Directs the president of the SUNY Upstate Medical University to conduct a study concerning the need for branch campuses in the Fort Drum/Watertown and Mohawk Valley

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.