A legislative panel Tuesday advanced the state Department of Health's request to use $4.7 million in federal American Rescue Plan funds for the University of Arkansas for Medical Sciences to pay existing staffers to expand its covid-19 bed capacity, after the recent surge in covid-19 cases spawned by the omicron variant.
The Legislative Council's Performance Evaluation and Expenditure Review Subcommittee recommended that the council approve the request, but not before a few lawmakers asked whether rural Arkansans will be able to access the additional 27 beds at UAMS and whether UAMS needs the funding. The council meets Friday.
Two weeks ago, legislative leaders authorized the Health Department to use $50.1 million in American Rescue Plan funds to hire outside staffing to open up 265 more beds at 11 hospitals across the state in response to the surge.
Two lawmakers Tuesday asked why legislative leaders authorized the emergency use of the $50.1 million two weeks ago instead of waiting for the subcommittee and the Legislative Council to consider this week's request.
The UAMS beds will consist of 20 negative-pressure medical covid-19 beds at $4,500 per bed for 30 days and seven negative pressure intensive care unit covid-19 beds at $6,500 per bed for 45 days, according to the Health Department.
Stephen Mette, CEO of UAMS Medical Center, said in a Jan. 21 letter to Health Department Chief of Staff Renee Mallory that "our greatest challenge continues to be the demand for nursing and other critical members of the patient care team.
"Given the time it would take to recruit contract labor staff and the current urgent need for increased capacities, we believe the most efficient way to staff these beds is to incentivize our existing staff," Mette wrote. "However, without external support, the expense of staffing additional beds would place a significant expense and unsustainable financial risk on the organization."
Sen. Missy Irvin, R-Mountain View, said Tuesday that it is increasingly difficult to transfer patients from rural hospitals to the larger hospitals.
"We cannot find beds," she said.
Irvin said she supported the request but wanted assurances that rural residents can benefit from the increased bed capacity.
Don Adams, the department's deputy director for administration, said, "We have systems in place for transferring patients. All of these facilities are required to accept patients regardless of the geography of where they come from. There are other triage factors that go into the decision of whether or not they are going to accept patients."
Thirty-five of the additional 265 beds authorized at the 11 hospitals were still available for patients as of Monday, he said.
"UAMS has assured us that as soon as this is approved they can stand those [27] beds up through contract nurses, through overtime, those sorts of things," Adams said.
Afterward, UAMS spokeswoman Leslie Taylor said the hospital would have 109 covid-19 beds if the funding for the 27 beds is authorized by the council.
"We could expand to 139 if we are truly in crisis and we have the staffing," she said in a written statement.
Irvin told her colleagues, "These smaller hospitals have to have some of this acknowledgment, and some of these dollars have to be spent to help them because I am not seeing it."
Sen. Jonathan Dismang, R-Searcy, co-chairman of the PEER committee, said funding the 27 beds at UAMS will increase bed space for the transfer of patients to take the pressure off of rural hospitals and medical clinics.
Sen. Trent Garner, R-El Dorado, said he interprets Mette's letter to mean that UAMS would be under financial stress that it cannot sustain by opening up the 27 beds without the federal funds.
"Can you all afford the $4 million without taxpayers giving you an additional $4 million? ... If you can, open the beds today. If you can't, then we have a decision to make."
Asked why UAMS isn't using its funds, Taylor said in a written statement, "This is a question of sustainability of staffing and supplying these beds at a further loss because of the expense of contract labor, supplies. There is no separate funding source nor rainy day fund."
Two weeks ago, Dismang and three other legislative leaders signed off on the request for $50.1 million in federal funds to open up 265 beds at 11 hospitals.
State Rep. Jim Dotson, R-Bentonville, and Garner questioned that decision by Dismang.
"It seems to me like this is a lot of money to go through an emergency process," and he asked why the $50.1 million request couldn't have been handled by lawmakers this week in regular meetings.
Dismang said it was his understanding that the omicron surge was expected to peak soon, and it takes quite some time to staff the beds because of the nursing shortage, and approval might have come too late.