Dear colleague: 

Chancellor Don Elliman and I joined a group of leaders from the Anschutz Medical Campus at the Colorado Capital Conference in Washington, D.C., last week. This annual event, sponsored by CU and by Colorado Mesa University in Grand Junction, allows for Colorado residents to meet with top elected and appointed officials in federal government. The event is hosted by U.S. Sens. Michael Bennet and Cory Gardner and we heard from several officials, including recently confirmed Supreme Court Justice Neil Gorsuch, Senate Majority Leader Mitch McConnell and Senate Minority Leader Chuck Schumer. 

For our campus delegation, it was a time to remind the Senators of our concerns about proposed changes to the nation’s health care system and to the budget for the National Institutes of Health. These are our top priorities in D.C. The discussions around health care are calling for significant revisions to the way Medicaid is structured and would take coverage away from millions of people, including the expansion population who qualified for care under the Affordable Care Act. In Colorado, that expansion population alone is estimated to be about 400,000 people who will lose Medicaid coverage. All involved in health care recognize the need to control and reduce health care expenditures and we reaffirmed our willingness to work with all interested parties to develop approaches that maintain coverage but provide value for patients and payers. 

Regarding the National Institutes of Health (NIH), the White House has called for a $5.8 billion reduction in its budget. In particular, the budget proposal calls for altering how the federal government covers the facilities and administrative costs associated with research projects. As structured in the proposed budget, money that covers the costs of heating, lighting and debt service on our buildings would be slashed. In the most recent fiscal year, the NIH funding covering such essential costs was $64.4 million. Under the proposal, a cap of 10 percent would be imposed on that portion of NIH projects. Based on that calculation, the total that would be available to our campus would be just $14.5 million. The portion of the NIH funding allocated last year to our heating, lighting and electrical costs was $13 million. Other institutions across the U.S. will be similarly affected. Facilities and administrative funding (“indirect costs”), along with our internal institutional co-investment, support the infrastructure that has made our country the world leader in biomedical research. The loss of such support will jeopardize our country’s leadership in this important area. 

These proposals are profoundly harmful to our patients, to our research program, and to our nation. In my meetings with elected officials, I made clear that any proposals to repeal and replace the Affordable Care Act should, at the very least, provide continued health care to those who most need it. We, along with our hospital partners, provide a large amount of service to the most vulnerable populations in Colorado, as historically has been the case for academic medical centers. I also noted that our campus is a vital economic engine for Colorado. Our campus employs more than 24,000 people who are dedicated to improving the quality of human health. Our collective effort has a $5.6 billion impact on the state economy. And most importantly, our community and our patients depend on us to provide the best medical care possible. As a country, we have historically led the way in providing the highest-quality care. We should respect that legacy and continue to make investments in health our highest priority. 

I would like to thank Angie Ribera, PhD, chair of physiology and biophysics, for presenting a report last week to the School of Medicine Executive Committee on her review of funding support for basic science research at academic medical centers. Angie chose that topic as her project for the Executive Leadership in Academic Medicine program in 2016-2017. Angie reviewed 10 academic medical centers, including the CU Anschutz Medical Campus, that were ranked among the top 40 recipients of NIH funding between 2001 and 2015. She looked at three whose rankings remained stable (as ours did), three that declined and three that improved to see whether there were lessons about how to improve support for the basic sciences. Academic medical centers make significant investments in their research missions – providing 53 cents for every dollar of extramural research received, according to the Association of American Medical Colleges. This is a particularly timely issue now as the NIH faces an extraordinarily large cut in its budget. While the other institutions offered no single solution that leads to increased external support for basic sciences, Angie found that innovative approaches and ongoing discussions are required. She indicated that leading institutions might consider focused efforts on specific targeted areas of research, encouraging innovative ways to channel philanthropic support and ensuring that research programs are the optimal size for the institution rather than growing on autopilot. 

The Center for Bioethics and Humanities has released Hard Call, a new podcast that presents some of the toughest issues facing health care professionals, patients and their loved ones. In such cases, the right or wrong choice may be unclear – or even unknowable. Hard Call follows true stories of people making some of the most difficult and emotional choices of their lives. The podcast also asks listeners to cast votes on what they would do if they were faced with making these hard calls. The first two episodes, now on iTunes, Google Play, and the web, are part of a five-part series titled “Derailed: When Mental Illness Throws a Life Off Track.” “Derailed” follows a wealthy entrepreneur living with a serious mental illness through five challenging episodes, asking questions like “Would you hospitalize this man against his will?” and “Should he tell his business associates about his illness?” The second story, “The Electronic Heart,” includes four episodes that track a man confronting a very risky and expensive treatment at the end of life. Hard Call is a collaboration between Center Director Matt Wynia, MD, MPH, veteran journalist and radio producer Elaine Grant, and the local theater community. Listen to the trailer here. 

The Office of Medical Education last week said it would be updating the medical student curriculum by merging two “threads” that had been woven throughout the four years of the students’ education. The Culturally Effective Medicine thread and the Medicine and Society thread will be combined into the Culture, Health, Equity and Society thread, with Rita Lee, MD, associate professor of medicine, and Paritosh Kaul, MD, associate professor of pediatrics, as co-directors. The opportunity to strengthen aspects of our curriculum that focus on culturally effective medicine, disparities, health care systems and access, and health care costs were identified by task force work done in preparation for the reaccrediting process by the Liaison Committee on Medical Education. 

Congratulations to the Family Medicine Interest Group for earning the 2017 Program of Excellence Award: Excellence in Programming: Policy and Innovation Initiative from the American Academy of Family Physicians (AAFP). Each year, the AAFP Family Medicine Interest Group Network recognizes efforts to stimulate student interest in family medicine and family medicine programming. The award will be presented at the National Conference of Family Medicine Residents and Medical Students, July 28-30, in Kansas City. 

A reminder that June pay for CU employees who are paid monthly will be distributed on Monday, July 3. Typically, the payday is on the last day of the month, but due to budget-balancing steps taken by state officials in 2003 during a budget crisis, the pay date for state employees was shifted from the last day of June to the first business day in July. That shift in the pay date allowed the state to achieve a balanced budget – a requirement of the state constitution – that fiscal year. Unfortunately, the cost of shifting the pay date back to June in subsequent years has become too expensive for the state budget while maintaining a balanced budget. Employees who are paid biweekly are not affected. 

Facilities management for the University of Colorado Anschutz Medical Campus has announced an increase in parking permit rates, effective July 1. The monthly fee for reserved parking spaces will increase to $85 from $75. Faculty and staff rates increase to $64 per month from $57 per month. The monthly parking rate for students increases to $38 from $36. This is the first increase in parking permit rates in nine years and is necessary to address the growing parking needs on campus. According to facilities management, the parking vacancy rate on a typical day hovers around 3 percent or less. The campus has a clear need for additional parking, and campus leadership is working on solutions to provide more parking capacity. The rate increase is intended to help support such parking solutions and provide students, staff and faculty with easier, more efficient options. 

Have a good week, 

John J. Reilly, Jr., MD
Richard D. Krugman Endowed Chair
Vice Chancellor for Health Affairs and
Dean, School of Medicine