Arkansas' American Rescue Plan steering committee Wednesday endorsed the state Department of Commerce's request for $35 million more in federal coronavirus relief funds for the state's broadband grant program.
Then, the 15-member panel heard Department of Health Secretary Jose Romero make a request for a total of $18.1 million for four nonprofit hospital locations to open 54 more intensive care unit beds for covid-19 patients.
Romero said he might ask the panel to vote on the request as early as next week.
"If the trend over the previous three weeks holds true, additional ICU beds will be needed to meet the continued demand for critical care of COVID-19 patients," the Department of Health said in its written request for federal coronavirus relief funds for Jefferson Regional Medical Center in Pine Bluff, St. Bernards Medical Center in Jonesboro, CHI St. Vincent in Little Rock, and CHI St. Vincent in Hot Springs to open the additional beds.
In May, Gov. Asa Hutchinson appointed the 15-member steering committee to recommend the best uses for $1.57 billion in state recovery funds that Arkansas will receive under the American Rescue Plan Act signed into law by President Joe Biden in March. The panel includes nine Hutchinson administration officials and six state lawmakers.
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BROADBAND GRANTS
State Commerce Secretary Mike Preston said Arkansas' Rural Connect program already has awarded $30.7 million in American Rescue Plan funds for broadband grants in fiscal 2022, and an additional $147.2 million will soon be needed to fund 46 "shovel ready" and "near shovel ready" broadband projects.
In June, the Arkansas Legislative Council authorized the Commerce Department to use up to $30.7 million in rescue plan funds for broadband grants with the approval of its co-chairmen.
Preston said 18 of the 46 broadband projects were "shovel ready" at the start of this week, and "we anticipate that by either the end of the week or sometime next week that all 46 will have moved into that status of final review."
The Department of Commerce is seeking $2.5 million more in American Rescue Plan funds to expand the state's Center for Toxicology and Environmental Health contract to provide some additional administrative support to the department's broadband office as the department continues vetting the projects, he said.
The department is seeking the steering committee's endorsement for $35 million more in rescue plan funds for the program in fiscal 2022, in addition to the $150 million endorsed in June, he said.
"Upon committee approval, the department will then seek review and approval by the Arkansas Legislative Council of the funding request as well as the necessary spending appropriation," Preston wrote in a letter dated Tuesday to steering committee chairman Larry Walther, who is also secretary of the state Department of Finance and Administration. The Legislative Council is to meet Friday.
In fiscal 2021, the Arkansas Rural Connect program made 76 broadband grant awards totaling $118.1 million, Preston noted in his letter.
ICU BEDS
Romero proposed the following amounts to hospitals to open more intensive care unit beds for covid patients.
• $8.28 million to CHI St. Vincent's Little Rock campus for 24 beds for 60 days at $5,750 per bed per day.
• $4.14 million to CHI St. Vincent's Hot Springs campus for 12 beds for 60 days at $5,750 per bed per day.
• $3 million to St. Bernards Medical Center for 10 beds for 60 days at $5,000 per bed per day.
• $2.736 million to Jefferson Regional Medical Center for eight beds for 90 days at $5,700 per bed per day.
Romero said Jefferson Regional is seeking American Rescue Plan funding for 90 days in order to secure the nursing staff for the eight beds because it must enter into a contract lasting that long.
Department of Finance and Administration spokesman Scott Hardin said a large portion of the funding would be dedicated to securing health care workers to staff the beds.
Romero said the Department of Health has received seven proposals in the past few days from hospitals for additional ICU beds and non-critical-care beds.
The department is going to move forward with four proposals involving nonprofit hospitals tapping American Rescue Plan funds to open covid-19 ICU beds, he said. There is a possibly of getting Federal Emergency Management Agency funds to repay the American Rescue Plan funds used to open these additional beds under this request, he said.
With American Rescue Plan funds, Baptist Health has added 33 covid-19, ICU beds in the past two weeks, Romero said. Unity Health White County Medical Center in Searcy has continued to struggle a bit in getting enough staffing to get nine covid-19 ICU beds on line, he said.
With the Baptist Health system intending to add 15 covid ICU beds by Friday, "it is felt that this would be enough to ease the strain over the next seven days or so," he said.
"But we wanted to bring this before you," Romero told the steering committee. "We are not asking for funding or a vote at this time. We want you to consider this, please."
State Rep. Jeff Wardlaw, R-Hermitage, asked why the per bed cost of the four proposals in this request is higher than Baptist Health's previously approved request for $4,000 per bed per day.
Romero said it's because "nurses are becoming more and more scarce."
For example, Texas has recently asked for 2,500 more nurses, and "that is driving the cost of these nurses upward," he said. "We are now trying to compete with other states and other organizations to acquire these nurses."
Wardlaw asked why Romero didn't ask the steering committee to take a vote on the Health Department's request for $18.1 million Wednesday "if this is so critical."
"We wanted to give you all time," Romero said.
"But if you feel ready to vote on this based on the information, we would welcome a vote on this particular application to you all," he said. "We respectfully wanted to give you time to analyze this.
"But you are correct. There is a concern that we are going to continue to increase, and time is critical," Romero said
Walther asked Romero when he expected to ask the steering committee to vote on the funding request.
"It would depend on where we are on our bed capacity," Romero said.
"We think as early as next week," he said, saying the need and ventilator use are increasing and "continues to increase, and those ventilated patients must be managed in the ICU, with rare exception."
In the past two weeks, COVIDComm has reported that there have been only a few days in which there has not been a situation where an ICU bed could not rapidly be identified for a patient needing transfer, Romero said. That means that individuals have to wait in the emergency room before they are hospitalized or have access to a critical care bed, he said.