Department of Health reports large vacancies at state facilities and high contract‑labor costs; committee to explore pay 'sweet spot'

Stefan Johansen and other Department of Health leaders told the Joint Appropriations subcommittee that staffing shortages across state run facilities are driving heavy use of expensive contract labor and lengthening waits for court‑ordered admissions to the state hospital.

"For CNAs at the Department of Health facilities, at the Life Resource Center I am about 65% vacant on CNAs," Johansen said, and he provided additional vacancy and pay figures to illustrate the department’s financing pressure. He told the committee the department’s entry‑level nurse pay band is about $31 to $33 an hour, while contracting for traveling nurses costs "$75 an hour" or more depending on assignment. For certified nursing assistants, Johansen said entry wages run roughly $17.90 to $18.90 per hour while contract CNAs can cost $45–$50 an hour.

Johansen described facility‑level vacancy rates he said the department has tracked: the Life Resource Center CNA vacancy rate (about 65%), the retirement center in Basin CNA vacancy (about 58%), and notable nurse vacancies he attributed to state facilities: state hospital nurse vacancies near 40%; the Veterans Home at 56% nurse vacancy; retirement center nurse vacancy around 70%; and the Life Resource Center nurse vacancy near 58%.

"When we have all of those vacancies... what we do in order to preserve a limited bed capacity... is we take that vacancy savings and we contract for more expensive agency labor," Johansen told members. He said the department expects to spend roughly $17 million this year on contract labor if trends continue.

Committee members and agency staff discussed tradeoffs: contracting maintains bed capacity and meets court or hospital needs in the short term but can depress morale among permanent staff when travelers earn much more. The committee asked the agency to analyze a pay‑level “sweet spot” — a compensation level for state hires that would reduce reliance on high‑cost contract labor while remaining fiscally sustainable and not inflating local labor markets.

The department also described coordination with the judiciary and county sheriffs over long waiting lists of people ordered to the state hospital under criminal forensic statutes (Title 7) and civil commitment (Title 25). Johansen described an ongoing proposal discussed with the judiciary to reimburse county jails for holding detainees awaiting admission and to pursue higher reimbursement tiers for sheriff offices willing to provide active treatment and medication administration to stabilize patients faster.

Why it matters: Large vacancy rates in state run safety‑net facilities affect court timelines, hospital discharge flow, and the availability of acute psychiatric care. The committee asked the agency to return with targeted analyses, including cost comparisons of salary increases versus contract spending, and to explore recruitment, retention and workforce pipeline options alongside compensation changes.

Next steps: Agency staff agreed to provide the committee with data and options on compensation thresholds, the staffing numbers and projected fiscal tradeoffs, and to invite Department of Administration and Information human resources representatives to a follow‑up meeting. The committee signaled interest in a broader waste/fraud and eligibility‑verification briefing in a future meeting as well.