At Kansas University Medical Center, state budget cuts are forcing enrollments down, hampering an effort to obtain National Cancer Institute designation and causing additional staff reductions.

Only about 2,400 students pay tuition on the KU Medical Center campus, leaving its budget much more reliant on state funding than other regents institutions in the state.

And yet, when it comes to allocating state cuts over the past year and a half, the medical center has had to absorb similarly sized hits as other universities.

Ed Phillips, vice chancellor for administration at KU Medical Center, said the $14.4 million in lost state funding since July 2008 is about equal to the entire combined budgets for the School of Nursing and the School of Allied Health.

Nearly 70 percent of the medical center’s state revenue and tuition dollars are tied up in personnel, Phillips said.

It’s likely KU will continue to have to limit or reduce enrollments in the schools of nursing and allied health, and the cuts are beginning to have an impact on the effort to achieve National Cancer Institute designation, Phillips said.

While the Kansas Bioscience Authority provides some funding to recruit new faculty, the ability to retain them once they arrive is compromised, because of a reduced ability to pay for salaries, space and other infrastructure, Phillips said.

“It’s the state budget that provides for those things,” he said.

State Rep. Paul Davis, D-Lawrence, is the minority leader in the Kansas House, and he said the state may begin to look at eliminating some tax exemptions or tax credits as officials work to resolve upcoming budget issues. But, he said, there’s still “a good deal of anxiety” about raising taxes in a difficult economic climate.

“When the Legislature began looking at budget cuts, I was concerned that we would start impacting some real vital investments that the state has made, and certainly the Cancer Center is one of those programs that we want to see succeed in the future,” Davis said.

The cuts have had a direct impact on employees, as well. Seventy-nine positions have been sliced from the payroll — including 46 layoffs — and an additional 360 employees have been shifted to other sources of funding.

For example, a typical professor in the School of Medicine is a medical doctor who has two sources of income — money from the state for teaching and instruction, and clinical revenue from seeing patients.

As state money has dwindled, Phillips said, KU Medical Center has, in many cases, forced professors to do more clinical work to maintain their incomes.

Therefore, he said, doctors are seeing more patients, and have less time to spend on instruction.

“And you can see the vicious circle that gets you in,” he said.

Gary Gronseth, an associate professor in the Med Center’s neurology department, said his department has adapted fairly well so far, in adding more patients without having to sacrifice much on the teaching side.

“Right now, we’ve been able to bend fairly easily with the breezes,” Gronseth said. “But if the budget keeps getting cut, eventually, in the out years, something’s going to break.”

Karen Wambach, associate professor of nursing and chairwoman of KU Med’s faculty assembly, said that for the most part, people continue to proceed with business as normal.

Still, the threat of additional layoffs and potential furloughs, which have not yet been deemed necessary, looms, she said.

“I think that anybody in higher education is thinking about (budget issues) every day,” she said.

Many KU Medical Center employees essentially have one-year contracts that expire annually on March 31, Phillips said. Because some budget reductions came after that date this year, the Med Center has relied on stimulus dollars to temporarily sustain its staffing levels.

Phillips said that even if state budgets aren’t cut any more, it’s likely that the medical center will lose at least another $2.7 million in the next fiscal year to replace stimulus funds, and likely at least another 50 positions along with them.

“We’re bleeding from a thousand cuts,” Phillips said. “And to continue to do that becomes very difficult without making major programmatic changes.”