Contra Costa's health services director has established a pay system for primary care doctors that boosts their salaries and spikes their pensions through false reporting of work hours.
Under the arrangement, about 40 family practice, internal medicine, gynecology and pediatric physicians who work in the county's front-line community clinics receive credit for an additional 30 hours of on-call time each week.
But the doctors aren't actually on call during those extra hours, acknowledges the health services director, Dr. William Walker. Because doctors receive an hour's salary for every four on call, the deal increases their pay by 7½ hours a week.
That amounts to an 18.75 percent salary increase. And for those retiring, it provides a significant pension boost because the on-call pay is wrapped into the salary used for calculating their retirement income.
Walker defends the extra pay, which he says he implemented in 2011 to attract and retain doctors that the county was otherwise losing to Kaiser. He says he acted on his own, without approval from the county Board of Supervisors or knowledge of the county controller.
Keeping physicians who treat some of Contra Costa's poorest and sickest patients presents a challenge for county officials. But that doesn't justify falsified payroll reporting to hide salary increases and pension spiking.
Walker told me that offering on-call pay was his only option for boosting primary care doctors' salaries under the county's current contract with physicians. Using a tortured -- and inaccurate -- interpretation of the contract wording, he claims it gives him the authority to act unilaterally. It doesn't.
Moreover, no county department head should grant salary increases for an entire group of workers. If Walker wants to boost his doctors' pay, he should do so transparently and only with the formal approval of the Board of Supervisors.
Walker also oversees the county's hazardous materials team where, as I reported two weeks ago, similar on-call pension spiking has been going on for years. In that case, workers sign up for extra on-call shifts in their final year on the job to boost their retirement pay.
The case of the doctors is different because they aren't really on call. Their arrangement was deliberately designed by Walker to boost salaries.
Because the doctors weren't on call, the arrangement raises serious questions about payment of public funds for work not performed. And, in turn, it calls into question the pension calculations, which were based on false accounting. The pension system for county workers has the authority to disallow retirement payments based on improperly inflated salaries.
To understand the effect of the pension spike, consider the case of Dr. Priscilla Hinman, who worked for the county for 16 years before she retired Dec. 28 at age 64. Her starting pension was $100,809 a year, of which 11 percent, or about $11,000, results from the on-call pay.
Hinman received the extra on-call pay for a little over a year on the job, but it boosted her pension every year for the rest of her life. Moreover, the pension, including the spike for on-call pay, will increase annually for inflation.
Drs. David Hearst, who retired Nov. 1, and Krista Farey, who retired Dec. 31, similarly used on-call pay to spike their pensions. All three doctors are double-dipping, still working for the county while collecting their pensions.
The county is negotiating a new contract with its physicians. Walker says the on-call issue will be resolved as part of the new agreement. That's good. But it doesn't justify the deception that has continued for two years.