Yale Settles

The parade of settlements continues. The basics of this story were reported by AP:

Yale University has agreed to pay $7.6 million to resolve allegations that it broke the law by mismanaging federally funded research grants, federal authorities announced Tuesday.

The civil settlement with the government resolves allegations that some Yale researchers at times charged a federal grant account for costs unrelated to grant objectives. The government also alleged the researchers wrongfully charged 100 percent of their summer activity to grants when the researchers spent significant time on unrelated work.

At issue were allegations that grant money was used to cover costs that did not relate to the objectives of the specific grant involved.

Researchers allegedly were motivated to carry out wrongful transfers when the grant was near its expiration date and they needed to spend down the remaining grant funds, authorities said. Regulations require that unspent grant funds be returned to the government.

The wrongful salary charges stemmed from the fact that researchers are not paid their academic-year salary by Yale during the summer, authorities said. The only salary received by the researchers during the summer came from what they charged to federal grants, prosecutors said.

A bit of the news coverage focused on why these problems may have occurred. The Yale Daily News reported:

The thicket of subpoenas, audits and new compliance policies was a source of strain and sometimes a point of contention between faculty members and administrators, who sometimes tended to see the burden of improving grant accounting as resting on each other.

“I recognize that this investigation has been stressful for many members of our faculty and staff, and I also recognize that federal regulations are sometimes burdensome,” University President Richard Levin said in a letter to faculty and staff Tuesday.

Also, the New Haven Register reported:

When asked if any researchers were disciplined, Yale spokesman Tom Conroy said, 'the focus of the investigation was Yale’s grant accounting systems and controls, not actions by particular individuals. Yale now has in place a comprehensive training program for faculty and staff on relevant aspects of federal grant accounting.'

When I first got involved in the world of US government grants as a medical school faculty member, I was told that I, as the Principal Investigator, would be responsible for the scientific conduct of the project. On the other hand, I was told that the organization receiving the grant, e.g., usually a university or research institute, would be responsible for the fiscal conduct of the grant. Therefore, I wonder why there was "confusion" in this case about who was supposed to do grant accounting. Someone correct me if this has changed, but I thought that in this case, it was the university administrators who were supposed to do the grant accounting, not the faculty. (Note that the university got the grants, not the faculty members as individuals.)

In that light, the statement of the Yale spokesman is illuminating. According to him, no individual was responsible for the problem. The fault rested with the "grant accounting system and controls."

That reminds me of the 1960s, when some hippies were heard to mutter, "it's the system, man, that's bad."

Of course, the "system" did not grow like a tree, but was created by people. So if the system's users were not at fault, then its designers and maintainers were.

However, it seems that when something goes wrong in a health care organization, it is never the administrators and executives who are at fault. Sometimes a low-level bureaucrat may be scapegoated. But the fearless leaders can do no wrong. They are never to blame. They are never punished.

I submit that it is this impunity, this lack of responsibility that is a fundamental problem with health care today. Doctors are often accused of assuming god-like authority. We doctors, unfortunately, are too often responsible for what has gone wrong. But at least there is some redress against doctors when they act in their clinical capacity. Doctors are sued for malpractice (sometimes unfairly, sometimes with good reason.) Doctors are subject to professional disciplinary boards, and can have their licenses suspended or revoked

But when do university, hospital, or corporate executives ever pay a penalty for mistakes, or even malfeasance?

As long as they have no incentive not to do wrong, they will continue to do so.