March/April 2015 Issue
Students Need Colleges, Colleges Need Resources
By Dr. Margaret Ellibee
Ellibee has been the president of Pulaski Technical College since 2012. She holds a Ph.D. in educational administration from the University of Wisconsin.President Obama’s proposal to “make two years of community college free for responsible students” has elicited an unprecedented nationwide conversation about community and technical colleges. As a technical college president, I think the plan is very ambitious. It offers a way for Arkansans to move from struggling, low-income status into the middle class. It also brings a laser-like focus on the essential role that community and technical colleges play in America — providing technical and liberal arts education and relevant job training.
The America’s College Promise policy points are worthy of deliberation. In the plan, a student who is enrolled in a community or technical college and maintains a 2.5 grade-point average can qualify. The participating college must offer programs that transfer to a four-year college or university and technical programming that aligns with high-demand areas in the local workforce.
Many politicos, educators, and others have followed the news with the caution that “the devil is in the details.” People heard “free” and “community college,” and that ignited the discourse. That’s not a bad thing.
When the White House first released the America’s College Promise, I was in line at my local post office with several other people. As we waited, talk of the recent cold weather turned to “free tuition at community college.” My fellow Arkansans thought the mission of community college was good, but they wouldn’t support the notion if it meant additional taxes. As one neighbor noted: “Everybody should go to college if they want to, but I can’t pay for all of the free part.”
That conversation mirrors what is happening nationally. The value of, and future investment in, community colleges is now entering policy and funding deliberations.
Many community colleges struggle with aging infrastructure. To potentially manage dynamic enrollment growth as a result of free tuition will be a challenge. Nonetheless, it can be a positive challenge if new investment is made with accessibility and quality education as the highest priorities. Education must be centered on meaningful career paths that complement further education and/or job training.
State funds have either flatlined or decreased. This growing negative funding rate has hit a critical tipping point. Colleges cannot keep pace with the costs of technical training — equipment, supplies, instruction.
Pulaski Technical College (PTC) is one such institution. The idea of having 10,000 more students on our campus is tremendous. However, the revenue required to provide a quality education for a significant enrollment increase is just not there; PTC receives significantly less than 75 percent of what the state of Arkansas deems a proper-funding level. Without sufficient state support or a local tax levy, PTC simply does not have the money to upgrade existing infrastructure, let alone to successfully handle an enrollment increase of that magnitude.
If we are to improve training and educational attainment in Arkansas, there must be a willingness to invest in our workforce. At PTC, 80 percent of our 8,500 students receive some sort of financial aid; 60 percent of those students receive federal Pell grants. Most of our students work full or part time. Their average age is 30. They are not looking for a handout. Rather, PTC and Arkansas community colleges as a whole provide career pathways and quality educational programming that provide a hand up to hard-working students.
With a $60 billion price tag for national implementation of America’s College Promise, a deliberative conversation will have to be had by federal and state leaders. Can a new investment be implemented now to allow for a quality “reboot” of our aging higher-educational infrastructure for the next 25 years? My business friends say in order to have a successful business, you have to invest money. As an educator, I believe it is time to make the same investment in our colleges. And with that, let those of us in two-year colleges show strong returns on those investments, such as increased rates of retention, completion, graduation, and job placement.
Support for community or technical colleges is nearly universal and crosses party lines. We all must be willing to listen and then engage in the hard work that will strengthen our colleges for our students and their success. Free or not, the mission of Arkansas’ community and technical colleges is vital for our state to advance educationally and economically.
Let’s Transform Our Health Care
By Troy Wells
Wells, president and CEO of Baptist Health, has worked in health care for 18 years and with Baptist Health for eight.As reforming the health care system continues to be a hot topic across the country, it is important to recognize that we don’t talk enough about the things that are right about health care in the United States. Physicians, nurses, and health care professionals provide lifesaving care to patients each day in American hospitals.
It is clear, however, that our health care system is not sustainable in its present form. The system operates in many ways that lead to some people getting too much care, some people not getting enough care, and all of it costing too much.
I would suggest that the primary goal for health care in 2015 is to redesign the system so it provides higher quality of care — the right care at the right time in the right place — at lower costs.
Achieving this goal means we have to address several challenges.
First, there is the challenge of innovation in clinical care. Work being done in fields such as angiogenesis (the process through which new blood vessels form from pre-existing vessels); in diagnostics by firms such as Theranos, a blood-diagnostics company that provides sophisticated test results at lower costs; or the development of “personalized drugs” will continue to impact how we practice medicine and care for patients.
With advancements in clinical technology comes the challenge of sorting out the difference between what adds real value to patients and what just adds cost to the system.
An additional challenge is access to care, which we have debated for just more than 100 years. In 1912, Theodore Roosevelt’s Progressive Party included a provision to create health care insurance in its party platform. These efforts to expand access to health care continue and are reflected in the expansion of the Medicaid program and the private option. With many more people accessing the system, we must find ways to affordably and appropriately provide the right care in the right setting.
There will continue to be challenges to improve the effectiveness of our health care system and to reduce the cost of care. It seems essential that we avoid across-the-board cuts and instead focus on how to improve the clinical, administrative, and financial systems we use to provide care to people who need it.
Finally, health care professionals face the challenge of managing an increasing pace of change. It is really no different than in any other industry. Whether it is change in technology, regulation, competition, or incentive, the pace of change is, and will, continue to accelerate.
Despite these challenges, it is an exciting time to be in health care. Extraordinary opportunities to redesign and improve clinical care will continue in this ever-changing environment.
At Baptist Health, and at many leading health care systems across the country, physicians are leading efforts to ensure patients get appropriate care rather than too much or too little care. The result is better care at lower costs.
Due to both changing technology and incentives, there are vast possibilities for better coordination of care across different organizations. Historically, physician offices, hospitals, nursing homes, and the myriad of other health care providers have operated independently. The result left patients trying to make sense of a confusing system. We have to better manage care across a variety of settings to ensure patients get the care they need.
For example, we have the ability to design new payment arrangements that encourage physicians and other health professionals to focus on value and keeping people well rather than the number of procedures, tests, or services they perform. Creating the right incentives and financial arrangements are critical to aligning providers to best serve patients.
Finally, there has never been a greater opportunity for health care providers to invest in wellness and prevention. In the past, the focus in health care has been on acute disease and the hospital. Health systems must lead the way in preventing chronic disease, investing in more primary care, and partnering with other health care providers and community members to improve the health of our communities.
Debates about quality, access, and cost of health care will continue. What is exciting to me is the opportunity to redesign what we do to provide a higher quality of care and service to more people.