UMMC, IHL: How lawmakers can change without amendment

Since the Institutions of Higher Learning Board of Trustees was created by constitutional amendment in 1943, Mississippians have used the ballot box only twice to edit the state agency that oversees all eight public universities.

In 1987, voters permitted the board to lend a trustee to the Le Bauve Scholarship Fund at University of Mississippi, and in 2003, they reduced the trustees’ terms from 12 to nine years and reconfigured the districts.

Now, with the ballot initiative weeded from the voters, a legislative watchdog has looked at how lawmakers might change the governing bodies that oversee Mississippi’s universities, community colleges, and only academic medical center through state statutes and board policy changes, without a constitutional amendment. 

Last week, the Joint Legislative Committee on Performance Evaluation and Expenditure Review (PEER) released a report on postsecondary governance in Mississippi and how it could be restructured. The report described the history, structure and function of IHL, the Mississippi Community College Board, and the University of Mississippi Medical Center.

The 69-page report offered questions for lawmakers to ask before determining how, if at all, the state boards overseeing colleges and universities in Mississippi should be restructured. It made no urgent recommendations, because the committee found that “no standards for best practices exist” for reformulating postsecondary boards because no state has the same system. 

“Leaders should consider working with the existing postsecondary governance before significantly altering it,” the report says. 

Lawmakers have discussed removing UMMC from IHL before, but the move would require an amendment to the state Constitution. But the report found it would be possible for IHL trustees to delegate more authority to UMMC by amending the board’s policies and bylaws. 

Lawmakers could look at “what, if any” functions IHL could delegate to UMMC, the report suggests, with “the primary focus … on how reimagined governance and policy could improve UMMC viability and future growth potential.” 

Marc Rolph, executive director of communications and marketing, said UMMC had no comment on the PEER report. 

The report also found that lawmakers could alter MCCB’s governance structure by amending the state statute that created the board. Still, the report says “a complete restructuring” of the state’s postsecondary boards would require a constitutional amendment. 

“Some of this is steeped in the Constitution,” said Sen. Kevin Blackwell, R-Southaven, the current PEER committee chair. “It would require an initiative, and we don’t have an initiative process right now.” 

The state Supreme Court struck down the ballot initiative process in May 2021, but lawmakers can still amend the Constitution via a two thirds vote in both chambers of the Legislature. Voters must then approve in a general election.

Unlike the state’s eight universities, each of Mississippi’s 15 community colleges have their own board of trustees. Created in 1928, MCCB was initially housed under the state Department of Education. It is mainly responsible for controlling and monitoring the flow of state funds to each community college. The central office, which has a $6 million annual budget, also oversees career and technical education programs. 

IHL, on the other hand, has vastly more power over the universities. The commissioner’s office and the trustees select the university presidents and have broad authority to decide how legislative appropriations are allocated among each school. For all eight universities and UMMC, the board approves new academic programs, and signs off on procurements greater than $250,000 and capital improvements totaling more than $1 million. 

This session, Sen. Rita Potts Parks, R-Corinth, proposed a bill to give UMMC its own hospital board, but it died in committee. Policymakers also discussed removing UMMC from IHL’s purview in 2015, when the board decided not to renew Dan Jones’ contract as chancellor of University of Mississippi. That same year, a report by the Center for Mississippi Health Policy and Veralon found that UMMC’s governance structure is unusual compared to other states. 

“The majority of state-based public universities with a medical school and associated academic health center are not governed directly by the state,” that report found. 

Academic health centers like UMMC in general have two sides, the academic medical center, which is more focused on education, and the clinical enterprise (the hospitals and clinics where care takes place). The state governance for these two functions is often partitioned, with one side operating more independently than the other, the PEER report found. 

At UMMC, the IHL board oversees both sides, and the budget lines between the two are murky – doctors often treat patients with the help of medical students. But some lawmakers have argued that IHL is not equipped to oversee the finances of UMMC’s clinical enterprise, which are structured differently from a university budget. 

“All risks associated with pursuing change efforts should be compared against the risk of doing nothing in a fast-paced and increasingly competitive and complex academic health care marketplace,” the report says. 

Others, including LouAnn Woodward, the vice chancellor for health affairs at UMMC, have disagreed with that. Shortly after IHL did not renew Jones’ contract in 2015, Woodward wrote in a public post to the UMMC community that she believed it should remain a part of the University of Mississippi. 

“Ole Miss, although out of sight and occasionally out of mind, is not only our parent campus to the north but our natural ally when the pressure is on,” she wrote. “From time to time there’s talk about separating our two campuses and treating UMMC as a distinct institution. It is critical that we remain part of the University of Mississippi. We’re stronger together.”

The PEER report suggested that if UMMC was separated from IHL, the academic medical center could remain under University of Mississippi with the clinical enterprise becoming a private nonprofit. The PEER committee interviewed staff at the University of Tennessee Medical Center which, in 1999, became a private nonprofit separate from the UT Health System. 

One benefit to this change, the UT Medical Center’s government relations officer told the PEER staff: The clinical enterprise was “no longer subject to open meetings law as a private nonprofit corporation.” 

Still, that step would require a constitutional amendment. Another idea the report suggested was that IHL could delegate more authority to UMMC – a step the board has taken in the past. In 2019, trustees decided to let UMMC, UM and Mississippi State University manage their own state-bond-funded projects after the lawmakers gave IHL sole oversight of capital projects funded by state bonds. 

The PEER report also reviewed reasons a state might want to restructure postsecondary governance, such as concern about rising costs, barriers to local or regional access to graduate programs, a change in state leadership, or “ill-defined or overlapping missions” of governing bodies.

Putting IHL and MCCB under a central coordinating board could be more efficient, the report says. Lawmakers could also give each university its own institutional board, though that would require a constitutional amendment and could result in “drawbacks” in the event of “attempts by the new board to delve into issues IHL generally does not (e.g., athletics).”