HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE ANCHORAGE, ALASKA October 21, 1993 4:00 p.m. MEMBERS PRESENT Representative Con Bunde, Co-Chair Representative Cynthia Toohey, Co-Chair Representative Bettye Davis Representative Irene Nicholia, via teleconference Representative Tom Brice, via teleconference MEMBERS ABSENT Representative Gary Davis, Vice-Chair Representative Al Vezey Representative Pete Kott Representative Harley Olberg COMMITTEE CALENDAR How to better serve the needs of university students in Alaska. Discussion to include WICHE/WAMI, student loan problems, and any other topics students wish to discuss. WITNESS REGISTER DR. MIKE DIMINO UAA Biomedical Program (WAMI) University of Alaska, Anchorage 3211 Providence Drive Anchorage, Alaska 99508 Phone: 786-4789 RAMONA GUYOTE, President Kodiak Student Association 525 Maple Kodiak, Alaska 99615 Phone: 486-1985 STEVEN FLOERCHINGER, M.D. 1200 Airport Heights Drive, Suite 220 Anchorage, Alaska 99508 Phone: 277-1040 GREG PARRISH 140 North Pine Anchorage, Alaska 99508 Phone: 274-3675 NELDA KOECHER P.O. Box 1442 Nome, Alaska 99762 Phone: 443-2898 ERIC LEEGARD P.O. Box 32806 Juneau, Alaska 99811 Phone: 465-8778 RACHAEL BERMUDEZ Prince William Sound Community College P.O. Box 3123 Valdez, Alaska 99686 Phone: 835-4555 DELBERT COLLETT Prince William Sound Community College P.O. Box 1092 Valdez, Alaska 99686 Phone: 835-1092 BRIAN BRUBAKER University of Alaska, Fairbanks P.O. Box 750585 Fairbanks, Alaska 99775 Phone: 474-7654 TERYL ELAM UAA WAMI Medical Student University of Alaska, Anchorage 1416 West 23rd Avenue Anchorage, Alaska 99503 Phone: 279-3000 KARIN PATTERSON, Student 5325 Sharon Street, Apt. C Anchorage, Alaska 99508 DAVE DAU 3211 Providence Drive Anchorage, Alaska 99508 Phone: 562-2660 JOSEPH F. CONNORS 13120 Saunders Road Anchorage, Alaska 99516 Phone: 345-5760 RALPH J. McGRATH Alaska Community College Federation of Teachers 2533 Providence Drive Anchorage, Alaska 99504 Phone: 562-2660 ACTION NARRATIVE TAPE 93-73, SIDE A Number 001 CO-CHAIRMAN BUNDE stated that, as is known, the state is facing some financial difficulties and the committee wants to make sure the money spent is serving the greatest needs and the legislature is being as efficient as it can be. CHAIR BUNDE asked each person who wished to testify to sign in, requesting that when they come up to testify, they identify themselves and their relationship with the university. He noted that this hearing was being recorded so that a written copy of the minutes can be prepared. It was further noted that the following locations were also on-line if anyone wished to testify or comment: Bethel, Fairbanks, Juneau, Kodiak, Kotzebue, Ketchikan, Sitka, Soldotna, Tok and Valdez. Number 019 CHAIR BUNDE ascertained that the bridge operator was on-line. He called the meeting of the House HESS Committee to order at 4:23 p.m., introducing himself and stating that Representative Bettye Davis and Co-Chair Representative Cynthia Toohey were in attendance. Number 035 DR. MIKE DIMINO, Director of the Biomedical Program (WAMI), University of Alaska, Anchorage, was the first person to testify. He stated he wanted to explain what WAMI (Washington, Alaska, Montana & Idaho) is. He also asked that the committee consider their relationship with the University of Washington (UW) as being one associated with a regional medical school. DR. DIMINO noted that Alaska is one of five states that does not have a medical or osteopathic school, and sometimes the question is raised as to why we need a medical school in our environment. He pointed out that Alaska has the lowest number of physicians per capita in the nation; one physician for every 719 people. It was noted by some people that in Anchorage this is not true. Dr. Dimino stated that the numbers he received from the Alaska State Medical Association shows that in Anchorage itself the ratio is still 1:708. Put into perspective, the next state which has the poorest ratio of physicians per capita is Mississippi, with a ratio of 1:676. He felt these numbers warrant some attention. DR. DIMINO added to this the fact that the medical profession in the state of Alaska is aging. Again, using the Alaska State Medical Association as a source, fifty-two percent of our physicians are over fifty years of age and forty percent are over fifty-five years of age. The income of physicians from the various sources such as PHS and the military has clearly changed. DR. DIMINO acknowledged that in the short term we could solve a lot of budgetary problems by cutting our medical program out, but he raised the question as to whether that was in the best long-term interest of Alaska. To show that UW has contributed significantly to the number of physician positions in our state, he told the committee that of those Alaskans who went through WAMI, fifty-one percent have returned to practice in Alaska. In states that have their own medical schools, the number of state resident students practicing in the state in which they are a resident and in which they were a medical student, the percentage is approximately thirty-five percent. Observing that this is sometimes viewed as an "elitist" program, DR. DIMINO said that of the 50 students taken into the program thus far, five of the students have been Native, thirty percent have been from families where neither parent has a college degree, and forty-four percent are female. DR. DIMINO commented that several goals have been set for WAMI and he felt that all of these goals have been met. DR. DIMINO suggested there are several resources available through UW that would not be possible unless we had a medical school affiliation. He said he could go through this list of resources, but suspected he was running out of his allotted time to testify. CHAIR BUNDE asked if there were any questions at this point from the committee. There were no questions. Number 074 DR. DIMINO asked to mention briefly that, obviously, WAMI educates medical students and he felt they have done an extraordinary job in that respect, especially here in Anchorage. He wanted the committee to be aware of the fact that from the University of Washington School of Medicine the following things are available, stating: "We have the Medcon line which amounts to about 3500 to 4000 calls from Alaskan physicians to physicians at UW. This is a referral service that does not cost the State of Alaska any additional money. "We have a Medex program, which is the PA program, and each year there are at least five or six Alaskans who are accepted into the program. In fact, there is a satellite program in Sitka now that has twelve Alaskan participants. "The Pacific Northwest Regional Health Sciences Library is at UW and we are part of that, which permits opportunities for our physicians. "Itinerant clinics in genetics and birth defects through UW come through the state. "Collaborative fertility clinics. "CME opportunities for our physicians are available. "We have several programs which encourage under-represented minorities to enter the medical field; and in fact, three of our Native students have gone through that program. "We have RAHEC which is Rural Alaska Health Education Center that had its genesis and indeed its funding for the first seven years through UW. "An underserved rural area opportunities program which permits our medical students, as well as other students from UW, to see our state. "We also, through UW, have been part of the Community Health Services Development Program and one of the first hospitals in that study was the hospital in Seward. "And last, but not least, we are now working very hard in putting a family medicine residency in the state, realizing there is only one other state that does not have a residency program, and that is in Montana. That is very important in the long term interest of the state as far as increasing the number of our physicians." Dr. Dimino left some handouts with staff. Number 098 REPRESENTATIVE BRICE, speaking via teleconference from Fairbanks, stated that Dr. Dimino had made mention that RAHEC had been funded for the past seven years, one way or another, through UW programs. He asked if that funding is continuing, and if so, what is happening with it. DR. DIMINO responded that federal legislation has built into AHEC programs, of which RAHEC is a part, a termination of seven years. After seven years, it is expected that if the program continues, the state must pick up that cost. For the present 1993/1994 year, the state of Alaska, DR. DIMINO thought, has put in approximately $150,000. That then permitted RAHEC to have some not exactly matching funds, but additional funds made available because there was a state contribution. In the future, if RAHEC is to continue, the state must support it. REPRESENTATIVE BRICE acknowledged that was on the capital side of things that were put in through what he believed was discretionary money. On the viability of the program, he asked Dr. Dimino how he felt the program worked. DR. DIMINO responded that he was very aware of RAHEC and, he thought, especially in the last three to four years, not only has focused upon a particular mission in the state that he found was very successful, but he also believed it was part of our overall health needs in the state. Dr. Domino stated he would like to see RAHEC continue to be funded, and he clarified that he speaks not for the university, but for his very own personal view on that. REPRESENTATIVE BRICE said he would appreciate any type of support that Dr. Domino might be able to pass on to both this committee and the subcommittee on the budget for the Department of Health and Social Services (DHSS) so that the legislators can look at this issue next session. DR. DOMINO confirmed they are working with RAHEC on that, and the committee will hear more from their joint ventures. Number 126 REPRESENTATIVE TOOHEY, regarding the 1:708 ratio of physicians per capita, asked if this ratio includes the Indian Health Service. DR. DIMINO responded that this ratio does include all the physicians in the area, stating that they asked the Alaska State Medical Association specifically to include the physicians at Alaska Native Medical Center (ANMC). He assumed these numbers were accurate. Number 130 REPRESENTATIVE B. DAVIS asked if the ratio figures also included military doctors. DR. DIMINO responded that he did not think the military physicians were included due to the obvious transience of moving back and forth to different duty stations. REPRESENTATIVE TOOHEY asked what the ratio is in the United States. DR. DIMINO responded that it is approximately one physician per 560 people (1:560). REPRESENTATIVE TOOHEY commented that we are not really out of line. CHAIR BUNDE mentioned a concern that he had was that the program is very expensive, approximately $800,000 per year for the ten students at the University of Alaska (UAA). DR. DIMINO said he brought a copy of the budget, thinking the committee might ask that question, and he believes the budget to be roughly $750,000. However, he pointed out approximately $65,000 of that comes from the tuition the students are charged - their students pay a higher tuition. CHAIR BUNDE calculated this would then make the cost per student about $70,000 per year. DR. DIMINO said he felt it was inappropriate to take the budget number and divide it by students. He asked the committee to broaden the concept of what WAMI is. It is not just educating ten students. Number 156 CHAIR BUNDE asked for clarification of whether fifty percent of the students in the program come back to Alaska or fifty percent of Alaskan students were in the program. DR. DIMINO said he could give the committee the names of all the physicians who were in the program and of those who had finished and where they are located. He does have numbers in his statistics which substantiate that fifty-one percent of the Alaskans in the program either have practiced in the state or are still practicing here. He went on to say there is another group of physicians who did undergraduate medical education at UW and are now in the state practicing and another group of physicians who did residency programs in association with UW who are now practicing in the state. These physicians comprise what he calls an equivalent return rate. He said he tries not to use this equivalent return rate number because it causes confusion, but the fifty-one percent he is proud of and can document. Number 166 CHAIR BUNDE asked that with the state investing approximately $160,000 in the education of each of these doctors, would not one hundred percent return to Alaska be a more defensible number. DR. DIMINO agreed that it would be the ideal and the same argument could also be used any time we educate someone in business or engineering, although the amount is not as high. Maybe we should expect them to come back to the state, he suggested. Number 170 CHAIR BUNDE stated he is not opposed to medicine as a field of study, he just recognizes this as a very expensive program and asked how many business degrees could we produce per doctor educated. He stated the average degree here costs about $40,000 and would therefore produce four degrees per the cost of educating one doctor. DR. DIMINO observed that if you get ill he doesn't think you would want a business major taking care of you, which is one of the things to be considered down the line. Number 176 CHAIR BUNDE inquired as to how many of the physicians who are training through WAMI are training to be primary care physicians. Number 179 DR. DIMINO said he could not give an exact percentage of the number of those who have finished which are now in primary care. He did say, however, that the emphasis at UW has changed dramatically in probably the last five years, such that the graduating class, (which, by the way, would have been the first group of Anchorage WAMI students to go through) had fifty-five percent who entered primary care. Dr. Dimino indicated that at fifty-five percent, UW was well ahead of the national trend or national average, which he thought was around twenty-five to thirty percent. Number 188 CHAIR BUNDE stated that in order to keep this very expensive program here, there has been some discussion in the legislature concerning the fact that Alaska needs doctors and because Alaska is investing a great deal of money in the education of these doctors, perhaps there ought to be a requirement that they do come back and work in Alaska for a period of time. He noted that, of course, we do not need more plastic surgeons, we need primary care physicians. If these students were required to return to Alaska and if they were required to specialize in primary care, or not specialize, he inquired as to how that might affect the student population of the program. Number 198 DR. DIMINO responded that his personal feeling, and he was not representing UW in this situation, is that it would not adversely affect the applicant pool. What he did suggest is that no restrictions be put on the return of the students outside of the fact that he or she return to Alaska. If there is an opening for a cardiovascular surgeon, a plastic surgeon, a pediatrician, or a family doctor, then we need to fill that position. If we just say primary care, that is only taking care of one aspect. It is true we have specialists in the state but, he stated; for example, the cardiologists in this city alone are overworked. Outside of the city, he was not aware of a board certified cardiologist in the rest of the state. There are cardiologists, but not board certified. He thought if the committee were to say that primary care physicians are the only ones that will be given a loan forgiveness or pay back, or whatever phrase is used, this might not be an enlightened view. He had no difficulty with saying there should be some pay back to the state. Personally, in the academic world, he felt you do not like to see these kinds of obligations. If he had his way, he would rather say that someone could cross the state borders and go to medical school in California, in Nevada, in New York, if they choose, and forget about borders. He acknowledged that the reality is that someone is paying for it and there are some requirements. CHAIR BUNDE pointed out that the first year here at UAA is a $700,000 impact to the budget. He asked why that first year is done here and questioned if it could be done more cheaply if they went from day one to the University of Washington. DR. DIMINO responded that if this were done, several aspects of the program would be lost. One of the key factors why this program has been so successful in returning students, in his estimation (when it was in Fairbanks and they like to think in Anchorage as well) is that the program has the Alaskan here. The Alaskan is being trained to be a physician in Alaska. He stressed that, indeed, if one looks at the course content, especially in clinical medicine, a tremendous amount of time is spent telling these students what it is like to practice medicine in Alaska. The program even sent them out for one week into the bush, so that they would have that experience and see what it is like. Dr. Dimino explained that they keep contact with their students all the time so that as one issue of recruitment, that is something he would not want the program to lose. In addition, he felt the program has had an impact on the sciences. The sciences are an expensive proposition at any university. This is one of the few opportunities where the program had a chance to help our science community and, he believes, the program has done that. DR. DIMINO further stressed that there is certainly a research emphasis now that has been on the campus in this program, and most of their faculty have extra mural funding, which he can document if the committee chooses to see the documentation. He felt this was a big step forward. This then means, in his view, that our undergraduate students not only can have some advanced courses at the 300 and 400 level, which frees the faculty to teach 100 and 200 level courses, but also means that students now have a research exposure which Dr. Dimino thinks is valuable. He thought also that if we are simply buying positions at another medical school, the committee can do that, there are programs like that in the country, but the difficulty with that is there is no way of hooking that student and attracting that student back to the state. DR. DIMINO advised that the committee keep in mind that in addition to the way this is set up, there are some clerkships and some clinical experiences that the students can have in Alaska. Number 244 CHAIR BUNDE commented that the hook would be, "Come back to Alaska or don't get $160,000 in state money." Number 246 REPRESENTATIVE TOOHEY asked if there are any requirements that state a student must do his residency in Alaska if trained through the WAMI program. DR. DIMINO responded that there are no residency programs in the state of Alaska at the present time. REPRESENTATIVE TOOHEY asked if interns are sent back to Alaska to the Native villages, to Ketchikan, once they graduate from medical school. Number 254 DR. DIMINO said there is no requirement, at this time, for anyone in WAMI to return to the state of Alaska. REPRESENTATIVE TOOHEY stated she felt that is certainly something we need, especially in light of the new push for health care, and this is something we ought to start looking into. She further stressed she felt it is an absolute must that we (1) educate primary care physicians because that is what we are lacking; and, (2) that they come back to the state for at least five years, then maybe we could forgive their loan. She suggested this is something which requires working together to resolve these issues. Number 260 DR. DIMINO indicated he would be glad to work with the committee on this because he does not think this is inappropriate. Again, however, he suggested it be shaped so that it is done in the best interest of the state in the long run. He acknowledged that primary care is certainly important to us, but specialists should not be excluded from coming back. He said we do need specialists to fill the loss of specialists that we are going to see in five to ten years. He went on to say it is fine to specify we will send someone out into a rural community, but his argument is still that if there is an opening for a physician in Anchorage, and he or she can find a position in Anchorage, obviously we have a need for that person here. He went on to indicate he would like to see incentives that would encourage people to go out into the rural areas and he has no problem with this. Number 272 CHAIR BUNDE asked, because this is such an expensive program, what Dr. Dimino's reactions would be to making part of the tuition alone, which costs $120,000 more than it does for a business degree, a loan. He questioned how Dr. Dimino felt about the medical students having a loan, an obligation of $100,000 when they graduate. Number 278 DR. DIMINO acknowledged this is the issue the committee has been discussing. He said he would be willing to work with the committee in shaping something that he thinks is not only in the best interest of the state, but, of course, in the best interest of the students. He said he thinks it could be done if phrased and put together in a package that is useful. He would ask, and he felt the committee would agree, that the rules not be changed for the students who are already in the program, feeling this would be inappropriate. He indicated that for future students the committee might want to shape it somewhat differently. CHAIR BUNDE agreed that the committee would not do anything retroactive and recognized that this was all in the preliminary discussion stage. Number 288 CHAIR BUNDE asked how many of the students are indeed students who would be financially unable to attend medical school if they were not in this program. Specifically, do they come from a background of means? He also stated he would be very interested in knowing, in the recruitment of these students, if new requirements are coming down the pike, what the reactions are of the students. Number 300 DR. DIMINO responded that the cost of the education is certainly on the minds of anyone interested in going to medical school. There are tremendous debts generated at most medical schools. He noted that UW students usually have a debt of somewhere around $50,000 - $60,000 and it is climbing because the tuition was increased again. Dr. Dimino stated that one medical school where he worked prior to coming to UW had students who had debts in excess of $100,000 - $120,000 and yet they still were coming. Dr. Dimino said that these students scared the faculty because the faculty did not know what the students were going to do to pay off their debts. He indicated, as the committee might guess, that the students that had those kinds of debts were students from disadvantaged backgrounds, and that is certainly not the way he wants to see it go. He suggested that if the committee is going to come up with a mechanism of increasing the tuition or some kind of pay back, the committee try to be realistic and try to do something on a need basis. He did not want to see those students who come from backgrounds of need frightened off. Number 300 CHAIR BUNDE stated that this was the thrust of his question; if you are the son or daughter of a doctor, do you need the same tuition help as if you are the son or daughter of a single parent who is making minimum wage? He pointed out that when we have equal tuition for everyone, actually it is a great subsidy for the wealthy and it is not much of a subsidy for the people who are not very wealthy. Number 314 CHAIR BUNDE thanked Dr. Dimino for his time and testimony, and asked Representative Brice if he had any further comment. REPRESENTATIVE BRICE said he had no further comment, but also thanked Dr. Dimino for his time and testimony. Number 323 CHAIR BUNDE recognized that there was someone in Kodiak who would like to testify, RAMONA GUYOTE, acting president of the Kodiak College Student Association. She said she was basically just there to listen to the testimony and to express their concerns about the cost of education and the interest rate the students are being charged. Number 337 CHAIR BUNDE said he understands their concerns. He explained that he is also a member of the Post-Secondary Education Committee and that they had received a communication from fourteen different campuses stating the students (1) would like a lower rate of interest on their student loan, and (2) would like a higher limit on the loan. He made the observation that the loan amount has not increased and the cost of living has gone up. He noted that this is a double-edged sword for those in the legislature because one of the great concerns is that students are now being graduated with $30,000 and $40,000 of debt. That, he stated, frankly scares the legislature, who acknowledge this is an awful burden for someone fresh out of college. He further noted that the student has the choice whether or not to take that burden on, but sometimes when the choice of going to school is take a loan or do not go to school, he wonders how much choice the student has. Number 337 CHAIR BUNDE said the interest rate is now fixed at eight percent. However, if the true interest rate was actually calculated, taking into account no interest is paid while in school and the year of grace after graduation, the actual rate is somewhere around five percent. If the legislature truly floated interest rates and made it reflect financial reality, the students would probably be paying closer to eleven or twelve percent interest. The student loan fund at this point is not self-supporting, Chair Bunde said, and if the legislature does not do something to make it self-supporting by the year 2000 there probably will be no student loan fund. Number 362 MS. GUYOTE thanked the Representative from Kodiak for his comments and said there also has to be consideration for educating welfare recipients to get them off the programs. This is a big concern -- when a single parent is trying to get off the system, education needs to be kept as an obtainable goal. Number 370 CHAIR BUNDE agreed and reflected her concerns. He recognized that the choice between assuming a $20,000, $30,000, or $40,000 debt or not going to school is often not a viable choice for many students. He stated the legislature is very aware of this. Number 375 REPRESENTATIVE TOOHEY said she would like to see people realize that this is a problem and to remember it when there is a choice between staying in school or not staying in high school, so that they can continue their education. It is a lot easier to train a high school graduate right out of school than it is somebody who is thirty or thirty-five years of age and has been out in the market place. Representative Toohey stated she knows this from experience because she was a high school drop-out. Number 384 CHAIR BUNDE asked if there was anyone in Fairbanks who wished to testify. REPRESENTATIVE BRICE responded that they are just there to observe and there was no one waiting to testify. Number 390 DR. STEVEN FLOERCHINGER was called as the next person to testify. He identified himself, saying he practices medicine in Anchorage and is a specialist in the areas of general and thoracic surgery. He stated he was before the committee today to discuss the importance of the WAMI program to the state of Alaska. Of primary importance with this program is the fact that WAMI gives the opportunities for medical education to the people of Alaska. He said he is an Alaskan. He grew up in Anchorage and is a graduate of Dimond High School. His family all remains in the state. He is not the child of a two physician family; in fact, he is the only physician in his family for many generations. He acknowledged that the committee has mentioned medical education is very expensive and he confirmed for the committee that, indeed, it is very expensive, probably the most expensive area of education that one could pursue. The WAMI program, he said, does provide the opportunity for people to get such an education when otherwise they may not have been able to. He stated he would have been one of those individuals because the only opportunity he had to obtain an education in medicine was through the WAMI program. DR. FLOERCHINGER pointed out that there is a program known as WICHE, of which he felt the committee was well aware, and it was his experience at the time of his application to medical school that most of the states participating in the WICHE program for medicine actually provide more lip service than actual participation. There were several states that he applied to, none of which were interested in taking WICHE students the year that he applied. At the request of Representative Toohey, DR. FLOERCHINGER clarified that WICHE stands for Western Interstate Commission on Higher Education. DR. FLOERCHINGER commented there are several other things that have already been mentioned that he would like to address. Addressing the subject of the need for primary care, from the perspective of a specialist he stated it has been tossed around a lot lately, in this age of health care reform, that we have a great need for primary physicians and this is true in Alaska as much as anywhere else. However, he cautioned anyone from believing that there is not a need for specialists. He offered a few numbers for Anchorage -- there are ten people in Anchorage practicing general surgery in the private world, covering a population of approximately 230,000 in the city alone. However, services are provided for many people coming in from the outside world. The American College of Surgeons gives a quote of approximately 10,000 people to support the practice of one general surgeon. If you take the ten people practicing private general surgery in our community, that means that we have one surgeon for every 23,000 people and, in reality, it is much higher than that. Of those ten surgeons, two are preparing to retire within the next two to three years. DR. FLOERCHINGER, recognizing that Chair Bunde had given an example of a plastic surgeon, stated that indeed this an example of an area as highly specialized as one can get. He explained there are three board-certified plastic surgeons in Anchorage, one of whom is due to retire within the next two years. With these people participating in the care of burn patients and other thermal injuries, he has found that it takes three to four months to get one of his patients in to see these physicians for any form of elective procedure. DR. FLOERCHINGER, commenting on Chair Bunde's mentioning of business degrees taking four years and costing substantially less than a medical degree, stated he has approximately fifteen years of education invested in getting to the point where he can practice the art he does in this community. He acknowledged that he practices in a much more highly specialized area. It is very expensive to obtain an education in this area; however, there is no way that one can practice medicine of any type with less than approximately twelve years of formal education. DR. FLOERCHINGER also acknowledged that Chair Bunde had made mention about the possibility of having interns come back to the state for a portion of their training. He offered wholehearted support for this as something that could be done. It has been his experience that the education he received in the state of Alaska was outstanding And was one of the primary reasons he was motivated to come back here and practice. Unfortunately, he observed, the decision as to where one will land for their post-graduate training, which is required to get licensed and specialized, is not made entirely by the individual. This decision is made by the American Council on Graduate Medical Education. They have a program that assigns people to specific residencies where they will rank the ones they want, but the individuals will not necessarily go where they have a wish to go. Individual programs are responsible for where people go to receive their training. Dr. Floerchinger agreed that it would be nice if every Alaskan trained through WAMI could come back to do some of their post-graduate training here, but he does not see how this can be done unless we have some form of residency training in our state. He hopes that one day this will happen and he understands that this is under consideration. Number 493 CHAIR BUNDE acknowledged that Dr. Floerchinger had mentioned the older doctors retiring and stated he admires the doctors greatly as practitioners of the healing art and also stated they are good businessmen -- they have to be or they don't stay in business. He felt certain that when an opening becomes available in a lucrative practice there are doctors who are smart enough in other parts of the country to see and fill these openings, even if they are not Alaskan students. To say that the people retiring will leave a hole that will not be filled, he felt, was not entirely accurate. Number 504 DR. FLOERCHINGER clarified that what he meant by bringing up the numbers he did was to point out that he doesn't want people to believe that there is only a need for primary care specialists in our community. He felt we could use many people in the specialties in Anchorage. He pointed out there is a shortage of physicians in our state that is across the board, not limited to any one specialty or one type of practice. He agreed that there are people who will come in to fill the vacated spots; it is not easy to get people to fill those spots. He emphasized there are a number of physicians who are actively seeking folks to come in and join the group that is practicing surgery in this community, but pointed out there are only so many physicians doing surgery. He said it is not easy to get people to come to Alaska. Responding to Chair Bunde, DR. FLOERCHINGER clarified he is a graduate of the WAMI program, having begun the program in 1983 when it was in Fairbanks. Chair Bunde observed that some of the qualifications the committee is looking at obviously would not have prevented Dr. Floerchinger from returning to Alaska, because he has. CHAIR BUNDE asked, if part of the program was a loan, and Dr. Floerchinger faced a substantial debt, as many graduates from medical school do, would that have kept him from the program? Number 532 DR. FLOERCHINGER responded that this would not have kept him from the program. As a matter of fact, he does have substantial debt; his debt at the time he graduated was approximately $63,000. If that loan were to have come from the state of Alaska, with whatever requirements attached (and in fact part of his loan did come from Alaska) if part of this program were a loan then, no, he would not have a problem with that. It would have been impossible, he stated, for him to attain this education without this program (1) because it was the only opportunity offered to him and (2) if he had had to pay for or obtain funding to attend a private program or a private school in the states. It is not likely he would have been able to do that without the state of Alaska's help. He explained he came from a very simple, middle-class family. Number 551 CHAIR BUNDE reflected that it costs $70,000 per year for those students, just for the educational portion, and he knows there are other aspects. For the 40 students total, it is $1.6 million per year. Chair Bunde suggested these students could be sent Outside and set up in housekeeping perhaps cheaper than we could have the program here. Number 561 DR. FLOERCHINGER emphasized that one of the most important factors involved in encouraging people to come back is their interaction with the medical community here. He felt the interaction he had with the medical community in Fairbanks promoted his coming back here. He had two opportunities to return to the state, one in Fairbanks and one in Anchorage, and he chose Anchorage; but if he had not the exposure to Alaska, he would not have known what was available. Number 563 CHAIR BUNDE said it may be a moot point, because he suspects there will be a requirement for students to return. He stressed he is not anti-education, having spent his whole adult life in education, but he is trying to balance many hats. Roads are not being paved and there are people who would much rather have that road paved than see a student have a great subsidy to go to medical school. He said all voices have equal weight as the legislature tries to sort out the budget. The income is diminishing. At this point right now the state is about $100 million out of whack as far as balancing the budget and there is no way to know where that money is coming from. Chair Bunde emphasized that this is not a personal attack; the committee is just asking for information. Number 585 DR. FLOERCHINGER said he simply wished to give the committee the perspective of someone who is practicing medicine here. As one who is up against the problems faced by those who do practice medicine in the state, he wanted to stress how important this program is to those physicians who are here and how important this program will continue to be to the state of Alaska in the future. CHAIR BUNDE said he appreciated Dr. Floerchinger's perspective and felt it was valuable to have his testimony. He thanked Dr. Floerchinger for taking the time to appear before the committee. Number 594 REPRESENTATIVE TOOHEY stated that if funds are tight and the only way the legislature can continue funding is to make sure that students come back and "serve time" in the state, then that is something that will have to be done. DR. FLOERCHINGER responded that he suspects there would not be a lot of opposition to that from the students who are participating. He acknowledged that he obviously could not speak for all of them, but his personal opinion was that it would not have bothered him. Number 617 CHAIR BUNDE clarified that GREG PARRISH would be testifying next, here in Anchorage. He said when Mr. Parrish finishes his testimony, the committee would go to Nome, Tok, Anchorage, then Juneau for testimony. Number 620 MR. GREG PARRISH stated his name and the fact that he is a member of the Physics Department at UAA. He said he was upset about the tendency of the university to parade in public and justify a need for more funding based upon teaching, primarily in the lower division, and then once the funding comes through, to switch it over into more or less research type faculty. There was a specific instance he was referring to in the physics department. He stated he is the only full-time teaching member of the physics department, in fact the only member since, of the other two people, one is physics astronomy and one is physics chemistry. He explained that they are part of a joint physics/chemistry department. His understanding is that for years it has been agreed that the next priority for a physics hire would be a person to teach physics labs, essentially a lab manager who would hire adjuncts who would teach the labs themselves. It is a very specialized teaching position, probably a staff position rather than a faculty position. He found that without his knowledge, and as far as he knows, without the knowledge of the other physics person, last year the department chair, as part of the submission package, had switched this over to a faculty position, and in fact a 3:1:1 position, which is one which has a research portion in the contract. The chair had used the justifications for the lab position, but attached a research qualification to it. This completely turned the whole position over. Once that happens, as a practical matter, research becomes dominant. Once you have a traditional department, the researchers always will run things if they can. He suggested that research be funded as an end in itself, rather than funding for faculty and then turning the funds to research. TAPE 93-73, SIDE B Number 651 MR. PARRISH continued by stating one faculty member was on sabbatical and the other member of the physics department left for the Bush. The positions came through and he attempted to get something done about this with the new chair then, and ultimately the new chair was told by the dean that things had been set in concrete and that this was now, what he calls, a research position, one that had a research portion. He felt that as a practical matter the research faculty works very hard (he was not arguing that) and they have to concentrate so much on research, there is no way it is practical to expect them to do much lower division teaching, particularly the basic grunt work, the lab work and so on. He testified that when the hiring committee was formed, he was a member. In fact, the situation became worse because the research people in physics, and with some backing from the chemistry people, wanted then to basically make this a research dominant position; that is, only make the application open to certain types of researchers whose specialty would more or less mesh with the researchers we have right now. MR. PARRISH went on to say they started out with something justified on a purely teaching basis, with the only research mentioned at all was the fact that it was a 3:1:1 position buried in the fine print. Then an attempt was made so that only people within certain areas of physics could even apply for the job, based upon the research areas, not teaching, because that had nothing to do with it; lower division teaching is essentially the same for everyone. There was a desire to specify certain researchers only, to even be possible candidates. He felt he managed to block that temporarily, but in actual fact, he said, every time he thinks he has the block in place, the position comes up again. He was assured by the committee chair just before coming to this meeting that the issue is dead, but he said he is aware that there is movement in the background, and has been for the last several days, to try to bring this back up. He felt the only way he has been able to limit this much, and it has caused a great deal of hard feelings, is that one 3:1:1 member of the committee agreed that basically, although he personally thought research was the way to go, research should be justified if you want research positions and justify teaching positions if you want teaching positions and not use one for the other. Number 675 MR. PARRISH testified that they also put the only black woman in the department on their selection committee, frankly, for racial and sexual balance on the committee. He said she is a member who voted with him. Had it not been for these circumstances, he stated, this would have been by now a totally research-dominated position. What will happen in the meeting tomorrow, he said, he simply does not know. He has been assured before that, at least, they will be advertising on a teaching level, but he felt that in any case they will end up with someone whose job will involve a significant portion of research. He not only felt the person selected will be under tremendous pressure to produce research, and this is not a good place for physics research, but will have very little time in reality to do basically the grunt work that has been done with the labs and so on. He said that this past summer he did this basically for free, setting it up, organizing, and doing the hiring. He explained that in the past Don Martens did this when he was department chair, because, again, he was getting some chair relief. The current chair is a chemist. Chemistry has someone to do this; they have a technician/lab teacher; physics does not. MR. PARRISH felt this should have been a first priority, but the fact is that it has been turned completely over, against everything that was agreed to; it had been done without his knowledge, and he was extremely upset about it, seeing it as simply part and parcel of the overall problem. It was his understanding through the grapevine, although he admitted he had no proof, that other positions that went up the line as 4:1 are now trying to be converted into 3:1:1's with the university. At this point, MR. PARRISH said, he was getting extremely upset about this. This has been a real battle, putting tremendous pressure on the one 3:1:1 member of the committee who did agree with him that this was basically not an honest thing to do. He also said pressure has been applied to him, although in a lesser degree, because he was so solid and it was known that he was not going to give. He felt something needed to be done about this. If the legislature is going to be prepared to fund research, he said he would have no objection. He said there are great reasons to fund research as an end in itself. If the legislature was to have the university say they do not really care about teaching for this position, it is purely for research, not primarily to promote lower division teaching, teaching of labs and so on, then if it is funded, he would feel fine about it. If the legislators feel they can go to their constituents and explain these funded positions are for research, he felt again this would be acceptable to him. However, he did not feel it was fine when something which was originally set up for essentially a teaching position, and a very specialized teaching position, much more specialized than his own 4:1 position, gets converted over and starts becoming research oriented. As a practical matter, as long as there is any flexibility whatsoever, the 3:1:1 are the most dominate of the faculty in academics -- they are research faculty dominated. Their mind-set is such that research will always be the dominant feature. If someone comes in to visit from another campus, the first question is, "What is your research area?" Mr. Parrish said they are usually flabbergasted to find that he does not have one, that he is a pure teacher, and this is the sort of thing he has to deal with over and over. The standard theme seems to be, if we are a university, we must do it this way. He said his own attitude is that UAA is not that kind of university. Ultimately UAA is a university because the state calls them one, but this is primarily a teaching area, he thinks. Number 707 REPRESENTATIVE TOOHEY asked Mr. Parrish if he was at all nervous about the possibility his job may be terminated because of his testimony. MR. PARRISH responded that he was not, and as a practical matter, he was tenured. REPRESENTATIVE TOOHEY inquired as to when a person is hired for a physics, or chemistry, or nursing teaching job, whether or not there are specifics in that job description that say the person will spend so many hours researching. MR. PARRISH responded that there are no such specifics in a job description for a teaching job. REPRESENTATIVE TOOHEY said, then there should be no problem. If a person was hired for a teaching job, then they should teach. MR. PARRISH clarified that the whole point is the job is specified for teaching, but once you go 3:1:1, then research is built in. REPRESENTATIVE TOOHEY asked for further clarification on what 3:1:1 means. Number 717 MR. PARRISH explained 3:1:1. He said normally the university divides the teachers work into five parts. In a 3:1:1 faculty, three parts would be teaching, one part would be research, and one part would be service. A 4:1 faculty, like he is, has four parts teaching and one part service. So, the subject job is going out as 3:1:1, which means that there definitely will be a research requirement built in; the person absolutely must produce publishable research or will not get tenured. It is a life or death issue for them; a person like that really cannot afford to concentrate too much on lower division teaching and, in fact, if they are really successful in research, what they try for is research grants; then they buy themselves out of the classroom, certainly out of the lower division teaching, and then they try to teach specialty courses in upper division. He stated that UAA has no physics degree. There is, therefore, no reason to have upper division teaching, but, in fact, he is already finding some of the other members of the department are trying to start putting in upper division courses for next fall, in part, he thinks, on the strength of this new position. So, he sees the whole thing as a new loss, if anything. Number 727 CHAIR BUNDE told Representative Brice that he would see that he gets a copy of the written material referred to, as well as materials from the committee meeting yesterday. CHAIR BUNDE commented that Professor Parrish had addressed a problem that the legislature was very aware of and concerned about, and that is, with the decreasing revenue stream, how does the legislature maximize the impact of the dollars spent on education to be of benefit to the greatest number of people. The catch words used to be that the state and the university were going to have to learn how to do more with less because there is less money available. Chair Bunde said he frankly thought we are to the point where we have to do less with less and have to decide what our priorities are. He felt there was a considerable sentiment in the legislature to see the greatest number of students served per dollar, which creates a need for efficiency and effectiveness. Number 750 MR. PARRISH wanted to make it very clear that the people he was talking about are not devils incarnate; many of them are personal friends. Research dominant positions are basically a mind-set, that universities do it this way, that we are a university, that, therefore, we must do it this way. He emphasized that the committee should not get the idea that these people are in any way doing anything that they themselves would consider wrong. It was just that they see themselves belonging to a great world of scholarship. He said he sees himself and the others as working essentially for the state of Alaska and he thinks this is a real distinct difference. Number 755 CHAIR BUNDE replied that he thought it has been said on this campus many times before, "Reasonable people can disagree and some reasonable people can be very disagreeable." Number 767 MS. NELDA KOECHER, testifying from Nome, introduced herself as a student at Northwest Community College. Responding to the committee having asked how to better serve the needs of students, she felt the needs of the rural areas could better be served by having more variety in degree programs. She is a single mother, working full-time for the criminal justice bills, and by default she has ended up in the social work program, because that is all that is offered in Nome other than education and business. She felt the course offerings were inadequate. Also, Fairbanks does not take or give out "Perkin's loans," which would be very beneficial to the criminal justice field because they do have a program where those loans can be used and be forgiven through the federal government for correctional officers or those who work in the correctional field. She also emphasized that the student loan forgiveness clause being reinstated would be very helpful to rural students, even if it was only partially forgiven. MS. KOECHER felt another thing that would be great in Nome would be the offering of more vocational programs. She stated there are a lot of people in Nome who do not work because of the fact that there are no vocational programs. Number 790 CHAIR BUNDE, commenting on the forgiveness portion of the loan program, said that when this was originally in existence, frankly, the state of Alaska was in the business of giving away money. The interest rate was nominal, there was a big forgiveness chunk, and when you defaulted on your loan, they did not make any real effort to track you down and make you pay. As he mentioned to a person testifying earlier, the student loan program is not financially sound; it is costing more money to run the program than the program produces; and if the forgiveness program is reinstituted, the student loan program would run out of money rather soon. While he understood this would be an asset to many students, he felt this would not be an option available to the legislature. Chair Bunde thanked Nelda Koecher for her testimony. Number 806 CHAIR BUNDE asked for testimony from Tok and was told that the participant who wished to testify had to leave, but would send in written testimony. The bridge operator reported that Juneau had someone ready to testify. Number 811 MR. ERIC LEEGARD, from Juneau, introduced himself, saying he is a former community college teacher and now teaches at the university full-time. He teaches boat building, drafting, wood working, and what the university calls "Hard Vocational," this year called "Smokestack Industries." He brought up what he felt was a lack of forethought and on-going vocational programs in Southeast. He said vacancies are not filled when someone terminates their employment, and the program dies due to a lack of instructors. When they moved into their new marine technology facilities, they had nine instructors. They now have five positions. When they started in September, they had only three instructors to fill those positions. They have been able to pick up one other instructor and this was the first time they have hired a new full-time instructor since they started losing instructors. He said Ketchikan had two full-time vocational instructors last year. There are none this year. He understands they do not intend to refill those positions. Sitka had one and one-half full-time vocational instructors and, again, they now also have none. MR. LEEGARD stated that basically vocational education in Southeast is in a descending spiral and has been for a number of years; funds have been cut; there is a lack of administration. At the UAS, there has not been a full-time vocational administrator for about nine years. There is a new one who has just been hired and he will be starting on November 15. With the lack of funds and administration, the instructors and students get discouraged and classes are canceled. This has been going on for a number of years. Number 853 REPRESENTATIVE TOOHEY asked what the teacher/student ratio is in the vocational classes. Number 855 MR. LEEGARD responded that the classes basically run with about twelve students, ten to twelve, with maximums of sixteen. Theoretically the instructors teach four classes. Without an administrator, the instructors have ended up doing more administrative work and less teaching. Number 863 MR. LEEGARD said, regarding hiring temporary visiting instructors, that many do not seem to be converted over to permanent positions, which again leads to disgruntled employees. He felt that an inordinate amount of time has to be spent on things other than teaching. Committee assignments take a lot of time, but are felt by the individuals to be necessary to protect their own positions. Also, in order to get any pay raises, they have to go through promotion and tenure sequences. Many hours are required for the instructors to prepare their file for evaluation (two of his three instructors have between 40 and 100 hours in preparation so far), and nobody cares whether they have a rank of assistant, associate or professor, they just want a pay raise. MR. LEEGARD said they would all prefer to see a pay raise after a certain amount of time. As it is now, there is only a 30 percent potential earnings increase when a person is hired. Each person who has been hired has been paid progressively less than the one before them. When you can only look forward to a 30 percent pay raise in your entire teaching career, it does not look too promising. Number 897 CHAIR BUNDE said he recalled many years ago when rank was taken away from the community college teachers and they were then going to be demoted and called instructor or teacher. This did not seem like much of a demotion to him. Number 906 CHAIR BUNDE called for a five minute break at 5:35 p.m. The meeting reconvened at 5:40 p.m. Number 911 MS. RACHAEL BERMUDEZ, the representative from Prince William Sound Community College, testified she moved to Alaska last December. She was not involved in student government until she started listening to people complain about student loans not being on time and voicing their concerns about the interest rate. The students were looking for alternative methods for financing their education and seemed to feel if these alternative methods could not be found they would be unable to go to school. She got involved in student government. Their student government joined the thirteen- campus coalition of student governments. The subject of student loans came up in the networking of this coalition. The same problems seemed to universally surface -- interest rates, timeliness, maximum loan amounts, and forgiveness. The students felt that perhaps they could obtain a loan with a lower interest rate through a bank. She said she personally just encountered a man who did not get his student loan check on time and got kicked out of his dorm room, has no place to go, and has dropped out of school. She wondered, if tuition were to be raised, what would students do who were already locked into maximum loan amounts based upon a lower tuition rate being in effect when their loan was approved. She said she is not knowledgeable about the ramifications of forgiveness of loans. Overall, she was aware of these concerns and would prefer to see some resolution, short of a student rebellion. Number 971 CHAIR BUNDE commented that he would not want to see the students rebel either; however, he felt the students of today are extremely busy trying to work, raise families and go to school, with enough priorities to keep them from thinking about rebellion. He told Ms. Bermudez that the issues she addressed are concerns of the legislature; further, he has been assured by the staff of the Post-Secondary Education Commission (of which he is a member) they are now able to turn loans around in a more timely fashion. As a blanket statement to all students, he said that if calls are not answered in a timely manner by this commission, he would like the students to call him. MS. BERMUDEZ said she has encountered students this year who have been having problems with not getting their checks on time. CHAIR BUNDE stressed there is a student responsibility to apply for loans in a timely manner. He recalled that he taught here in 1969, and without a student loan program, there were students lined up trying to get in the door. He said a loan program is not necessary for students to go to school. It is nice, and it is great if it can be done, and he wants to continue the program as long as possible, but he felt the program must be self- sustaining. The state, right now he felt, cannot put general funds money into that student loan program. He also strongly encouraged students to go where they can get lower interest money. There are federal loans that are at a lower interest and students ought to take advantage of those loans first and then the state loans as a last resort. He reiterated that if the loan interest rate actually reflected the cost to the state, the students would have to paying about twelve percent. In addition, there is a terrible default rate, resulting in the recent hiring of another "skip tracer" to track people nationwide who are not paying back their student loans. Chair Bunde encouraged students not to take out loans, making the observation that it would be wonderful if they could graduate and not be in debt. Perhaps students will have to do it the old fashioned way, "work a year and then go to school for a year." Many people have done that, he said. CHAIR BUNDE commented there is no question that the state is facing decreased revenues. He said that as much as his heart wants to support education, and while subscribing to the notion that if education is expensive, ignorance is far more expensive, he recognized there are many people out there whose needs are not being met as well and to them the university is just another small special interest group. Number 036 MS. BERMUDEZ asked how much money is given annually for student loans. CHAIR BUNDE responded there was just a bond sale for this year in the amount, he thought, of approximately $60 million; he was not sure of the amount. Number 040 MS. BERMUDEZ asked how many student loan applications come in and how many are denied. Number 041 CHAIR BUNDE answered that, as far as he knows, virtually none are denied as long as they meet the requirements that they are a state resident. He also observed that one of the reasons the loan costs so much is that there is no credit check. Number 075 REPRESENTATIVE BRICE stated that another practical reason why there is probably not that much dedication to credit checking is due to the fact that, although the average of many students is generally high, there is a very substantial population of students who are entering out of high school (18, 20, 22 years old) who have very little to no credit established. Regarding the bonding, he stated this was a decision made by the legislature a couple of years ago, to drop the forgiveness and establish the revenue bond situation whereby the legislature would sell bonds at five to six percent to pay for the student loan program. Over the next ten years the state will require a certain level of capitalization of that program, but the responsibility of the state would continue to gradually decrease, until finally it is a self-sustaining program, fully paid for through bonding, with a certain level of revenue coming in above and beyond what was going to the retirement of the bonds issued. The discussion at that point in time was that revenue might be used for scholarships, expanding the program, a partial forgiveness, or whatever -- but that was going to be a little bit down the road. He said the last he heard, they were not refusing to sell these bonds, so the state's obligation to that has been dropping. Number 118 CHAIR BUNDE acknowledged there is little or no general fund money put into the student loan program, the idea being that it would become revolving "you pay your loan and the next person gets their loan." But at this point, he said, it isn't there yet. We are borrowing money and paying six percent and we are getting back from the students really about five percent. There was the mention by Chair Bunde of a possible lawsuit coming up that could cost the student loan program $8 million. CHAIR BUNDE told Rachael Bermudez that he understands the student problems, that she has stated them well, and asked that when she goes back to Valdez she tell them it is not that the legislature is ignoring the students, but that there are financial realities. Students are doing the right thing to get the scholarships, the federal loans, the bank loans at a lower interest rate, whatever they can get, and take the state student loan as a last resort. Then, once a state loan is taken, pay it back, or you contribute to its demise. Number 147 MR. DELBERT COLLETT, president of the Prince William Sound Student Community Association, said he'd like to talk about distance education. The state of Alaska, through its constitution, provided for the University of Alaska system. He said that somewhere along the line the focus of this system has been lost. At the time of statehood, the federal government instructed the state to form a state educational system. At this time, however, unless a person lived in a metropolitan area, they are denied an education. He said rural people do not have a wide variety of resources and some of these people live entirely by subsistence. Their lifestyle should not preclude their education. Mr. Collett said the state has a responsibility to educate all people in the state, not just the ones who have the resources to seek out education. MR. COLLETT felt that right now the university government was in a state of transition. The Board of Regents has called for a system of government to be formed that would combine the resources of faculty, students and staff into a single government system whereby recommendations can be made to the Board of Regents, the president, and the legislature as to the function of the university as a whole. The rural students have special needs that are in contradiction of the metropolitan students. He said they have problems in science, location, structure, and student lifestyle. In outlying areas, there are mostly part-time students; students who take as little as one credit to better their jobs or their lives. They take what they can, when they can, and that puts a burden on these people, he said. MR. COLLETT said he felt there are problems with the student loans right now. In his personal experience, he applied for a student loan in March. He had a disbursement date of September 30, 1993, but didn't get the check until October 20. The check was dated August 28 and held in Anchorage. He pointed out that this shows there is a problem somewhere. Many people struggle to go to school and without that check the struggle is worse. Mr. Collett knew of cases where people had no money to feed their children when the check was late. He felt there has to be a better system of distribution. MR. COLLETT pointed out that the RATE (Rural Alaska Teacher's Education) program was created by the legislature specifically for the Prince William Sound Area, but it is run through the university system. Mr. Collett said the state can teach rural teachers to be rural teachers so that they can go out and guide their own curriculum in their own Alaska. He said there were 39 people that had to be dropped from this system in Valdez -- 39 people who wanted to be teachers in Alaska that had to be dropped from the program because all of a sudden the courses were unavailable. Mr. Collett said they were the only community college in the state. They receive other funding other than the state, but keep running into brick walls. MR. COLLETT said they have a broadcast communications school in Valdez that is capable and willing to set up a distance education program. He pointed out that there are many forms this could take: telecourses, correspondence courses, interactive services. Mr. Collett explained that a student can be 400 miles away and still have direct access to a teacher through their computer. He said the possibilities for this type of distance education are endless. He noted he has a copy of a presidential task force report made in Juneau in June 1993 that has relevant facts in it that need to be pursued. Mr. Collett said there are people out there that want an education but can't get it and there is obviously no way they can. He said the state must be able to provide that opportunity in a timely and cost effective manner. MR. COLLETT said he sees a need to have an official organization to set goals and planning. He said they have a system of student government called the United Association of Rural Alaskan Students. This breaks the rural students away from the associations in Anchorage and Juneau. The rural students need a voice, he said, because they have special problems and need representation. Mr. Collett is from Los Angeles and came here eight years ago. He, at first, thought Anchorage was a small town and, now that he is in Valdez, he said he had a special understanding of the type of access that should be in place and the special needs of those in rural areas who don't have that access to higher education. He said the legislature and university need to focus on distance education and student needs. TAPE 93-74, SIDE A Number 000 MR. COLLETT concluded that Alaska does not have a system in place to provide an education to rural students. CHAIR BUNDE thanked Mr. Collett for coming all the way from Valdez to testify and said he shared his frustration in trying to make the legislature more accessible to students. He said legislators frequently hear from administrators and boards, but not from students. Number 015 REPRESENTATIVE DAVIS asked what the RATE program was and why had 39 people been dropped. CHAIR BUNDE said the courses were no longer available. REPRESENTATIVE DAVIS asked if this was a statewide program. CHAIR BUNDE responded that he wasn't sure, but he did know that there was once a program in Northwest Alaska in which $1 million was invested and not one student ever graduated and became a teacher because there was no interest in the program and no people with the right abilities. Number 027 REPRESENTATIVE TOOHEY asked Mr. Collett if he was talking about undergraduate students, not high school students. MR. COLLETT replied yes. CHAIR BUNDE said he understood there was a distance education program for high school already in place. Number 031 CHAIR BUNDE noted that Mr. Collett was from California and that their liberal system of education went broke. He said he hoped Mr. Collett was not suggesting Alaska imitate that system. Students in Alaska have many different needs that have to be balanced, he pointed out. A college student in Chukchi costs the state $30,000 a year for them to go there. Chair Bunde said he felt that wherever a person lives they have choices to make. People who live in Anchorage get to have K-Mart, but they also have to have K-Mart; they get to have UAA, but they also have to have UAA. He said if someone chooses to live in a village, the state can't afford to provide them with a private education. Alaska has 21 public schools that have a student population of 12 or fewer students, and it costs in excess of $100,000 per school and the state cannot afford it. The legislature's job is to put the money where it will serve the greatest need. People in rural areas can make the choice to go to where a higher education is offered. MR. COLLETT said there are three national organizations that provide funding to states that provide distance education. He felt that one location that provides long distance education through modern technology will cost considerably less than many campuses with as few as 12 students each. CHAIR BUNDE agreed, but said it was even less if you only have one campus. He said Alaska needs $20 per barrel of oil to balance the budget now, and it barely has $16. The money is not there. Number 067 MR. BRIAN BRUBAKER from the Association of Students at the University of Alaska, Fairbanks (UAF) said he was there to talk about student loans. He said he represented a new group that has been formed and they were trying to solve some of the problems with the loan and hoped to build a stronger loan program. He wanted the students, administration, and legislators to work together and each unique viewpoint should be heard. His group believes there are improvements that can be made in all stages of the programs, including the timeliness of applying for a loan and the need for loan information to be communicated to students. MR. BRUBAKER said there is a 30% rate of rejection for first time loan applicants because information is not clear and concise. He said students are often misled into believing they have their loan because of unclear information in the packet sent out by the commission. He felt there was a need to make it easier for the institutions to administer loans, to have a better system for determining eligibility, and a better system for appeals. Mr. Brubaker suggested institutions could make eligibility and appeals decisions themselves. Number 113 REPRESENTATIVE TOOHEY asked if this new group would be able to go to the problem areas and help work through the problems. MR. BRUBAKER responded that his group thought they could work in cooperation with the student leaders, the institution officials, and the commission. Number 117 CHAIR BUNDE said a new executive director had just been hired and he agreed that the paper chase can be reduced through electronics, Visa cards, and other means. He said he would like to see no more paper searches. He said the legislature is trying to get the commission to work harder and smarter. The commission has a bad public relations problem. Chair Bunde asked Mr. Brubaker and other students to give DHSS and the commission time. He said they are improving the application process and the way information is communicated with the students. The commission just completed an MTV video that explains the process through a rap song that speaks the student's language. Number 136 MR. BRUBAKER said there is a lot of information that the group, as students, does not have and it is their fault for not researching further. He felt the bad reputation of the commission is a small problem, but small problems build up and cause the breakdown of the system. Number 156 CHAIR BUNDE replied that in talking with constituents, many felt that the commission and DHSS were not addressing problems with student loans and he felt this was not true. A large part of the work done by DHSS concerns student loans. For example, Chair Bunde said he does not feel there should be a separate set of paperwork for loans. If a student qualifies for resident tuition, they should automatically qualify for a loan -- that would be more efficient. He said the commission was moving forward and the loan program was under a lot a pressure to remain viable. Number 163 REPRESENTATIVE TOOHEY suggested the group get some publicity to the students explaining why it is so important to repay their loans -- if they do not, there will be no money for the students that follow. Number 165 MR. BRUBAKER said the interest rate and the maximum loan amount were two other areas of concern to his group. He said they also felt the students should have gotten together and addressed the problems with loans before things got so out of hand. Number 178 CHAIR BUNDE instructed Mr. Brubaker to please ask the students to look carefully at the interest rate, which is actually only 5%. A floating rate could go to 20% in a year. He thanked Mr. Brubaker for his testimony and recognized TERYL ELAM as the next speaker. Number 188 MS. TERYL ELAM, a first-year student in the UAA WAMI program, came to talk about that program. There are ten students each year who do their first year there and then go the University of Washington to finish. She said the program has two purposes: (1) to provide doctors for Alaska to service the population and (2) to provide Alaskans with an education. Ms. Elam pointed out that there are very few states that do not have a medical school and Alaska is one of those. Because of that, she said, it is hard for Alaskans to get into a medical school. She explained that each state has its own system that gives preference to students likely to remain in that state. The only option for Alaskans, Ms. Elam said, is to apply to private schools, which are extremely expensive. She felt this was a barrier to those who would like to go into general practice and work in an underserved area because they would have to pay back the $130,000 cost of going to a private school. Ms. Elam said that most of the students who go into the program here want to come back to Alaska and serve their community. If there isn't a WAMI program, they can't afford to do that. Number 225 MS. ELAM said she had the choice of going to several private schools and a couple of state schools, but she was told by several of these schools that she could not be in the WICHE program because they were no longer accepting Alaskans into WICHE. She felt the public schools give lip service to WICHE and rarely accept nonresidents. She said WAMI is well respected, a premier research center, and it emphasizes primary care. By being in Anchorage, Ms. Elam said, students learn about the culture of Alaska and the health care needs of Alaskans. She said students get to work with local health care providers and that encourages them to want to come back and practice. She explained that in a student's third and fourth years they can rotate and come back to Alaska and see how medicine is practiced in rural Alaska. Ms. Elam concluded by saying she supported continuation of funding for the program. Number 271 CHAIR BUNDE asked if it is common for the first year of medical school to be the most expensive. He said it costs $70,000 a year for students to attend this program in Anchorage, yet when they get to Washington the cost lowers to about $30,000 a year. Number 280 MS. ELAM responded that she wasn't aware of exact figures, but she had heard it costs between $50,000 and $100,000 a year to educate medical students because of all the special facilities and research. Number 290 CHAIR BUNDE said that still didn't explain why the first year here was so expensive, and that with only a 50% return of students to practice in Alaska, it was not a very good state investment. He said he was surprised to hear we are paying $75,000 a year to belong to WICHE and yet they are not accepting our students. MS. ELAM said this was because Alaskans have access to WAMI -- another means of funding their education. She suggested that Alaska choose one method of funding and to back that strongly. She said medical students are not getting a free ride. She has $40,000 in undergraduate loans and medical school requires loans of $17,000 per year. Number 331 CHAIR BUNDE said by the time Ms. Elam finishes medical school, the state will have invested $160,000 in her education. How much of that would she be willing to pay? Number 338 MS. ELAM replied it is important to keep people concerned about going into primary care. Her loans come from a variety of sources with interest rates up to 12%, so her actual repayment of loans will total about $140,000 instead of $75,000. Number 359 MS. KARIN PATTERSON, a student in Anchorage, said she also wanted to talk about WAMI. She said she was born in Alaska and has lived here all her life except for the five years she spent at college in California, where she graduated with honors. During her college years, Ms. Patterson said she worked, got a scholarship and a grant and is still $29,000 in debt to the state of Alaska and pays $329 a month on her student loan. She is currently taking science courses to qualify to go to medical school and repayment of her current loan at this time is very difficult. MS. PATTERSON pointed out that interest accrues on loans during the grace period while a student attends school and when students graduate all their money goes toward interest. She said WAMI would allow her to get a quality education and return here to practice. As a student, Ms. Patterson is concerned about support of WAMI, especially in a state where students cannot get a medical education. She has been advised that if she applied for a WICHE program, she would not get accepted. State schools give preference to their residents. MS. PATTERSON stated that the only options open to her are WAMI, the military, or even larger debts. Without WAMI, she said she could borrow and incur large debts. She felt that students in this position might as well go to John Hopkins and have no incentive to return here. The purpose of the program is to produce a highly qualified graduate and attract that graduate to come back to the state. She believes WAMI does that and she would support the requirement of mandatory return to Alaska. The federal government has a similar requirement of graduates working in underserved areas. Number 446 REPRESENTATIVE TOOHEY said she had information on other programs if Ms. Patterson would like a copy. MS. PATTERSON responded that she would. Number 452 CHAIR BUNDE said there was a recent "60 Minutes" program about people with six-digit salaries who renege on their student loans. MS. PATTERSON replied she shared his concern. CHAIR BUNDE said he didn't think Alaska could afford to incur this kind of debt and loss with so little return. CHAIR BUNDE called for JACK DALTON and was told he had left. He asked the bridge operator if there was anyone waiting to testify and was told no; only Kodiak was listening to testimony. He then called DAVE DAU. Number 510 MR. DAVE DAU said he is a professor in the psychology department at UAA and was there to talk about problems in the university system. He said Alaska is one of only six states that does not provide a medical education and it is one of only two states that does not have a functioning community college. One of the most common complaints he hears from students is that they cannot get the courses they want and cannot obtain a degree in four years. In response, the university comes up with elaborate systems, such as the priority registration system. This system effectively allows people in degree programs to register before people who are not. Mr. Dau said there is debate now within the university to make that system even more restrictive by allowing seniors to register before anyone else. Another elaborate solution, he said, is increasing class sizes. In his department, they offer Introduction to Psychology to a class with 200 students. MR. DAU said the university in Anchorage has an unacceptable ratio of part-time to full-time faculty members. He added that UAA has an unacceptable level of "visiting" faculty who visit year after year. He explained that this means the university does not have much obligation to these people and they respond in kind. The solution, Mr. Dau stated, is to put teachers in the classroom. MR. DAU said teachers need to do less research and administration so they can offer more courses to students. He encouraged the legislature to scrutinize requests for funds for more instructors. The university is currently advertising for two additional positions for his department and each of those positions are expected to spend 25% of their time doing research. He thought that was unacceptable. Number 610 REPRESENTATIVE TOOHEY said she would like to see some cooperation with the Science and Technology Foundation, where they grant the funds for research and all funds that come through the legislature for the university are spent on teaching. She said she was part of the community college in Anchorage and was sorry to see its demise. She said Alaska is not an academic state. Alaskans are not catching and teaching the people of this state. Number 637 CHAIR BUNDE said this issue has been discussed in the legislature and if research is so important to the private sector, they should pay for it. TAPE 94-74, SIDE B Number 637 CHAIR BUNDE said very little research is geographically specific. The legislature can no longer give intent. The legislators' hands are tied and they can only cut the budget. CHAIR BUNDE thanked the speaker and called for the next testimony. Number 671 MR. JOE CONNORS, a faculty member at UAA, said he wants to use existing funds wisely. He said this is currently not the case. Mr. Connors felt that existing faculty have major disparities in their workloads. Some faculty teach 140 students per semester, others as few as 40. In addition to the teaching disparity, Mr. Connors said there is the problem of research. He said he felt the university has not scrutinized the type of research going on. He asked, Who benefits from a particular research project? Students, state, UA? What is the value of the research? Does it have state value? Does it have national value? Mr. Connors said he thought that faculty was being taken out of teaching for administration and special projects and not being replaced. He commended the legislature for approving funding for 26 new commissions within the year. However, he said they are being filled as research and specialty positions, even though the student body says they need more lower division teachers. This costs Alaska more because a doctorate degree is not needed to teach basic classes. Number 735 REPRESENTATIVE TOOHEY asked who was accountable for this. MR. CONNORS replied that the president of the university was responsible now, and really each of the universities should be held accountable. Number 748 CHAIR BUNDE said it was his understanding that three-quarters of the new hires are bipartite or tripartite and Mr. Dau might want to check his research on this. MR. CONNORS responded that it was obvious that for every four 3:1:1's hired, the university could hire another teacher and serve another 1020 students per semester. CHAIR BUNDE said he has taught six or seven classes per semester and would not like to see that type of system made mandatory by the legislature. Number 761 MR. CONNORS agreed. However, too many people are no longer doing their jobs, he said. Number 765 REPRESENTATIVE TOOHEY said if this is the case, it is not the person's fault, it is the system's fault. Number 768 MR. CONNORS said that insisting on bringing in doctorates to teach basic classes was harmful. That person will soon want to join his or her colleagues teaching higher classes and doing research. In essence, he said, Alaskans pay more and get less. Number 776 REPRESENTATIVE DAVIS said he would like more information on new hires and jobs open. Number 793 MR. RALPH McGRATH, president of the Alaska Community College Federation of Teachers (ACCFT), said they have the bargaining status as the bartering agent for the full-time cooperative of the 160 who teach vocational and undergraduate 100 and 200 courses and they also represent faculty that teach at the extension sites of all three universities. Mr. McGrath said ACCFT has a broad responsibility of representation, but the one thing that holds this group together as a faculty is a priority on teaching and a priority on community college. MR. McGRATH felt that the university was at a defining point in its history. Seven years ago the community college merged with the university. Mr. McGrath felt that seven years was long enough to test whether or not that merger has worked. It was his assessment that it has not. He said the legislature established the community college act and ACCFT has turned to the legislature and DHSS for the past 25 years for guidance, direction, and support. He said his group was looking for support for community colleges and would be seeking that support in the up-coming legislative session. Mr. McGrath thought the university was currently out of control. Departments are making decisions as to what is important. Mr. McGrath asked, Where's the leadership? He felt that leadership has abandoned collegial administration and there is a question as to why teachers are here. As a teacher, Mr. McGrath asks himself, Am I a university professor or a community college instructor? The two, in his opinion, do not mix. Mr. McGrath said this leaves teachers in the position of spending a hundred hours applying for promotion. That time replaces the time they used to spend doing something for the community. He said the current system has become the equivalent of the movie "The Paper Chase." Mr. McGrath stated that the result is an internalized shifting of what the community college is all about. Number 844 CHAIR BUNDE thanked Mr. McGrath for his testimony. He said, as representatives of the people of Alaska, we cannot make decisions in a vacuum. He asked that any written testimony be left with the secretary. He said legislators will be back in November looking at the university and hearing testimony. Seeing no further business before the committee, CHAIR BUNDE adjourned the meeting at 7:10 p.m.