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IOWA CITY - Iowa's rural health care providers are struggling, and one lawmaker wants to better the odds that newly educated University of Iowa physicians serve those at-risk regions by mandating the state's only medical and dental colleges admit mostly Iowans.
Rep. Ann Meyer, R-Fort Dodge, introduced House File 2115 Thursday, a bill that would compel a Board of Regents policy requiring at least 75 percent of students accepted into the UI Carver College of Medicine and UI College of Dentistry be from Iowa or previously enrolled in an Iowa community, private or public college or university.
'We want to make sure we are keeping and attracting people in Iowa, so that Iowans get the benefit of their tax dollars,” Meyer said, stressing the public nature of the University of Iowa - in that it receives state appropriations - as another driver of her proposed legislation.
'This is a taxpayer-funded university,” she said. 'And we want the people who need health care in Iowa, who are paying taxes, to benefit from that.”
RuraL HEALTH CARE
Iowa's rural health care providers need all the help they can get - as nearly 18 percent of the state's rural hospitals are at high risk of closing in the near future, according to a national analysis last year, with some experts surmising the percentage could be higher.
Chicago-based consultant Navigant reported 17 of Iowa's hospitals are at high financial risk - an indicator of potential closure. And the Iowa Hospital Association in the fall reported the average operating margin for the state's critical access hospitals in fiscal 2018 was negative 2.7 percent.
UI Health Care and its College of Medicine have enacted and promoted programs and initiatives aimed at addressing the state's rural health care concerns - like the Carver Rural Iowa Scholars Program. That initiative - meant to 'attract, educate, and inspire future rural physicians who will help Iowa meet its need for health care in rural areas” - provides students the chance to receive $100,000 toward loan repayment.
NO MANDATES Now
But, Meyer said, she wants to do more to make sure the quality education afforded by Iowa's premier medical college benefits the state that helps fund it.
'If (students) are coming from California and the East Coast, they are probably going to go back there,” she said. 'I would like to think that our ‘Iowa Nice' could keep everyone here. But sometimes the pull of family is strong.”
Neither the state nor the Board of Regents currently have resident- or non-resident enrollment mandates for the medical and dental colleges.
The UI College of Medicine's 2019 entering class of 152 students included 104 Iowa residents - about 68 percent. That's about the same residential percentage for the UI College of Dentistry's 2019 entering class of 80, which included 55 Iowans.
In terms of total enrollment, the UI College of Medicine in the fall reported 774 total graduate and professional students - including 502 Iowa residents, or 64 percent.
The UI College of Dentistry in the fall reported 354 graduate and professional students, including 240 residents - or 68 percent.
OUT-OF-STATE STUDENTS BRING IN MORE MONEY
Keith Saunders, state relations officer for the Board of Regents, told The Gazette the board opposes mandates like the one proposed and said the universities already are close to the 75 percent threshold.
Where they aren't, he said, requiring a change would represent a budget cut - as out-of-state students pay higher tuition rates.
The regents recently paid for and published research showing their universities' economic impact on the state - highlighting, specifically, the boon out-of-state students provide.
About 44 percent of students attending the University of Iowa come from outside Iowa, according to that report.
'Some of these students relocated to Iowa,” according to the report. 'These relocated and retained students spent money on groceries, mortgage and rent payments, and other living expenses at state businesses.”
Specifically, relocated and retained students in the 2018 budget year added $119.2 million to the Iowa economy, according to the board's impact report.
Meyer said she's willing to compromise and amend the language or the percentage.
'But the impetus behind this is to keep more Iowa kids in Iowa,” she said. 'By starting out as Iowans, they are more likely to stay here and practice, and that's what we want.”
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