Federal Policy Agenda 1-21-10 The University of Kansas Medical Center prepares students for leadership roles in today's dynamic health care environment in Schools of Medicine, Nursing and Allied Health. We offer more than 3,100 students an innovative curriculum and patient-centered clinical training in partnership with many institutions, including The University of Kansas Hospital. KU Medical Center is also recognized as a leader in biomedical and public health research within the city, state and region. However, the recent unprecedented state budget cuts have put our institution’s forward motion in jeopardy. The American Recovery and Reinvestment Act of 2009 has proven to be critical in stabilizing funding for higher education during this difficult economic time. KUMC’s federal policy agenda includes: Support for National Institutes of Health (NIH) funding as we continue to build on our strong research efforts. Federal support for life sciences research is crucial for discovering new cures and treatments for disease, as well as for propelling economic growth. The primary federal support for medical research comes from NIH-funded grants. KUMC NIH Funding, reflecting cuts to overall NIH funding At KUMC, sponsored research support over the past four years has risen 29 percent to $98 million in fiscal 2009. The national ranking of the KU School of Medicine has increased from 81st in fiscal year 2005 to 65th in fiscal year 2009. Since 2005, 178 new faculty positions have been created and filled, including 38 basic scientists, 15 clinical scientists and 105 clinical educators. Research faculty members recruited to new positions include 12 professors, nine associate professors and 42 junior researchers. Over this same period, KUMC has grown its number of MD/PhD students from three to 31. Currently, 24 out of the 25 investigators at the Stowers Institute have KUMC faculty appointments. Unfortunately, state budget cuts have recently slowed down faculty recruitment making NIH funding all the more critical. This past year saw a spike in NIH funding through the American Recovery and Reinvestment Act (ARRA), but NIH funding has otherwise remained generally flat in recent years, even declining in terms of inflation. This has had a negative effect on many NIH programs including the Clinical and Translational Science Award (CTSA) program, designed to help institutions increase and accelerate translational research to more rapidly bring discoveries made in laboratories to application in health care practice, and to train new clinical and translational researchers. The University of Kansas Medical Center applied for a CTSA in late 2009, but the available funds at NIH will greatly restrict how many new CTSA programs may be funded in this cycle, requiring most applicants to re-apply despite receiving meritorious scientific reviews. While Congress and the President recently passed an additional increase for NIH funding, sustained, constant growth in the NIH budget is essential for fostering economic growth and scientific breakthroughs. Support for National Cancer Institute (NCI) funding as we work toward NCI designation. The top research priority for the University of Kansas continues to be the pursuit of National Cancer Institute (NCI) 1 designation. Our goal is to build a world-class Cancer Center at the forefront of discovery, development, and implementation of knowledge, technology, and novel therapeutic agents for the treatment and prevention of cancer. NCI designation would mean greater access to cutting edge clinical trials for local patients, and independent analysis suggests that NCI designation would mean thousands of jobs and billions of dollars for the local economy. Critical to our efforts is the procurement of equipment and facilities necessary to reach our goal. Our federal delegation has been helpful in these efforts, and thus far this year KU received $5.5 million in federal appropriations for equipment and facilities. Support for expanding the Health Care Workforce and Graduate Medical Education. Expanded health insurance coverage, a major emphasis in federal health reform, will require developing a health care workforce sufficient to handle increased demand, particularly for primary care services. In Kansas and across the country, we face shortages of physicians, nurses, and allied health professionals like physical therapists and occupational therapists. This is especially true in rural areas. A national, coordinated, well-planned effort to develop health workforce policy is essential to ensure that workforce challenges are met. In addition, federal workforce programs like those in place through Title VII and Title VIII of the Public Health Service Act, as well as the National Health Service Corps program, have been effective in focusing on areas of need as we face a rising demand in health care services. In addition, specific to the physician workforce, both the House and Senate health care reform bills address the current cap on residency slots supported by Medicare funding. However, both bills only go so far as to redistribute the system’s unused residency slots, which is unlikely to benefit Kansas under the listed criteria. Increasing the amount of total residency slots is crucial to meet the need for additional physicians. Primary Care Residents being trained at the University of Kansas Medical Center Program Kansas City Wichita Salina - Family Medicine 30 82 12 - General Pediatrics 25 14 0 - Geriatric 2 0 0 - Internal Medicine 84 36 0 - Med/Peds 3 8 0 Primary Care Sub-total 144 141 12 - OBY/GYN 11 20 0 - General Surgery 22 31 0 All Primary Care Residents 177 191 12 Ensuring routine coverage of health care costs for those who participate in clinical trials. A growing number of states have implemented rules or established agreements requiring health plans to cover the routine costs for health care services when a patient participates in a clinical trial. However, not all states have these rules or agreements, and those that do exist vary in terms. A requirement that health plans cover the cost of routine health care services that a patient would otherwise receive would help ensure fullest participation in clinical trials, which is critical to a number of important research efforts, including our Clinical Translational Science Unit (CTSU) and our NCI designation efforts. Support for general higher education policy. The University of Kansas is the only Association of American Universities (AAU) institution in the state, and works closely with the AAU as well as the Association of Public Land Grant Universities (APLU) on federal policy issues impacting higher education institutions. These issues include support for expansion of the Pell Grant program and other federal direct lending programs, support for expanded funding for basic and applied research, and support for educating tomorrow’s workforce. 2