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Winter Meeting GEISEL SCHOOL OF MEDICINE AT DARTMOUTH BOARD OF ADVISORS Winter Meeting FEBRUARY 7, 2020 DUANE A. COMPTON, Ph.D. Dean Professor of Biochemistry and Cell Biology January 30, 2020 Dear Geisel Board of Advisors, Happy New Year! I am looking forward to the conference call next week. Our agenda has two main items for discussion. One is to discuss our ongoing planning efforts for reaccreditation by the LCME (Liaison Committee on Medical Education for the AAMC). The school has a standing committee that is charged with ensuring continuous attention to all of the LCME accreditation standards. However, our current accreditation is due for renewal and that process requires extensive self- study documentation followed by in-depth external assessment and review. The self-study document is due in January 2021 with the site visit scheduled for April 2021. Thus, a major focus of our efforts during the next year will be the data collection and writing of the self-study document. Second, we will review the financial performance in the current fiscal year and discuss the recently submitted budget for the next fiscal year. Overall, our financial performance continues to track very closely to our long- range projections for the school, although there are several specific activities that have substantial impact on our budget that are important for us to discuss. I look forward to our discussion next week. Sincerely, Duane A. Compton ONE ROPE FERRY ROAD • HANOVER, NEW HAMPSHIRE 03755-1404 • TELEPHONE: (603) 650-1200 • FAX: (603) 650-1202 1 GEISEL SCHOOL OF MEDICINE FY20 PROJECTED OPERATION RESULTS MANAGEMENT DISCUSSION & ANALYSIS (Updated January 2020) I. EXECUTIVE SUMMARY Having completed two full quarters of the fiscal year, management of the Geisel School of Medicine is projecting a fiscal year end operating deficit of ($7.3M), against a budgeted operating loss for the period of ($10.2M), an improvement of $2.8M or 28%. The improvement in overall operating performance against budget is focused primarily within the research enterprise and is driven by two revenue events: (1) The anticipated receipt of a gift to support the Serious Health Illness Incubator, a joint program between the school and Dartmouth-Hitchcock (D-H) that will support interdisciplinary team projects formed to address improving the care of serious illnesses, over the next three fiscal years at $1M per year, and (2) The one-time conversion of a sponsored project from the Moore Foundation into a gift of $1.7M. Additionally, vacancy savings are anticipated across both faculty and staff lines as the school has been actively managing and prioritizing the filling of vacant positions across all missions of the school, amounting to $0.8M. Programmatic highlights are discussed below. II. UNDERGRADUATE MEDICAL EDUCATION The program in Undergraduate Medical Education (UME) is currently projected to perform slightly below budget by $0.3M, or 2% for the fiscal year. A reduction in tuition revenue due a higher than budgeted number of student splits and research years ($0.5M) is the main driver of this change. Total UME expenses of $18.1M are down slightly ($0.1M) compared to budget. III. GRADUATE AND OTHER PROFESSIONAL EDUCATION All Geisel-based PhD programs met enrollment targets in FY20. Combined enrollment for the master’s level (MPH) programs at TDI is up compared to budget (Residential: 65 actual vs. 66 budget; Online: 76 actual vs. 68 budget), which resulted in an anticipated surplus in tuition revenues of $0.3M, or 4%. Personnel expense is expected to be down compared to budget by $0.5M largely due to a reduction in administrative support for the MPH program as part of the TDI FY19 reorganization activities. Enrollment for the master’s in health data science degree in the Quantitative Biomedical Sciences (QBS) program was down significantly compared budget (30 budgeted vs. 13 enrolled) with a resulting reduction in tuition revenue of ($0.7M). Work is currently underway to execute on strategies to bolster enrollment for this program in the upcoming fiscal year, including working with a third-party firm to enhance digital marketing towards potential applicants. IV. RESEARCH PROGRAMS Research-related activities are anticipated to perform better than budgeted by $2.9M, or 19%. The improvement in overall operating performance is based on the two previously mentioned revenue events: 2 (1) The anticipated receipt of a gift to support the Serious Health Illness Incubator, a joint program between the school and D-H that will support interdisciplinary team projects formed to address improving the care of serious illnesses over the next three fiscal years at $1M per year, and (2) The one time conversion of a sponsored project from the Moore Foundation into a gift of $1.7M. Additionally, at the time the FY20 budget was established, it was contemplated that the Office of Clinical Research (OCR) would transition from the Norris Cotton Cancer Center (NCCC) to D-H prior to the start of the fiscal year. Due to the timing of the renewal of the NCCC core grant, submitted in January 2019, it was decided to defer this transition to October 2019, resulting in offsetting revenue of $0.5M from D-H and expense of ($0.5M) for this jointly-supported program. Finally, the faculty recruitment plan contemplated in the FY20 budget has slowed due to the pace of active searches to fill faculty line positions, resulting in an anticipated savings of approximately ~$1.3M. V. ADVANCEMENT ACTIVITIES The Joint Development Office, which provides philanthropic support services for Geisel and D-H based programs, is expected to have a slower than budgeted rate of spend on operating expenses during the period as they continue to ramp-up operations under their recently formed leadership team and in alignment with budget expectations. Across Geisel, current-use gift revenues are once again anticipated to exceed expectations in FY20 by $2.7M. VI. OTHER ACTIVITIES There are two activities that currently reside in this mission: the High Value Healthcare Collaborative (HVHC) and ongoing work related to joint research activities with clinical departments at D-H. In both cases these activities should breakeven on the school’s operating statement, with HVHC membership funds drawn down from the balance sheet to offset expenses incurred by HVHC and payment from D-H for expenses incurred on the school’s ledger in the period. The projected improvement compared to budget of $0.2M is due to clinical department activity that did not have an offsetting payment in the budget, which has been resolved in the revised projection. VII. PLANT OVERHEAD AND ADMINISTRATION Plant Overhead revenue is projected to be down slightly compared to budget by ($0.2M) due to the elimination of an internal rent charge to TDI as part of the reorganization of that program in FY19. Similarly, debt service is also projected to increase due to an internal accounting change where the debt service TDI had been directly charged (previously captured in the admin cost pools) is now recorded in plant operations at ($0.3M). Additional savings are anticipated as the school continues to exit leased space and occupy school owned space, freeing up $0.2M. Administrative cost pools are anticipated to perform better than budget due to the previously mentioned changes in internal accounting and the realized savings in personnel expense of $0.5M, both of which are associated with the TDI reorganization in FY19. VIII. LOOKING FORWARD TO FY21 Management of the Geisel School of Medicine recently submitted its FY21 budget for approval by the College Trustees projecting a fiscal year operating result of ($6.0M). Compared to the current FY20 projection, this would be an improvement of $1.3M or 18%. This improvement is largely driven by the anticipated receipt of $4M from the Geisel bequest distribution in FY21. These proceeds will be largely offset by an expected decline in sponsored research activity across the school in FY21 that was associated with the non-renewal/replacement of several large multi-year 3 research projects ending in the current (FY20) fiscal year. Where we expect to see some erosion in the funded portfolios for some departments (TDI – AHRQ, CDC & Microsystems Academy; Microbiology & Immunology – COBRE & Superfund), we are also anticipating significant growth in other units, including two of our newer departments (Biomedical Data Science, $1.5M – new COBRE, and Epidemiology, $2.1M – ECHO program) compared to FY20 projection. Overall, the FY21 operating budget, absent the Geisel bequest distribution of $4M, aligns with prior year long range projections. It also includes $5M in new program development support for continued faculty recruitments (10 planned) and increased investment in our core education programs (Medical Education, MPH and graduate education). 4 Geisel School of Medicine Board of Advisors February 2020 Strategic Update Geisel School of Medicine 2020 Medical Education Research Dartmouth-Hitchcock • LCME reaccreditation Partnership update • Tenure-track Faculty • COBRE grant submitted recruitment process Center of Neurocircuitry • LCME reaccreditation & Neuromodulation strategic plan • Joint Development • Launch of enhanced Office updates mental health services Healthy Students – Healthy Physicians • Leadership recruitment • Department of Medical Education faculty recruitment 6 LCME Reaccreditation Planning Dashboard 7 LCME Reaccreditation Planning Dashboard Subcommittees • Leads should be completing drafts of their portions of the DCI • Can expect ISA table
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