By Tim Carpenter, Kansas Reflector
TOPEKA — The state of Kansas invests more than $60 million annually to hire contract nursing staff to work at state psychiatric hospitals in Larned and Osawatomie, but the financial boost hasn’t closed job vacancy gaps exceeding 33% at both facilities.
On Tuesday, Kansas legislators on a special committee exploring contract nursing shared disappointment with results of years of stopgap appropriations to hire temporary nurses provided by private companies. The state also has devoted resources to raising salaries and providing bonuses to encourage state-employed nurses to remain at the hospitals.
Lawmakers expressed skepticism Kansas would ever have enough people to fill vacancies at state hospitals serving involuntarily committed or criminally charged individuals with mental health issues, as well as sexually violent offenders detained at Larned after serving prison sentences.
“In my experience, we’re not going to build this staff to take care of the number of people that are out there right now,” said Rep. Will Carpenter, an El Dorado Republican who chairs the Legislature’s interim health committee. “Prove me wrong, because I want to be wrong.”
Carpenter suggested consideration be given to transferring about 100 patients from Larned to other locations so staffing levels could be sustained without contract nurses. In 2027, Kansas is scheduled to open a new 104-bed state psychiatric hospital in Sedgwick County.
Expenditures at Larned State Hospital for nursing contract labor increased from $5.9 million in 2019 to $8.6 million in 2021, $43.1 million in 2023 and $46 million in 2025. At Osawatomie State Hospital, contract costs surged from $233,000 in 2019 to $3.2 million in 2021, $16 million in 2023 and $15.4 million in 2025. The job vacancy rate at Osawatomie stood at 35.5%, while the rate at Larned was 33.5%.
“I’ve been incredibly disappointed on how that’s worked,” Carpenter said.
Scott Brunner, deputy secretary of the Kansas Department for Aging and Disability Services, said the agency used state tax dollars to bring in dozens of registered nurses and licensed practice nurses to care for patients who generally had complex medical needs. Some require one-on-one care.
“To keep our bed count open at the levels that they are,” he said, “we have to have enough staff to make sure patients are safe.”
He said the starting salary for a registered nurse at the state hospitals was about $40 per hour. The state paid companies providing contract registered nurses $90 to $100 per hour to take on the same responsibilities, with the nurse receiving approximately two-thirds of the total.
“We certainly don’t think contract labor is a solution,” Brunner said. “It’s a way of addressing the need to keep beds open and keep patients moving through the system.”
He recommended the Legislature pass House Bill 2237, which is hung up in the Senate, to place in state law the ability of state agencies to award employee bonuses in amounts up to $10,000 per year. He urged lawmakers to keep funding cost-of-living and market-rate adjustments to salaries so state hospitals could compete with the private sector for labor. The existing budget for contract nurses needs to be sustained, he said.
In addition, Brunner suggested the state expand college scholarships for nurses, consider providing nursing students with financial support in exchange for post-graduation employment agreements and provide training opportunities for experienced nurses to advance their careers.
Ashley Byram, superintendent of the Osawatomie hospital, said only half of the facility’s RNs, LPNs and mental health technicians were state employees. Here’s the split between state employee and agency contract workers at Osawatomie: RNs, 16 state and 16 private; LPNs, three state and 13 private; and mental health techs, 39 state and 33 private.
She said Osawatomie contract nurses were asked what it would take for them to accept state employment. The nurses weren’t interested in signing bonuses or housing allowances, she said, but were keen to earn salaries of at least $50 per hour. The average RN at Osawatomie has been paid $44 per hour, or $59 per hour when benefits were included.
“I would increase the salaries,” Byram said. “It’s the current wage gap between agency and state positions that is our primary obstacle.”
If the Legislature prohibited payment of contract nurses to staff the Osawatomie hospital, she said, the facility had enough nurses to make use of 43 beds. She said 116 beds at Osawatomie would be closed if contract nurses were removed and replacements weren’t hired.
Lindsey Topps, superintendent at Larned, said the hospital averaged 400 patients with more than half the total in a sexual predator treatment program.
“We have, I say, no fat on campus,” Topps said. “We’ve maximized the amount of residents or patients to the RNs and LPNs in order to provide safe and good patient care as well as follow the regulations.”
Here is the breakdown between state employees and contract laborers at Larned: Registered nurses, 17 state and 38 private; LPNs, nine state and 27 private; mental health workers or CNAs, 194 state and 179 private.
Topps said debate by the Legislature about reducing contract nursing labor should take into consideration the aggressive, disruptive, suicidal and homicidal conduct of people at Larned. She said most community-based health facilities didn’t have the staff or facilities to deal with individuals who ended up at the state hospital.
“We have some of the most severe mentally ill individuals in the state of Kansas,” Topps said.
During the 2025 legislative session, the House and Senate didn’t approve financing for new spending on contract nursing at the two state hospitals.
“Sometimes we set aside money because that feels good and we think that’s going to to do something,” said Sen. Beverly Gossage, a Republican from Eudora.
Sen. Renee Erickson, R-Wichita, said the state had a handful of initiatives designed to develop a Kansas pipeline of nurses who could fill jobs at state hospitals. She said the state spent millions of dollars so 2,700 high school students could take courses required to become a certified nursing assistant. She said only one-third of those students became CNAs.
“We’re paying to fill that pipeline, but it’s not translating,” she said. “It doesn’t appear like (it’s) actually reducing the demand and getting to the root of the problem. It doesn’t seem to be making the impact it should or we would hope it should.”
