The West Virginia Department of Health Facilities is seeking a single vendor to manage all of its contact laborer services. (Leann Ray | West Virginia Watch)
The Department of Health Facilities, reliant on contract nurses to staff state-run hospitals, is now seeking a single vendor to manage all of its contact laborer services.
The changes follow a recent legislative audit that said the financial implications of relying on contract labor at a significantly higher rate of pay “was not sustainable for the state.” Contract positions pay more than the state’s own full-time nursing jobs.
Since 2015, the state has spent $284 million on contract positions in state-run facilities, including long-term and psychiatric care. The millions of dollars spent on contract nursing were paid out to 33 vendors over the last nine years; 28 of those were out-of-state vendors.
Del. Evan Worrell, R-Cabell, said on Tuesday that he didn’t believe the decision was connected to the audit but questioned the timing of the Department of Health Facilities soliciting a new vendor as Gov. Jim Justice’s administration winds down. “I’m not sure this is the right approach because ultimately, it won’t save the state money,” he said. “The timing of this is odd. A month and a half before [Patrick] Morrisey takes office. Let Governor-elect Morrisey make this decision.”
On Nov. 18, the DHF began soliciting bids for a vendor that “would contract with the staffing agencies and provide support and guidance as a contract staffing agent [broker]” for seven facilities across the state. The bid window closes Dec. 5. The announcement comes as the state is strongly considering selling several of the facilities to private companies due to long-term cost.
A spokesperson for DHF didn’t respond to multiple questions for this story, including how much the contract could cost the state.
House Speaker Roger Hanshaw, R-Clay, said he supported the change to one vendor.
“I think the data would bear out consolidating into a single vendor with a solid track record of doing this and doing it well is the exact right way to care for West Virginians,” he said.
Lawmakers and educators have attempted to bolster the state’s nursing programs, but shortages persist. The number of medical staff determines how many patients can be served; as of August 2023, only two of the hospitals — William R. Sharpe, Jr. Hospital in Weston and Mitchell Bateman in Huntington — were operating at licensed bed capacity, according to the audit.
“The remaining five facilities were operating 309 beds short of the total licensed bed capacity,” the audit said.
Del. Kayla Young, D-Kanawha, said the new effort from DHF showed that the department “would rather contract with a vendor to outsource most of the jobs permanently.”
“We knew there wasn’t one solution to this problem facing most of the country, but this doesn’t seem like the best outcome for West Virginia workers or patients,” she said.
Contract nurses key in filling vacant positions
There’s a national shortage of nurses, and the audit said most nurses were leaving West Virginia due to low wages. Del. Amy Summers, a registered nurse, said that some nurses prefer contract work as they can earn the wage they feel they deserve.
“The contract is usually limited to 12 weeks so if the work environment is poor they can leave. If they like it they can sign on to another contract,” said Summers, R-Taylor. “They may also want to not work during the summer when their children are out of school and this gives them schedule flexibility.
She agreed with DHF’s decision to streamline its process for hiring contract nurses in hopes of filling positions. Choosing a company to assist with this is much faster than the old way of doing things through the Office of Personnel, she said, which had contributed to the hundreds of days it previously took to fill positions.
The recent audit, conducted by the , said that up until 2023, the hiring process for full-time nurses was on average 688 days. DHF said the process has improved.
As the state considers selling its four long-term care facilities, Disability Rights West Virginia Legal Director Mike Folio said he questioned whether the change “would right size the government or merely bloat DHF’s growing bureaucracy.”
DRWV advocates for patients in state-run facilities.
“If DHF wants to get out of the health care business why not enter a management contract and let a provider manage and operate the facilities?” Folio questioned.
“State W-2 health care workers have the same duty to patients as contract health care workers. Hiring a contractor to establish a parallel personnel management system exclusively for contract workers will likely create confusion and turf wars between DHF’s entrenched bureaucrats and the vendor,” he continued.
The seven facilities are authorized for 845.90 full-time employees (FTEs); as of fiscal year 2023, only 289 FTEs were filled with facility employees, while contracted labor accounted for roughly 543 FTEs.
Over the last two years, contract nurses have been linked to crimes and patient mistreatment in state-run facilities. After West Virginia Watch reported that multiple contract employees at Sharpe were arrested and charged with crimes in 2023, state health leaders said they’d change the contract employee vetting process.
Earlier this year, three contract nurses were fired from Hopemont Hospital in Terra Alta for their involvement in a gruesome death of an elderly patient in a boiling whirlpool.
YOU MAKE OUR WORK POSSIBLE.