The panel appointed by Gov. Asa Hutchinson to recommend the best uses of $1.59 billion in federal American Rescue Plan funds on Thursday voted to support requests from the Department of Human Services and Department of Health for more than $250 million to assist hospitals and nursing homes struggling with increased covid-19 costs.
The 15-member American Rescue Plan steering committee endorsed a $129.1 million request from the Department of Human Services to help hospitals with staffing and bed shortages, and the additional costs of providing covid-19 treatment; and a $116 million request from the Department of Human Services to address some of the nursing homes' most significant costs amid the covid-19 pandemic.
The steering committee -- comprised of nine Hutchinson administration officials and six state lawmakers -- also endorsed a $10.54 million request for federal funds from the state Department of Health to partner with Unity Health White County Medical Center to increase covid-19 bed capacity in Searcy.
The steering committee's actions Thursday came one day after the panel recommended approval of the Department of Health's request for $37.68 million in federal funds to partner with Baptist Health to increase hospital bed capacity and staffing for covid-19 cases.
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Under that proposal, Baptist Health in Little Rock would provide 50 more staffed medical covid-19 beds, Baptist Health in Van Buren would provide 74 more staffed medical covid-19 beds, the Little Rock hospital would provide 12 more staffed intensive care unit covid-19 beds, and Baptist Health in Fort Smith would provide 21 more staffed intensive care unit covid-19 beds.
Sen. Keith Ingram, D-West Memphis, raised questions about the Department of Health's request for $10.54 million in federal funds to partner with Unity Health White Medical Center,
Unity Health White County Medical Center submitted a proposal to the Department of Health dated Wednesday under which it would increase staffed hospital beds by 43, including 34 covid-19 medical beds and nine covid-19 intensive care unit beds at its campuses in Searcy.
"To staff to the level needed for this increase in patients Unity would be required to secure contract staff from outside the state in a short time," Unity Health President and Chief Executive Officer Steven Webb wrote in a letter dated Wednesday to Department of Heath Deputy Director Renee Mallory. "The compressed timeline to recruit and hire staff entails considerable expense and financial risks for the organization."
Unity Health estimated a cost of $10.54 million to secure the needed personnel, physicians and supplies for patients for up to 60 days, he said.
Ingram pressed Health Secretary Jose Romero, "How do we miss that we had a facility, except they didn't have staff?"
Romero replied, "I don't know, sir."
"This [request from Unity Health] came in yesterday after our meeting," Romero said, referring to the steering committee.
Sen. Jonathan Dismang, R-Searcy, told the steering committee that Unity Health White County Medical Center set up covid-19 bed space a year ago and "in essence, they are going to be able to turn a light on and be able to move forward and, as long as they have the staffing, take some of these patients that are currently having to go out of state at a much higher cost to our system and to our insurance companies."
"They are concerned that we can't cannibalize the nurses from each other," he said. "I think that is why they are pretty laser-focused on making sure that we are getting the nurses that are not in the state come into the state utilizing resources that they have through compacts or associations.
"We do have a surge in White County and surrounding areas," Dismang said.
He added, "I didn't understand that this opportunity [for Unity Health White County Medical Center] would be out there until we saw the Baptist proposal."
According to the Department of Human Services' request for $129.1 million in federal funds, the request includes:
• $97.5 million to assure the continued availability of essential hospital care by making formula-based payments to offset the extraordinary costs related to retaining and acquiring frontline staffs.
Each hospital in Arkansas has experienced the negative effects of the public health emergency caused by covid-19, and shortages of clinical staffing affect the ability of hospitals to respond to the covid-19 pandemic and provide necessary patient care, according to the department.
The allotment formula has been based on several factors that include the Department of Human Services providing an allotment of $9,000 per licensed bed to the Arkansas State Hospital and each acute care hospital, critical access hospital and long-term-care hospital, excluding rehabilitation and psychiatric hospitals, and the payment by bed size will be based upon the Department of Health's determination of licensed Medicare beds for each facility as of March 1, 2021.
The allotment of up to $9,000 per bed is based upon estimated staffing cost, the department said.
• $22.2 million for a COVIDComm receiving hospital "add-on."
The COVIDCOmm system was established during the 2020 winter surge to coordinate covid-19 patient transfers, according to the department. "In order to be eligible for this payment, hospitals must receive patient transfers from other facilities utilizing the COVIDComm system."
In addition to the formula payment, an additional $2,500 per licensed bed will be available for distribution to the Arkansas State Hospital and acute care, critical access or long-term acute care hospitals that participate as a receiving hospital of covid-19 patients in the COVIDComm transfer system as of Aug. 20, 2021.
• $9.6 million for a monoclonal antibody administration "add-on." The monoclonal antibody treatments reduce the risk of severe disease and hospitalization when administered early in the course of illness.
In addition to the formula payment, an add-on payment of $1,000 per licensed bed will be available for distribution to hospitals that administer monoclonal antibodies in an outpatient setting, including an emergency department, to covid-19 positive patients as reported through Aug. 20.
The Department of Human Services' request for $116.4 million for assisting nursing homes includes $45.6 million to provide one-time funds to assist skilled nursing facilities to meet the demands created by unreimbursed fixed property costs associated with addressing the covid-19 pandemic, according to the department.
The request for $45.6 million is one-time funding equivalent to 18 months of Medicaid rate cuts because of total occupancy dropping below 80% and a portion of the per bed value associated cuts, the department said.
The department's nursing home request also includes $40 million to cover these facilities' unreimbursed costs of biohazard medical waste disposal and covid-19 testing of staff and residents incurred from March 3, 2021, through Feb. 28, 2022, and $30.8 million to create a fund so each qualified skilled nursing facility will receive $2,000 per occupied licensed bed to help them meet continued extraordinary staffing needs during the pandemic, according to the department.