The people who run the state’s only medical school say its national accreditation falls in jeopardy or is lost, if money isn’t raised for a new, $75 million structure at its Kansas City campus.
“If you're not an accredited medical school, your students can't take board examinations. Your graduates cannot get into residency programs that are accredited. And in most jurisdictions if you can't sit for your boards and you don't graduate from an accredited residency program you can't practice (medicine), you can't get a license. So accreditation is a huge deal,” said Dr. Glen Cox, the dean in charge of keeping the school OK with the Liaison Committee on Medical Education, the national group that certifies medical schools.
The current education building on the school’s Kansas City campus was built in 1976 and officials here say if it isn’t obsolete it is nearly so, especially given the changes happening in the ways doctors and other health professionals are trained.
“A building built in the 1970s just can't fit the technology needs of today,” said Dr. Steven Stites, acting executive vice chancellor of the University of Kansas Medical Center, which includes the medical school. “We have a structural problem and we can’t renovate it. It would cost more to fix it up than it would to replace it.”
Lecture halls, even in the first year of study, now are considered less important to learning than small practice rooms that allow for simulations that mimic the conditions students — as doctors — will face when they encounter real patients. Also, with growing emphasis on coordinated care within the health care industry, schooling now focuses increasingly on teamwork, not just among fellow medical students but also drawing in nursing students and other health-care trainees.
The school has some spaces for that sort of teaching by doing in small groups, but not enough, according to the people in charge. The accreditation process is so meticulous, as described by Cox, that it even dictates how much private space and storage must be allowed for each resident.
Cox said he is among the few people at the medical school to remember the accreditation problems it experienced in the 1990s, a years-long ordeal he said he would prefer not to live again. And that was before he was the administrator tasked with keeping those things in order.
Need for more docs
Besides warding off accreditation woes, a new school would allow for training more doctors, KU officials said. Experts across the country for years have warned of doctor shortages that have since arrived and are growing and of the need to expand medical schools to slow or reverse that trend.
KU between 1998 and 2007, according to medical school statistics, graduated an average of about 165 medical students per year and 41 percent (an average of about 67 graduates per year) stayed in the state.
The new building would allow the school to have 25 more students per class year in Kansas City and — after counting graduates from expanded satellite campuses in Wichita and Salina — the state should see 96 new KU-trained doctors a year practicing in the state by 2016, according to projections prepared by KU. That would be a net gain of almost 30 doctors a year.
With a generation of baby-boom doctors retiring or soon to retire, many Kansas towns struggle to recruit new doctors. A disproportionate number of the doctors working in the state’s rural and underserved areas are KU graduates.
There are about 259 doctors per 100,000 U.S. residents. In Kansas, however, there are only about 213 doctors per 100,000 residents. The state also is below the national average when it comes to primary care doctors.
According to KU estimates, the state will need 213 new doctors a year by 2030 just to maintain the state’s current below-average ratio. To match the national average, it would need about 285 new doctors a year by 2030.
The tricky part
It’s been known since Coronado traipsed the Plains that gold doesn’t always turn up in Kansas. And, unfortunately, Dr. Glen Cox did not win the Lottery last week (he said), so KU is struggling to come up with a way to pay for the school building that KU and other higher education officials say it must have and that the state needs.
In what could be a first for the state, if it is chosen, Kansas officials are considering contracting with an out-of-state organization to provide services for children in foster care.
Since the state privatized its foster care program in 1997, it has relied on a group of Kansas-based, non-profit organizations to manage the care provided to children who have been deemed wards of the state due to parental abuse or neglect.
Typically, there are about 6,000 children in the state’s foster care system at any given time. The state's lead foster care contractors collectively employ about 800 people.
Each of the organizations that have secured the state’s foster care contracts since the privatization initiative 15 years ago has been active for decades in Kansas child welfare services and are well known by the state’s foster care parents, welfare workers, and court and law enforcement officials.
The current contract holders are: TFI formerly known as The Farm, Inc., which has offices in Emporia and Topeka; KVC Behavioral Healthcare, Olathe; United Methodist Youthville, Wichita; and St. Francis Community Services, Salina.
Now, they face a potential, nonprofit competitor from Florida that provides similar services in multiple states: Florida, Louisiana, Texas, Iowa, North Carolina and Vermont.
“A large part of what we do is very similar to the work that’s being done in Kansas,” said David Dennis, chief executive of Eckerd, which was one of six organizations that met the state’s Sept. 20 deadline for submitting contract proposals.
Eckerd was founded in 1968 by Jack and Ruth Eckerd. The couple, now deceased, also started the Eckerd drug store chain in the 1950s.
In Florida, Dennis said, Eckerd manages the state’s foster care contracts in Pinellas, Pasco, and Hillsborough counties.
“It’s pretty much the Tampa Bay area,” he said, noting the contracts there involve more than 6,100 children.
The State of Florida pays Eckerd about $120 million a year for its services. Kansas spends about $140 million a year on its foster care program, not counting about $10 million spent on family preservation programs.
“Our piece of what’s going on in Florida is larger than the (foster care) systems in 14 other states and the District of Columbia,” Dennis said.
Florida privatized most of its foster care system in the late 1990s and early 2000s.
Another new entry
Another new entry to the contract competition is Olathe-based Kids TLC. The nonprofit organization has a history of providing child welfare services as a subcontractor, but has never before bid on a lead Kansas foster care contract.
The group seeks to provide services in the region that includes Atchison, Douglas, Johnson, Leavenworth, and Wyandotte counties.
“We’re known for having the largest PRTF (psychiatric residential treatment facility) in the state of Kansas,” said Jeremy Brenneman, the organization’s marketing and public relations coordinator. “But we also have a foster care program, an outreach program that goes out and looks for homeless and runaway kids, and a case management program that helps families that are at risk.”
Most of the program’s current services, Brenneman said, are provided in Douglas, Johnson, and Wyandotte counties.
Kids TLC is ready to expand its reach, he said, noting that its bid for the foster care work “really fits in with what we want to do.”
With the new contracts, which are expected to become effective July 1, 2013, the state is reducing its five foster care service regions to four. The new contracts are for four-year terms with two, optional, two-year extensions.
Organizations are allowed to bid on providing services in more than one of the four regions.