An Arkansas man accused of killing his teenage daughter’s alleged abuser recently won the Republican nomination for local sheriff while waiting to stand trial for murder in his rural county, where he ran on a message of seeing the failures of law enforcement.

Aaron Spencer defeated Lonoke county sheriff John Staley in a primary election Tuesday, according to unofficial results posted by the Arkansas secretary of state. He would not be able to serve if he is convicted of killing Michael Fosler, 67, who at the time was out on bond after being charged with numerous sexual offenses against Spencer’s then 13-year-old daughter.

Spencer’s attorneys do not deny that he shot and killed Fosler – but maintain he acted within the law to protect his child from a predator.

Spencer won more than 53% of the vote with all precincts reporting, according to unofficial results. Staley, whose department arrested Spencer in 2024, conceded the loss.

“Congratulations to Mr Spencer,” Staley said in a statement posted on Facebook. “Tonight the voters made their decision in the Republican Primary, and I respect the decision.”

Spencer said in a statement that his message of accountability resonated with voters.

“Tonight, the people of Lonoke county stood up and chose transparency and accountability,” Spencer said. “This wasn’t a campaign about me. It was about every family who called for help and got nothing. That betrayal ends tonight.”

He is now set to face Democrat Brian Mitchell Sr in the heavily Republican county in November.

Spencer has pleaded not guilty and is out on bond while awaiting trial, which was originally scheduled to start in January. The trial was delayed after the presiding judge was removed from the case. A new date has not been set.

Court documents show that on the night of the October 2024 shooting, Spencer woke up to find his daughter missing from her bedroom and went searching for her in his truck. He found the girl in the passenger seat of a vehicle Fosler was driving. Spencer eventually forced Fosler’s truck off the highway and, after an altercation, called 911 to report he had shot the man, records show.

Prosecutors argue Spencer had planned to kill Fosler even before that night and that he could have called police while pursuing Fosler.

Spencer’s attorney, Erin Cassinelli, wrote in an email to the Associated Press that the election results have no bearing on the facts of the case.

“Aaron Spencer did exactly what the law allows and exactly what any father would do: he protected his daughter and himself from harm,” Cassinelli said. “At some point, those responsible for this prosecution will have to reckon with that.”

Spencer pledged in a Facebook post in February that if elected he would establish a dedicated team to combat sex crimes against children.

Arkansas has made significant investments to strengthen its primary care physician workforce over the past decade. New medical schools have opened in the state, residency program slots have increased, and loan forgiveness programs have been established to incentivize residency graduates to remain in the state to practice. Despite these efforts, access to a usual source of care (i.e., a place where one goes for routine healthcare needs) remains a challenge for many Arkansans, according to a new report.

Published February 12 by the Milbank Memorial Fund, the report, “Investing in Primary Care: The Missing Strategy in America’s Fight Against Chronic Disease,” evaluates states’ primary care performance. Among its findings is that 18% of Arkansas adults report not having a usual source of care, which is comparable to the national estimate of 17%. That means that nearly 1 in 5 Arkansans do not have a consistent way of interacting with the state’s healthcare system.

Access to a Usual Source of Care

Nationwide, the report finds that among adults with chronic disease, having a usual source of care is associated with lower odds of hospitalization and lower total spending on health care. These findings are particularly relevant for Arkansas, where chronic disease prevalence remains high. The most recent America’s Health Rankings report from the United Health Foundation ranked Arkansas 44th among all 50 states and the District Columbia for its percentage (15%) of adults with three or more chronic conditions — such as arthritis, diabetes, or cancer — in 2023, with the top-ranked state having the lowest percentage.

The Arkansas Primary Care Payment Improvement Working Group, established under Act 483 of 2025, is currently examining primary care investment in the state. The group, which includes a representative from ACHI, is tasked with measuring current primary care spending, evaluating the adequacy of the primary care delivery system, and recommending spending targets for Medicaid and commercial insurers. These efforts align with national recommendations to track and increase primary care investment, an issue we highlighted in a previous post.

Arkansas’s Primary Care Workforce

The country’s primary care workforce supply is another focus of the Milbank report. The report estimates that Arkansas had 58 primary care physicians per 100,000 residents in 2023, below the national average of 68 per 100,000 residents. The Milbank report also finds that 29% of Arkansas physicians were working in primary care in 2023, compared to 27% nationally.

The state’s higher-than-average share of physicians choosing primary care is encouraging, but long-term retention and geographic distribution remain challenges. ACHI developed the Arkansas Primary Care Physician Workforce Dashboard, an interactive tool that allows users to view data on primary care physicians practicing in Arkansas. The dashboard — which uses a broader definition of “primary care physician” than the Milbank report’s — shows that per capita rates of primary care physicians vary widely between urban and rural counties, and that two counties, Montgomery and Newton, had no active full-time primary care physician in 2022. The dashboard also shows that 26% of fill-time primary care physicians in the state were 60 or older in 2022, raising concerns about future supply as many approach retirement.

The Milbank report finds that in communities with higher levels of social deprivation — measured by the social deprivation index, a composite indicator of socioeconomic hardship — primary care physician availability in Arkansas is lower on average than in similarly deprived communities nationwide. Given the high burden of chronic disease among Arkansans, this is a concerning finding.

Recommendations

States that invest in primary care, as highlighted in the Milbank report, experience downstream improvements in population health and lower healthcare costs. Arkansas has established the infrastructure to evaluate and potentially increase those investments. ACHI will continue to track physician supply, distribution, and access to help inform primary care policy discussions.

Find more information about Arkansas’s healthcare workforce on our topic page.