Board Report 7D Backup, July 26, 2006
CCCCD STUDENT HEALTH SERVICES

Background and Analysis

Providing health services for students enrolled in the colleges of the District has long been a topic of conversation. Such services were offered to District students until the passage of Proposition 13 in 1978 which required huge reductions in services to students. Health services were eliminated as a result. With the recent enactment of legislation allowing a health services fee to be paid by students, many Districts have begun offering such services once again. A recent survey showed that 91 of the 109 community colleges provide health services for their students. Districts providing health services generally charge the full amount permitted by law and the same amount for part-time and evening students as full time/day students, students attending satellite campuses, and on-line students.

Districtwide student surveys, conducted in 2001 and 2005-06, revealed that the majority of students enrolled in CCCCD would use health center services and would be willing to pay a fee to have access to these services. Students who lack health coverage tend to neglect preventative care, tend to wait longer to seek treatment for illnesses, and generally suffer worse health outcomes for similar illnesses than students who have health coverage. With no health services on our campuses, students often turn to the District police for assistance with health emergencies. Over a four-year period, District police responded to over 500 requests for medical aid, many of which could have been assessed and treated more effectively by health service personnel. Without a campus option, these students often need to be transported via ambulance to local emergency rooms for assessment and treatment. For many students, the lack of access to health and mental health services has created a barrier to their academic success, often contributing to academic probation and dismissal. As a result of the survey outcomes, the student leadership, with the assistance of District employees, began the work of developing a proposal for the offering of health services at each of the colleges and centers.

During the fall of the 2005-06 academic year, Associated Student representatives consulted with the senates and shared governance councils at each of the three colleges, sharing their ideas and responding constructively to concerns raised and incorporating input into the a proposal. With the endorsement of the Associated Students and of the shared governance bodies at each of the three colleges, a presentation was made to the District Governing Board on the implementation of health centers at each District college and center on January 25, 2006. Prior to approving a proposal to bring student health services to the colleges and the accompanying health service fee, the Governing Board requested more detailed budgetary information and elaboration on the outsourcing concept within a Request for Proposal.

Following the January Board meeting, Chancellor Benjamin convened a Districtwide ad hoc student health services committee, co-chaired by District Student Trustee Val Lorien and DVC Dean of Student Life Bill Oye and composed of representatives from students, faculty, classified staff, a campus business manager, Associated Student advisors and other student service managers.

The charge of the committee was to develop a more detailed proposal and to make recommendations to the Chancellor and the Governing Board on:
• whether or not to outsource the services;
• which services were to be provided;
• staffing needed to deliver those services;
• the fee structure and possible exemptions;
• the development of a Request for Proposal; and
• an estimated operating budget and start up costs.

A second presentation that included more detailed information was made to the Governing Board on May 31, 2006. The Board was satisfied with the presentation and directed the Chancellor to place the implementation of a student health services fee on a future Board meeting agenda so that the fee could be assessed to students enrolling for Spring 2007 classes.

CCCCD STUDENT HEALTH SERVICES PROPOSAL

For many students enrolled in CCCCD colleges and centers, the lack of access to medical and mental health services has created a barrier to their academic success, often contributing to academic probation and dismissal. A survey of over 1,000 reinstatement petitions found that 11% of students on dismissal identified a treatable medical condition as significantly contributing to their academic decline and failure. Similarly, 35% identified treatable mental health concerns (grief, family issues, anxiety, depression, etc.) as contributing to their academic problems. Because the District is committed to the success of every student, health services will be provided at each District college and center beginning in the Spring 2007 term. The details of the program follow.

• Health services together with mental health services will be provided, utilizing a holistic and wellness-oriented approach. (Refer below for List of Required Health and Mental Health Services.)
• Comparable services and staffing will be provided at each of the three colleges and at least part-time service will be provided at the Brentwood and San Ramon Valley Centers beginning spring 2007.
• All funding for student health services will derive from a mandatory student health fee, to be set as allowed by the Education Code (with periodic adjustments as permitted by State Chancellor for inflation), beginning spring semester, 2007:
$15 per student Fall and spring semesters
$12 per student Summer term and for each intercession of at least four weeks duration
$ 9 per student Any semester or intersession of at least four weeks duration, if enrolled in less than one unit.

The following student groups will be excluded from the health services fee:

  • students who are only enrolled in non-credit classes;
  • students who are concurrently enrolled high school students;
  • students enrolled in contract education (where the fees are paid by an employer or agency, but not by the student);
  • students who depend exclusively upon prayer for healing in accordance with the teachings of a bona fide religious sect, denomination, or organization; and
  • students who are attending a community college under an approved apprenticeship training program.

Following will be the minimum initial staffing for:
CCC, DVC, and LMC

  • 1.0 FTE - registered nurse (preferably nurse practitioner)
  • 1.0 FTE - mental health counselor
  • 1.0 FTE - support staff (reception, appointments, records, supplies, etc.)

Brentwood and San Ramon Valley Centers (to be split between the centers)

  • .5 FTE - registered nurse
  • .5 FTE - mental health counselor

Utilization statistics and needs assessment data will be gathered at the end of each year services are provided. At that time, adjustments to staffing will be considered, based upon student need and utilization patterns. Any increases in staff FTE will be funded from health service fees and, once initial startup costs have been covered, revenues will be made available.

Following will be the hours of service:

  • CCC, DVC, and LMC
    Fall and spring, while school is in session:
    9AM - 7PM Monday through Thursday
    9AM - 1PM Friday
    One Saturday a month (half day)
    Summer:  Adjusted Monday through Thursday hours
          No Friday or Saturday hours
  • Brentwood and San Ramon Valley Centers
    Negotiable, depending upon student need and space

A Request for Proposal (RFP) process will be used to choose a vendor(s) to provide health and mental health services, with a preference for a vendor who would provide both.

The RFP will include a list of essential services comparable to services at other campuses in the region (developed from consultation with students and other constituencies on our campuses and HSACCC members), to be provided for students at the colleges and the centers.

In addition to health and mental health services, the committee recommends that health services staff provide assistance to the District through the following:

  • health education and outreach - workshops and class presentations;
  • crisis planning and response - disasters and public health matters;
  • campus involvement - committees and events (such as graduation);
  • services to faculty and staff who pay the (optional) fee;
  • tuberculosis testing, etc., for new hires, to be reimbursed by District Human Resources; and
  • hiring and supervision of staff and management of the operations and budget within set funding (from health service fee funds) by the vendor.

 

List of Required Health and Mental Health Services

Required Health Services:
Nursing assessment and evaluation
First aid for minor injuries and accidents (cuts, strains, sprains, etc.)
Management and treatment of minor health problems (upper respiratory, urinary tract infections, skin rash, etc.)
Emergency response on campus
Referral to community medical resources (for treatment of major health problems)
Physical exams
Breast exams
Testicular exams
Blood pressure screening
Weight checks
Referral for hearing and vision screening to off campus resources
Breastfeeding/pumping support
Self-care (Band-aids, aspirin, Tylenol and over-the-counter (OTC) medications, cough drops, etc.)
Limited number of prescription medications available at Center - at free or reduced rates

Health Counseling:
Health education and outreach - workshops and class presentations
Nutritional information/advising
Brochures and pamphlets on various heath topics

Miscellaneous:
Routine immunizations (measles/mumps/rubella, tetanus, flu shot, Hepatitis A/B)
Family planning services/referrals
Emergency birth control
Pregnancy testing, counseling and education
Laboratory tests - free or reduced rates
Pap smears
HIV testing (confidential)
Sexually transmitted diseases/gonorrhea/chlamydia testing (confidential)
Information on sexually transmitted diseases and referrals
Tuberculosis testing
Strep screening
Smoking Cessation - information, materials, OTC supplies
Substance abuse (alcohol, drugs) - information/referral
Supervised rest area for ill students (waiting for ride home, migraines, dizziness, etc.)
Assist student with completion of medical insurance claim forms for on- or off-campus accidents

Mental Health Counseling:
Mental health counseling - crisis and short-term counseling (up to 6-8 sessions)
Referrals for mental health services in community (longer term or specialized)
Self-help group

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