Licensing and certification asks exemption to transfer personnel funds to pay contract nurses to meet inspection workload

The Department of Health and Welfare asked the Joint Finance-Appropriations Committee Monday for an exemption that would allow Licensing and Certification to transfer personnel dollars to operating to retain contract nurses and meet federally and state-required inspection schedules.

Alex Williamson, budget and policy analyst with the Legislative Services Office, told the committee that Licensing and Certification historically has supplemented its permanent staff with contracted nurses to perform surveys and inspections and that recent legislative language limiting transfers of personnel dollars had required the division to request one-time transfers in prior years.

Director Alex Adams told the committee the division has a statutory obligation to inspect nursing facilities on a regular cadence and cited a requirement to inspect skilled nursing facilities about every 15.9 months. Adams said the long-term care inspection team’s vacancy rate peaked during the pandemic and that contract surveyors were used to satisfy inspection requirements while the division rebuilt staff capacity. He said permanent employee pay for licensing staff is roughly $35 per hour while contract surveyors can cost $90–$95 per hour.

Senator Lori Den Hartogh (Senator Wintrow asked about provider waits for licensure and inspection turnaround) and other members asked whether the division could hire more permanent staff instead of relying on contractors and whether contract use represented a recurring cost or a bridge to permanent staffing. Adams said turnover in the division is declining — the presentation listed turnover falling from about 21% in earlier years to 7% most recently — and said the agency still needs contract support to meet inspection timelines while recruiting continues.

LSO and the department said the licensing and certification supplemental and enhancement requests are recommended by the governor in the budget materials; the licensing supplemental asked for an exemption from the personnel-transfer limitation set out in last year’s budget language so the division could make transfers as needed rather than annually requesting a specific amount.

Committee members requested further detail on overall cost differences between contract labor and permanent hires and asked LSO to follow up on how much of last year’s $400,000 transfer was spent versus reverted.

The committee did not record a vote on the licensing and certification transfer request during the presentation; LSO and agency staff agreed to provide additional cost and hiring detail in follow-up work-group and division hearings.