Regents reply to Senator Crowell

The following letter was sent to state Sen. Jason Crowell of Cape Girardeau by the regents of Southeast Missouri State University in response to a previous letter from Crowell regarding the Caring for Missourians initiative. For background on this issue, please see the story on Page 1A of today's Southeast Missourian.

Dear Senator Crowell,

Thank you for sending to members of the Southeast Missouri State University Board of Regents copies of your June 10 letters to president Ken Dobbins and Gov. Jay Nixon regarding the Caring for Missourians initiative. We also noted that the June 25 issue of your e-mail newsletter, "The Crowell Connection," basically contained the same points as your letter. Since the decisions that would be necessary to comply with your positions voiced in those letters and e-mail would ultimately be the responsibility of the board of regents, the members of the board unanimously agreed to reply to your letter on behalf of the university.

We appreciate your support for the Caring for Missourians initiative and your concern about the critical shortage of health-care professionals in our state. The board shares that concern. We agree that our colleges and universities must step up efforts to increase the supply of these professionals. That is why we are planning to expand our nursing faculty and increase the number of bachelor of science in nursing (BSN) and family nurse practitioners (FNP) students using the one-time funds that are being made available through the one-time Caring for Missourians appropriation. We believe these funds will enable the university to carry forward its part of the Caring for Missourians initiative for at least the next two years without additional appropriations. We will use these two years to show the governor and General Assembly that with additional dollars Southeast can make a difference in meeting this critical state need.

Having said that, however, we are concerned by your positions that only Missouri students should be selected for any new slots in our BSN and FNP programs and that those selected should be required to remain in Missouri after completing the program. We believe president Dobbins was correct in the quotes attributed to him in the article you referenced in your letters and e-mail, i.e. such requirements are not necessary and that the vast majority of our graduates already stay in Missouri after completing their education. We want to specifically address your two suggestions in order and provide some data that may eliminate your concerns that the Caring for Missourians initiative may not provide health care professionals for Missourians.

First, you have suggested that we adopt an only-Missouri residence requirement for the Caring for Missourians BSN and FNP openings because without such a requirement, you believe "Missouri taxpayer dollars could very well be paying to help students from all around the country or world to have increased access to education and training." We respectfully point out that this is a possibility for all academic programs at every public college and university in Missouri.

In fact, there are advantages to Missouri in admitting out-of-state students to university programs. To illustrate, the premise for the Bright Flight program, which you have so generously supported in the past, is based on the assumption that students who attend college in Missouri are apt to remain here after graduation and we want the brightest and best students to contribute to building the economy of our state. The data indicate that this premise is also correct insofar as our BSN and FNP programs are concerned. Of the 46 graduating BSN students in 2008 and 2009, 41 were residents of Missouri when they first enrolled, but 44 of those graduates chose to be licensed in this state after graduation. So Missouri has gained nursing professionals from nonresident students. Additionally, the six students who have been admitted to the FNP program this fall due to the Caring for Missourians expansion of that program are all Missouri residents. All of the 16 graduates of the Family Nurse Practitioner program in 2008 and 2009 are now in Missouri practices.

Consequently, we believe admission to programs in the health professions, like the admission to all other programs at the university, should be based on the merit of the applicants rather than their current place of residence. This is particularly true, perhaps, in the health professions, since our policy is to admit the brightest and best applicants, regardless of their residency, because Missourians expect their health care to be provided by the best and brightest professionals.

Your second suggestion was that graduates of our health profession programs should be required to remain in Missouri after completing their education.

It would be relatively easy for the university to require all students entering due to the Caring for Missourians program expansions to sign a form stating that they would always practice their profession in this state. However, since students are paying for their education and this is not a scholarship program, we know of no legal recourse that would make it possible to enforce such an agreement. Market factors such as salary, benefits, working conditions and demand normally determine where a university graduate locates initially or relocates later in his or her career. We see no legal or practical way Southeast could dictate such personal choices to its graduates. In fact, we believe imposing such a requirement for admission would be counterproductive to efforts to enroll the best students in our health profession programs.

We sincerely hope you will consider our views on these matters, and in light of the actual data we have provided, that you will reconsider the June 10 ultimatum in which you stated "At this point, I feel so strongly that the Caring for Missourians initiative should be targeted only to Missouri resident students and those who agree to stay in Missouri upon graduation that unless internal policies are adopted and followed, I will oppose any future funding statewide and/or locally for this program."

We hope you can see that the university, using the Caring for Missourians funding, will provide more health professionals in Missouri even without the conditions you want us to impose. We believe that your continued support for Caring for Missourians is essential to the ultimate success of this vital initiative and we look forward to that continued support.

Finally, it would also be appreciated if you would convey our response to your constituents via your e-mail newsletter in order to provide them with information they may need to understand both sides of the issues you have raised.

DONALD "Brad" BEDELL, President; ALBERT M. SPRADLING III, Vice President; and REGINALD D. DICKSON, JAMES P. LIMBAUGH, DOYLE PRIVETT and DAREN TODD, Members, Southeast Missouri State University Board of Regents