Ill at ease - that's what some employees are at Sutter Amador Hospital.

A "flex-out" work policy installed recently is paining employees by effectively cutting their income. The flex-out policy sends employees home when patient volume drops. They lose pay, either immediately - off the next paycheck - or eventually, when the non-worked hours get subtracted from paid time off.

Sutter Amador is one of Amador County's largest employers, but it is financially strapped in an ailing economy.

"Flexing is matching the work force with the patient volume," explained Jody Boetzer, hospital spokeswoman.

The policy is hospital-wide.

"It's infecting every department - for the last two weeks, I had to give up eight hours per week," said an employee, who asked not to be identified for fear of reprisal. "That's 16 hours out of a two-week, 80-hour paycheck. It's 20 percent."

The employee said department managers are assigned a number of hours per week, during which employees must be sent home.

Sutter Amador is currently operating "significantly short of budget," Boetzer said. "We need to bring our expenses more in line with our income or our ability to deliver much-needed health care programs and services to our communities will be at risk.

"We have asked all departments to flex."

"I've talked to maybe 20 others," the employee told the Ledger Dispatch. "We've been unhappy. We're barely making it (before the flex policy). AT&T doesn't want to hear that excuse. They want their money. The power company - they want their money. But it's better than a layoff."

Boetzer said that's part of the rationale for implementing flex-out. "We are all in this together, working as a team to ensure that our patients' needs are met and, at the same time, trying to protect positions from full layoffs," she said.

Bill Gleeson, spokesman for parent organization Sutter Health, said he did not know how many of the region's 26 Sutter hospitals had gone to a flex-out practice. The policy is not entirely new, having been available off-the-shelf for emergency situations, Boetzer said.

"Flexing has always been a past practice for both our union and management represented employees," she said. "We cannot predict how long the struggling economy will affect our day to day operations. While we cannot determine how long it will be necessary, this is not something we plan to continue long-term."