Town Hall Meeting

March 12, 2004

Agenda

Organization Chart Central Admin. Updates Finances Campaign Priorities Introduce Roy Vagelos

COLUMBIA UNIVERSITY MEDICAL CENTER

Gerald D. FischbachExecutive Vice President for Health and Biomedical Sciences

Dean of the Faculty of Medicine

Gerald D. FischbachExecutive Vice President for Health and Biomedical Sciences

Dean of the Faculty of Medicine

Ira LamsterDean, School of Dentistry

and Oral Surgery

Ira LamsterDean, School of Dentistry

and Oral Surgery

Allan RosenfieldDean of the Mailman

School of Public Health

Allan RosenfieldDean of the Mailman

School of Public Health

Mary MundingerDean of the School

Of Nursing

Mary MundingerDean of the School

Of Nursing

Institute & Center Directors

Institute & Center Directors

DepartmentChairs

DepartmentChairs

Joanna Rubinstein

Senior AssociateDean for

Institutional and Global Initiatives

Joanna Rubinstein

Senior AssociateDean for

Institutional and Global Initiatives

Harvey ColtenVice President

and Senior Associate Dean

forAcademic Affairs

Harvey ColtenVice President

and Senior Associate Dean

forAcademic Affairs

Kevin Kirby

Chief Operating Officer and Vice President and

Senior Associate Dean for

Administration

Kevin Kirby

Chief Operating Officer and Vice President and

Senior Associate Dean for

Administration

Edward ShortliffeDeputy Vice

President and Senior Associate

Dean for InformationTechnology

Edward ShortliffeDeputy Vice

President and Senior Associate

Dean for InformationTechnology

Marilyn Castaldi

Chief Communications

Officer

Marilyn Castaldi

Chief Communications

Officer

Michael O’Connor

Vice President andSenior Associate

Dean for Budget and

Finance

Michael O’Connor

Vice President andSenior Associate

Dean for Budget and

FinanceKathleen O’Donnell

Vice President and Senior Associate Dean

for Clinical Administration

Kathleen O’Donnell

Vice President and Senior Associate Dean

for Clinical Administration

Joseph Tenenbaum

Senior Associate Dean for Clinical Affairs

Joseph Tenenbaum

Senior Associate Dean for Clinical Affairs

Eric RoseAssociate Dean

for Translational

Research

Eric RoseAssociate Dean

for Translational

Research

John Scales

Vice President for

Development

John Scales

Vice President for

Development

Dr. Harvey Colten, VicePresident and Senior AssociateDean for Academic Affairs.

Dr. Colten is accountable for: education, research, IRB, Clinical

Trials office, faculty affairs, appointments and promotions, and

departmental reviews.

Dr. Harvey Colten, VicePresident and Senior AssociateDean for Academic Affairs.

Dr. Colten is accountable for: education, research, IRB, Clinical

Trials office, faculty affairs, appointments and promotions, and

departmental reviews.

Dr. Joseph Tenenbaum, Senior Associate Dean for Clinical Affairs. Dr. Tenenbaum is accountable for: the strategic plan for patient care and clinical programs, the quality of clinical care, faculty practice plan, affiliation agreements, and oversight of clinical administration and operations, billing compliance and malpractice. In addition, Joe continues to be engaged in his clinical practice. Kathleen O’Donnell, Vice President andSenior Associate Dean for ClinicalAdministration, will be responsible for: clinical administration and operations, andmalpractice.

Dr. Joseph Tenenbaum, Senior Associate Dean for Clinical Affairs. Dr. Tenenbaum is accountable for: the strategic plan for patient care and clinical programs, the quality of clinical care, faculty practice plan, affiliation agreements, and oversight of clinical administration and operations, billing compliance and malpractice. In addition, Joe continues to be engaged in his clinical practice. Kathleen O’Donnell, Vice President andSenior Associate Dean for ClinicalAdministration, will be responsible for: clinical administration and operations, andmalpractice.

Dr. Edward Shortliffe, Deputy Vice President and Senior Associate Dean

for Information Technology.

Dr. Shortliffe is accountable for: the strategic use of information technology in patient care, education and research

and oversight of the central IT operations (CUBHIS). In addition, he continues his responsibilities as

Chair of the Department of Biomedical Informatics.

Dr. Edward Shortliffe, Deputy Vice President and Senior Associate Dean

for Information Technology.

Dr. Shortliffe is accountable for: the strategic use of information technology in patient care, education and research

and oversight of the central IT operations (CUBHIS). In addition, he continues his responsibilities as

Chair of the Department of Biomedical Informatics.

Dr. Eric Rose, Associate Dean for Translational Research. Dr. Rose is accountable for: the

facilitation of translational research efforts including the development of opportunities with the NIH and commercial partners. In addition, he continues his responsibilities as

Chair of the Department of Surgery.

Dr. Eric Rose, Associate Dean for Translational Research. Dr. Rose is accountable for: the

facilitation of translational research efforts including the development of opportunities with the NIH and commercial partners. In addition, he continues his responsibilities as

Chair of the Department of Surgery.

Dr. Joanna Rubinstein, Senior Associate Dean for Institutional and

Global Initiatives. Dr. Rubinstein is accountable for:

developing financial support for basic and translational research from

foundations, philanthropy and through strategic initiatives with industry. In addition, she oversees graduate and

postdoctoral programs and is responsible for international programs.

Dr. Joanna Rubinstein, Senior Associate Dean for Institutional and

Global Initiatives. Dr. Rubinstein is accountable for:

developing financial support for basic and translational research from

foundations, philanthropy and through strategic initiatives with industry. In addition, she oversees graduate and

postdoctoral programs and is responsible for international programs.

Marilyn Castaldi, ChiefCommunications Officer

Ms. Castaldi is accountable for:external communications and

marketing, internal communications, media relations,

and publications.

Marilyn Castaldi, ChiefCommunications Officer

Ms. Castaldi is accountable for:external communications and

marketing, internal communications, media relations,

and publications.

John Scales, Vice President for Development.

Mr. Scales is accountable for: leading the one billion dollar capital campaign and for the

annual giving programs.

John Scales, Vice President for Development.

Mr. Scales is accountable for: leading the one billion dollar capital campaign and for the

annual giving programs.

Dr. Michael O’Connor, Chief Financial Officer and Vice President / Senior Associate Dean for Budget and Finance. Dr. O’Connor is accountable for all financial matters at the Medical Center including: financial planning, budget systems and accounting, clinical finances, and controls. All School and Departmental administrators with financial responsibilities have a dual reporting relationship to Michael.

Dr. Michael O’Connor, Chief Financial Officer and Vice President / Senior Associate Dean for Budget and Finance. Dr. O’Connor is accountable for all financial matters at the Medical Center including: financial planning, budget systems and accounting, clinical finances, and controls. All School and Departmental administrators with financial responsibilities have a dual reporting relationship to Michael.

Kevin Kirby, Chief Operating Officer and Vice President / Senior Associate Dean for Administration.

Mr. Kirby is accountable for: the execution of the Medical Center’s strategic plan, space and facilities, housing, grants and contracts, human resources, environmental health and safety, security, non-academic student services, and government / community relations.

Kevin Kirby, Chief Operating Officer and Vice President / Senior Associate Dean for Administration.

Mr. Kirby is accountable for: the execution of the Medical Center’s strategic plan, space and facilities, housing, grants and contracts, human resources, environmental health and safety, security, non-academic student services, and government / community relations.

Finally, I am accountable for: driving vision and strategy for the medical Center, setting standards for educational, research, and clinical excellence, advancing philanthropic efforts at all levels, providing executive interface with the University and Hospital, and serving as the Medical Center’s liaison to the national and international arenas.

Updates

Update - Grants

$358M overall

Special mention– Multicomponent Columbia AIDS Program (W. El-Sadr)

– Regional Center of Excellence for BioDefense and emerging Infectious Diseases Research (I. Lipkin)

– Molecular Pathogenesis of Breast Cancer (R. Dalla Favera)

Update – Research

(Obesity and Inflammation)

Update – Research

(Prions)

Update - New Faculty

Betty A. Diamond Prof. Of Medicine; Chief of Rheumatology

Thomas Herzog Professor of Clinical Obstetrics and Gynecology; Chief of Gynecological Oncology

Update - New Faculty

Fiona Doetsch Assist. Prof. Neurology and Pathology

Thomas Pickering Prof of Medicine; Director of Behavioral Cardiovascular Medicine Program

Timothy Wang Prof. of Medicine; Chief of Gastroenterology

Thomas Martin Director of the Institute of

Comparative Medicine

Update - Searches Psychiatry (R. Mayeux)

Urology (K. Forde)

Cancer Center (D. Brenner)

Genetics and Development (R. Kass)

Biochem. and Mol. Biophys. (A. Marks)

Update - Recent Gifts Naomi Berrie Foundation $12M (P&S)

Kavli Institute ($7.5M P&S)

Edward Reiner Center for Behavioral and Psychosomatic Medicine ($5M P&S)

Francis Somers Estate – $4.4M SON

H. and R. Heilbrunn Scholars Program – ($5M MSPH)

Anonymous – Faculty, Students, Staff, Space ($5.7 MSPH)

Update – the University

Manhattanville

Tennis Court Building

DrNP

Finances

Our Challenges

Implement strong financial controls

Establish new comprehensive budget process

Eliminate $19.5 million deficit in central administration budget

Conduct other business as usual

2003-04 Sources of Operating Funds for the Medical Center

Tuition 7%

ICR9%

Other 9%

Affiliations 13% Clinical Practice

33%

Sponsored Awards 29%

Note : Other includes gifts, endowment, patent and miscellaneous revenues

Total = $1,125 Million

School of Medicine2003-04 Central Operating Budget

Centrally Controlled

($168 Million)

18%

Restricted *

(774 Million)

82%

Total = $942 Million

* Primarily departmentally controlled

A Balanced Budget (2004 – 2005)

(millions)

Original Deficit Projection -19.4– Increase in revenue + 4.1– Increase in expenses

- 2.5

Net -17.8

Non-personnel expense reduction + 7.5 Personnel expense reduction +6.0

Net -4.3

Additional revenue +4.3

Net 0.0

JULY 1, 2004

Balanced budgets in place

More training, better tools and stronger financial controls

Annual salary increases for central administration staff

Update - Hospitals

NYPH doing well– GE initiative

Children’s Hospital up and running

Harlem Hospital contract negotiation

St. Luke’s/Roosevelt

Campaign Priorities

Priorities

Our mission is to improve the health of our local, national

and global communities.

As we embark on this ambitious mission, we will revolutionize education in all of

the health sciences restoring education as a high calling throughout the CUMC

community; we will become one of the premier centers in the world for research

in biomedical science and prevention of disease; we will apply our knowledge to

provide the highest quality of care. We will restore a sense of trust in medicine

and science as a profession. We will make health care more effective, more

available and more affordable.

Priorities - Overview

Based on Strategic Plan

We must be excellent in all areas – but will begin according to certain principles

– Build from strength– Break down preclinical/clinical barriers– Translational and clinical research– Interdept and interschool programs

Priorities - Education

Glenda Garvey Academy of Education

Student Scholarships

Education Center

Priorities - Patient Care Ambulatory Care Center

Recruitment of Clinical Department Chairs

Recruitment of superb physician/educators

Strong faculty practice plans and organizations

Quality Initiative (including outcomes research)

New information systems

A Big Medical Center

Priorities - Research

Neuroscience

C2B2 / Genome Center

Translational and Clinical Research

Metabolic disorders

Cancer Biology

Global Health

A Big Medical Center

Priorities – Research Infrastructure Saul Silverstein and Richard Sohn (Chairs)

Retreat October 29, 2003

– Cores (D. Bickers)

– Research administration (R. Sohn)

– Research computing (A. Califano)

– Space (M. Shelanski)

– Research costs (M. O’Connor)

Key Issues: Amount, quality, and configuration of lab

space:– Difficult to recruit new faculty – Difficult for current faculty to be as

productive as we’d like– Not conducive to collaboration

Insufficient capacity of animal facilities and other core facilities

Limited data available on space utilization and effectiveness

No swing space to facilitate renovations

No process for assigning new space; same space can be committed to multiple parties

Clinical Sciences

153.6K41.6%

Research Space

Clinical Depts.232.4K41.3%Basic

Sciences141.7K25.2%

Centers & Institutes

140.7K25.0%

Other47.7K8.5%

Total Research NASF = 562.5K1

Approximately 50% of research space has been renovated in last 5 years

Priorities – Innovation Fund

Support for Core Resources Facilitate recruitment of extraordinary individuals Seed funding for new opportunities – e.g. stem cell

and/or gene therapy (Restorative Medicine) Promote collaborations between Schools Maintain and improve the physical plant

NIH Roadmap

New Pathways to Discovery– Building blocks, pathways & networks – Molecular library and imaging– Structural biology– Bioinformatics and computational biology– Nanomedicine

Research Teams of the Future

- High risk research– Interdisciplinary research– Public-private partnerships

Reengineering the clinical research enterprise– Clinical research

Themes & Implementation GroupsImplications for

Columbia

How to better organize and execute on multidisciplinary grants:• Grant development• Core facilities • Manage

multidisciplinary efforts

2003-04 Sources of Operating Funds for School of Medicine

Tuition 4%

ICR9%

Other 9%

Affiliations 15%

Clinical Practice 37%

Sponsored Awards 26%

Note : Other includes gifts, endowment, patent and miscellaneous revenues

Total = 942 Million

Toward a Balanced Budget

Reduce non-personnel expenses - $7.5 M• 4.0 M debt restructuring/common costs• 1.0 M consultant agreements• 1.0 M contractual services (facilities, operations, etc.)• 1.4 M NYPH expense reimbursement• 0.1 M Other non-personnel reductions

Reduce personnel expenses -$6.0 M• Eliminate vacancies • Reduce use of casual and temporary staff• Transfers and potential layoffs – 40 (of approx. 4000)

Additional Revenue -$4.3 M