JOHNSON CITY, Tenn. (WJHL) — Students from East Tennessee State University’s Gatton College of Pharmacy often come from rural backgrounds and serve rural communities after graduation, but area leaders say that important pipeline is under threat.

Privately funded since its inception more than 15 years ago, the school has seen a gap between its tuition and that of the University of Tennessee Knoxville pharmacy school grow in recent years. ETSU now costs $37,916 annually compared to $27,000 and change for UT out-of-state students and only $22,370 for in-state students.

East Tennessee State University Gatton College of Pharmacy students work a vaccine clinic in 2021. Tennessee representative Gary Hicks has proposed a $2.9 million annual state subsidy for the privately-funded school. (ETSU)

The school wins numerous awards, its graduates express higher satisfaction with their experience there than the national average and this year’s graduates are being snapped up and offered sign-on bonuses. But enrollment has dropped almost 18% the past two years, from 315 in 2019 to 281 in 2020 to 259 in 2021.

State Rep. Gary Hicks (R-Rogersville) has proposed a budget amendment that would provide Gatton’s first state funding ever, to the tune of $2.9 million a year. He told News Channel 11 Friday the enrollment decline is almost exclusively the result of the tuition gap — and that rural constituencies like his have benefited greatly from Gatton’s existence.

“The neat aspect for me is to see that those first-generation college students are able to go and right here in Northeast Tennessee get a solid education and become a pharmacist, and really satisfy a great need that we have in the area,” Hicks said.

When enrollment numbers began declining, Hicks went to his alma mater and began asking what the cause was. He said he found a solid program with a “world class” facility, instructors and administrators.

“There was nothing internal that I saw causing the issue and so that just kind of concreted that there’s definitely something else going on here and so when I began to dive into it it really came back to the point that there is some disparities,” Hicks said.

Gatton’s dean, Debbie Byrd, said she was painfully aware of those disparities and of the challenges facing Gatton when she took the helm from founding dean Larry Calhoun nearly six years ago. At that time, she said, pharmacy schools faced a dearth of demand and 80% saw enrollment decreases.

Gatton College of Pharmacy Dean Debbie Byrd said the school is at a disadvantage in attracting and retaining students due to tuition gaps with the University of Tennessee’s Memphis campus.

But that demand wasn’t as soft in rural Appalachia, and though she said the funding model and high tuition haven’t created an existential threat currently, it could over time.

Byrd said she worries about not just whether students will decide to come to Gatton, but whether they’ll pursue pharmacy at all.

“I worry about that to some degree especially for our first-generation rural students – are they making the decision not to be a pharmacist because they’re concerned about the cost differential that they’re asked to bear?”

ETSU and Gatton specifically have a mission to serve rural and underserved communities. About half of its students are first-generation college students and more than a third of them hail from rural areas.

“We serve East Tennessee, Northeast Tennessee and rural parts of Tennessee in a way that no one else does and has for many years,” Byrd said. “If not for this college we would still have a pharmacist shortage throughout East Tennessee.”

A first-generation college student herself, Byrd said a high proportion of Gatton graduates are changing their families along with rural communities.

“THEC did a report back in 2019 and found that our student population had a higher percentage of those students that are more disadvantaged,” she said. “So those are the students that are needed most as pharmacists, most disadvantaged, being asked to pay the most tuition.”

A deal’s a deal, right?

When local leaders approached then-Governor Phil Bredesen in 2005 about the pharmacist shortage in Northeast Tennessee, state budgets were tight. Bredesen said he’d only consider authorizing a college of pharmacy at ETSU if the region could raise $5 million in 90 days. They did it in 58 days.

Another part of the deal was that ETSU would operate Gatton as a separate entity and it would be all privately funded. At that time, Byrd said, out-of-state tuition for the Memphis campus was significantly higher than in-state.

Hicks said those goalposts have moved a little, and now out-of-state students at Memphis pay less than they once did. He said the current situation isn’t anyone’s fault per se, but he believes it justifies consideration of a state subsidy for Gatton.

The lack of public funding “was the original agreement as long as everything stayed the same, so to speak, across the state and that wouldn’t be a problem,” Hicks said.

“The strategic decision they made had an unintended consequence for ETSU. That was kind of the issue that I looked at.”

While he doesn’t think it’s time “to hit the panic button,” Hicks said now is a good time to put forward a push for change. All the state funding would go to help offset the cost for students, whether in the form of officially lower tuition or scholarships and subsidies that lower that tuition practically if not on paper.

“Why wait until we get to that point, because we can see the trajectory. It’s like you hear the train coming, let’s get off the track here. That’s kind of the way I saw this,” Hicks said.

“Let’s fix this problem now because at the end of the day I want the college of pharmacy to be there because of those first-generation students that are going there, those other students that are going there.”

He said newly minted pharmacists are definitely needed in his rural district that spans most of Hawkins County, all of Hancock and part of Claiborne County.

Even though a request ETSU leaders have been pressing for several years didn’t make it into Gov. Bill Lee’s budget, Hicks said he believes its prospects are fairly good.

“I think the administration feels like this should be a legislative initiative,” Hicks said.

His proposal went to the House Appropriations Committee Monday and now sits in the hands of that committee and the Finance Committee. He said he believes representatives and senators from East Tennessee understand and support the proposal and will need to convince colleagues.

“I don’t want to put words in their mouths but I think everyone is supportive of the Gatton College of Pharmacy and so I think we’ve got a chance to get there,” Hicks said.

“We’re competing against a lot of other really good causes, and so we’ll have our work cut out for us. It’s certainly not a done deal at this point, but the fact that we have been able to shed light on the problem, now it’s a matter of whether we want to fix the problem or not.”