EXECUTIVE SUMMARY

Montana State University-Billings (MSU-Billings) proposes to join the established existing agreement between the Montana University System (MUS) and the three clinical laboratory training centers (University of North Dakota (UND), HealthONE School of Medical Technology in Denver, Colorado and the Sacred Heart Medical Center School of Medical Technology in Spokane, Washington). This agreement, which was approved in 2000, currently includes MSU-Bozeman and the University of Montana, Missoula (UM) and allows each of the institutions to send students to UND, HealthONE School of Medical Technology in Denver, Colorado and the Sacred Heart Medical Center School of Medical Technology in Spokane, Washington for three semesters of training. In this agreement students spend a summer semester at UND and then return to hospitals throughout Montana for two semesters of clinical bench training or the entire year at the other two affiliated institutions. The credits they earn during this year of professional training contribute to a baccalaureate degree in Microbiology at MSU-Bozeman and Medical Technology degree at UM. At MSU-Billings, the credits they earn during the year of professional training will contribute to a degree in Biology.

We propose that MSU-Billings be included in the MUS affiliation agreement so that all students from both universities and MSU-Billings have an equal opportunity to participate in the training program. All affiliated Schools have a three-semester program, but students remain in their respective training programs for the entire year. All programs are excellent, have openings for 5-8 students from the MUS and have a keen interest in training laboratory professionals for the region. Each training center is acutely aware of the current shortages in personnel for clinical laboratories and is more than willing to provide training and transfer credit for students to each university. The training and credits from all three programs will allow students to fulfill the requirements needed to take the national examinations to become certified clinical laboratory scientists or medical technologists. All students enrolled at each training program will remain MUS students at their respective institutions. They will be assessed tuition from each university for 37 credits (three semesters) and in turn, each university will reimburse the programs from $135 to $190/credit as agreed upon under their respective affiliation contract.

Entering into an agreement with three programs and one university system, will provide the greatest opportunity for all students in Montana to choose the type of program that best suits their needs. It will also provide the MUS the opportunity to send more students to each center and have a better negotiating position to keep the cost/credit at a reasonable level. This agreement also signifies a greater co-operation between institutions within Montana and a broader regional effort to train personnel in an important allied health profession.

INTRODUCTION

In 1997 the Board of Regents approved the change of curriculum in the Medical Laboratory Science option at Montana State University-Bozeman from a 4 +1 year program to a 3 + 1 year program. This meant that students could obtain their degree and clinical training in four years instead of five (3 years at MSU + 1 year of clinical training through UND). A successful change in curriculum was accomplished that year and MSU-Bozeman entered into a formal agreement with UND to provide training for students in their senior year. The agreement meant that students would spend a summer semester in laboratories at UND and then return to Montana hospitals for two semesters of bench training in clinical laboratories. Since then ten students have taken advantage of this agreement and have successfully completed their accreditation and are practicing clinical laboratory scientists in laboratories throughout Montana.

In 1998 the University of Montana asked and received approval from the Board of Regents to enter into a similar agreement with UND to provide post-baccalaureate training for UM students. These students graduated with a degree in Medical Technology. Since then 5-10 students have completed training with UND. Most UM and MSU-Bozeman students in the UND program are employed in Montana clinical laboratories.

In 2000, UM-Missoula and MSU-Bozeman, sought and obtained Board of Regents approval to enter into a Montana University System agreement with three affiliated training programs. Besides UND, the two other programs included in the agreement were Sacred Heart Medical Center in Spokane, Washington and HealthONE School of Medical Technology in Denver, Colorado. In addition, UM also recently obtained approval for a 3+1 curriculum so that students from UM in Missoula could obtain training in their senior year.

The current affiliation agreements provide that students pay either MSU-Bozeman or UM tuition for three semesters and 37 credits. In addition, in order to pay the affiliated institution for the increased cost of providing student laboratory instruction, each student also pays an extra laboratory fee.

Both universities have a single, cooperative agreement with each of the affiliated institutions that is administered through the Office of Commissioner for Higher Education and Barbara Hudson, MS from MSU-Bozemans Department of Microbiology.

JUSTIFICATION

         Why does MSU-Billings want affiliation agreements?

A 3 + 1 program at MSU-Bozeman and UM has allowed many students from the above institutions the opportunity to train and become employed in Montana. MSU-Billings desires to join the agreement so that it would also provide MSU-Billings students the same opportunity to train in highly qualified training programs, and benefit from the affiliation with the three training programs. To this end, we have developed a 3+1 curriculum in the Biology Major which is similar to MSU-Bozemans and UM-Missoula.

Many clinical laboratory science/medical technology programs have closed within the last ten years. This is due to the heavy costs of financing a burgeoning health care system. Therefore, it is important that new and innovative ways of allowing students to become practicing professionals be found. The UND program is unique and fits the needs of many students while HealthONE Hospital in Denver and Sacred Heart Medical Center in Spokane gives the students a broader range of programs to choose from. The single affiliation agreement with all three training programs has allowed all students from MSU-Bozeman and UM equal opportunity to compete for training slots. In addition, an increased number of students from Montana, represented under one agreement, has given programs an incentive to keep tuition and laboratory fees competitive with the other programs in order to fill their training positions. In short, MSU-Billings would like to combine efforts with MSU-Bozeman and UM to obtain the same training opportunities for all our students and to keep the cost for training at a reasonable level.

2.Is there still a demand for Clinical Laboratory Scientists?

There has been and continues to be a high demand for qualified appropriately trained laboratory professionals. In addition, the 1993 legislature of the State of Montana passed a personnel licensure bill for medical laboratory professionals which insured the public that qualified personnel were performing laboratory testing. The public can now be assured that a recent high school graduate or Asomeone off the street@ is not performing complex, multi-step procedures such as testing of blood to be used for transfusions in life-threatening situations. However, the licensure bill has increased the need for trained and certified laboratory professionals.

Graduates from the few remaining training programs have many job opportunities. For example, the students from the Benefis Health Care Medical Technology Program in Great Falls have numerous job offers, especially in rural areas of the state. Students from the UND program, because they return to Montana hospitals for part of their training, also have had many opportunities for employment.

Another important consideration is the increasing age of practicing laboratory professionals. For example, in the Great Falls and Billings area there is an increased concern because >70% of the workforce is over 50 years of age and many of these professionals will soon retire. An increased number of qualified personnel must be available to take their place. This is more than likely the case in many areas of the state, especially in rural Montana.

The Montana Society for Clinical Laboratory Science (MTSCLS) has endorsed MUS affiliation with UND, Sacred Heart Medical Center and HealthONE programs and efforts to increase the numbers of students who can obtain training in the state of Montana. Because of the increasing demand for qualified personnel, they have encouraged technologists in many hospitals to train students during the bench phase of their clinical training in the UND program. Most have agreed that having students in laboratories has challenged technologists as professionals and kept them more acutely aware of procedures and practices in the clinical laboratory.

In addition to working in laboratories where clinical analyses are performed, other career opportunities are available to medical technology/medical laboratory science graduates. These include working in industry (pharmaceuticals, biomedical technology research and development, food analysis, environmental and occupational health, etc); working in research laboratories (medical research laboratories in immunology, virology, oncology, endocrinology, nuclear medicine, pathology, etc); becoming health care administrators (laboratory directors, laboratory consultants, hospital infection control officers, health promotion officers, etc.); working in the public health sector (epidemiology, crime laboratory science, community health administration, Peace Corps, Red Cross, etc.); teaching in higher education (instructor at university, clinical instructor, program director, science news writer, etc.); and some graduates are more than qualified for graduate school, medical school, dental school, veterinary science, health law or even public health policy.

         Why are joint affiliation agreements with MSU-Billings, MSU-Bozeman and UM important?

Students from MSU-Bozeman, UM and MSU-Billings would benefit if they were not competing under three different arrangements for training positions. This situation could arise if programs develop a preference for one type of student due to the strength of the curriculum or whether they have four instead of three years of undergraduate courses. In the first BOR agreement, both universities were only affiliated with one program (UND) and only MSU-Bozeman had a guaranteed published 3+1 curriculum. To address this UM recently obtained approval for a 3+1 curriculum. Consistent with MSU-Bozeman and UM, MSU-Billings has also developed a 3+1 curriculum that is suitable to the affiliated programs. Because MSU-Bozeman, UM and MSU-Billings will have a cooperative agreement with three training programs in place, MSU-Billings students will have a greater opportunity to access three training programs through their 3+1 program.

Another important consideration is cost of the training. Because both universities and MSU-Billings have a guaranteed, published 3 +1 curriculum, it is important that a professional training component be in place for all three institutions. Therefore, in order to guarantee that program changes not be dictated by affiliate institutions whenever they deemed appropriate, greater combined student numbers will have more impact than each universitys smaller numbers alone. For example, when both MSU-Bozeman and UM collectively said no to UNDs desire that Montana students must enroll as UND students and pay nonresident fees, they agreed on other options which were less costly to Montana students. This was, in part, because they became acutely aware that ten students and not five would be lost to their program if both universities decided not to sign another affiliation agreement.

After this incident, both UM and MSU-Bozeman realized the importance of having more options available to students in case it is deemed necessary to terminate an affiliation with one of the programs. Therefore, they sought and obtained BOR approval in 2000 for the MUS clinical laboratory science agreement with three training programs B UND, Sacred Heart in Spokane and HealthONE in Denver. We propose that MSU-Billings students have that same opportunity and choices for training.

PROGRAM STRUCTURE

A description of the affiliated programs, how the universities will coordinate activities on campus and the resources necessary to do this is included below. All three training programs are accredited by the National Association for Accreditation of the Clinical Laboratory Sciences.

        UND Training Program

The curriculum and mechanism for senior students at MSU-Billings to apply, be accepted and obtain the clinical training through the UND program will remain the same as with MSU-Bozeman and UM. Each student will spend the summer semester in Grand Forks on the campus of UND for student labs and lectures. They will then move to an assigned hospital to complete their bench training during the fall and spring semesters. Three semesters and a total of 37 credits will be taken by each student B 12 credits in the summer, 13 in fall and 12 in spring. After successful completion of this year, MSU-Billings will award a Bachelor of Science degree in Biology/Clinical Laboratory Science option and all students will take one or more national certifying examinations. After passing the exam(s), each student is qualified to work in a clinical laboratory.

The current cost for the entire year is resident tuition for Montana students and a laboratory fee each semester. UND will charge each institution $190.00 per credit for a total of $7030.00 for 37 credits. Each semester, students enroll at MSU-Billings, MSU-Bozeman or UM, pay tuition and fees and each institution pays a bill received from UND. Except for the increase of $15 per credit and minor changes in how this is done, the agreement will remain the same as before under the current MUS agreement and will be administered by Barbara Hudson, the Director of the MSU program and the Commissioner for Higher Education of the Montana University System.

         HealthONE Hospital Training Program

The HealthONE School of Medical Technology is located in Denver, Colorado and is housed in HealthONE Hospital. HealthONE Hospital is a partner with Columbia HCA making them the largest healthcare provider in the Rocky Mountain region. The curriculum for the program is designed so that students have an intensive laboratory experience with didactic and technical training before clinical rotations. The clinical rotations are in laboratories throughout Denver such as Presbyterian/St. Lukes Medical Center, Aurora Regional Medical Center, Swedish Medical Center and others. Students are also able to have unique experiences with other patient service departments within the Columbia-HealthONE system and a variety of physicians, nurses, technologists and research personnel. This means they are exposed to other equipment and methods, career options, other working environments and health professionals. They also have an elective program that allows students to choose their areas of interest and participate in a research and development project of their choice. They currently have affiliate relationships with over 50 elective sites including rural laboratories and are willing to consider Montana Hospital sites in the future.

Students from MSU-Billings, MSU-Bozeman and UM (either 3 +1 or 4 +1) will apply to HealthONE School of Medical Technology and once accepted, stay in the Denver area the entire year. Students will register for the same three semesters and 37 credits as in the UND program. HealthONE will bill either MSU-Billings, MSU-Bozeman or UM $5,820 ($157/credit) for tuition and fees and in turn the institutions will collect tuition and lab fees from the students. If a student is attending in their senior year at MSU-Billings they will receive a degree upon successful completion of the coursework. In addition, all students will be eligible for national certification exams after completion of the year. The undergraduate curriculum at MSU-Billings meets the admission requirements by HealthONE. Although the final acceptance into the program will be made by HealthONE faculty, recommendations for acceptance will be made by the institutions in Montana.

        Sacred Heart Medical Center School of Medical Technology Training Program

The Sacred Heart Medical Center (SHMC) is a large 623-bed non-profit Catholic hospital that offers a complete spectrum of medical services to Spokane residents and patients throughout the northwest. It offers a wide array of medical services and treatments that reflects todays healthcare advances. The Medical Center has 19 operating rooms and maintains the latest in therapeutic and diagnostic equipment. The Department of Laboratory Medicine performs approximately 600 different procedures and handles around 1.6 million samples per year. The School of Medical Technology is in the Department of Laboratory Medicine and has been accredited since 1932. In the 1950s the program was a 3 +1 program and in 1979 became a 4+1 program requiring a baccalaureate degree prior to clinical training. They recently agreed to accept a mix of qualified 3+1 and 4+1 students into their program.

Students who attend SHMCs School of Medical Technology will experience a wide variety of clinical experiences as they receive didactic lectures and rotate through the laboratories at SHMC, Pathology Associates Medical Laboratories and the Inland Northwest Blood Center. Students also have the opportunity to rotate to a small laboratory such as a community hospital or physician office laboratory prior to graduation. This provides them with exposure to laboratory technology from the perspective of a smaller facility.

Many MSU-Bozeman and UM students who have graduated have been accepted into the SHMC program, have successfully completed their training and many have returned to Montana to work in clinical laboratories throughout the state. SHMC currently does not charge tuition to 4+1 students and that is expected to remain the same. However, a fee of $135/credit will be assessed to 3+1 students as they will receive college credit for the coursework and clinical rotations they successfully complete. The 3+1 students will register at MSU-Billings for 37 credits over three semesters and pay tuition and a laboratory fee similar to students who attend the other affiliated programs. Although the final acceptance of students into the program will be made by SHMC faculty, recommendations for acceptance will be made by the institutions in Montana.

         Number of Students affected by the Affiliations

Each year 10-20 students from MSU-Billings, MSU-Bozeman and UM apply for internship programs. These programs exist in almost every state and students who graduate with a degree from any of the institutions are eligible to apply for training. It is also important that MSU-Billings students have the opportunity to enter into training with these programs so that more Montana students can obtain training positions. The 3 + 1 students will especially benefit because they will complete their degree and training at the same time. It is estimated that up to 5 MSU-Billings students will attend one of the three affiliated programs.

         Administration of the Agreements

Each program has a single agreement with the Montana University System. This agreement is administered through the Director of the MSU and the Office of the Commissioner for Higher Education and each university operates under the same terms as set forth by the agreement. MSU-Billings will also operate under the same terms as set forth by the agreement. In addition, MSU-Billings will have a faculty member who will assist students in the application process, coordinate the curriculum for the undergraduates involved in the 3+1 and 4+1 programs and handle administrative aspects of the program. As stated previously, MSU-Billings will collect tuition and a laboratory fee from students. The extra laboratory fee will vary and be dependent upon the tuition rate at each program. MSU-Billings will retain a small portion of the tuition to handle administrative costs. This would include travel for the coordinator to attend meetings with each training program.

         Resources Required by MSU-Billings

Faculty advisors in the Department of Biological and Physical Sciences are currently advising and coordinating activities for students interested in the program. It is expected they will continue to administer the university portion of the programs and recover additional fees the university will attach to each students tuition to do so. An important aspect of the proposal is that MSU-Billings will not have to provide additional facilities or faculty and yet more MUS students will have the opportunity to become practicing laboratory professional in a cost-effective and efficient manner.