Assembly Bill A8173

                                BILL NUMBER:A8173A

TITLE  OF BILL:   An act directing the president of the State University
of New York Upstate Medical University to conduct a study to explore the
viability and compelling need for branch campuses of the State Universi-
ty of New York Upstate Medical University in the Fort Drum/Watertown and
Mohawk Valley Regions of New York State

PURPOSE OR GENERAL IDEA OF BILL: Directs  the  President  of  the  State
University  of New York Upstate Medical University to conduct a study to
explore the viability and compelling need, for Branch  Campuses  of  the
State  University  of  New  York  Upstate Medical University in the Fort
Drum/Watertown and Mohawk Valley Regions of New York State.

SUMMARY OF SPECIFIC PROVISIONS: Section 1 directs  State  University  of
New York UPSTATE Medical University to examine, evaluate and make recom-
mendations  concerning  establishment  of Branch Campuses of the Upstate
Medical University for the Fort Drum/Watertown Region of New York  State
and  the  Mohawk  Valley Region of New York State, including the greater
Utica and Rome areas.

Section 2 directs State University  of  the  New  York  Upstate  Medical
University  to report the findings to the Governor, the Legislature, and
the Board of Trustees of the State University of New York, on or  before
January 2, 2011.

              

Section 3 would provide that the bill would take effect immediately.

JUSTIFICATION: SUNY Upstate Medical University in Syracuse wants to live
up  to  its  name  by taking its people, programs and classroom into the
17-county region it serves. By acting now, the University may be just in
time to address serious health care and economic uncertainties shared by
many communities.

Academic Health Centers (AHC) have a reputation for exhibiting  symptoms
of  "build  it and they will come" syndrome. Indeed, most other AHC's in
New York State sit in the center of their defined universe, waiting  for
patients, referrals, students and trauma victims.

Upstate  Medical  University wants to do something different. It sits in
the center of a region which includes some of the best specialists,  the
finest    facilities    and   access   to   excellent   training.   This
15,000-square-mile region (one third of New York's land  mass)  also  is
home  to  some of the worst health care disparities - and that situation
is getting more dire as we look five and 10 years down the line.

Statewide census and workforce numbers point to the problem: not  enough
physicians  and  health  professionals are choosing small communities in
which to set up practice. The Center for Health Workforce Studies recent
report bears this out. Physician  supply  lags  significantly  in  rural
areas.  While  New York's cities have 340 physicians per 100,000 people,
rural areas have just 169 physicians per 100,000 people, and the  number

is  falling.  In the North Country, the physician population has dropped
by eight percent over the last five years. In that same time period  the
number of active physicians in the Mohawk Valley declined eight percent.

Several  important  documents  have  described the inadequacy of primary
care in New York State. The final report of  the  Commission  on  Health
Care  Facilities  in  the 2st Century (known as the Berger Report) cited
evidence that there is a remarkable lack of  primary  care  services  in
rural  areas  and recommended that all New York residents have a primary
care "home" and that an investment in the  development  of  an  educated
work force is needed to stern the erosion of primary care capacity.

The  American Association of Medical Colleges (AAMC) has also emphasized
the need for more physicians, particularly primary care  physicians.  In
its  "Recent Studies and Reports on Physician Shortages in the U.S." the
AAMC documented 15 independent state  reports  on  physician  shortages,
including  New  York,  and  cited  16  specialty  medical  care shortage
reports, and three national studies on physician work force shortages.

Many call this a "collision of realities". The challenges of rural medi-
cine have left many communities  in  the  region  looking  for  ways  to
produce,  attract - and keep - the physicians, allied health and nursing
professionals to staff their facilities. The withdrawal of a once robust
manufacturing and family farm base has left the populace  older,  poorer
and sicker with fewer resources to take care of them.

Multiple  issues  surrounding  care  of the elderly continue to surface.
The existing lack of primary and specialty care is made  more  acute  by
the  prevalence  of  the big four diseases: diabetes, asthma, cancer and
heart disease. Upstate's name reflects  its  mission...  that  means  it
further plans to extend itself to the community in ways not seen before.
Fortunately,  a  good  outreach model exists - the Cooperative Extension
pioneered by Land Grant Colleges  and  Universities,  including  Cornell
University.  To  create its own version of an extension program, Upstate
would join forces with the health care, higher education,  and  business
leadership  of  the  region  to  complement their services and establish
branch campuses and programs. All four colleges at SUNY Upstate would be
involved: the Colleges  of  Medicine,  Nursing,  Graduate  Studies,  and
Health Professions.

SUNY  Upstate is committed to being part of the solution with its recent
launch of a "regional extension" concept to meet health care and medical
workforce needs. This ambition  includes:  providing  medical  care  and
access for patients; educating students; developing degree programs that
respond  to  State  needs;  increasing  the student body, especially the
percentage from New York State, and offering  continuing  education  for
doctors,  nurses  and other health professionals in Central and Northern
New York, and the Southern Tier.

Upstate already occupies a small footprint in the region. Its Binghamton
Campus has been training 80 third and fourth year medical students  each
year since the 1970's. Upstate's Department of Family Medicine is on the

cusp  of  enhancing  its  Rural  Medical  program  which  places medical
students into outlying communities for a real-time, up close  experience
with regional hospitals and physician preceptors.

The prospect of a Branch Campuses for the Fort Drum/Watertown and Mohawk
Valley  regions  is a perfect fit for Upstate's Regional Extension model
and should be explored in detail. Such campuses would  provide  a  ready
supply of professionals - including medical graduates, physician assist-
ants  and  nurse  practitioners specializing in family mental health and
lift the clinical profile of the communities.

PRIOR LEGISLATIVE HISTORY:  2009: A.8173 - Reported to Assembly  Ways  &
Means Committee.

FISCAL IMPLICATIONS:  Not applicable.

EFFECTIVE DATE:  Immediately.