Proposed Reductions in State Funds to Affect Schools Differently
After consecutive years of cutting state general funds from their budgets, UCSF deans are preparing for another round of reductions for fiscal year 2008-2009.
No decisions have been made about the budget for this coming fiscal year, but if UCSF must implement a proposed 7 percent cut in state general funds, the Graduate Division and the schools of dentistry, nursing and pharmacy are expected to be hardest hit because state funds comprise a greater proportion of their budgets.
UCSF deans say that they will do everything they can – including looking for other revenue sources -- to preserve the high quality of their teaching and research programs. State support is vital to the education of future physicians, nurses, dentists, pharmacists and PhD students.
Graduate education and research at UCSF and throughout the UC system have long fueled California's innovation and economic development, helping establish California as one of the ten largest economies in the world.
The quality of the University's professional schools is critical to maintaining California's leadership role in health sciences, health care and policy. Increased funding is needed to offset rising salary and other professional school costs, as well as to maintain and enhance the schools' ability to compete for the best students and faculty. This is particularly critical after years of devastating cuts to professional school budgets.
Fortunately, UCSF ranks among the nation's top universities in competing for grants from the National Institutes of Health (NIH). In fact, UCSF was the third largest recipient of NIH support in 2007, receiving about $439 million from research and training grants, fellowships and other awards excluding research contracts. Gaining NIH research support has become increasingly competitive, with only about 15 percent of grant applications receiving funding.
School of Medicine
If required to implement cuts to state general funds, the medical school will be the least affected, since its share of state general funds comprises about 7 percent of its total operating budget of $1,372 million. The medical school's operating budget is augmented by extramural grants and contracts (39 percent), clinical revenue (27 percent), and gifts and endowments (6 percent), among other sources.
"Although state funds only provide a small portion of the school's overall budget, state cuts have a disproportionate impact on our education programs and our ability to train physicians to care for Californians in the future," says Sam Hawgood, MB, BS, interim dean of the School of Medicine. "State funds are the primary source of salary support for faculty and staff responsible for teaching, curriculum development and other education activities. Any reduction forces us to rely more on clinical and research programs and stresses the faculty's availability for teaching."
Graduate Division
"For the UCSF Graduate Division, a 7 percent budget reduction translates into the loss of precious graduate student fellowships at a time when graduate programs are in desperate need of student support," says Patricia Calarco,
PhD, dean of the Graduate Division. "Despite our extremely high national research rankings, there has been no increase in state graduate fellowship allocation, known as the block grant, since 1992. Thus, the Graduate Division now provides only 12 percent of the needed fellowship support for PhD training."
The combination of increased fees, reduced state student support and declining federal grant dollars further erodes UCSF's competitive edge in the recruitment and retention of diverse, high-quality graduate students and faculty, Calarco points out. "State funds are essentially the only source of UCSF graduate fellowships," she says.
As well, despite increasing the staff workload, a 7 percent reduction may result in the loss of one staff position in a small division providing student and postdoctoral scholar services to about 1,500 graduate students and 1,100 postdocs, Calarco adds.
School of Dentistry
The UCSF School of Dentistry receives about 20 percent of its overall $70 million operating budget from state general funds alone. This figure climbs to approximately 30 percent when all state-derived funds inclusive of dental teaching funds and professional student fee income are accounted for.
The school's budget reduction plan encompasses a combination of strategies such as using other fund sources wherever possible, increasing the workload on faculty and staff, improving clinical efficiency, and leaving some vacant staff and faculty positions open permanently. Unfortunately, layoffs are also part of the plan and notices in anticipation of a 7 percent, or $1.5 million cut, are in process, says John Featherstone, MSc, PhD, interim dean of the dental school.
"Cuts in state funding will have a major effect on the School of Dentistry's ability to maintain its premier position in the education of dentists, faculty and dental scientists," Featherstone says. "With two major state cuts in the last 15 years, the school is already very lean and efficient, having eliminated two programs during the last major budget crisis. This funding was never restored, and the present cuts also will be permanent. This makes the task of educating the future members of the dental profession even more difficult."
And, Featherstone emphasizes, "All of these actions will have a detrimental effect on the school's teaching programs and could have a serious, long-term impact on the oral health of people in California."
School of Nursing
The UCSF School of Nursing, which has increased enrollment in the past few years to help solve the nursing shortage, receives about 40 percent of its total $27.6 million operating budget from the state, including contracts.
"If we have to absorb 7 percent reductions, we will certainly be facing staff and faculty reductions, decreasing the numbers of students we will be able to accept, which would be a very painful decision, given the state mandate to increase nursing enrollments," says Kathy Dracup, RN, DNSc, dean of the nursing school.
Currently, the nursing school is funded to educate 640 nurses in pre-licensure, masters and doctoral programs.
Unlike the School of Medicine, the School of Nursing cannot rely on clinical revenues generated by its practices. Its nurse-run clinics, such as Valencia Health Services in San Francisco's Mission District, serve patients who are primarily uninsured and underinsured, meaning that the school does not receive adequate revenues from these activities to meet the costs incurred, Dracup adds.
State funds also support faculty salaries. "The majority of our state-funded faculty salaries need to be augmented from non-state funds, since the basic state-funded salary is far lower than competitive salaries paid by our own medical center," Dracup notes. "Currently, an advanced practice nurse, such as a nurse practitioner or nurse midwife, working in San Francisco makes about twice the salary of an assistant professor in the UC system. Although we cannot begin to approach a competitive salary for our faculty, we do need to cover some of the shortfall in order to attract faculty who live in the Bay Area."
School of Pharmacy
The UCSF School of Pharmacy has seen the percentage of state general funds allocated to its $60 million budget decline from 24 percent in 2001-2002 to 16 percent in 2006-2007.
The decline in state general funds exacerbates the fact that -- for the past 41 years -- the school's doctor of pharmacy curriculum has been grossly underfunded. The reason is that the state funding workload formula for teaching pharmacy students was established at an 11:1 student-to-faculty ratio.
In 1967, the pharmacy curriculum shifted from a classroom-based model to a small group, faculty-intensive clinical experience. This model requires a student-to-faculty ratio similar to that in the UCSF School of Medicine (3.5:1 student-to-faculty ratio). Unfortunately, the School of Pharmacy's state funding model remains locked at a student-to-faculty ratio of 11:1.
"The school projects a deficit in its state funds and operating budget this year, despite a painful, but necessary 14.8 percent increase in student professional fees," says Mary Anne Koda-Kimble, PharmD, dean of the pharmacy school. "Because faculty and staff are already stretched thin, the school will augment its outside contracts to support its core missions. We will not compromise our education and research programs. We are determined to graduate high-caliber pharmacists who can meet the increasingly complex medication needs of patients and top-notch PhD scientists who will do the innovative new research needed for drug discovery."
