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Appropriations Committee hearing on Building a Healthier Nebraska, February 2012
Good afternoon. My name is J.B. Milliken and I am president of the University of Nebraska. I am here today to speak in support of the four bills – LB 1055, 1065, 1066 and 1089 – that we refer to collectively as the Building a Healthier Nebraska initiative. This is an exciting initiative that holds tremendous promise for Nebraska – contributing both to a healthier economy in our state, and to the health and well-being of all Nebraskans. I’d like to thank Senators Hadley, Fulton, Hansen and Nelson for their leadership and support.

This initiative addresses a critical workforce need, especially in rural Nebraska – the growing shortage of nurses and allied health professionals, which include physician assistants, radiation therapists, physical therapists and other medical support professions.

It supports the development of a state-of-the-art research and treatment center for cancer – a disease that will impact one in two Nebraskans in their lifetime.

It begins the planning process for a new veterinary diagnostic laboratory that is critical to the economic health of our state’s very important livestock industry.

And, it will create thousands of new, well-paying jobs and have a positive and lasting impact on our state’s economy.

As the State of Nebraska’s only public university, the University of Nebraska has both the opportunity and the obligation to work with our elected public officials to address challenges that have an impact on the health and quality of life of our citizens.

One of those challenges is the nursing shortage. As Nebraska’s population ages, the demand for health care professionals continues to grow. And increasingly, especially in rural areas, the people on the front lines of medical care are nurses, physician assistants, nurse practitioners, pharmacists and other professionals rather than doctors.

Last November, the Dean of our College of Nursing, Dr. Julie Sebastian, testified at a hearing on Interim Study Resolution 285 that in just eight years (and you all know what a short time eight years is), Nebraska will have a shortage of almost 4,000 nurses. Already, 74 of Nebraska’s 93 counties have fewer nurses than the national average. The problem is not a lack of interest in careers in nursing – Nebraska institutions turned away more than 400 qualified applicants last year. The problem is a shortage of space and of instructors. Our proposal addresses both.

We have been working for some time toward a solution to the nursing shortage. We know that we cannot immediately solve the entire problem, but we can make major strides in educating more nurses and nursing instructors, improving the educational experience for our students, and expanding our capacity for nursing education and related research. The proposed expansion of the Kearney and Lincoln programs, coupled with the new nursing division in Norfolk and a recently expanded Omaha program, would ultimately close about 40 percent of the nursing gap.

Similar shortages are expected in the allied health professions. The Bureau of Labor Statistics projects that by 2018, the demand for physician assistants will increase by almost 40% and the demand for physical therapists by 30%. Other allied health fields are projected to need 15-20% more practitioners. As with nursing, we can’t immediately meet the entire demand, but we can begin now to educate more allied health care professionals to serve our state, and at the same time offer more of our students the opportunity to pursue the career they desire. These two workforce needs are addressed in LB 1065, which funds the construction of a new College of Nursing facility in Lincoln, and LB 1055, which funds an addition to Bruner Hall of Science in Kearney to house both an expanded nursing program and new allied health programs.

The Lincoln project, as you know, has been our number one capital priority since 2008, and you have previously provided planning funds for this facility. Students in our Lincoln program currently attend classes in a former downtown Lincoln department store, with just enough seats for the number of students. Because we have no room to grow, we turn away up to 60 percent of qualified applicants. We need to move these students to an on-campus location and provide more space for classrooms, modern clinical simulation labs, computer labs and faculty offices.

In Kearney, UNMC’s division of the College of Nursing is located in a small area of the business college building and, like Lincoln, has inadequate space for expansion. The Kearney program turns away about 50 percent of its qualified applicants. The recent renovation of Bruner Hall of Science has created a great facility for science education, and we can leverage that investment with an addition that will house both an expanded nursing program and a new allied health program. The benefits to the campus, the students, the community and the state – especially rural Nebraska – are many.

The third component of the Building a Healthier Nebraska initiative is a $50 million investment in a cancer research center at UNMC. The research center is part of a larger initiative that will include both inpatient and outpatient care, directly creating more than 2,600 new jobs and adding hundreds of millions of dollars to the state’s economy. Jerry Deichert from our Center for Public Affairs Research will provide his analysis of the economic impact in a few minutes. More importantly, however, this initiative will improve the scope and quality of cancer research, diagnosis and treatment for Nebraskans. It has long been a goal of UNMC to attain the designation of a Comprehensive Cancer Center from the National Cancer Institute. That designation is currently held by only 40 institutions – names you would recognize such as M.D. Anderson, the Mayo Clinic and Johns Hopkins. It carries with it an increased ability to compete for research funding and for top faculty talent, as well as increased patient access to clinical trials. It is highly competitive – which is why the State of Kansas is investing $60 million in KU’s quest to gain CCC designation and the State of Oklahoma is investing more than $90 million.

Cancer research is one of the six overarching priorities of the University of Nebraska Foundation’s Campaign for Nebraska, and we have been working closely with our partners at the Nebraska Medical Center to develop the concept that you have read about in recent weeks. This project has created tremendous excitement and support among business and community leaders in Omaha, who understand the value it will bring in attracting talent and investment in our state, and in giving new hope to the more than 9,000 Nebraskans who were diagnosed with cancer in 2011 and the thousands more who are battling this disease.

The final component of this initiative is the veterinary diagnostic lab in Lincoln, which risks losing its accreditation if major deficiencies are not corrected. We believe that replacing this 35-year-old building is the most cost-effective approach and have requested planning and design funds to move that project forward. Like cancer research, agriculture is one of the six major priorities in the Campaign for Nebraska. It is central to the economy of Nebraska, and the University has long played a role in increasing the productivity and profitability of the agricultural economy.

Over the past two months I have met with representatives of the Nebraska Cattlemen, Farm Bureau, Nebraska Veterinary Association, Ag Builders and other livestock and agriculture organizations, all of whom have made it very clear how vital it is to their economic success to have an accredited diagnostic lab in the state. It is also important to the quality and competitiveness of our joint veterinary program with Iowa State, and is a great resource to our state Game & Parks Commission.

Some people have questioned the timing of this request, and I want to address that.

There is some urgency to our request. The process of building new facilities in Lincoln and Kearney and expanding or establishing academic programs there is projected to be about 1-1/2 – 2 years – and each year we wait to begin puts us further behind in making up the gaps in the healthcare workforce. The cancer center is a major economic development initiative that hinges in part on a commitment from the state. And the clock is ticking on the diagnostic center’s ability to maintain its accreditation.

I agree with Senator Hadley that the time is right to pursue this initiative. The state is in a strong position to make one-time investments from the cash reserve. More importantly, that investment would be leveraged many times over – helping the University secure private and business support for the remaining $320 million cost of the cancer center, and ultimately putting hundreds of millions of dollars back into the state’s economy. A commitment from the state would allow us to move forward with our plans, much in the same way that your commitment last year to Nebraska Innovation Campus had immediate rewards in the form of some $80 million of planned investment from the private sector.

In recent years the state has put in place a wide range of financial incentives to lure new businesses to Nebraska … to build facilities, create new jobs and spur economic growth. And we agree that those incentives are appropriate and powerful tools for economic development. If the formulas used by the Department of Economic Development for tax incentives were applied just to the cancer center project, our $370 million investment would be eligible for more than $81 million in sales tax credits, as well as additional tax incentives, over the next 10 years. So, our $50 million request to the state is only 60% of the $81 million of state tax credits a private sector employer would get for this project.

Summary

In summary, I urge your support of all four components of the Building a Healthier Nebraska initiative. It aligns with University priorities, as identified both in the capital campaign and in our strategic framework. It aligns with the state’s needs: to grow the health care workforce, especially in rural Nebraska; to provide the best possible care for Nebraskans diagnosed with cancer; to create new jobs and economic activity. The support of the Lincoln, Omaha, Kearney and State Chambers of Commerce, which were conveyed to Sen. Hadley this morning, is evidence of broad business support for the initiative.

And, I would echo Senator Hadley’s comments regarding the wisdom and value of making strategic one-time investments that have a significant return to the state and that can be leveraged for even greater public and private support.

A great deal hinges on a timely state commitment to and partnership in these projects. Thank you for your consideration.
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