Kansas officials review data, gaps in oversight of supplemental health‑care staffing agencies

Deputy Secretary Scott Brunner of the Kansas Department for Aging and Disability Services told the Committee on Social Services Budget that KDADS has compiled a registry and initial quarterly reports from supplemental health‑care staffing agencies after a 2024 budget proviso directed registration and reporting.

Brunner said KDADS assembled a contact list of about 205 companies (drawing from roughly 80 vendors on the state contract list and other sources), sent notices in June and began collecting quarterly submissions on July 1. "We have no regulatory authority to penalize anybody who doesn't report to us," he said, describing the reporting as voluntary and noting the proviso covers the current fiscal year only.

The agency reported that 20 staffing agencies registered with KDADS submitted reports; 55 reported placing nursing employees in Kansas facilities; 13 said they were registered but placed no staff in the state; and 52 registered agencies submitted no information. On pay and charge data for agencies that reported placements, Brunner said the average facility charge for a registered nurse was $80.64 per hour while agencies on average paid RNs $43.26 per hour. He gave similar ranges for other roles, saying agencies charge roughly $37 per hour for certified nurse aides and pay those workers about $23–$26 per hour.

Representatives and conferees pressed for context and limits to the data. Brunner said the proviso requires quarterly reporting through the end of the fiscal year and that KDADS can continue collecting information, but it lacks enforcement powers to fine or sanction non‑reporting agencies. He also said the data set has not yet been analyzed for geographic patterns or distribution (for example Johnson County vs. Sedgwick County) and that averages shown were simple means across reporting agencies.

Industry groups and long‑term care providers described operational risks that arise when facilities use contract staff. Linda Mowbray of the Kansas Health Care Association and Kansas Center for Assisted Living said facilities must perform background checks, verify licenses and keep records; state and federal surveys and Medicaid/Medicare rules require documentation. She warned of gaps in accountability when an agency staffer is involved in an incident: "We don't have their personnel records. We don't have their home address. We don't pay them. We go through the agency. So there's some gaps in our safety net," Mowbray said.

Mowbray and Kylie Childs of LeadingAge Kansas described differences between W‑2 staffing agencies and 1099 platform companies. Mowbray noted W‑2 workers typically receive employer withholding, benefits and workers' compensation coverage, while 1099 platform workers often do not and may rely on occupational accident policies or individual coverage.

Childs summarized how other states regulate staffing agencies: "There are at least 23 other states who have codified staffing agency standards into their statutes as well as the District of Columbia," she said, and added that only two (Colorado and Missouri) use statutory language aimed specifically at 1099 tech platforms. She and other conferees recommended consideration of statutory standards that could require registration, minimum insurance or bond coverage, verification of credentials, transparency of charges and, in some cases, bans on non‑compete or liquidated‑damages clauses that limit workers' mobility.

Panelists and legislators discussed specific policy options and limits. Childs said some states require general liability, professional liability or fidelity bonds for agencies; she noted professional liability and fidelity bonds often do not automatically extend to 1099 contractors unless policies are structured to do so. Brunner said KDADS could add requested fields (for example, whether agencies offer benefits) to future data collection if the proviso or future legislation allowed it.

No formal committee action or vote was taken. Members mentioned two pending bills on staffing agencies; conferees identified HB2184 as a vehicle under consideration this session to create more durable statutory authority and oversight than the current proviso allows.

The committee members and witnesses recommended further review of the data KDADS is collecting, consideration of minimum insurance and credentialing standards, and attention to platform workers' classification and protections. Several legislators said they want to move incrementally in next year's session—targeting one or two statutory changes at first—while others urged a broader package modeled on neighboring states' laws.

The committee adjourned after a short discussion of logistics for a scheduled site tour of the state 988 call center and when KDADS would provide additional data.