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DHW asks JFAC for exemption to transfer personnel funds to operating to hire contract surveyors; governor recommends request
Summary
The Department of Health and Welfare asked JFAC for an exemption to a statutory transfer restriction to allow personnel funds to be moved to operating expense to hire contract nurses for licensing and certification surveys. The governor recommended both the supplemental and enhancement that include this exemption.
The Department of Health and Welfare asked the Joint Finance-Appropriations Committee on Monday for a limited exemption from a transfer restriction so licensing and certification can continue using contract nurses to perform facility surveys.
Legislative Services analyst Alex Williamson told the committee that the division historically has outsourced nursing survey work because it lacks sufficient full-time staff to complete statutorily required inspections. The division is seeking an exemption from language in Section 8 of Senate Bill 1268 (2024) that restricts transfers from the personnel-cost expense class to other expense classes within the department.
Director Alex Adams told JFAC the licensing and certification unit must inspect, certify and license health-care facilities and that federal or state requirements set inspection frequency for certain facilities. "We have an obligation to get to them every 15.9," Adams said, referring to the regulatory survey cadence for skilled nursing facilities. He added licensing relies on contract nurses when state staff levels are insufficient and said the pandemic pushed the division's vacancy rate as high as 80% for a time; current vacancy sits near 19% and turnover has fallen from 21% in an earlier year to about 7% most recently.
Adams described a cost difference: approximately $35 per hour for state employees performing surveys versus roughly $90 to $95 per hour for contract nurses.
Williamson said last year the division requested a one-time transfer of roughly $400,000 from personnel to operating to hire contract nurses; about $300,000 was used and roughly $100,000 reverted. For the current budget the division seeks an exemption so it can transfer personnel dollars to operating as needed rather than seeking a one-time transfer each year. Both the supplemental and the enhancement for this exemption were recommended by the governor.
Committee members sought more detail about the relative costs and whether more ongoing state hiring would reduce reliance on contractors. The director said turnover has improved and that a long-run solution could involve hiring additional full-time staff, but that the division currently depends on contractors to meet legally required inspection schedules. The committee did not take a final vote Monday; the request will be considered in upcoming budget actions.
