… in the Minneapolis Star Tribune notes that the most charitable description of what’s been going on at the clubby University of Minnesota medical school would be “bizarre.”
Tuesday, March 3, 2015
For the Record: Science - AAAS Journal - blasts University of Minnesota for "damning" AAHRP Report
So how much has this damaged our brand, Pfutz?
From Science, along with Nature, considered to be one of the premiere scientific journals:
A damning report on how the University of Minnesota (UM) protects volunteers in its clinical trials concludes that researchers inadequately reviewed research studies across the university and need more training to better protect the most vulnerable subjects. It also found that a “climate of fear” existed in the Department of Psychiatry, where concerns about clinical trials first surfaced.
The 97-page report, released 27 February, was prepared by a group of six experts appointed by the Association for the Accreditation of Human Research Protection Programs. It comes after years of complaints by some UM faculty members, led by bioethicist Carl Elliott. They charged that the school and its doctors failed to protect 27-year-old Dan Markingson, who died by suicide while enrolled in a psychiatric drug trial in 2004. They also expressed grave concerns about how Markingson’s death was investigated. (More on that case is here and here.)
Recently, Elliott’s crusade began having an impact. In December 2013, the UM Faculty Senate called for an independent review of current practices in clinical trials. The administration agreed to open its records to outsiders. Although the review did not look back at history, it nonetheless had plenty to say about how the university handles trials, which bring in millions of dollars from drug companies along with much prestige.
“[T]he external review team believes the University has not taken an appropriately aggressive and informed approach to protecting subjects and regaining lost trust,” the authors write.
They examined protocols from 20 active trials as well as minutes from meetings of the institutional review board (IRB). Many IRB members, the panel noted, did not regularly attend meetings from January to July 2014. “[T]here were no individuals on the IRB during this time period with expertise in adult hematology, oncology and transplant, cardiology, surgery, or neurology, although those fields taken together represented over 300 protocols. There was only one psychiatrist on the IRB, despite the fact that the Psychiatry Department submitted 85 protocols for review during the time period examined.” That doctor attended only four of the 26 medical IRB meetings at which new protocols were reviewed. “This departure not only contravenes the University’s own policy of having at least one member with ‘primary professional expertise in a scientific field relevant to the type of research reviewed by that panel,’ but also prompts concern about the quality of review.”
Fueling those concerns, the authors noted that the IRB spent an average of 3 to 5 minutes discussing each protocol, and there was “little discussion of the risks and benefits to subjects.” Most of the protocol changes the IRB asked researchers to make addressed administrative issues such as misspellings or adding standard language to a consent form. Requests by researchers running trials to modify who was eligible for a study—“changes that may increase or decrease risks to subjects—were almost always approved without any documentation of related discussion,” the authors write. “The review process, as documented in the minutes, does not reflect a meaningful discussion of the risks and benefits of research protocols and the necessary steps taken to protect human subjects in the face of scientific or ethical concerns.”
The outsiders made other observations. Although the university is in the process of enhancing training in basic human subjects protections for researchers, which the authors praised, they remained concerned that beyond basic instruction, “there are currently no human subjects protections training requirements for investigators, including those working with high-risk or vulnerable populations.”
Along those lines, the authors touched on some of the central issues raised in the Markingson case: Dan Markingson agreed to enroll in a trial while committed involuntarily to the hospital, raising questions about his ability to consent, and the lead researcher on the trial was also his treating psychiatrist. Although vulnerable individuals like Markingson often participate in clinical trials, the authors of the review worried that Minnesota had not drawn lessons from that case. “We found only a single instance where consideration of the dual and potentially conflicting role of treating psychiatrist/investigator was addressed,” they noted. And, they added, “the external review team found no evidence that the University, Fairview [Hospital], and its investigators have taken steps to ensure a broader understanding of the implications of this very fraught situation” of enrolling patients who have been involuntarily committed into trials.
A death during a clinical trial, possibly attributed to it, is every university’s nightmare. Elliott and a widening circle of others were harsh and relentless in their criticism, the reviewers acknowledge. The university’s response, they suggest, has been “assuming a defensive posture. In other words, in the context of nearly continuous negative attention, the University has not persuaded its critics (from within and outside the University) that it is interested in more than protecting its reputation and that it is instead open to feedback, able to acknowledge its errors, and will take responsibility for deficiencies and their consequences.”
In the Department of Psychiatry, faculty and staff told the reviewers that they work in “a ‘culture of fear,’ ” and “[t]hey provided stories of intimidation by researchers and fear of retaliation should staff voice opposition to practices that were of concern.”
As the report creates ripples across campus, the Faculty Senate is preparing to meet this Friday with University President Eric Kaler and the authors of the report. Kaler released a statement Friday thanking the outside reviewers for their advice. He stressed that they looked at a “small fraction of our clinical research enterprise,” involving individuals with diminished decision-making capacity. “[C]onsistent with our charge to them, the panel’s view and subsequent analysis was limited,” he noted. (The authors described their report as covering protection of human research participants at UM with “special attention” to adults who may lack decision-making capacity.)
Kaler expressed hope that with the advice of the authors, UM could enhance its research protections. “The panel has provided us with a clear road map for making our program truly exceptional,” he wrote in his statement. “[T]he University of Minnesota has the opportunity to become a national model against which all other research institutions could be measured.” Senior administrators said in a statement that they hope to develop an “action plan” to respond to the report within 60 days.
Monday, March 2, 2015
University of Minnesota administration needs to learn that unethical can be as important as illegal, especially at a university.
But, how much damage will this do to our brand?
In response to a Minnesota Daily piece on the release of the University funded report on clinical trials - but not the Markingson situation - I wrote the following:
The most disappointing thing about this review is the reaction of the administration:“I am particularly gratified—but not surprised—that the panel found no legal or compliance violations, affirming numerous previous reviews and accreditations of our program” President Kaler
There is a significant difference between unethical and illegal. Sadly the same kind of rationalization was used by former AHC vice-president and medical school dean, Frank Cerra, while the conflict of interest scandal was going on. See:"We're not violating a legal statute."link: http://bit.ly/1M3EZLK
This kind of response is not worthy of an institution purporting to be a great university.
Our "brand" certainly has been damaged by this clinical trials fiasco. Claiming to potential participants in research trials that we will do nothing illegal to them is hardly an encouragement to participate.
And for those without the free time to read the report, here are some examples that should serve as examples of why fixing the situation in our clinical trials operation and medical school is so important.
Bill Gleason
UofM grad and former med school faculty
"For example, faculty and staff in Psychiatry repeatedly characterized the climate of work as a 'culture of fear.' They provided stories of intimidation by researchers and fear of retaliation should staff voice opposition to practices that were of concern."
"The review team found little evidence that the University’s IRB engaged in a meaningful process of evaluating research risk."
"Investigators have failed to address issues of vulnerability to coercion or undue influence."
“It was clear to the external review team that the membership of the Medical IRBs did not include sufficient members with the scientific expertise necessary to adequately address the research being reviewed at corresponding meetings.”
“The failure to have either adequate number of IRB members, or adequate expertise, during IRB deliberations raises profound questions about the IRB’s ability to conduct a robust and reliable protocol review.”
“Of the 30 protocols examined for scientific review, five cases were identified where the scientific review was completed by a subordinate faculty member for research in which a department chair was the principal investigator. In these cases, a conflict of interest exists and the risk of bias in the review is significant.”
“Accordingly, the minutes did not completely or accurately appear to represent what occurred during the IRB meetings. “
“The review process, as documented in the minutes, does not reflect a meaningful discussion of the risks and benefits of research protocols and the necessary steps taken to protect human subjects in the face of scientific or ethical concerns. “++++
If anyone should be stumbling on the Markingson case at the University of Minnesota for the first time, copious posts have been made on this blog regarding this sad situation.
Saturday, February 28, 2015
For the Record: Outside review faults University of Minnesota on research ethics
From the Star-Tribune
By Jeremy Olson (with Paul Tosto, Primack Award winners from the University of Minnesota for investigative journalism)
Safeguards for human subjects are inadequate, according to review that spun off patient’s death in ’04.
The University of Minnesota needs stronger measures to protect people participating in its scientific research, according to an outside review that found “inconsistent and inadequate” practices to prevent vulnerable patients from being coerced into clinical studies.
The review, released Friday, strikes at the same issues critics raised about the recruitment of Dan Markingson, a man with schizophrenia who died by suicide in 2004 while participating in a U drug study. Markingson was enrolled by a psychiatrist who had been treating him and advising a judge whether the young man needed to be committed to an institution.
The report, paid for by the university and conducted by the Association for the Accreditation of Human Research Protection Programs, found that the university’s lapses had left research subjects “susceptible to risks that otherwise would be avoidable.”
“Some research subjects, by virtue of impairment or incapacity, may be unable to fully protect their own interests at the point of study enrollment and during the course of research participation,” according to the review. The university, it said, gave “inadequate attention” to the issue.
Researchers were poorly equipped to deal with unstable patients whose ability to consent to research fluctuated, for example. The researchers also were inconsistent in determining when guardians or others could consent on patients’ behalf.
The report did credit the university for a “thoughtful” overhaul of the policies and training for its Institutional Review Boards, which oversee the safety and appropriateness of research involving humans. But it recommended the use of clinical gatekeepers who could provide unbiased, hands-on observation to make sure patients are safe.
In a letter also released Friday, University President Eric Kaler and vice president for research Brian Herman said the U would assemble a plan for responding to the report within 60 days.
“Measuring the difference between our current research program and our commitment to becoming beyond reproach was the charge given to the independent review panel,” they said. “Now, we will be accountable for taking action.”
In an interview, Herman pledged an immediate correction to one finding — that subordinates in some cases are reviewing the soundness and safety of their boss’ research. Reviewers found five instances, which they described as conflicts.
‘A cloud’
The review was commissioned by the U’s Faculty Senate in late 2013 following media coverage of Markingson’s recruitment into the so-called CAFE study, which was funded by drugmaker AstraZeneca to compare three antipsychotic drugs, and his subsequent death.
Many believed that lingering questions from the Markingson case had harmed faculty recruitment and retention.
“Frankly, the whole reason we pressed so hard for this, is we feel like there is a cloud over the university that affects all of us who work there,” said Karen-Sue Taussig, an anthropology professor.
Relatives blamed the university for recruiting Markingson when he was delusional. They argued that a psychiatrist, Dr. Stephen Olson, held too much sway as both a recruiter and caregiver, and that the doctor was unmoved when the family said Markingson was getting worse during the study and needed to be withdrawn from it.
The Legislature has since made it unlawful for doctors to recruit their own patients into their own drug studies.
Carl Elliott, a U bioethics professor and outspoken critic of the school’s conduct in the Markingson case, said the review vindicates his concerns. “The PR line of the university has always been that this is an old case. We’ve been cleared repeatedly, and we’ve fixed everything. Now it turns out they haven’t fixed anything.”
The Psychiatry Department received stinging criticism, including that its human subjects protections do “not reflect the best efforts of a University of this caliber.” Fairview Health clinical staff members also told the reviewers privately that they lacked trust in two U psychiatrists and worried that research recruiting tactics were too aggressive.
The doctors’ names were redacted from the public version of the review, which recommended that one receive supervision and training in leadership and in protecting human subjects.
University officials have been incredulous over the continued attention to the Markingson case, which was reviewed years ago by the U.S. Food and Drug Administration (FDA) and Minnesota’s mental health ombudsman. The university also was excused from a lawsuit by Markingson’s mother; Olson, the psychiatrist, settled the case.
More attention is coming. A preliminary investigation by Minnesota’s legislative auditor is due in March, and one lawmaker recommended delaying regent appointments until then. Former Gov. Arne Carlson has pressed for legislative hearings, accusing university officials of “concocting fiction” that the Markingson case was thoroughly reviewed.
“Nobody has pressed them to tell when, where and how these investigations were conducted,” he said. “And where are your findings?”
University officials recently acknowledged that FDA investigators were back on campus last fall, meeting with Olson, though the precise subject wasn’t disclosed.
Some comments from the Star-Tribune web site.
It just sickens me to read that the University will not publicly come out and admit what they have known all along, that there human subject research program is broken and has never been held accountable as far as the department of psychiatry is concerned. I would hope that after the next report is made public from the auditors office that the chair of psychiatry and his unnamed rogue investigator are fired.
What a disappointing comments section. I was expecting to find the usual defenses we've seen over the last several years, saying that the U had been exonerated over and over, and that this whole thing was the private obsession of one or two faculty on some rogue crusade: "Why can't we just fire this guy?" and so on. I guess that approach is losing currency now?
Thanks, I was looking for the same ignorant comments from a few UMN plants or department of psychiatry paid lobbyist. meegwich brought up the medical school deans and their attempts over the years whether on the radio or within the Strib to discredit bioethics professors from their own university for having done their job that they were hired to do, and apparently did it too well as they exposed the very findings within this report. Just a couple of weeks ago I listened to Dean Brooks Jackson on MPR radio make the comment that this report would put to bed the harsh criticism of the medical school and the psychiatry department in particular. Dr. Jackson has no clue what he is talking about or has been seriously mislead. If the upcoming report from the legislative auditor is anything close to this report there should be more than a few people at the university looking for new jobs.
Let me try again with proper prose. The full report, which is easy to find with any major search engine, is very revealing. It has a section concerning "vulnerability to coercion or undue influence". The first two paragraphs in that section made interesting reading, at least for me, because it seems this distinguished review panel has stated they have found no evidence of active compliance with a Mn State Law at UM. A later section suggests some 'retraining' and, between the lines, some housecleaning in one of UM's distinguished medical departments. What will be, will be......
I just don't understand why the university thinks they are now going to be able to be above reproach by simply making a few token changes. This report indicates a continuance of the despicable behavior that they have exhibited for years and years when it revolves around their psychiatric research program. I have to agree with why did it take so long and an outside investigation for the university to even admit they have a problem? They have no one to blame but themselves for a tarnished reputation and public perception that the department of psychiatry is poorly run and managed, and has direct causation to numerous instances of patients being harm or mistreated. Shame of the university.
My opinion after reading the article and report is that neither come anywhere close enough to exposing the corrupt manner in which psychiatric researchers at the U have ignored or blatantly disregarded vulnerable patients basic civil rights, and I am speaking specifically about PHI and or HIPAA. Having had a family member hospitalized at Fairview-Riverside and then hounded and hounded by her own psychiatrist and his study staff to enroll into a study was just outrageous. Total disregard for HIPAA rights as she had never even been approached to sign a release and yet multiple staff came at her night and day citing her personal information like no big deal. I am quite sure the redacted psychiatrist's name is the same individual behind harassing our family member.
Missing in nearly every article related to the Markingson case is attention to the greatest breach of medical care ethics, involuntary commitment. Under legal coercion, which made any research ethics and human subject protection breaches particularly acute, the physician ordered participation in the study. The foundational problem here is the involuntary commitment. If not itself, then in the court order that specified that Markingson was to follow the specific treatment plan of his physician rather than simply requiring him to follow a plan by a physician, with the ability for himself (or guardian if appropriate) to choose treatment and physician.
With science everyone is a guinea pig. Nobody cares about the person, it is all about meeting the goals of the researches outcome. Also who is behind this and funding it. They have motives to reach a certain outcome. This isn't about careing for people in the study, it is about how much money will we make with the desired outcome. All these big drug companies bringing in their poison to test on vulnerable people is sick and immoral.
I cannot speak on behalf of the psychiatric researchers or the present psychiatry chairman but there have been considerable efforts to ensure that clinical research research is carried at the highest level possible at the University of Minnesota starting with study coordinators and investigators and that the IRB has not ignored this matter. Dr. Elliott continues to state that nothing has been fixed - may be what he is saying is that certain individuals should terminated or something be done in the department of psychiatry and we will see what comes of this from the new Dean. To taint the whole University on this tragedy and to claim the AHC needs to be fixed is to neglect to see the fine work of many being spoiled by a few.
I guess all those claims by the administration over the years citing all is well in University-Land were not exactly truthful. Seems like first Aaron Friedman and now Brooks Jackson can't seem to understand what a scandal is, and their repeated lines that we've investigated ourselves and found nothing wrong just got shot out the window. The Legislative Auditors report should be the final nail that drives some sweeping changes in personnel within the department of psychiatry and the academic health center, otherwise it's just more of the same with Kaler who doesn't seem capable of walking the walking...
I think you've hit the nail on the head. Very disturbing for me to read the statement from Mr. Kaler that now we can be accountable going forward ! My god, why hasn't the U been held accountable before now? Why did it take this outside investigation, paid for by taxpayers, to inform both the public and the U that there are serious on-going problems within the department of psychiatry and their researchers and failing's to protect a very vulnerable population. I read through the report and it's very alarming, and the Minnesota chapter of NAMI should be ashamed of themselves. Their endorsement of the department of psychiatry's sitting chair is shameful considering some of the most critical aspects of the report deal solely with the department of psychiatry. NAMI has lost credibility over the years and now I believe they have gone over the edge and lost all of it.
Friday, February 27, 2015
For the Record: AAHRPP Final Report With Prefatory Note and Cover Letter #Markingson
If you wish to download a pdf copy of this document, please click the link above.
This is really depressing reading for a Gopher alum ...
Wednesday, February 25, 2015
For the Record: UofM faculty concerns about status of independent [sic] review of clinical trials, #markingson
February 25, 2015
Dear Vice President Herman and Professor Durfee,
We are writing to you to express our grave concerns regarding the status of the AAHRPP’s review of clinical trials at the University of Minnesota. We have been informed that the AAHRPP has submitted a draft report to the administration prior to the release of the final report, which is due to be released no later than Friday, February 27, 2015.
Vice President Herman assured the public (and directly told some of us) that the administration would have no involvement in what was specifically meant to be an independent report. Yet the submission of a draft report to the administration prior to the release of a final draft opens the door to accusations that the administration exercised inappropriate influence on the content of the final report and hence jeopardizes the integrity of the independent review. The appearance of impropriety is reinforced by the lack of transparency regarding the administration’s access to a draft prior to the release of a final report. This unfortunate development undermines the central purpose of the report: to restore trust in the University.
To restore faith in the integrity and independence of the review, the administration should do the following:
1. Publicly release every draft of the report that was shown to anyone in the administration
2. Provide a public explanation for any changes that were made between the initial and subsequent drafts that were sent to the administration
The administration’s handling of this process threatens to undermine further the institution’s credibility with the legislature and the public. Full transparency is essential to address these concerns and ensure the credibility of the review.
Sincerely,
Teri L. Caraway, Associate Professor, Political Science
Francis Harvey, Associate Professor, Geography, Environment, & Society
Amy Kaminsky, Professor, Gender, Women, & Sexuality Studies
Rick McCormick, Professor, German, Scandinavian, & Dutch
William Messing, Professor, School of Mathematics
David Pellow, Professor, Sociology
Riv-Ellen Prell, Professor, American Studies
Naomi Scheman, Professor, Philosophy
JB Shank, Associate Professor, History
Karen-Sue Taussig, Associate Professor, Anthropology
Monday, February 23, 2015
For the Record: Former Governor Arne Carlson Letter to the Legislature Concerning False Claims by University of Minnesota Administration
(To download a pdf of this document, click the download link in the line above.)
For the Record: Letter to Star-Tribune Editor about UMore Park
The following letter was published on February 23, 2015
UMORE PARK
Change in course is years too late
The University of Minnesota administration has finally been thinking about turning off the spigot after $12.5 million has gone down the UMore Park drain (“U changes course on UMore,” Feb. 13).
Just think how many students could have received a college education with the use of those funds.
Even worse, the gravel mining at the Dakota County property presents a risk to the agricultural research that has produced hundreds of millions of dollars for the state economy.
For years, Bill Gleason and other professors were ringing alarm bells. But the senior administrators and the regents ignored the warnings. Now they walk away without any personal accountability.
Each biennium, the citizens of our state invest more than $1 billion in the U in general appropriations. With that much at stake, the Legislature should appoint a watchdog to monitor on a continuing basis the operations of the university and the use of state appropriations.
Michael W. McNabb, Lakeville
Friday, February 20, 2015
For the record: Open Letter to Minnesota Legislature from Student Member of University of Minnesota Regents Concerning Relationship between Regents and University of Minnesota Administration
https://www.scribd.com/doc/256373369/Open-letter-from-Matt-McGeachy-to-Minnesota-state-
legislature
To download a pdf of this document click on the download button directly above.
Monday, February 16, 2015
Friday, February 13, 2015
For the Record: Recommendations for Extricating Ourselves from the UMore Park Development Fiasco
to download a pdf of the document, click on the download button above.
Thursday, February 5, 2015
For the Record: Open letter of former Governor Arne Carlson to the Minnesota State Legislature concerning the Markingson matter
Former Governor Arne Carlson, a great supporter of the University, makes some remarks about the Markingson situation. He also suggests that ultimately the legislature is responsible for this matter and makes suggestions for better monitoring of the Board of Regents.
To download a pdf copy of the document simply click on the Download button in the line above.
Sunday, October 26, 2014
The Management of the University of Minnesota
The Management of the University
1. Internal Audit.
In September 2014 the Audit Committee of the Board of Regents received an internal audit update. The expected implementation rate of outstanding essential recommendations since June 2014 was 40%. You might think that the U of M administration would easily clear such a low bar. You would be wrong. The actual implementation rate of 23% did not even come close. See p. 8 of the October 2014 BOR FRI Docket.
The report on this dismal performance did not rouse the somnolent Regents who asked nary a question. But there are serious questions to ask. What is the effect of the failure to meet even the low expected implementation rate for essential recommendations? What are the essential recommendations that have not been implemented? Are the multiple levels of administration at the University an obstacle to achieving even essential goals? How many resources of the University are being squandered as a result of the failure to implement the recommendations?
2. External Audit.
The Deloitte Consulting firm, the external auditor for the University, is about to expand its role (and profits) by providing advisory services for the Enterprise Asset Management project. For this service the University will pay to Deloitte the sum of $1,744,000 in fees and expenses.
When this matter was presented to the Audit Committee of the Board of Regents in September 2014 Regent Brod asked about the effect of this contract on the role of Deloitte as an external auditor. An associate vice president responded that the appearance of independence is at the heart of the issue in retaining an external auditor. He acknowledged that there is general guidance for the examination of non-audit services but no clear dollar amount or ratio to determine when the independence of the external auditor may be affected. He promised to provide the general guidance at a later meeting.
So did the Regents decide to wait until they had at least some general guidance on whether $1.7 million (and the prospect of millions more in income for non-auditing services now that the wall has been breached) might cause an external auditor to go easy on the administration on future audits? No, instead the docile Regents voted unanimously to approve the contract. See p. 9 of the October 2014 BOR FRI Docket.
As the external auditor Deloitte knew that the U of M spent more than $37,000,000 on administrative consulting and professional services in fiscal year 2014. See line 18(d) of the Expense Summary in the Administrative Cost Benchmarking Report at p. 77 of the October 2014 BOR FIN Docket. Having seen the explosive growth of the university administration--consulting firm complex Deloitte hopped on the gravy train. Who now is left to be vigilant about the escalating costs of administration?
3. Facilities Management.
The condition of 50% of the facilities at the University is below average or worse. It would require an investment of $1 billion to bring all facilities to at least fair condition. In September 2014 the associate vice president in charge of facilities management informed the Finance & Operations Committee of the Board of Regents that the current approach to facilities management is unsustainable. Expenses have increased by 75% over the last decade. The increase is due to rising service costs and the addition of space even though there has been a reduction in operations cost per square foot. See p. 23 of the October 2014 BOR FRI Docket.
Although the addition of space is a major factor in the soaring expenses, the Regents are planning a 10 acre Education District in downtown Rochester that would accommodate 587,000 square feet of development. See p. 60 of the October 2014 BOR FAC Docket.
Constructing the Education District before the administration comes to grips with the current unsustainable approach to facilities management will accelerate the deterioration of existing facilities. See Crumbling Academic Infrastructure.
4. Budget Management.
For the last three fiscal years the administration has presented an Administrative Cost Benchmarking Report to the Regents. The Report divides expenses into three broad categories: direct mission activities (instruction, research, and public service); mission support and facilities, and leadership and oversight.
Once again in fiscal year 2014 there were net increases in all three categories. See the Report at pp. 72, 74, and 76 of the October 2014 BOR FIN Docket. Vice president Pfutzenreuter noted that savings within each category "are masked by program growth and service increases." See p. 79 of the Docket (emphasis added).
Yes, the University budget operates like a giant balloon. When one side is pinched to reduce expenses, another side expands with even greater costs. See The Phantom Reduction Part II.
Just as the Wall Street bankers created a housing bubble using other people's money, the senior administrators and the Regents have created a higher education bubble. The U of M budget exploded from $2 billion in fiscal year 2002 to $3 billion in fiscal year 2012. See p. 18 of the 2002 annual financial report and p. 15 of the 2012 annual financial report. Skyrocketing tuition far exceeded the reduction in state appropriations. See Ten Year Review of University Inc.
When this budget balloon bursts, the senior administrators and the Regents will walk away unscathed just as the investment bankers did. The students (and their parents) will suffer the harm from the student loan debt that inflated the balloon. They will be shackled by that debt for many years (or even decades for many students in the graduate and professional schools).
5. Cost of Administration.
Many hours are wasted on unneeded and unexplained paperwork and permissions, making University authorities seem both oppressive and out of touch.U of M Strategic Plan at p. 84 of the October 2014 BOR FRI Docket.
The Expense Summary in the Administrative Cost Benchmarking Report for fiscal year 2014 is a list of personnel and non-personnel expenses for the three broad categories of expenses: direct mission activities (instruction, research, and public service); mission support and facilities; and leadership and oversight. Here are the administrative expenses for mission support and facilities and leadership and oversight:
The Report shows total operating expenses of $3,171,787,000 for fiscal year 2014. So the cost of administration ($918,956,000) accounts for 29% of those total expenses. See the Expense Summary in the Report at p. 77 of the October 2014 FIN Docket.
Is 29% in administrative overhead excessive? There is no national system for comparing administrative costs at universities so we have to look to the world outside the campus. With an administrative overhead of 20% American private health insurance companies have the highest administrative costs of any health insurance system in the world. See T.R. Reid, The Healing of America (New York: Penguin Press 2009) at pp. 36--38.
The Affordable Health Care Act now requires health insurance companies to send rebates to consumers if administrative costs and profits consume more than a set percentage of premiums (20% for individual and small group markets and 15% for large group markets). See the August 17, 2014 Star Tribune report on Health Insurers Must Pay Up or Pay Back.
It is likely that there would be an immediate and sharp reduction in the cost of administration if the legislature were to require the University to send rebates of state general appropriations to the state treasury if the U of M administrative costs exceeded 15% of its total expenses.
The U of M administrators might resist by asserting that the University enjoys the privilege of a separate constitutional status. Then it is also likely that the citizens of Minnesota, outraged by the spectacle of highly paid senior administrators claiming special privilege, would vote to abolish that status. See The Cost of "Top Talent" Part III.
6. Finding Solutions.
Our system of higher education is broken. Over the past decade we have seen escalating costs, skyrocketing tuition, and staggering student loan debt.
Freezing tuition in return for an increase in state appropriations is a shell game and not a solution.
The U of M administration should revise its new Strategic Plan to include the steps necessary to reduce the escalating costs of higher education--not just ways to reduce the rate of increase but to actually reduce the costs. The very expensive report produced last year by Huron Consulting fails too often to describe the specific actions necessary to get from point A to point B just as it fails too often to provide even ball park estimates of the costs of implementing its recommendations and the savings to be realized. See The $495,000 Report.
The state legislature should obtain a commitment from the University to review the increase in administration over the past 40 years. If there has been an increase in the number of administrators that is disproportionate to any increase in the number of students or in the level of research, we should ask why. If there has been a substantial increase (in constant dollars) in the compensation of any administrator, we should ask why.
We should also compare the compensation paid to senior administrators in state government who have similar qualifications and duties to University administrators. For example, the annual salary of the state commissioner of human rights is $108,000. The annual salary of the vice president at the U of M Office of Equity & Diversity is more than twice that amount at $225,000. See Nice Work If You Can Get It.
Each biennium the citizens of our state now invest more than $1 billion in the U of M in general appropriations. With that much at stake the legislature should appoint a qualified person to monitor on a continuing basis the operations of the University and the use of state appropriations. This legislative liaison (or watchdog) should have the responsibility to review the information produced by senior administrators, to collect additional information through his or her own independent research, and to meet with all groups at the University so that the perspectives of other well-informed and thoughtful members of the University community are presented to the legislature.
Michael W. McNabb
University of Minnesota B.A. 1971; J.D. 1974
University of Minnesota Alumni Association life member
Friday, October 3, 2014
Monday, September 15, 2014
The Phantom Reduction Part II
The Conjurer
"The Conjurer," painted by Hieronymus Bosch. The painting accurately displays a performer doing the cups and balls routine, which has been practiced since Egyptian times. The shell game does have some origins in this old trick. The real trick of this painting is the pickpocket who is working for the conjurer. The pickpocket is robbing the spectator who is bent over. Source
The Phantom Reduction Part II
"OK, so you're not raising tuition; why do the costs increase so much that we have to buy that freeze?"
State Senator Terri Bonoff in the September 12, 2014 Star Tribune report.
There are two principal reasons for the continuing escalation of costs at the University of Minnesota:
(1) The promise to reduce the cost of administration by $90 million over a six year period will not reduce the U of M budget by a single penny. President Kaler intends instead to simply spend the $90 million on "mission and mission support." See The Phantom Reduction.
(2) Reductions in some categories of expenses are more than offset by increases in other categories.
There was a net increase of $41.7 million in expenditures for mission support and facilities (from $956,896,120 in fiscal year 2012 to $998,643,697 in fiscal year 2013). There was a net increase of $7.9 million in expenditures for leadership (from $263,801,546 in fiscal year 2012 to $271,699,441 in fiscal year 2013).
The one expense that is most symbolic of the cost of administration is the compensation for leadership. The highly paid senior administrators, deans and directors collected an additional $2,250,198 in compensation for fiscal year 2013. (The total compensation for those leaders in fiscal year 2013 was $104,088,093.) See A Complete Accounting.
A former interim U of M president observed in November 2013 that "with real productivity gains, tuition could actually be reduced, assuming that state funding for the U holds where it is at currently." (emphasis added) See A Question of Productivity.
The Star Tribune has advocated a concentration on greater efficiency:
A freeze at the price Kaler and Rosenstone propose appears to resume a pre-2008 growth rate that had long exceeded the rate of inflation. It wouldn't appear to give the institutions much incentive for changes in higher education that might slow that growth rate or bring costs down.
See the September 18, 2014 Star Tribune editorial.
It will be necessary to stop and then reverse the escalating costs of higher education in order to reduce the staggering amount of student loan debt. The eventual solution will involve substantial reductions in the cost of administration and better allocation of state appropriations. See Whose Fault--Crushing Student Debt and Devouring Our Children.
Michael W. McNabb
University of Minnesota B.A., 1971; J.D. 1974
University of Minnesota Alumni Association life member
Tuesday, September 9, 2014
For the Record: Most damning evidence in #Markingson case from Minnesota Board of Social Work
The U of M administration uses this 2005 FDA conclusion as a primary reason to reject calls for another investigation. But in 2012 the Minnesota Board of Social Work took corrective action against the social worker who was the study coordinator. Perhaps the most damning findings were these:
2(g)(1) Despite the large amount of data gathered as part of the CAFE study, the records are devoid of any evidence that the data was critically analyzed or used in the treatment planning process. . .
2 (g)(4) There were critical omissions in Licensee's [U of M study coordinator] documentation that were relevant to suicide prevention and chemical dependency treatment. . .
2(h) On March 17, 2004 Licensee received an e-mail message from the CAFE study sponsor warning of a new risk of hyperglycemia and diabetes for patients taking medications used in the CAFE study. This new information effectively invalidated client #1's [Dan Markingson's] original informed consent.
See pp. 3--4 of the report of the Minnesota Board of Social Work (emphasis added).
See also A Question of Accountability
Monday, September 8, 2014
For the Record: Univ. of Minnesota faculty concerns about investigation into clinical trials
Sep 7, 2014
Last fall 14 faculty senators at the University of Minnesota called for the Faculty Senate to take action to address ethical concerns arising from the tragic death of Dan Markingson in a clinical trial conducted at the University of Minnesota. The Faculty Senate passed a resolution last December calling for an independent investigation, and President Kaler agreed to conduct such an investigation. Unfortunately, events since then have led some of the senators who called for a review to have serious concerns about both the scope of the review and the impartiality of the team conducting it. The letter appended below, which we have sent to Vice President for Research Brian Herman and Professor Will Durfee, expresses some of our concerns.
The team conducting the investigation will be on campus this week (Tuesday and Wednesday).
Two of the signatories of the letter, Naomi Scheman have agreed to serve as our media contacts.
In addition, at the end of the email, you will find useful links that provide background information about the independent investigation.
Sincerely,
Teri L. Caraway
Associate Professor and Faculty Senator
Department of Political Science
University of Minnesota, Twin Cities
***
Dear Vice President Herman and Professor Durfee
As members of the University of Minnesota Faculty Senate who called for an investigation into human subject research at the University in the wake of the Markingson case (as detailed in the "whereas" sections of the resolution), we would like to express our concerns with the process as it is unfolding so far. Although the resolution passed by the Senate and supported by President Kaler called for a review of present policies and practices, it has been clear to us that a review can serve the stated purpose of clearing the cloud of suspicion about the treatment of vulnerable human subjects only if it also looks at relevant aspects of the past. In particular, an investigation of "present practices" needs to include how the University has dealt and is dealing with--including learning from--serious allegations concerning past practices.
Our intention of communicating that conviction to the review team has, however, come up against concerns regarding conflicts of interest on the part both of members of the review team and of AAHRPP, which selected the team and is supervising the review. Put simply: we are convinced that a credible review would need to investigate the Markingson case, but that such an investigation would itself need to be credible, especially in light of the history of the University's appealing to clearly noncredible reviews as supposedly exonerating; and the conflicts of interest raise serious questions about the credibility of the present review.
We do not want to prejudge the work of the review team or to impugn the integrity of its members. We do, however, want to put on the record our sense that the review is not proceeding in a way that seems likely to satisfy the principal requirements behind the resolution we brought to the Senate: for a genuinely credible, independent review that takes a hard look at how the University dealt--and continues to deal--with activities that are widely perceived as profound breaches of ethical responsibility.
Signed:
Teri L. Caraway, Associate Professor, Political Science
Cesare Casarino, Professor, Cultural Studies & Comparative Literature
Francis Harvey, Associate Professor, Geography, Environment, & Society
Amy Kaminsky, Professor, Gender, Women, & Sexuality Studies
Rick McCormick, Professor, German, Scandinavian, & Dutch
William Messing, Professor, School of Mathematics
Kevin P. Murphy, Associate Professor, History and American Studies
David Pellow, Professor, Sociology
Riv-Ellen Prell, Professor, American Studies
Naomi Scheman, Professor, Philosophy
JB Shank, Associate Professor, History
Karen-Sue Taussig, Associate Professor, Anthropology
cc: Eric Kaler, Eva von Dassow, and Rebecca Ropers-Huilman
***
LINKS TO BACKGROUND DOCUMENTATION
October 2013 letter from 170+ scholars calling for an investigation:
List of signatures from October 2013 letter:
November 2013 letter from faculty senators to the FCC:
Minutes from the Faculty Senate meeting that passed the resolution calling for an investigation (starts on page 16; the resolution was amended as described in the minutes):
The RFP:
The AAHRPP's proposal:
Professor Trudo Lemmens's et al April 2014 letter to President Kaler regarding the RFP:
Public Citizen's letter expressing concerns about the investigation:
Professor Trudo Lemmens's et al June 2014 letter to President Kaler:
Professor Leigh Turner's July 16, 2014, letter to the AAHRPP regarding conflicts of interest:
Wednesday, September 3, 2014
U of M Scoreboard: Athletics Department 84, All Other Departments 16
U of M Scoreboard: Athletic Department 84
All Other Departments 16
The U of M administration has announced a $25 million donation from Land O' Lakes. Of the total amount $21 million (84%) goes to the athletic department and $4 million (16%) goes to all other (academic) departments.
This new commitment and innovative model of support . . . will further position the U as a continued leader in addressing society's pressing challenges.
President Eric Kaler in the September 3, 2014 Star Tribune report at http://www.startribune.com/sports/gophers/273662841.html. (emphasis added).
Especially that pressing challenge of winning football and basketball games.
The writer of a letter to the editor in the September 5 Star Tribune argued for excellence in both sports and academics at the U of M. But there is a limit to available funds. Most large universities, including the U of M, continue to provide annual multi-million dollar subisdies (in direct and indirect support) to their atheltic departments despite the exponential increase in TV revenues. See Athletic Accounting. Beyond the cost, big time sports are simply irrelevant to the purposes of a university.
The window to the U of M is not athletics (as President Kaler claimed in the September 5 column of Sid Hartman) but rather its performance in the fields of education, research and public service. Imagine the effect of the Land O' Lakes $25 million donation if the U of M administration had persuaded the company to give most of the funds for those purposes. A donation for agricultural research would have promoted the University and the state economy as well as the corporate purpose of Land O' Lakes, the purpose of its foundation, and the financial interests of its shareholders.
Michael W. McNabb
University of Minnesota B.A. 1971; J.D. 1974
University of Minnesota Alumni Association life member
====
Comment by Bill Gleason:
I noticed a tweet from the Ministry of Propaganda this morning:
Seems a little misleading in light of the distribution of the loot ...
Perhaps they are embarrassed?
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