Direct care nurses who work at long-term facilities operated by the state are eligible for a bonus of $5,000. Newly hired nurses are also eligible for bonuses, but the $5,000 would be paid in installments over several months.
The goal is to reduce the state’s use of “travelling” nurses, who are hired through agencies temporarily. Last fiscal year the state paid for about 173,000 hours of contract nursing.
The state Department of Human Services operates the State Hospital in Little Rock for people with mental illness. It also operates the Arkansas Health Center formerly known as the Benton Services Center, a psychiatric nursing home for the elderly and people with disabilities.
The department also operates five Human Development Centers for people with severe intellectual and developmental disabilities. They are in Arkadelphia, Booneville, Bradley County, Conway and Jonesboro.
Registered nurses and licensed practical nurses will be eligible for bonuses, but certified nurse assistants will not.
The department proposed the bonuses, which were approved by the Personnel Subcommittee of the Legislative Council. The joint Committees on Public Health, Welfare and Labor also reviewed details of the bonus program before it took effect on November 1.
Legislators and DHS officials acknowledged that one-time bonuses would not be an adequate long-term fix for staffing shortages. Higher salaries for nurses at state facilities will be addressed during the 2025 regular session, when legislators consider a new state employee pay plan. The session begins in January.
The state’s top personnel director told lawmakers that nurses’ salaries would be a priority in the pay plan.
In Fiscal Year 2024, which ended on June 30, the state paid contract nurses $4.8 million to work about 70,000 hours at the State Hospital. The state paid $3.2 million for 50,000 hours of nursing at the Arkansas Health Center and $3.24 million for 53,000 hours at human development centers. However, the center at Booneville did not require the use of any contract nurses. In comparison, the cost of bonuses to full-time nurses will total $1.26 million, department officials said.
Legislators have heard from family members of clients at the human development centers about the use of contract nurses. No legislator voiced concerns about the quality of care provided by travelling nurses, but several said that full-time nurses could get to know better the long-term needs of clients. Thus, permanent nurses could provide better care simply by providing continuity of care.
In trying to make salaries of full-time state nurses competitive with travelling nurses, the department doesn’t have to match salaries dollar for dollar. That’s because the state doesn’t have to pay for fringe benefits for travelling nurses. The value of fringe benefits provides an additional 30 to 32 percent to the compensation paid to state nurses, a department official said.
The fringe benefits brings state nurse salaries closer to a competitive level. Recently, the department re-hired seven nurses who had gone to work for contract nursing agencies.
State facilities will probably continue to rely on contract nurses, if at reduced levels, in order to maintain staffing levels. Long-term care facilities must have available a certain number of nurses per client, to be licensed and to qualify for federal funding.
