Severe cuts that are proposed to the state's three teaching hospitals could threaten a potential Fort Drum-region branch campus, and require other public colleges to share the pain the cuts will inflict.
"We're committed to upstate New York, and we're trying like the devil to make it work," said Dr. David R. Smith, president of Upstate Medical University, Syracuse. "We're not moving. We're not a corporate giant that will move to another state or country."
The cuts forecast to hit the north country's public colleges could double if Gov. Andrew M. Cuomo has his way.
The governor's budget proposal includes cutting state aid to the State University of New York's three teaching hospitals to the tune of more than $170 million.
"It's like the Titanic," SUNY Canton President Joseph L. Kennedy said. "The Titanic missed the ice they could see; they hit the ice they couldn't see. The hospitals are the ice we can't see."
The hospitals are Upstate Medical University; Downstate Medical University, Brooklyn, and Stony Brook Health Sciences Center, Long Island.
The teaching hospitals are being cut from multiple directions: they receive cuts as SUNY institutions and as hospitals. As academic medical centers, they also are subject to Medicaid cuts. For Upstate alone, all of those cuts could total close to $80 million. Its annual operating budget is $600 million.
The hospitals have taken on more of the cost of the medical schools — money that in the past had been paid by the state. But now even that arrangement threatens those facilities, as hospitals grapple with further funding reductions at the federal level tied to the health care reform act.
There is a proposal in committee in the state Senate to restore $115 million of the $170 million. A proposal from the Assembly would restore $64 million, Dr. Smith said.
But the minimum manageable restoration would have to be about $100 million, Dr. Smith said. The cuts could be managed with the proposed Senate restoration.
"If the number is less than $100 million, there would be significant consequences for Downstate, Upstate and eventually Stony Brook," he said. "What's at risk is not being able to support medical schools."
Meanwhile, his hospital is overcrowded: it has 409 beds, but patients outnumbered beds by nearly 20 Friday afternoon, the emergency room was closed to transfers and every fourth ambulance has had to be turned away over the last few weeks, Dr. Smith said.
'WOULD BREAK MY HEART'
Upstate is the main system for several different medical areas for the north country and other rural areas around the state. It's the main trauma system for an area that stretches from Canada to Pennsylvania. It also is the burn treatment center for more than 30 New York counties, and the poison control center for many of those counties, as well.
"We have the largest regional responsibility of really any hospital in the state," Dr. Smith said.
The Fort Drum-region branch campus seeks to bring quality health care to the north country, a big concern for a rural area with a major military installation. The extent of cuts will determine whether that project moves forward. Dr. Smith was planning to bring staff members to the north country as soon as this summer, he said.
If that doesn't happen, "it just would break my heart," Dr. Smith said.
Upstate Medical University is a partner in Jefferson Community College's Higher Education Center initiative, through which it offers some bachelor's and master's degree programs at the campus in Watertown. Jefferson Community College programs offered through Upstate could be in jeopardy because of the cuts, too.
If that cut goes through, it doesn't affect the budgets of community colleges in the same way as other state colleges, because the funding structure is different. But JCC President Carole A. McCoy is worried about what a cut to the teaching hospitals would mean for the close relationship between Upstate Medical University and the north country.
"They are committed to programs here on campus and working with the Fort Drum Regional Health Planning Organization. They're very committed to helping," Mrs. McCoy said. "Anytime you're going to lose major dollars like that, you're going to need to make harder decisions. My worry is about how rural areas like ours and others around the state will be affected."
SHARING THE PAIN
A cut that large would make it difficult for the hospitals to function and might necessitate the rest of the SUNY system stepping up and contributing funding from already-shrinking budgets.
North country college leaders are bracing for the impact, but there has been no official talk about sharing the pain within the SUNY system, according to Mr. Kennedy.
The hospitals will tighten their belts, but they will not be able to make up for the full level of cuts if Mr. Cuomo's budget is adopted. Without any restoration of funding, the other campuses will have to help.
Dr. Smith has heard suggestions of other SUNY campuses sharing the pain of the hospital cuts, but he hasn't seen anything definitive, he said.
"I think the worry is that the hospitals are getting hit in so many different directions," Dr. Smith said. "So something may need to be done with distribution."
SUNY Chancellor Nancy L. Zimpher has been lobbying to reverse some of the funding cuts since the governor's budget was announced. In addition to the hospital cuts, $100 million has been cut from the 64-campus SUNY system.
"Without state support, the teaching hospitals cannot operate. SUNY must step in to keep the teaching hospitals open," SUNY Potsdam President John F. Schwaller said. "It is simply a life-and-death choice they have to make. Unfortunately, this will also cause additional harm to other sectors within SUNY."
SUNY Canton is budgeting for an additional $1 million to come out of its coffers, according to Mr. Kennedy. That figure comes from his estimate that the 64 campuses will have to divvy up a cut of $100 million by the size of their budgets. Under the same assumption, SUNY Potsdam would have to contribute $2 million.
The saga strikes a familiar tone with Mr. Kennedy, whose college was on the chopping block 15 years ago.
"When I came here 15 years ago, they were thinking of shutting us down," Mr. Kennedy said. "I am not complaining about helping the hospitals. Having been a beggar, I know what it's like."
There is no formal relationship between SUNY Canton and Upstate Medical University. SUNY Potsdam and Upstate last year announced a partnership to automatically accept talented pre-med students into the Syracuse doctoral program.
If the state funding continues, there must be more relaxation on contracting requirements and labor issues "significantly and not modestly," Dr. Smith said.
"How the full cuts would be managed has yet to be determined as we consider a variety of options," SUNY spokesman Morgan Hook said. "But without restorations, the budget cuts that have been proposed will have a profound effect on SUNY's ability to provide services, whether those services be hospital care or higher education."