Can Caring for Missourians training program endure?

Gov. Jay Nixon is touting a program aimed at producing more medical professionals at universities as an effective way of dealing with a critical shortage of doctors and nurses in the state.

But some Republicans are questioning whether funding for the program can be sustained, especially in these tough budgetary times.

The initiative – which has been dubbed “Preparing to Care” and “Caring for Missourians” – was the brainchild of former interim University of Missouri System President Gordon Lamb. The idea was to use additional state funds to expand the number of slots at colleges and universities for medical professional students. After graduating, some of those individuals would then build up the state’s health care infrastructure.

After several fits and stops in the past couple of years, legislative budget writers allocated about $40 million in federal stimulus money to jumpstart the program. Roughly $24.3 million will go to the University of Missouri system.

Although the money could technically be used for any purpose, the UM system announced it would use the funds to carve out more space for students in the health care professions.

According to a fact sheet provided by the University of Missouri system, the funds will go toward expanding facilities and increasing class sizes. For example, MU’s School of Medicine plans to use funding from the program to graduate an additional 16 physicians.

And Kris Hagglund, the associate dean of the MU School of Health Professions, said people graduating with health care professional degrees typically set up shop near their learning institution. That would mean people who become medical professionals from MU could settle in the Mid-Missouri area.

“For nurses, for example, we find that depending on which school you look at and where you are, their retention rate in their region is up around 90 percent,” Hagglund said.

Hagglund said that drawing medical professionals into a community can increase economic growth, in addition to filling the need for health care in underserved areas. He said studies have shown that a physician working in a rural Missouri community generates around $1 million in economic development for the surrounding area.

“It’s great for the state’s economy,” Hagglund said.

Gov. Jay Nixon has championed the program over the past few weeks, saying in a statement that the program “will help us train the next generation of medical professionals to meet the health care needs of tomorrow, while also helping our economy turn around today.”

But two powerful Republicans say funding for the initiative might not be sustainable.

Lt. Gov. Peter Kinder and House Budget Chairman Allen Icet said in a June conference call that funding for the program will dry up during the next budgetary year. That could be problematic, especially because medical professional degrees require many years to complete.

That brings up a question: If a program requiring a multi-year commitment was meant as a one-time expenditure, why did the initiative receive funding at all?

“As everyone on the line knows, [the budget process] is an art of compromise,” Icet said. There were legislators who wanted some funding for the initiative, and Icet made it clear his commitment was “one-time only.”

“And as I spoke with some colleagues, as well as some universities, if this program is a priority they may want to cut another program and use funding from that program to support, and supplant for, Preparing to Care,” Icet added.

Icet had expressed concerns about the program in the past. Earlier this year, he said funding for the program was “dead on arrival.” He also adamantly opposed funding the program in 2008.

One local lawmaker – state Rep. Chris Kelly – disagrees with Icet’s prognosis for the initiative. He said there’s enough support within the legislature to continue funding the program at least through the next budgetary cycle.

“The votes were there, and I think that the votes will be there next year too,” Kelly said. “I like Allen, and I don’t like to disagree with him. But you know, I believe there’s widespread support from both sides of the aisle for that program. And I believe it will get funded again next year.”