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Taking Your Medicine: The Politics of North and South

Giving Rutgers its own medical school was the easy part. Will Christie go for a University of South Jersey? And what happens to what's left of UMDNJ?

This is the second article in a two-part series

For Gov. Chris Christie, deciding to merge Robert Wood Johnson Medical School, the School of Public Health, and the Cancer Institute of New Jersey into Rutgers University to give the state's flagship university its own medical school was the easy decision.

Understandably, officials at the University of Medicine and Dentistry of New Jersey (UMDNJ) and their allies in Newark and Essex County were not happy about Christie's quick – although not unexpected -- decision. It took away three of UMDNJ's major schools in order to immediately implement the merger recommendation of his UMDNJ Advisory Committee.

For Christie, the tough decisions now revolve around what to do with what's left of UMDNJ. Should , other mergers of higher education institutions be considered? And how can he satisfy the regional interests of George Norcross and Joseph DiVincenzo, the powerful South Jersey and Essex County Democratic leaders whose continued support the Republican governor needs to continue to advance his agenda in what is still expected to be a Democratic-controlled legislature after the election?

"Whatever happens is going to have to be fair to all three regions of the state -- south, central, and north," Senate President Stephen Sweeney (D-Gloucester), said in an interview. "And the roadmap is a lot clearer in central and south Jersey than it is in north Jersey, where leaders like Joseph DiVincenzo in Essex County are going to have to feel comfortable with the eventual result."

The starting point for New Jersey's medical school merger was the 2002 Commission on Health Science, Education and Training chaired by former Merck CEO Roy Vagelos, which recommended the creation of a single New Jersey research university system similar to the University of California.

The proposed University of New Jersey would have had three largely independent universities: The University of New Jersey-Central (36,700 students) based in New Brunswick and Piscataway was to include Rutgers-New Brunswick and the three UMDNJ units whose merger Christie just authorized. The University of New Jersey-North (21,400 students) was to include Rutgers-Newark, UMDNJ's Newark schools and University Hospital, and the New Jersey Institute of Technology. The relatively small University of New Jersey-South (5,600 students) was to get Rutgers-Camden and UMDNJ's School of Osteopathic Medicine.

In the last nine years, however, the higher education landscape in South Jersey has changed dramatically for the better, and George Norcross, the South Jersey Democratic power broker who is arguably the second-most powerful politician in New Jersey after Christie, had a lot to do with that change.

Norcross, as chairman of the board of Cooper Health System and its Camden-based Cooper University Hospital , was the driving force in establishing the Cooper Medical School at Rowan University, for which he was honored as 2011 Healthcare System Trustee of the Year by the New Jersey Hospital Association.

"Cooper has undergone tremendous transformation taking what was once a vision for a truly academic health campus and making it a reality," Norcross said in January in accepting the award. "I am proud of the establishment of the Cooper Medical School of Rowan University, which is on target to open in 2012, setting the stage for the next level of medical education in our region."

Norcross, however, is already looking beyond medical education to the future of higher education as a whole in South Jersey, the eight-county region where he holds unquestioned sway in Democratic politics.

At a business luncheon in Mount Laurel, Norcross recently urged the creation of a University of South Jersey that would include Rutgers-Camden, UMDNJ's School of Osteopathic Medicine, the new Cooper Rowan Medical School, and the rest of Rowan University. Boosted by a game-changing $100 million donation from alumnus Henry Rowan for whom the former Glassboro State College was renamed, Rowan added a new graduate school of engineering and has grown into a modern campus with more than 11,000 students.

Rowan's administrators have already discussed the possibility of a merger into a regional university with Rowan family members, and the creation of what would now be a 17,000-student university -- whose consideration was included in Christie's charge to the UMDNJ Advisory Committee chaired by Celgene CEO Sol J. Barer – is much more viable than the small 5,600-student university that the Vagelos Commission originally envisioned.

Taking the Camden-based School of Osteopathic Medicine away from Newark-based UMDNJ -- along with the Robert Wood Johnson Medical School, the School of Public Health and the Cancer Institute of New Jersey that it has already lost -- would leave UMDNJ a shell of what was once the largest free-standing medical school in the country.

Perhaps anticipating that result, Christie's charge to the UMDNJ Advisory Committee specifically included the possibility of merging UMDNJ with another institution such as Rutgers-Newark or the New Jersey Institute of Technology -- or presumably both, as the Vagelos Commission originally recommended.

UMNDJ President William F. Owen has been fighting to keep UMDNJ together, insisting in an open letter that "We can best serve as a statewide asset as a unified university with extraordinary competency . . . With our experience and expertise in medical education, we are well on our way toward building a stellar, leading 21st century institution."

However, UMDNJ is in a much weaker position today than it was in 2002 when the Vagelos Commission originally recommended its breakup and merger into three large regional state universities. Over the past decade, UMDNJ has dropped 20 spots from 72nd in the nation to 92nd in its ability to secure federal research grants. UMDNJ's insistence that free-standing medical schools can attract large federal dollars is undermined by the fact that Oregon, the only other major state with a free-standing medical school, actually ranks 25th as a state in securing major federal health science grants -- below New Jersey, which is in 23rd place.

Perhaps most important, UMDNJ has been rocked during the past decade by a series of crippling scandals, capped by the conviction of former Senate Appropriations Committee Chairman Wayne Bryant (D-Camden) on corruption charges after UMDNJ hired him to "lobby himself" to steer increased funding to the medical school. UMDNJ in Newark was being used as a patronage haven for Newark and Essex County Democrats. Most serious of all, UMDNJ illegally billed the federal-state Medicaid program for $4.9 million in overcharges . It was that case that led Christie, as U.S. Attorney, to appoint a federal monitor to oversee UMDNJ as part of a deferred prosecution agreement that required UMDNJ trustees to relinquish control of the school or face a criminal prosecution by Christie that would result in the cutoff of all federal funding to UMDNJ and its associated institutions.

"Having spent what feels like most of the last 10 years of my life dealing with UMDNJ in my last job and in this one, I'm looking forward in this role to providing the type of certainty and organization to the life sciences education system here in this state that I think it most desperately needs after a long time of corruption and failure and problems and waste of taxpayer and other monies," an exasperated Christie said during the September 21st press conference at which he announced he was moving ahead with plans to merge three of UMDNJ's most successful operations into Rutgers.

Losing the UMDNJ name might be a plus, rather than a minus, as the UMDNJ Advisory Committee is well aware.

The most difficult issue is what to do with UMDNJ's University Hospital in Newark, which provides health care services to the largest indigent population in the state. St. Barnabas Medical Center, based in Livingston, has expressed interest in merging University Hospital into its healthcare system if it receives reasonable assurances of continued state assistance for the hospital, whose operations have been subsidized by UMDNJ's money-making operations. Making sure that University Hospital is able to continue to fulfill its core healthcare mission is a top priority of the state, former Governor Tom Kean said after the state's Higher Education Task Force report last January led to the creation of the UMDNJ Advisory Committee.

Newark and Essex County politicians who turned out in force for a public hearing earlier this month are worried about the future of University Hospital. But they are also troubled by what they see as a diminution of power and control over jobs in their Newark base, now that decision-making authority over the Robert Wood Johnson Medical School, the School of Public Health, and the Cancer Institute of New Jersey has been transferred to Rutgers, with control over the School of Osteopathic Medicine in Camden likely to follow.

Assembly Speaker Sheila Oliver (D-Essex), who works as a senior administrator under Essex County Executive DiVincenzo, has been one of the most vocal critics of the shift of the three medical units to Rutgers, telling the Star-Ledger that "I don't think it's fair for New Brunswick to benefit when the city of Newark loses."

However, her boss, DiVincenzo, had a seat at the table when the five-member UMNDJ Advisory Committee voted for Rutgers to acquire the three UMDNJ units, and Joyce Wilson Hartley, a lawyer and longtime DiVincenzo ally whom he appointed to be his second-in-command last month as Essex County Administrator, voted for the interim report.

So did Anthony Perno, the CEO of the Coopers Ferry Development Association who has worked closely with Norcross on Camden development projects. The interim merger of the three UMDNJ units in New Brunswick and Piscataway was a unanimous vote.

No one will be surprised if the final report is unanimous, and if it satisfies Norcross, Sweeney and South Jersey leaders by merging Cooper Rowan Medical School with UMDNJ's School of Osteopathic Medicine -- or even goes further by urging consideration of a University of South Jersey that would encompass all of Rowan and Rutgers-Camden.

Nor would it be surprising if the final report recommends a consolidation that subsumes the Newark-based units of UMDNJ into Rutgers-Newark -- with or without the New Jersey Institute of Technology being included. The UMDNJ Advisory Committee's interim report rejected the idea of allowing NJIT to set up its own medical school in a collaborative venture with the St. George's University School of Medicine in Grenada, West Indies – which would have put NJIT in competition with UMDNJ's Newark-based medical school.

Creation of a larger and stronger university based in Newark would undoubtedly satisfy DiVincenzo, Oliver, and other Essex County Democrats almost as much as the creation of a major university in South Jersey would please Norcross -- especially if the decisions result in an infusion of additional state money into the new institutions, which most academic experts believe will be necessary to effect the mergers.

The fact that such powerful political forces are at play in these realignment decisions is one of the reasons that officials from UMDNJ and other potentially affected institutions -- as well as other college presidents and veteran observers of the higher education scene -- have been so loath to make public comments about the behind-the-scenes machinations that have been underway.

The realignment that began with Rutgers acquiring a medical school and could end with the establishment of major regional institutions in both southern and northern New Jersey is potentially the most important change in New Jersey higher education since Gov. Christine Todd Whitman's 1994 abolition of the position of Chancellor of Higher Education, which freed colleges like Montclair, Rowan, and The College of New Jersey to set their own course and to grow in size and stature.

"Are you kidding?" one top New Jersey higher education official said when asked to comment for this article. "No."

Mark J. Magyar teaches labor studies at Rutgers University and is a frequent contributor to New Jersey Spotlight. He covered the 2003 Rutgers-UMDNJ-NJIT merger proposal for New Jersey Reporter magazine. A veteran Statehouse reporter, he served as deputy policy chief in the Whitman administration and as director of policy for the independent Daggett for Governor campaign in 2009.

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