at the hospital since january of 2009. before we jump into the powerpoint i wanted to just talk about what happened to radiology in may of 2016. when the hospital expanded we greatly expanded our footprint as did many departments in the hospital. the expansion of those departments, particularly the operating room and the emergency department had a big impact on our department. we went from six ultrasound rooms

to nine from two ct scanners to four, from two mri scanners to three. the emergency department expanded capacity to 52 beds from 35 and we are now embedded within the emergency department. so 24 hours a day we staff a crew of people, x-ray techs and ct techs who work in the emergency department and the operating room also greatly expanded their capacity. all those areas we work in. one of the good things about the opening of the new hospital is for radiology it finally separated our out patients who walk in for their general x-rays and their routine mri and ct scans from inpatients who tend to be much sicker and emergency department patients where everybody used to come one place and kind of all wait in line for the same small number of rooms.

that's meant that we have to staff those different areas. in order to have out patients come to the old building, building 5 and inpatients and emergency room department patients come to the new equipment in building 25. we also have some out patients coming to building 25. the first slide we are going to look at is just a brief over view of the registry and over time use. just to highlight a couple of things. i know you already heard some statistics and seen some numbers. there are four classifications in discussion today that 2467, 2468, 2469 and 2470. the registry use for the calendar year 2017/2018 has been about 15.78ftes of registry use. like andrea said that's mostly been

in the -- one the general x-ray classification. since we moved our exam count has also gone up and the next slide is basically just an agate sum of all radiology exam counts. we've seen the biggest increases in volume in our department in competed tomography, the operating room, internationally radiology and general x-ray. again, all of those places are now -- all of those areas are now functioning in multiple places all at the same time. our wait time has been discussed. andrea discussed our tnaas, the third next available appointment. of concern is our

scheduliing cue that's reached very high proportions. so for example, right now there's 396 people waiting to have their ct exams scheduled. those are out patients who are coming from the neurology clinic, 1m, the richard fine clinic for mr i332. we have been able to recruit some stenographers. we've hired four new. they have been hired at step five and six of the ultrasound scale of a 7-step scale. we've held interviews for ct and mri over the last year and a half with either no qualified candidates

or the two candidates who were offered positions dekleclining positions at other hospitals with higher pay. the pay scale for ultrasound stenographers just briefly shows that particularly at the entry level we are $3.50 behind the next lower institution. our reliance on registry is a revolving wheel

of technologists coming in and out of our department. from the period of june 16th, 2016, to june 26th, 2017, nearly 20% was on registry because of the expansion into the new building. there has been an effort definitely on the part of the new radiology director to reduce reliance on registry and increase the civil service position. we are still using a great deal of over time and still using registry to meet the demands in the different places. there's improved patient care for patients. and to meet the needs of our radiology department patients. add an

extra step to recruit and retain people. to look into converting registry hours and over time hours into permanent civil service position and to create an internal per diem classification and stop the reliance on outside registry companies. many hospitals have this internal per diem classification. >> sheehy: we should probably head to public comment. anybody who would like to testify i have cards and i will call out names. on the right i have bob ivory

and then talib -- i'm sorry, i'm going to butcher your name, abu. allen ridge cooper. i'm just talking them in the order of my stack. holly johnson and mark rose. i have more but this is to get us started to people don't have to stand up forever. then you have two minutes, please. >> when he -- when we moved hospitals it's a beautiful unit. with all respect to they did expand the radiology department but when we went from the new

hospital. the hospital is running well over 110% capacity for the past 6 months. so somebody has to take care of these patients, both in the emergency department and in the department over staffed and understaffed. so we are here to take care of the patients of san francisco. we have a new beautiful hospital. we need to get the maximum added to hire the right people and put them in the right jobs. if i have a minute let me just say as a 35 year emergency department nurse i want to echo what andre said, i've seen gun violence and taken

care of gun violence and i hate guns. thank you for the service today. >> sheehy: next speaker. >> my name is talib. i'm a tech. the scanner creates a strong and visible magnetic field that's on 24/7. it does not turn off. it's always on. the field that i'm talking about is about 30,000 times stronger than the magnetic field of the earth. so imagine a magnet of that kind in this room. imagine that. it seems like a

hypothetical but it can turn into a tragedy. a 6-year-old boy died after an oxygen tank was brought in the room and it flew in and crushed the skull. this is real. here in the bay area a 17-year-old girl suffered a bun because the tech failed to remove something. in a hospital less than three miles away a doctor was pinned between a magnet and a bed that was brought in. these are all realful according to the american board of mri safety there are almost 7,000mri related accidents here a year in the united states. the sad part is 85% of those are avoidable. now what do we do? our accre t accrediting bodies created some guidelines that are considered the standard of care how we practice mri. guidelines say two techs per scanner. at the zuckerberg of san francisco

general we do not do that. we do not have the staff. we are stretched really thin and we work in a very high stress environment. all you got to do is pick up the phone, call ucsf. i've been to stanford. we are the only hospital -- >> [bell ringing] >> sheehy: thank you. next speaker, please. next speaker. >> hi. hi name is ellen ridgecooper and i've been a stenographer at the general for over 20 years. i would like to clarify that the 15% raise that they said was eligible for ultrasound is only one person is eligible for that raise on that. i've been a senior tech there for about 20 years. my salary is a step 7 out of 7. i've maxed out my salary ladder many, many years ago. when asked payroll to grant us more steps so we are competitive with other hospitals and the hospitals that were most closely related to

were ucsf and keizer, they have 12 steps. we already had preexisting salary ladder for the nurses that had 10 steps. we were declined. we are still on the seven steps. we've actually -- actually our four newest employees were hired at step five and six. we haven't been using one, two, three or four. so this means that within three years they max out on the salary ladder and will be making the same i do after 20 years. so we are currently about 15% behind other compatible hospitals with our kind of staffing and high pace. so why would you stay with us if all you could look forward to was a cost of living raise occasionally? we are just an on the job training center. registry and senior students stay with us to use their name, the zuckerberg name on their resume. i can't begin to count how many of these students and residenti registry people rotated through our hospital only to leave and

take high paying jobs somewhere else. we are a high level i trauma center. if you can work here you can work anywhere. is that a 2 minute bell? >> 30 seconds. >> one of our competitors called us to thank for the well trained candidate that they were about to hire that was trained at our facility. we ask our new techs that work on the on call discredit and this requires that you be able to be in the hospital within 10 minutes after your pager goes off. >> [bell ringing] >> thank you.

>> level one trauma center. it's highly respected in the we have the ucsf raidology and they've rin the textbooks in the field. they provide feedback for scans and they're he had skating the stenographer. this is why we're highly-skilled staff as well as students. after receiving the training,

people leave here to take better-paying jobs. leaves us short staffed and unlike extra we can't pull from x-ray or ctmr we're left short-staffed. so we hire and retrain. this is frustrating to us the doctors. they expect high level of skills and the bear is an expensive place to live. the s.f.g. need competitive salaries. i myself is a single person with a mortgage who commutes from oakland. why wouldn't i take a higher-paying jobs closer to home. we're advocating to take care of the employees who take care of the people of san francisco. we like to keep good employees and provide safe patient care. >> thank you. nnext speaker, please. >> hello there. i've been a raidology tech for 15 years and ctmri. san francisco general is a level

one trauma center. i've seen patients come, shot, stabbed, in a plane crash, even tiger attacks. you see it all there. working at sfch is like being on the front lines a lot of the time. we sometimes find ourselves in generation situations to help people who need it. unfortunately last year, i was punched in the face by a psyche patient who was violent with staff members in the past. on top of a stressful working environment, the city pays less than local hospitals. this leads to under staffing which inhir inhibits our abilito take care of patients. steed of the city paying a competitive wage they pay o.t. and out of state registry company to fill our ranks. a lot of these techs have very little experience and many of them are actually graduates from san francisco city college. since we cannot hire externally

at san francisco general, we're training techs and spray cat stan and interventional and mammography. this is a very time-consuming and expensive progress. after the techs get this training nothing keeps them from getting a better-paying job and better working environment. it takes a special type of person to work at general. for me and my co-workers behind me, it's not all about the money. we do it because we feel like we work in a place where we make a difference. we all help the people of san francisco. >> thank you. >> next speaker, please. >> while you are coming up i'll call ramsey omary. alice geese and wilson lee. >> i was wondering if the registry is offering an incentive with greater job

flexibility. it sounds like that is what people are looking for and they're receiving it in various ways. it may be detrimental to the operation of the organization, however. also, i wonder if stenographers can meet patients at home if they have preference, otherwise it sounds like the stenographer are loosing jobs 30% job reduction it sounds like. rather than hire near-term, can you provide greater education opportunity given that we're speaking of the profits center providing high value service, hopefully facility profit in higher incomes and possibly generating general higher tax revenue. would it be feasible to expand the raidology department at city college and yeah, i understand the courses there are personal and the public is paying for

this so, i would imagine placement referenced for impacted courses could go to exiting senior medical workers. since only 2% of patients are privately insured, where are the profits coming from? >> next speaker, please. >> hi, good afternoon. my name is talma and i started working at san francisco general hospital january of 2012. i began working as needed as an employee which allowed me to work for either six months or a thousand 40 hours, which came force. when i was terminated i began working as a registry. so i did this back and fourth for three years until i became a part-time employee. but during this time, i didn't pay into retirement nor did i get vacation pay. i stuck it out because i enjoyed

my time working as x-ray tech at sfgh. i loved working with our patient population. i have basic communication skills in spanish that allowed me to help like i was helping the hispanic population. i worked hard to be where i am in my career. today i work at interventional raidology as a technologist we cover vascular surgery, neuro i.r. and also body i.r. we use light you will extra sound and c.t. for imaging. i have compared earnings from my classmates who graduated at the same time as i and they are making $15 more per hour than i am. i work very hard but i can't even afford to live in the bay area. i commute with my kids from fair field every day to work in san francisco and nearly spent almost two hours driving back home every day. it's unfortunate that i have to

do that because i love working where i work and i don't want to look elsewhere. that might be the case eventually, thank you. >> next speaker, please. >> good afternoon. my name is nancy and i've been a technologist at the general for 28 years. currently, i'm the lead tech at the avon breast center where last year we performed over 8500 exams in our clinic and at 11 community clinics in the street. in our mobile van we detected 68 new cancers. in the last few years, two of our techs have retired. we've been unable to recruit any new experienced technologists and therefore, i have been open to training inexperienced technologists. we've trained three techs, two of which were registry techs.

each new tech requires about 40 hours of training just to do the save mammogram. all three techs are no longer working at san francisco general hospital. one left for a higher paying permanent job at stanford and another left to take a job with better pay after she got tired of waiting for us to offer her a permanent position and the third left ultrasound school in hopes of a career with better pay. he was informed a season technologist makes 12 and a half dollars more than a heck at zfgh. currently, we've been operating on the bar minute yum staffing. if someone is sick or on vacation we're short and both my supervisor and i will fill in to cover our gaps. we often times have to compete with c.t.s who are also very short for the one tech we can use but it's usually available

for a few hours here and there. we have one tech that is due to retire this year and we need additional tech positions with better compensation. thank you. >> thank you. i'd also like to call up daniel becker. emma gerard and david cannon. >> my name is ramsey. i'm a computer tem ography technologist on the graveyard shift. i run the c.t. scanner from 11:30 at night to 7:30 in the morning in the emergency department at san francisco general. our job requires us to be fast and accurate. we provide the images that help diagnose and treat the sickest, most injured patients. last week, we scanned three children who had fallen within 90 minutes. the first one had fallen from

his mother's lap after she had fallen asleep. the second one, had been shaken and dropped to the ground which her mother who was suffering from postpartum depression. the third one had fallen on to his head getting out of a parked car. in may of 2016, as you know, we all moved into a new hospital building. with that move, we doubled the number of c.t. scanners and we did not add a single new c.t. technologist. last year, we offered two outside candidates job in our c.t. department. both declined receiving higher offers at other facilities. from my memory i can remember at least four people from registry or the permanent staff leaving specifically for reasons of steveing another job offer or higher pair. not all of us can work here strictly for our dedication and

without considering additional money. >> hi, my name is alice. i live here in san francisco. i'm a diagnostic imaging tech one at sucker burg san francisco general where i have worked since october of 2004. my point is pride. we work for pride in our trauma center and service to the needy persons of our city. i would encourage you to support us in that to the point that i myself maxed out my step many years ago.

there's no further steps for me to go to and because i've worked for a number of years the people who are promoted from training are required to work weekends and i was able to no longer work weekends because i worked for a long time. you know, despite, colleagues leading for better offers, those of us that stay with the facility is because we love our city and we love the people we serve. and would ask you to continue that we can have great pride in our service to our needy and as

the best trauma center that you ever want to come to if you are in need for our services. if you yourself have an accident. thank you. >> thank you. next speaker, please. >> good afternoon, my name is wilson lee. i have been a tech just for three years. i have a c.t. technologist and also the raidology clinical instructor on behalf of city college of san francisco. i have actually been through the whole loop of going through the program myself. move of us techs at the raidology department have graduated from city college of san francisco and been in partnership for 40 years now. and i just want to bring up that i waited for three years, worked in the registry for three years and we have a permanent position. with the students we train, the time and money we spend training with the students and seeing them leave because we can't hire and retain them.

it's a issue and a problem. i know we just ended a discussion about gun violence and i just want to say that sometimes these registry people's that we hire they don't have the qualified skills. if we can be serving your kids, your family, your friends, and if we don't have the qualified people to handle this situation and get the proper diagnosis, you know, we might not be able to have the proper skills and the doctors won't have the proper information to give the care and heal with your family and friends. basically we really need to is it retain and i know you've heard that we've been training people within and we're taking people from x-ray but, at the same time, x-ray is getting reduced and we take people, we hire people from the registry but again, these registry folks might not have the proper skills to work at a level one trauma center. we hope you can support us with

the proper staffing and also the proper raises and wages to keep these people. >> thank you, next speaker, please. >> i'm here to speak in support of the raidology department. the department has suffered from inadequate staffing and also wages that are not competitive and this is effecting our members greatly. staff members are being hired and they leave for better opportunities after training. this is resulting in more people just coming and getting the training and leaving and even though the members are suffering the people that are really suffering are the patients. for a city that prides itself on

quality public services and good jobs this should be alarming. the union has been engaging with the city over this matter for a couple of years but the slow process has produced not a lot more than excuses and reasons why this is impossible for the city to fix so again, this is the patient that are suffering the most and we are asking for your help in fixing this problem. some of the ways is adding an extra step to the current series and by converting registry hours and overtime hour to permanent civil services for 17f.t.e.s and create an internal classification and for raidology techs and you wil ultrasound te. >> my name is jonas. i was a student in 2009 at sfgh

is 2067. we cover going to the patient room to do the x-rays and e.r., we have seven recess rooms and pod a and pod b, pod c, two of them have 20 rooms that we have to go through the patient room to prosecute form the x-rays. orth owe has out patient facility in the old building and since 2009, i graduated in 2012 and i was working as a tech for six months for 10-40 hours and i had to let go and come back for another six months. i've been doing that for a while. i was hired as category 13.

i was became permanent at the hospital. the past week we were just looking at the statistics of how many patients procedures we do per week. 2,332 and we're doing one. this is just x-ray only. 3,149. 807ctnr. my classmates are going to ucsf for better pay and wages so i will ask you to help us to better staffing and better wages for our staffing. >> thank you. >> thank you. >> next speaker, please. >> good afternoon.

my name is mondonaa. i've been with city and county of san francisco for 30 years. i currently am a charge shift for the swing shift in raidology. six or seven months after i started working in 1988, in 1989, we got the 50% raise and this is the historical situation that we have in raidology. we've always been below the industry. in 2004, again, you have to take drastic majors to be heard by the city of we are under raidology workers. the last director came from outside. he brought some new evidence and expertise to do the reclassification for us. we started that six years ago.

i've been trying to make people understand what we do as raidology and what is it that we need to have to be compared to other hospitals in the bay area. we got halfway there and they keep saying five, 10, 15%, 15% is only one percent is going to get 15% in ultrasound. the rest of us won't get anything. all those one and twos won't get a cent raise. this is not fair to the people that they work at a level one trauma center. we're not recognized for what we are doing, we also are not com pennated accordingly. with our new leadership and your help i hope we can fix this issue and put an end to this craziness. thank you so much. >> thank you, next speaker,

please. >> good afternoon, emma gerald with 1021. i wanted to go through a couple numbers with you. regarding recruitment and retention from 2013 to 2018, there was 54 dip ones trained from registry. 20 of those 54 were hired. 34 were lost. of the 20 that were hired, 13 were given dit2 training. which is the next level. of those 13, four left and six retired. i want to demonstrate in the turnover and retention rate in this classification is very low and this is one of the classifications we're asking for. for sten ography there was 10 trained and these folks were hired at step 5 or step 6 and

five were lost to go to other hospitals because they were offered more money. when you look eight situation when you need, if you can hire experienced folks that step five and step six and the pay scale only goes to seven, people are very dedicated to san francisco. they're dedicated to the patients. they're dedicated to the hospital. they're dedicated. level one trauma is an exciting place to work but sometimes you have to bring home the bacon and you have to do what you need to do for your family and that's what is happening here so what we're asking for is fair. what we're asking for is an extra step for one, two and three and we calculate this at 17s.f.e.s and create a classification which san industry standard skull find it

at any other hospital that does that and public or private that m.r.i. should be. >> can i ask a follow-up question. when you say convert it to 17s.t.e.s do you mean you no longer use the registry? >> yes. >> i wanted to make sure. >> thank you. >> next speaker, please. >> thank you for scheduling this hearing. like previous speakers, we've been struggling to fix this problem for years. and we feel like there's an opening and there's an opportunity to fix it and we want to fix it during this budget season. you have heard about the patients safety concerns that were raised. the wait times. someone from d.h.r. mentioned these folks are well paid. this is a highly competitive industry. other hospitals know each other. they recruit each other.

and they compete with kaiser and ucsf in this city and kaiser and ucsf pay way more money than san francisco general hospital. you just can't ignore that. they have to try to compete with kaiser and ucsf in order to run this department. you can't run a raidology department or hospital with 40% reliance on registry in the biggest group which is the basic raidology classification. it's unacceptable and shouldn't be happening. and by the way, your questions, the people that are making the money here are the companies, not the employees. they are getting rich off of this problem. management is stalling. they have no plan on how to fix this. yes, steve from the department of human resources who did this survey and analysis, he says there's no crisis. we're just loosing registry people. yeah, buffet constant revolving

door registry people and you can't run this hospital that way. the city is proposal is true, they gave us a proposal. of about 86 people, 55 will get zero dollars and that is in the dip one and dip two series where the highest turnover rate is happening. that's where the recruitment and retention problem is happening. actually, you asked what do other hospitals do? what does the industry do? they have a career path in these classifications. they have m.r.i. 1, 2, 3.