Arkansas Advocate: Southwest Arkansas needs more funding for health services, providers and law enforcement say
Southwest Arkansas Regional Medical Center Chief Administrative Officer Shelby Brown (second from right) presents the financial state of the hospital to Arkansas lawmakers on Thursday, Sept. 11, 2025. From left: Rep. Aaron Pilkington, R-Knoxville; Sen. Clint Penzo, R-Springdale; former Rep. Danny Watson, R-Hope; and Arkansas Ambulance Association President Amanda Newton. (Tess Vrbin/Arkansas Advocate)
HOPE — Hempstead County health care providers and law enforcement officers told Arkansas lawmakers last Thursday they need more money in order to meet Southwest Arkansas’ mental and physical health care needs.
Southwest Arkansas Regional Medical Center is owned by Jamie Pafford Gresham. Neither Pafford Medical nor Pafford Health owns any part of the hospital.
Jamie Pafford Gresham purchased the local hospital a year ago after its previous corporate owner filed for bankruptcy.
In addition to Hempstead County, the Southwest Arkansas Regional Medical Center serves three counties that do not have hospitals: Lafayette, Nevada and the southern portion of Pike. If financial strain closed the hospital, it would leave “a big hole in Southwest Arkansas,” Chief Administrative Officer Shelby Brown said.
“Right now, we have more money going out than we have money coming in,” Brown told the Joint Public Health, Welfare and Labor Committee, which met Thursday morning at the hospital.
Brown and Republican Rep. Dolly Henley, who represents Hope and serves on the House Public Health committee, both said they have asked Gov. Sarah Huckabee Sanders and her staff to visit the hospital and help them come up with financial solutions. Sanders has not yet visited the facility, Brown and Henley said.
In a statement Thursday evening, Sanders spokesperson Sam Dubke said rural hospitals nationwide will receive $50 billion through the Rural Hospital Transformation Fund created in President Trump’s “One Big Beautiful Bill,” adding that the governor is “working closely with her federal partners to secure resources for Arkansas’ rural hospitals, including the Hope Hospital.”
Reps. Dolly Henley, R-Washington, and Carol Dalby, R-Texarkana, at the Joint Public Health, Welfare and Labor Committee meeting on Thursday, Sept. 11, 2025. (Tess Vrbin/Arkansas Advocate)
The Legislature distributed nearly $60 million in federal pandemic relief funds to 17 rural hospitals deemed eligible for the aid between 2022 and 2024. Hope’s hospital, then called Wadley Regional Medical Center, did not receive aid from this subset of COVID-19 relief funds.
Medicare and Medicaid make up roughly a combined 66% of the hospital’s payers, Brown said, and many “people who are really at risk see us as their primary care provider.”
The hospital gets paid $12 per Medicaid patient who uses its emergency room for non-emergent primary care, she said.
She also said Southwest Arkansas Regional has applied to be a critical access hospital, a federal designation for facilities located no less than 35 miles from other hospitals and maintaining no more than 25 beds. The federal Centers for Medicare and Medicaid Services subsidizes critical access hospitals for inpatient treatment of Medicare recipients.
If CMS approves Southwest Arkansas Regional’s application, it will have to reduce its inpatient beds from 48 to 25. The hospital will also be required to retain intensive care patients for no longer than an average of 96 hours.
Brown said she and other hospital administrators considered seeking rural emergency hospital status, which draws more federal funds to rural hospitals if they reduce or eliminate inpatient services and focus on emergency and outpatient treatment.
“But if we did that, you have to get rid of all your acute beds, and the community decided that’s not where we need to be,” Brown said.
The Hempstead County Quorum Court and the Hope board of directors each passed resolutions in June 2024 pledging $1,000,000 to support the hospital in 10 installments of $100,000 per month.
From left: Arkansas Ambulance Association President Amanda Newton and Southwest Arkansas Regional Medical Center Chief Administrative Officer Shelby Brown present Pafford’s Medlink for telehealth calls for the ambulance providers to Joint Public Health, Welfare and Labor Committee members Rep. Denise Ennett, D-Little Rock; Sen. Missy Irvin, R-Mountain View; and Rep. Aaron Pilkington, R-Knoxville (far right) on Thursday, Sept. 11, 2025 in Hope, Arkansas. Second from right is Jessica Hardin of Pafford Health Systems, which owns the hospital. (Tess Vrbin/Arkansas Advocate)
More services needed
After the committee meeting, Brown and Pafford employees led lawmakers on a brief tour of the facility, including the intensive care unit and a Pafford ambulance.
The Medlink is technically separate from the hospital and is owned and operated by Pafford, Brown said. The hospital also has a geriatric psychiatric ward.
The hospital wants to add services, such as colonoscopies, “but we need to get our feet planted and financially stable” first, Brown said.
About 25% of local ambulance calls result in a patient refusing to be transferred to a hospital, and this creates expenses with no attached revenue stream, said Pafford marketing director Suzy Barham and Arkansas Ambulance Association President Amanda Newton.
In addition to becoming a critical access hospital, Southwest Arkansas Regional is also in the process of becoming a nonprofit. This will help repay some of the money the Pafford family has invested in keeping the hospital afloat, Brown said, and it will make the hospital eligible for the federal 340B discount prescription drug pricing program.
Lawmakers and local law enforcement officers said another potential revenue stream for the hospital would be mental health services if it had the funding to provide such care. About 20% of county jail inmates in Miller County, Hempstead County’s neighbor to the west, need mental health treatment, Miller County Sheriff Wayne Easley said.
Texarkana, Arkansas, is the Miller County seat and no longer has a hospital, leaving Southwest Arkansas Regional as the closest facility. Texarkana Police Chief Ed Chattaway and Hope Police Chief Kimberly Tomlin both said Hope’s hospital could be a good point of intervention for people whose mental health struggles attract police attention.
“If they aren’t breaking the law and they’re in that limbo spot before something happens, sometimes you have to walk away from people that you know need something,” Tomlin said.
Arkansas has three crisis stabilization units — located in Little Rock, Fort Smith and Jonesboro — established in 2017 as alternatives to incarceration for people with substance use and mental health issues.
Sen. Missy Irvin, a Mountain View Republican and the Senate chair of the Public Health committee, said the units are underfunded and mental health resources need a stronger support system.
“We have to have a collaboration and a partnership to go back and see what’s working, where it’s working and how it’s working,” Irvin said. “It’s going to require a commitment and spend from the Legislature, in my opinion, and I think it’s a worthy spend.”
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