[{"_1":2,"_88":-5,"_89":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6352915,"mediaKeyId","2222165-317ed44046690b4ab484933dac12165f","parentId",2222165,"title","KDADS officials tell committee contract nursing drove $59M in state hospital costs in 2024; bonuses and hiring strategies aim to curb use","audioSeconds",1740,"startMs",1260000,"endMs",3000000,"viewUrl","/Search/View?dp=1&key=2222165-317ed44046690b4ab484933dac12165f&start=1260&end=3000","thumbnailUrl","https://assets.pipeline.soar.com/2222165-317ed44046690b4ab484933dac12165f/thumbnail_1260000.jpg","articleUrl","/articles/6352915/Kansas/KDADS-officials-tell-committee-contract-nursing-drove-59M-in-state-hospital-costs-in-2024-bonuses-and-hiring-strategies-aim-to-curb-use","mediaUrl","https://secure.pipeline.soar.com/6352915-93525ebfc88bea1e88cce60d0379a8ef/orig.mp4?Expires=1776218578&Signature=oKmaXMslZrrD0CVQcYocK27Wbj-x01QJKZSVwgY-EoTnGKL9rVqepUINM9cy1hEhm5ZMY~fLSpxyMnRL3pOD-~Q1sj7uIwP1ICW2KRvkAPJ1I4DDVfdkBxd8oUKNX3FsOe01fNuANpliD-94EYZtDgiTzX6OjEWT8fV4a8B4ObacqlSbRu9IAuoBYEK-dHKllfy9RYJo3j4rrkWoAvkmG~VtMmkNCkWWrf0~BvrmRg6dazzSgcdpqmVCH3eeEcyNWRrAcm1lhKHSY7RFNQO~exiX0udBzz0zF4vee964ORY7JVjCCKT~QXk3wK4emuiD89JfvTnmOFjkCA7B3sU4Sg__&Key-Pair-Id=KUT5TJCACFTXG","author","Committee on Ways and Means, KS","date","2025-02-04T00:00:00Z","article","Scott Bruner, deputy secretary for hospitals and facilities at the Kansas Department for Aging and Disability Services, told the Senate Ways and Means briefing that contract nursing has driven substantial costs at the state's two primary psychiatric hospitals and described recruitment, retention and policy steps KDADS has taken to reduce reliance on agency staff.

Bruner said Larned State Hospital spent $41.3 million on contract staffing in fiscal 2024 and Osawatomie State Hospital spent about $17.9 million, for a combined total in the neighborhood of $59.2 million. \"We've been coming to the governor and the budget process and really asking for just-in-time funding to fund what our need is for the current fiscal year,\" Bruner said. He and legislative staff said the governor included enhancement requests in her budget and the House Appropriations Committee has partially funded those requests.

Dayton Lemunyan, senior fiscal analyst with Kansas Legislative Research, summarized the House committee recommendations: Larned requested $32.7 million for contract staffing in FY2025 and the House recommended $30.0 million for FY2025 and added proviso language to prohibit contract staffing at Larned beginning in FY2027; Osawatomie requested about $16.0 million and the House recommended adding $8.0 million for FY2025 and FY2026.

Superintendents described day-to-day care needs and the workforce gap. Dr. Lindsey Dinkel, superintendent of Larned State Hospital, said Larned currently averages about 237 contract nursing staff on campus compared with roughly 55 FTE nursing staff and that many patients require one-to-one direct-care assignments. \"When you think about that, in comparison to 3 shifts that it takes to cover a 24 hour day, that's 90 additional people we need to cover direct care,\" Dinkel said, describing how dozens of one-to-one assignments magnify staffing needs.

Ashley Byram, superintendent at Osawatomie State Hospital, said Osawatomie requires about 48 nurses, 20 LPNs and 96 mental health tech-type positions per day across its programs and that earlier implementation of bonuses and scheduling changes has reduced the weekly average contract nursing count and cost. Byram said weekly average contract spending fell from about $355,000 to $277,000 after bonuses and recruiting efforts and the average number of contract staff declined from roughly 108 to about 82 in December.

KDADS described several recruitment and retention strategies now in use:
- Bonus authorities increased by proviso last year to allow higher employee bonuses (the cap was raised from $3,500 to $10,000), enabling sign-on, referral and retention payments; KDADS reported a layered sign-on/retention bonus structure (up to about $3,000 across milestones) and a $100 pickup-shift bonus for critical shifts.
- Pilot scheduling changes such as RN self-scheduling and other flexible-work approaches to reduce turnover.
- Targeted hiring and training pipelines, including nursing clinical relationships with community colleges and university programs.

Officials said vacancy rates remain high but are improving in some places. Bruner said the system-wide authorized staffing for the relevant programs is roughly 1,430 positions, with about a one‑third vacancy rate system-wide and direct-care vacancies closer to 50–60% in some classifications. Dinkel said Larned’s vacancy rate declined from about 45% to 35% during the latter part of 2024 after bonus and recruiting work; KDADS also reported it had hired more FTEs in 2024 (158 hires) than separations (43) for the Larned campus in that calendar year.

Cost and contract mechanics: KDADS officials noted the headline per-hour cost the state pays to a vendor does not equal the nurse’s wage; the agency pays the vendor rate (which includes agency overhead), and the vendor pays the clinician. Committee members pressed officials on whether raising state pay would reduce reliance on contractors; KDADS officials said market competitiveness matters but also cited rural housing availability, the specialized nature of some patients and multi-year effects at larger campuses such as Larned.

House and governor funding: Bruner said the governor included the requested enhancements (Larned $32.7 million; Osawatomie $11.0–16.0 million depending on the calculation) in the executive budget and House Appropriations provided a portion of those requests. Staff cautioned that these are fluid figures while the appropriations process continues.

Why it matters: state hospitals provide court-ordered and acute psychiatric care, and reliance on high-cost contract nurses affects both the state’s operating budget and the hospitals’ ability to maintain consistent staffing and clinical continuity.

Questions remaining: committee members asked what would happen if the state could not fully fund contract nursing needs, how many FTEs are authorized versus filled, the average ages of staff and housing/childcare issues that affect recruitment. Superintendents and KDADS committed to provide additional data to the committee upon request.

","mediaType","Video","parentTitle","Senate Committee on Ways and Means 02/04/2025","oneSentenceSummary","KDADS and state hospital superintendents told the Senate committee Larned and Osawatomie used large amounts of contract nursing in 2024, described vacancy and turnover pressures, and outlined bonuses, recruitment and scheduling changes that officials say are beginning to reduce agency reliance on agency nurses.","taxTitle","Ways and Means, Standing, Senate, Committees, Legislative, Kansas","taxId",20425,"location","Kansas","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6352920,"House Appropriations Committee restores some budget items, trims others in early FY2025 deliberations",505,56000,561000,"/Search/View?dp=1&key=2222165-317ed44046690b4ab484933dac12165f&start=56&end=561","https://assets.pipeline.soar.com/2222165-317ed44046690b4ab484933dac12165f/thumbnail_56000.jpg","/articles/6352920/Kansas/House-Appropriations-Committee-restores-some-budget-items-trims-others-in-early-FY2025-deliberations","https://secure.pipeline.soar.com/6352920-e5334479a51eadcd8c86e991ee8011c8/orig.mp4?Expires=1776218578&Signature=Se7ppWEsia2WK4bbNextPbfUeYFnZt0jByeW3-xdmewoZ8Uv8OwMu3anCWKCx7Nc38a6Tr5nWC0ug0D53a9HZtxRmispPtWWeyvIyMxhsdsOM97DLVtWWfJ4dZGYMEc9SihMnCJ9XJ-8ljS6s3Wl8~SSHEeJKW4CM1XL4ynrtTkXzqKnDUZ3f3LSTskGEh5LBn43LzJ4dam-S~jI6-qFM4FUGknwuyoGfKaDGDzHX49onhhgFE51fbnn~KmA2NoaSkytgPbLejstwU-hIe-wPU6uQxNUXgv~zKloLyG0zNAll2b-F8ACl5Y06y~f02HSao1qsOQy~ZNoiFiSOjCzPQ__&Key-Pair-Id=KUT5TJCACFTXG","Dylan Dear, with the Kansas Legislative Research Department, told the Senate Ways and Means briefing that the House Appropriations Committee has made targeted changes to agency budgets as it considers the fiscal 2025 and 2026 appropriations.

Dear said the committee has added about $46.3 million to its FY2025 adjustments and $41.5 million to FY2026 compared with its prior recommendation, offsetting part of larger deletions the committee made from agency requests earlier in the process. \"So for FY2025, so far during deliberation on the budget, the House Appropriations Committee has added $46,300,000 to their previous adjusted recommendation,\" Dear said.

The changes include both restorations of lapsed reappropriations and new additions. Major adjustments noted in the briefing included deletion of $248,322 in State General Fund (SGF) support for the Attorney General’s VINE victim notification system; restoration of roughly $3.0 million in legislative reappropriations; an added $2.0 million SGF for the Office of Information Technology Services’ IT emergency account; and $1.5 million placed into a technology communications fee fund to support an electronic regulation system under the Secretary of State. The committee also added $200,000 SGF to meet a 20% state match for a HAVA (Help America Vote Act) election-security grant, which Dear said will draw down an additional $1.0 million in federal funds for county election modernization grants.

Other significant adjustments in the House package included an added $30.0 million SGF for special-education state aid in FY2026 (and the same amount included for FY2027), partial restorations of reappropriations for Larned State Hospital and another hospital program, and debt-service and infrastructure changes in public safety accounts. Dear described a reconsolidation of certain debt-service obligations into the Department of Administration, noting a $3.1 million SGF line related to the Pittsburgh KBI laboratory debt-service would appear in the Department of Administration’s budget.

Dayton Lemunyan, senior fiscal analyst with Kansas Legislative Research, provided additional context on state hospitals and other items after Dear’s overview, and said the documents underlying the briefing — agency budget summaries and a list of Legislative Budget Committee deletions and LBC adjustments — will be distributed to committee members for review.

Why it matters: these adjustments indicate the House committee is selectively restoring funding and directing some new priorities while keeping overall reductions from agency requests; several of the restored or added items have near-term operational impacts (hospitals, election security, forensic lab capacity) and may influence final negotiation with the Senate and the governor.

Details of selected adjustments (as described by staff)
- Attorney General: deletion of $248,322 SGF for the VINE (Victim Identification and Notification) system; staff said VINE previously had a mix of federal funding sources, and some federal grants (including VOCA-funded programs) have declined. (Source: Dylan Dear.)
- Board of Indigent Defense Services: added approximately $4.0 million SGF and reappropriations in FY2025 to help fund assigned counsel caseloads and expert witness fees (staff characterized this as a partial restoration of lapsed reappropriations).
- Legislature: added $3.0 million SGF to reduce the size of reappropriation lapses from the legislative operational budget.
- Secretary of State: added $1.5 million to the technology communications fee fund for an electronic regulation-making system; staff noted questions remain about fee-fund use and the Revisor’s Office may be asked for an opinion. Also added $200,000 SGF for the state match on HAVA funds.
- Judicial branch: deleted a targeted FY2026 enhancement (about $385,000) that would have provided a 5% salary increase specifically for court reporters; staff said the broader judicial salary adjustments remain but this targeted enhancement was removed.
- Kansas Department for Aging and Disability Services (state hospitals): partial restorations of reappropriations and added funding for contract nursing were noted (see separate article on state hospitals for details).
- Education: added $30.0 million SGF for special-education state aid in FY2026 and FY2027.
- Kansas Bureau of Investigation: $3.1 million SGF for Pittsburgh lab debt-service was noted as being reconsolidated under Department of Administration bookkeeping; additional KBI adjustments included infrastructure and IT positions.

Staff said these figures are a moving target while House deliberations continue and that the full packet of budget summaries and LBC deletion descriptions will be circulated to the committee to support further questions.

Additional context and next steps: committee members asked staff for the detailed deletion list and for copies of the budget summaries. Staff said they will distribute those materials and that agencies will present more detail on items (for example contract nursing at state hospitals) in follow-up briefings.

","Kansas legislative staff briefed the Senate committee on House Appropriations Committee adjustments to the FY2025–FY2027 budgets, including restored reappropriations and targeted additions for hospitals, elections and special education.","actionData","errors"]

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KDADS officials tell committee contract nursing drove $59M in state hospital costs in 2024; bonuses and hiring strategies aim to curb use

House Appropriations Committee restores some budget items, trims others in early FY2025 deliberations