An Arkansas legislative panel on Tuesday approved diverting funds from a state health care data hub to start a midwifery education program at the state’s largest medical school.
Rep. Mary Bentley, R-Perryville, proposed removing the Arkansas Center for Health Improvement from a section of a University of Arkansas for Medical Sciences appropriations bill and rewriting it to direct $500,000 to “personal services and operating expenses of [a] certified nurse midwifery program” that the school plans to begin in 2026.
ACHI is not a state agency, but its administration is housed within UAMS.
Certified nurse midwives, which Bentley said could help improve maternal health outcomes in Arkansas, are required to have bachelor’s degrees in nursing and two years of experience in the field before entering a two-year midwifery training program.
Several lawmakers on the Joint Budget Committee voted against the measure, which failed Thursday but passed Tuesday, mostly along party lines. Sen. Jimmy Hickey of Texarkana was the only Republican to vote no.
Bentley, a retired nurse, said Thursday that she did not believe the funding cut would have a negative impact on ACHI’s services, which mostly consist of compiling and presenting healthcare data to state agencies and the general public.
“We have a lot of data centers here, so it’s really not [affecting] anything we need that we can’t do without,” she said.
ACHI President and CEO Dr. Joe Thompson disagreed Tuesday.
“This will impair our ability to support state agencies and the Bureau of Legislative Research in analyses of the All-Payer Claims Database,” he said, referring to the state’s database that tracks “how and where healthcare is being delivered and how much is being spent,” according to its website.
The APCD contains data from Medicaid coverage, qualified health plans provided by the state Department of Human Services, and employee health plans for state and public school employees, among other things, Michelle Kitchens, ACHI’s Director of Governmental Affairs and Community Outreach, said Thursday.
Kitchens said she believes ACHI has the best ability in the state to gather and organize this data.
“[State funding] allows us to explore what’s out there, help see the landscape, help tell the General Assembly and the public more about what’s happening,” she said.
One unique dataset the organization has compiled is an analysis of the rates of Cesarean section births throughout Arkansas, broken down by maternal age, volume per county and how frequently C-sections occur in a pregnant person’s first time giving birth.
ACHI’s annual budget is roughly $7 million, and the proposed $500,000 cut would account for 7% of the budget, Kitchens said.
UAMS would prefer that the Legislature fund both the midwifery program and ACHI, so the university is neutral in the debate over whether to fund the program at ACHI’s expense, Andy Davis, UAMS’ Vice Chancellor of Institutional Relations and a former Republican state representative, said Tuesday.
The program is scheduled to begin in 2026, meaning its first graduating class would complete their certifications in 2028.
New midwives could help both rural and urban Northwest Arkansas residents who sometimes travel to Missouri or Oklahoma to receive care from certified nurse midwives because there are so few in Arkansas, said Rep. Delia Haak, R-Siloam Springs.
“I’ve had this issue brought up to me many times over the course of my two terms here, and I support this wholeheartedly,” Haak said Thursday.
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Concerns
Democratic lawmakers said their qualms about reducing ACHI’s funding existed alongside their support for increasing midwifery services in Arkansas in order to reduce the state’s maternal and infant mortality rates — the highest in the nation, according to ACHI data.
The Legislature could “look at some other funding mechanisms as opposed to taking it from the place where we actually utilize the assimilated data for each one of our agencies and resource hospitals,” said Rep. Denise Garner, a Fayetteville Democrat and retired nurse.
The Joint Budget Committee approved another appropriations bill Tuesday that would double a taxpayer-funded grant to support pregnancy resource centers, which are often religiously affiliated and discourage abortion while encouraging birth. The state has distributed the $1 million yearly grant to 27 organizations over the past two years.
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Garner pointed out that pregnancy resource centers are “non-healthcare entities” and that the $2 million proposed for the grant fund would support four years of the upcoming midwifery program.
Republican Rep. Charlene Fite of Van Buren, who presented Bentley’s proposal in her absence Tuesday, said she believed Bentley “and others spent a great deal of time looking through the budget and trying to find the best way to fund this program.”
On Thursday, Bentley and Sen. Dan Sullivan, R-Jonesboro, both said the state Department of Health disputed ACHI’s research during the COVID-19 pandemic that led the organization to recommend face masks and vaccinations as protective measures against the virus.
In response to this discussion, Rep. Andrew Collins, D-Little Rock, asked Bentley if the defunding proposal was meant “to punish ACHI for publishing public health information that you disagreed with during the pandemic.”
“It has nothing to do with punishment,” Bentley said. “It has to do with prioritizing.”
