Avera McKennan

Fred W. Slunecka, Regional President, Avera McKennan, responded to questions from the committee.

Representative Richter questioned Avera McKennan's future involvement with the School of Medicine. Mr. Slunecka said that the future of the School of Medicine is very important to Avera as the hospital has a long history with the medical school. He said that the medical school's psychiatric residency program is located at Avera McKennan and that the hospital provides approximately $700,000 annually subsidizing this program, and this does not include the federal funding that passes through the hospital because of the psychiatric program.

Mr. Slunecka said that he would like to see an expansion of the internal medicine program. He said that Avera presently sponsors two full-time internal medicine residencies for the medical school and wants the number of residencies to three in the future.

In response to Representative Richter, Mr. Slunecka said that the $700,000 subsidy Avera provides the School of Medicine will increase to $1 million this year and he anticipates a $300,000 annual subsidy for the expanded internal medicine program. He said that Avera will be watching to see how the new medical school management program develops. He said the hospital will be asked to provide medical support for the medical school at a rate that doesn't reflect the hospital's true costs.

In response to a question from Representative Adelstein, Mr. Slunecka said that Avera McKennan supports one-half of the School of Medicine's clinical residencies that are in Sioux Falls. He said the division of the residencies between Sioux Valley and Avera McKennan has evolved over time.

Also in response to Representative Adelstein's questions, Mr. Slunecka said that there are no faculty members on the Avera McKennan board of directors nor have Avera McKennan officials been invited to participant on the School of Medicine's board. Mr. Slunecka indicated that it is essential for everyone to get behind the School of Medicine and he is opposed to any actions that will decrease the school's political base of support. He couldn't speak as to how much money Avena would have paid for the use of the medical school's name.

In response to Representative Richter, Mr. Slunecka indicated that Avera should be a part in assisting with the School of Medicine's accreditation needs.

Adil Ameer, CEO, Rapid City Regional Hospital, appeared before the committee.

Mr. Ameer spoke of three elements in the relationship between Rapid City Regional and the School of Medicine as being: a clinical for the 3^rd and 4^th year students; the family practice residency program; and the assistance of University Physicians has provided in recruitment efforts for physicians in specialty medicines.

In response to Representative Adelstein, Mr. Ameer said that Rapid City Regional had not been invited to be on the University Physicians or School of Medicines boards and likewise these entities had not sought to be on the Rapid City Regional's boards. Mr. Ameer said he would not speculate nor comment on this situation. He said that the hospital is quite concerned with the implosion of the University Physicians.

There was a discussion between Representative Adelstein and Mr. Ameer concerning the expanded possibility of hospitals providing medical care to the reservations. Senator Putnam suggested that this could be discussed in the Tribal Relations Committee.

Senator Putnam questioned whether Rapid City Regional had invited medical school or University Physicians to be on the hospital's board. Mr. Ameer indicated that there had not been discussions.

In response to Senator Putnam, Mr. Ameer indicated that once analyzed, Rapid City Regional and the School of Medicine could come up with a mutually acceptable arrangement.

University of South Dakota

James W. Abbott, President, The University of South Dakota, spoke to the committee. He said that the programs previously discussed by Avena McKennan and Rapid City Regional had little to do with the $20 million required to operate the medical school, of which $9 million comes from the state. He said the School of Medicine needs funds for and that the School of Medicine accepts money from hospitals because the school can't operate without this support.

Representative Richter commented that the appropriations committee has initiated discussions with the hospitals, that there is a new medical school mission and role, that the state needs to continue to help facilitate meetings,that the medical school is important to the state.

President Abbott said that the $300,000 needed for the medical assessment component needs to be totally independent from the hospitals. He again emphasized that for the School of Medicine to be independent from the hospitals, it needs to be funded independently.

President Abbott requested that there be no summer studies on the medical school this summer as

the school needs to gear up for accreditation; however, next year would be a good time for a study.