Lawmakers press DHS on contract nursing costs and staffing shortfalls at Human Development Centers as federal funding hangs in balance

Lawmakers used the Arkansas Legislative Council meeting on March 18 to press Department of Human Services officials about spending on contract nursing, projected seven‑year contract costs and staffing shortages at Human Development Centers (HDCs).

"The paid to date amount across all 5 of those contracts is roughly 7,200,000 and our total projected cost for those 5 contracts is 28,500,000," Melissa Weatherton, director for Medicaid Specialty Populations, told the committee as she walked members through on‑call contract totals for the Arkansas Health Center. For Human Development Centers, DHS provided paid‑to‑date and projected totals: "across those she has spent to date 10,900,000 utilizing the on call and the projected total cost for her contracts is over 7 years is 63,700,000," Weatherton said.

Members repeatedly raised alarm about the scale and recurring use of contract nursing. Representative Painter noted contract nurses paid to date totaled about $28.9 million and asked whether the seven‑year projection to $145 million for contract nursing was accurate; DHS confirmed that figure represented a seven‑year projection if contract usage continued at current levels.

DHS officials also described workforce metrics at the Human Development Centers: HDCs are budgeted for 1,880 positions, with 1,712 currently filled — a vacancy of 168 positions — and onboarding/outflow numbers showing the state is losing more staff than it is hiring in several centers. Weatherton said the agency is preparing "a comprehensive recruitment and retention plan" and prioritized the HDC staffing strategy with the governor’s office; she said some centers (for example Conway) show strong applicant pools while others (Arkadelphia, Booneville, Jonesboro) continue to struggle.

Concerns extended to other contracted settings: members said the VA nursing home relied heavily on contract labor (about 70% contract labor reported earlier), and Representative Brown warned that contract staff do not develop the same continuity of care as state payroll employees.

Federal funding risk and leadership change: Secretary Hugh McDonald (Commerce) and DHS representatives described fiscal problems at the Division of Services for the Blind (DSP). McDonald said the federal Rehabilitation Services Administration designated DSP a "high risk grantee" after finding excessive spending and insufficient fiscal planning; a $4 million federal payment needed to restore operations is contingent on the DSP board chair acknowledging the governor's interim director appointment. Committee members discussed referring the matter for additional review.

What happened next: the committee asked DHS to provide a written, comprehensive recruitment and retention plan and signaled it would expect to see that plan before the next full ALC meeting if possible. Senator Irvin moved to adopt the personnel report and refer the DSP fiscal concerns to the Joint Performance Review; the motion to adopt the personnel report passed by voice vote.