Marina
Kansas is spending more than $60 million every year to hire contract nurses at its psychiatric hospitals in Larned and Osawatomie, yet staff shortages remain severe.
Vacancy rates are still above 33 percent in both facilities, leaving lawmakers frustrated with years of costly stopgap measures that have failed to solve the crisis.
1. Rising Costs of Contract Labor
Spending on contract nursing staff has surged dramatically in recent years.
| Hospital | 2019 | 2021 | 2023 | 2025 | Vacancy Rate (2025) |
|---|---|---|---|---|---|
| Larned | $5.9 M | $8.6 M | $43.1 M | $46 M | 33.5 % |
| Osawatomie | $0.233 M | $3.2 M | $16 M | $15.4 M | 35.5 % |
Despite these rising costs, hospitals still cannot maintain adequate staffing levels without relying heavily on outside agencies.
2. Lawmakers Express Frustration
Legislators have openly voiced disappointment with the results of repeated appropriations for contract labor. Many argue that Kansas may never be able to fully staff its psychiatric hospitals through traditional hiring alone.
Some officials even suggested transferring patients to other facilities to help reduce dependence on contract workers until the state can stabilize its workforce.
3. Why Contract Nurses Cost More
Contract labor is expensive but necessary to keep psychiatric hospital beds open and ensure patient safety.
- State-employed RN pay: about $40/hour
- Contract RN cost: $90–$100/hour
- Contract nurses typically receive two-thirds of the total paid to agencies
This pay gap has made it harder for the state to attract and retain nurses directly.
4. Hospitals Struggling With Retention
At Osawatomie State Hospital, nearly half of nurses are contract workers. When asked what would convince them to switch to permanent state employment, many pointed to one factor: higher pay.
- State RNs earn around $44/hour, or $59/hour with benefits
- Contract nurses want $50/hour or more to consider state roles
Without competitive wages, the state risks losing more staff and closing hospital capacity. Without contract nurses, Osawatomie could only operate 43 beds, compared to 116 beds with contract staff.
At Larned State Hospital, the average daily patient count is around 400, including a large number of individuals in the sexual predator treatment program.
Staff there stress that patients often exhibit aggressive or self-harming behaviors, requiring more intensive nursing oversight.
5. Legislative Proposals and Possible Solutions
To address the crisis, officials have proposed several strategies:
- Passing House Bill 2237 to allow bonuses of up to $10,000/year for state nurses
- Continuing cost-of-living and market-rate salary adjustments
- Expanding scholarships and financial support for nursing students
- Offering training opportunities for career advancement
- Building new facilities, including a 104-bed psychiatric hospital scheduled to open in Sedgwick County in 2027
However, efforts to create a pipeline of new nurses have not yielded expected results. For example, while the state funded 2,700 high school students to take courses for nursing assistant certification, only about one-third completed the path.
Kansas legislators are increasingly worried about the unsustainable $60 million annual cost of contract nurses at state psychiatric hospitals.
The problem is not just about money—it is about the wage gap, recruitment pipeline failures, and the difficulty of retaining qualified staff in high-stress environments.
Unless bold steps are taken—through higher pay, better incentives, and new workforce development strategies—the state risks continuing a cycle of high costs and chronic shortages in its mental health system.