Capitol DisPatch: UConn — Connecticut's Cambridge?

Questions linger weeks after legislators approved a massive plan to remake the University of Connecticut Health Center. 

In the last days of the 2011 legislative session lawmakers approved an $864 million plan to expand UConn’s medical and dental schools, construct a new 100-bed inpatient tower on the Farmington campus’ John Dempsey Hospital, and inject millions of dollars into bioscience research and development. But exactly how this vision will become reality and how the health center will end its troubled financial history, particularly at a time when the state’s coffers aren’t flush with cash, remains a puzzle.

“Now oddly these kinds of things are front and center. Whether it’s the busway, light rail, or this thing, one could argue those scarce funds could be applied elsewhere,” said state Rep. Jonathan Steinberg, a Democrat representing Westport in the 136th House District.

Steinberg ultimately voted for the deal.

In the end, the promise of developing a bioscience research corridor in the manner of Cambridge, Mass. or Research Triangle Park, NC is what swayed legislators, be they Democratic or Republican.

“It’s an opportunity for Connecticut to distinguish itself in research,” Steinberg said. “It will create a research corridor and can identify where Connecticut can be a leader.”

Thomas Q. Callahan, UConn Health Center’s Chief of Staff,  said the plan "will allow the state to compete regionally, nationally, and globally. It will help create a broad environment for innovation, discovery and commercial application of those ideas."

Yet, there appears to be no specific benchmarks to help transition the plan from concept to reality. For example, there is no timeline attracting needed venture capital for start-up companies.

“Bioscience Connecticut doesn’t address all those issues,” Callahan said. “It takes care of the front end. It’s a very important step the state is taking. The governor made clear this was not the end of bioscience, that bioscience-based economy will be a strong component going forward.”

In other words, the plan calls for ensuring there is adequate research and laboratory space, and it provides an environment for potential commercialization of such research.

“Everybody points to Pfizer leaving. They didn’t leave because they were over-taxed; they went to Cambridge, where they are surrounded by like-minded people,” state Rep. Elaine O’Brien, a Democrat representing Suffield, East Granby, and Windsor in the 61st House District, said. “We have a well educated workforce and we value education; it’s our only resource. This bioresearch center, research investment, will help attract and keep young people.”

Those supporting the deal said it will create thousands of jobs in a state with a 9.1 percent unemployment rate. They argue it will position Connecticut as a leader in bioscience research. And, they said it would put the health center on sound financial footing.

Those opposing the deal said it would harm competing hospitals. They question the cost of the program. And they question the center’s ability to run efficiently.

“I voted against it because it’s a major increase in our bonding,” said state Rep. John Hetherington, a Republican representing New Canaan in the 125th House District.

The deal will add $254 million in bonding to the $362 million in bonding the legislature approved last year. Private donations are expected to fill in the remaining $203 million.

However, UConn’s Callahan said the deal doesn’t impact this biennium’s budget; there is no new debt service and no operating costs. Rather, Bioscience Connecticut builds on a plan begun during the last legislative session.

Another question surrounds the numbers. Using numbers crunched from the University of Connecticut Center for Economic Analysis, Malloy said the deal would create 3,000 new construction jobs that will last during the center’s six-year construction.

“It’s all speculative,” Hetherington said. “It’s a jobs program. One legislator explained it as a vision. It’s a hallucination. I thought the whole thing was poorly explained and I didn’t want to put the state on the hook for that amount.”

However, UConn’s contract with the state means it must take care of prison population and Medicare population – so in some ways it’s financially set up to fail.

“It’s a true public service facility,” said state Rep. Bill Wadsworth, a Republican representing Farmington in the 21st House District. “They have a high percentage of uninsured patients. We owe public health to our residents.”

Wadsworth acknowledged the hospital doesn’t always meet its financial obligations, but he said that pales in comparison with the service the hospital provides.

“However, the facts as I’ve understood them – show this as a significant economic driver. This will provide the confidence to private sector to come in,” Wadsworth said.

Yet, the health center deal comes just as hospitals statewide face a newly imposed provider tax. That has some asking whether it is fiscally sound to shoulder this expansion.

“The hospital tax contributes to the state’s revenue base and therefore generally contributes to funding any state-funded initiatives,” said Scott Orstad, Stamford Hospital’s Corporate Communications Manager.

Still unanswered is whether expanding Dempsey Hospital is necessar,y given the area’s concentration of hospitals. 

“Off the top of my head, I can count six hospitals within 15 minutes of UConn. I have said many times in the past that I don’t even think we need the hospital at all,” said state Rep. Jason Perillo, a Republican representing Shelton in the 113th House District.

Medical education is another component to the plan. On any given day Hartford Hospital has 275 residents, the majority of whom are from UConn, said the hospital's Chief Medical Officer Dr. Rocco Orlando.

"We don't anticipate that will change significantly," Orlando said. 

As to increasing the number of beds at Dempsey, Orlando said "Connecticut has about the right number of beds for the current population. The increase in the number of beds is more to answer [UConn's] need to meet its academic mission, not so much its clinical mission."

The General Assembly bailed out the health center four times since 2000. Malloy asserts the health center would break even by 2018; but skeptics remain, even among the supporters.

These legislators said the deal provides zero assurances UConn’s inefficiencies will end.

“The state tends to throw money at it whenever it gets in trouble. It has a reputation for inefficiency,” Steinberg said. “This is the last shot UConn gets.”

While the Connecticut Hospital Association won’t discuss details, it said it was pleased Malloy acknowledged the health care industry’s contributions to the state’s economy.

“CHA has been supportive of the governor’s goal of jobs, economic growth, and innovation—most particularly his objectives of increasing access to high quality health care and graduating and retaining more physicians and dentists to help address our forecasted workforce shortage,” said Kim Hostetler, CHA’s Vice President for Communications.

The plan would reportedly add 100 students to the medical school, 48 students to the dental school, and about 50 bioscience researchers. That’s key for Connecticut to grow and keep a crop of doctors, said some legislators.

“For several years, the Connecticut State Medical Society has been advocating for student loan forgiveness and forbearance programs a means of beginning to address our state’s physician workforce shortage and increasing Connecticut patients’ access to quality medical care,” said Matthew C. Katz, Executive Vice President for the Connecticut State Medical Society. “Too few of the physicians in training from our medical schools stay in Connecticut; these programs go a long way to helping reduce the burden of debt while helping them establish practice and offsetting the higher-than-average cost of living.”

Yet, the bill contained no such language regarding student loan forgiveness and forbearance. Callahan said that’s because it will likely be addressed during the next biennium.