The Student Health Clinic supports the mission of the college by prioritizing goals such as resolving health, life and safety issues and promoting wellness for students. These priorities support the college standards of retention, completion and transfer. The Student Health Clinic (SHC) provides medical and mental health services for eligible students of all cultural backgrounds, learning abilities and socioeconomic levels. The SHC promotes self responsibility, knowledge and skills necessary, for students to work at their optimal level of mental, physical, and emotional wellness. This, in turn, aids them in achieving their academic and personal goals This responsibility includes being responsible for one’s own health. We use a humanistic approach that promotes self-care and self-actualization. An individual’s health status is greatly influenced by knowledge and personal choice. The emphasis of control and wellness is shifted from health care provider to the individual. This positive action effects health, life and safety issues for the student while at Butte College and within the community. The SHC will continue to integrate student learning outcomes into our teaching while providing medical and mental health care needs. The SHC will also continue to contribute to the campus culture of sustainability provided by a solid, consistent,well respected, competent health care team that provides excellent quality medical and mental health care. The SHC will continue to assess the scheduling needs of students and provide as much flexibility as possible. The strategic direction plan emphasizes the value of a learning culture. The SHC achieves this goal with daily professional patient education on health, illness, treatment, and disease prevention. We focus on instilling personal responsibility by focusing on responsibility for one’s own health. This goal indirectly assists coordination and integration of general education across the life span. The SHC is proactive regarding a safe campus environment and seeks collaborative resolutions. SHC is budgeted through categorical funds that are supported by the Health fee (AB982) with the District funding costs not met by that fee.
The SHC is located in a rural area. Our philosophy to provide primary care services to all of our students, and especially students without resources and transportation, makes our clinic, our successes, and our challenges unique. The SHC consists of a wonderful team of health care providers who work well together and collaborate effectively with the Campus and community.The SHC remained open during summer 2015 allowing us to see 658 more students. Our overall patient census continues to climb each year in spite of reduced college student numbers. SHC saw a total of approximately 6,800 patients during 2014-2015. The Student Health Clinic, per the Butte College Health Service Plan, operates as an immediate care and primary care facility available to students enrolled in credit classes offered by Butte College. Medical services are available during the fall, winter, spring and summer semesters. The clinic is open Monday through Friday and is staffed by Nurse Practitioners and a Physician. Our Medical Director is on site Tuesday's during the fall and spring semesters. He is available to us by phone during holiday and summer hours. Medical conditions are assessed, diagnosed and treated by the Nurse Practitioners or the Physician. Problems for which students are commonly seen include dermatology, upper respiratory infections, allergies, reproductive health, respiratory problems, campus injuries, Tuberculosis testing, preventative care, physical examinations, immunizations, and medication consultation or prescription. Both medical and therapy staff members work closely with the Safe Place located on campus. Our Mental Health Specialist is a licensed Marriage and Family Therapist. She provides brief individual and couple therapy to registered students. Common issues include depression, anxiety, alcohol and drug issues, relationship problems, grieving, and Attention Problems. Mental health services are provided to students during fall and spring sessions. A minimal number of appointments are available during the winter and summer. Maureen Hernandez, LMFT provides these services. Maureen is a precious resource. Her mental health specialist capacity was utilized by 600 students over the past year. She also presented to over 120 students on mental health and stress-related topics. Almost every day her already impacted schedule is interrupted with mental health crises often more than once daily. Her services not only aid the health of many of our students, but also aid the safety of the campus by identifying individuals that may not be mentally healthy enough to participate in college life at this time. Maureen also works closely with Campus Police to provide presentations to faculty and staff. The purpose is to prepare them to deal with difficult or threatening students and also to identify how to contact community and campus police. We are an isolated clinic on the Main Campus located off Parking Lot 3-C. This location provides a sense of confidentiality to the students, but mainly assures easy access to emergency service vehicles and personnel. The staff of the SHC provide emergency care to students until other resources arrive. Due to the wide variety of services offered at SHC, specialized equipment and additional emergency care training for staff is important. As expected, our equipment and education costs are significant. The Nurse Practitioners obtain Advanced Cardiac Life Support (ACLS) training every two years. Our therapist stays current on the required educational training and education required for her license. Currently, patient census for both medical and mental health services has exceeded our expectations and resources. The phenomenal growth and popularity of the Student Health Clinic is a direct reflection of our students trust and dependence on these critical health care services. Triage is a reality and some students with non emergent health care complaints must be redirected to other facilities. A third part-time mid level provider and additional medical staff is needed to assist those students with restricted access.
The Student Health Clinic has placed a strong focus on the group of students who seek our help with ADHD. Students can receive information, have a thorough assessment, obtain a diagnosis and engage in a treatment plan. Adults with ADJD experience anxiety, depression and often ungrounded fears that they are not capable of attaining a college educ ation. Referrals to the Disabled Students Programs and Services (DSPS) help students gain access to services that support their diagnosis. The Medical-Psychotherapeutic staff of the SHC provides enormous help to students with ADHD and combined with the services of DSPS improve the probability of educational success to our students. Motivational support and continued medication are important for improved outcomes in adults with ADHD.
The Student Health Clinic supports the college in meetings its student achievement standards by:
Maintaining the health of our students and campus community.
Most Butte College Students cannot afford to be treated for non-emergent health issues at local walk-in clinics or hospital ERs. Most Butte College Students cannot afford to be seen or treated by a mental health specialist. The Student Health Clinic treats all students who seek our care but for uninsured students, the student health clinic is often their only option and lifeline for healthcare. Healthy students are academically productive students. The health clinic plays a vital role in supporting Butte College's efforts to support student achievement. The clinic treats all medical and mental health issues. Whether providing IV therapy to a severely dehydrated athlete, suturing a lacerated leg or draining an abscess and starting the student on antibiotics, the health clinic staff are dedicated and focus on helping students maintain their health. Other areas of support include:
* Treating the students with learning disabilities with testing, counseling and treating;
* Testing, diagnosing and treating infectious communicable diseases;
* Preventing infectious disease through in classroom PowerPoint educational lectures
* Responding with advanced life support supplies and equipment to an on campus medical emergency.
* Collaborating with County and State Public Health agencies.
* Advocating for students with substance abuse issues seeking to 'get clean.'
* Collaborating with the Athletic Department to provide physical exams for our athletes.
* Providing medical standby for major events or Fire/Law Enforcement training
* Provide needed support to transferring students to maintain continuity of care.
These effort are essential in providing students with optimal physical and mental health enabling students to remain successfully engaged in the academic milieu.
The Student Health Clinic supports the college in meeting is Strategic Direction and Priorities by Enhancing a Culture of Completion and Academic Achievement (Strategic Initiative 1.a.5)
The health clinic provides a nurturing and supportive staff to assist students who are experiencing adversity. The collaboration among providers, both medical and mental health, provides the optimal treatment environment. The collaboration between providers in the clinic is a considerable factor in student success and the direction we encourage these students to direct their efforts. Just as important is the role of the instructors and counselors who also collaborate with us in addressing the student's issues. Most often the counselor or instructor is the first to identify a student with a learning issue. We might encourage the newly diagnosed student with ADHD to take a lighter load for the first semester as they will be re-learning the basics they missed in grade school. The patient with depression or anxiety might be encouraged to see our mental health and medical provider weekly until their symptoms have become manageable. The clinic works with the students to help them develop a more productive learning plan.
Enhancing a Culture of Inclusiveness (Strategic Initiative 6.3) - Improving access, success and completion of targeted student populations through the implementation for the Student Equity Plan.
The Student Health Clinic has an effective outreach program but it could still be improved. Working with Safe Place has been an eye opener. Stronger collaboration with Safe Place is already becoming a working requirement.
Overall, the clinic has reached out across the campus with classroom involvement, taking the clinic to some groups such as fire, law enforcement, nursing and athletics with physical exams and vaccinations. Access to the clinic has been improved for some groups largely through collaborative verbal agreements. It is widely understood and appreciated that if any instructor or counselor feels a student is in need of medical or mental health assistance, the First Alert referral process can streamline a student into our care in a matter of minutes.
Recommendations from the last program review was to expand clinic hours. Implementing new ideas to provide a more consistent availability of clinic resources is being planned. This will include better coverage hours and a much more collaborative staff effort.
Another recommendation was to develop an instrument to assess Student Learning Outcomes. This instrument has been developed to measure the outcomes of our ADHD diagnosis, testing and treatment program. The effort is directed at helping students to better understand their condition and learning disability in order to play a more proactive role in their own treatment and learning outcomes.
The primary goal of the Student Health Clinic is to meet the immediate health care needs of our students. Our goal is to provide quality care and services for our students. With the proper staffing levels, we believe these goals can be accomplished.
Strategy 1 - Medicat EHR Annual Maintenance Fee
The addition of Electronic Health Records(EHR) is a vital emerging technology that the Federal Affordable Health Care Act mandated for all private clinics. The annual EHR maintenance fee is $11,500.
The SHC purchased the Medicat hosted system at an initial installation cost of $28,500. Through an ongoing augmentation request, we will ask for funding to pay the annual Medicat EHR maintenance fee of $11,500. This hosted system requires no assistance through our Butte College IT staff or servers. The Electronic Health Records is a federally mandated medical clinic regulation. The district's coverage of the maintenance fee assures the SHC can continue to use our EHR and remain in compliance with this federal mandate.
Strategy 2 - Full Time Therapist
The College needs another full time Mental Health Therapist to meet the needs of our students. Maureen is very busy, and the student demand exceeds our ability to help the numbers of students seeking help. Maureen can only work twenty eight (28) hours per week as a Professional Expert,or 960 hours for the fiscal year.Maureen plans on reducing the number of hours she works per week in the year 2016 as she prepares for full time retirement. We propose the District hire a second therapist full time to help fill the needs of our 14,000 students. An additional Therapist will potentially help to provide service in outlying centers. The Chancellor’s office has established a commission to address this problem.
"It is clear that mental health services in California’s colleges and universities need to be given a higher priority and focus in order to prevent crisis and tragedy and to assist young people towards healthy and productive lives. The greater numbers of students who need mental health services, along with the increased complexity of the issues they face, have overwhelmed the capacity of colleges and universities to respond appropriately. Much like the public mental health system, they must focus on crisis response rather than crisis prevention and promotion of well-being.” California Mental Health Services Oversight and Accountability Commission May 2010.
Additional mental health services at the Main Campus and outlying centers will increase the availability of critical services and fulfills Program Review recommendations.
Augmentation $105,000
Strategy 3 - Per Diem NP
Per Diem Nurse Practitioner: A variable work schedule of 20 hours per week would provide ideal coverage. The cost of this additional provider would be approximately $40,000/year. We ask that the District increase our budget to cover this position. We realize there are currently no funds for this position but planning for it and introducing the idea is critical for long term planning.
$60/hr
In order for the SHC to operate at full capacity, a part-time Nurse Practitioner is needed to cover those times when a care provider needs time off for illness or vacation. One Nurse Practitioner alone is not capable of seeing all the patients on a busy day. Those times when additional coverage is needed creates an extra work burden and stress to the remaining staff, and significantly decreases the ability to see the number of students that need care. The part-time practitioner would also assist in the clinic two days a week and more when the patient census was unusually heavy such as during the flu season.
The clinic census has grown to the point that the current providers are unable to support the needs of all students coming to the clinic. At this time, there are insufficient funds to initiate this but we would like to implement this when possible.
Strategy 4 - Part time Records clerk
Permanent Clerk II- Medical Records Clerk: 24 hours per week for 10 months requires augmentation of approximately $14,000 for salary and $7,000 for benefits. The handling of confidential medical records is currently completed by a trained Student Assistant. It is important to maintain consistency and efficiency when working with confidential materials and should be held by a classified employee.
Currently there are only 2 permanent staff members in the front office area while our patient census has increased over 350%. The handling of confidential medical records is currently completed by a trained Student Assistant. The Union is aware of this, the board is aware of this and due to inadequate staff we are forced to use our Student Assistants in a non-authorized manner. Having this Medical Record Clerk will provide needed staff power in the front office and help us follow appropriate guidlines for using our Student Assistants within their job scope. A records clerk will also assist the clinic in gathering data for analysis of Student Learning Outcomes which are necessary for improvement, program review, and accreditation.
Strategy 5 - Emergency Medical funds through payroll deduction
For many years there has been an emergency medical fund available though payroll deduction. We plan on becoming more active in promoting this fund throughout Butte College Staff and Faculty, and students. It is a service that can truly be a miracle for those folks who become patients and have a true financial need for some sort of monetary help.
Currently only 60% of our students have any form of medical insurance. Although many of them may be eligible for Medi-cal or Californnia Path to Health, most students have not applied. Those students with families often are able to obtain coverage for their chiildren but not themselves. This emergency medical fund may also be used for some acute, medications prescribed through the clinic, that the patient has no way of affording.
Strategy 6 - Mental Health Interns
As our current therapist, Maureen Hernandez plans for retirement after 2016, we are initiating a plan to have her take on mental health therapy interns, possible 2-3 a semester, which she would oversee. This will allow more students to have therapy services, and hopefully we could recruit 1 or 2 interns to replace Maureen after she retires.
Interns will increase access to mental health services on campus. The current ratio of one therapist to 11,000 students in unrealistic. Our hopes are that one or more of these interns will continue their therapy careers at Butte College. This service, helps the community by providing intern opportunities, and it significantly helps with student success, retention and completion. Interns may also help by providing service to outlying centers.
Strategy 7 - Additional Office space
With the addition of per-diem FNPs and future mental health interns that will be seeing patients for brief therapy, the clinic will need to expand. Our previous facilities director, Mike Miller envisioned this need and in doing so he left a large parcel of land on the east side of the SHC building, which is perfect for extending the clinic out with several additional exam, therapy, and treatment rooms.
SHC services and demands for services are continually growing. Additonal office space provides the opportunity to provide additional services to students. Our ADHD testing, therapy sessions and additonal medical staff can utilize additonal space without compromising the daily office operations and patient visits.
Strategy 8 - Distric support of Mental Health Therapist
Psychologist/Mental Health Therapist: In 2008 with the hiring of Maureen Hernandez, the district agreed to fund $20,000 of this cost. Our unit plan requests the district contribute agreed to funds, for our Mental Health Specialist. The SHC contributes $64,300 to finance the cost initial annual salary to provide mental health services. With Maureen Hernandez’s recent pay increase the SHC can no longer afford to fund this position without assistance. Our only alternative would be to cut therapy hours which are critical for the mental health of our students.
The Mental Health Specialist is one of our greatest resources on campus assisting students in resolving life issues. Our therapist is an asset in keeping the campus safe from students that may have mental instability and/or anger or violence issues. Maureen Hernandez is a Licensed Marriage and Family Therapist. She is so popular with students she quickly schedules out weeks in advance. The Mental Health Specialist provides the following services;
o Assessment, counseling and advising for students with psychological disorders
o Intervention for students with acute emotional or mental health crises.
o Aids the Vice President of Student Services in assessing the safety of a student’s emotional status.
o Liaison with community groups and agencies providing services to individuals with psychological disorders
o Referral within the community to medical and mental health care providers, in support of students with psychological disorders
o Develop and provide information and strategies for working with students with a focus on veterans with traumatic brain injury, survivors of sexual abuse and support groups for high stress student groups.
o Provides intake, T.O.V.A. testing and evaluation for students with Attention- Deficit and Attention-Deficit Hyperactivity problems.
o Acts as a liaison with the Chancellors’ office for the recently formed California Community College Mental Health and Wellness Association
Strategy 9 - Modifying Front Door for ADA Compliance
Install ADA actuator to open the door from the outside and inside. Plus a lock out switch in the event of a lock down which will have the door properly lockdown without anyone needing to leave the reception desk
$10,180
With the varied medical needs of our students and limited physical limitations, the campus community needs to be able to access the front door of the Student Health Clinic.
Recently, a student in a wheelchair was found by a Student Health Clinic Nurse Practitioner attempting to access the Student Health Clinic. Unfortunately, the student was unable to open the door (door opens out) while trying to maneuver his/her wheelchair. As another example, this could have also been a student in a wheelchair who was quadriplegic – resulting in being unable to open the door without an actuator. In addition to an actuator, it is important to include a panic door operator. This is needed in an emergency situation in order to prevent the door from being opened by an actuator. With the latest community college shooting incident, staff need to be able to secure the door for protection.
This project is important to fund for the access of our campus community for health care needs and protection of our campus community during a crisis.
Strategy 10 - Insurance Card Scanner
Insurance Card Scanner to streamline the patient registration process by eliminating the need to photocopy/manually enter patient ID cards, and medical insurance cards resulting in greater efficiency, reduced human error, and lower costs.
$600
Enhances sustainability by reducing the need to copy each side before scanning document into EHR and discarding.
Prevents costly manual data entry errors (e.g. patient name, date of birth, insurance card number).
Collect accurate information.
Fast processing time, just a few seconds per scan.
Expedited patient registration.
Providing a better overall patient experience.
Strategy 11 - Expand Nurse Practitioner to 12 month
Implement a 12 month position for Nurse Practitioner to see students over summer session.
Expanding position to 12 months will ensure coverage for the summer months. Summer health services directly correlate with unit plan prioritization. Summer Connection students, Academy cadets, welding students and early football training session students need access to medical care throughout the summer. Also, the Allied Health programs require physicals and immunizations prior to the start of the program. The SHC is instrumental in keeping costs down for all students and is instrumental in student success from this standpoint.
Strategy 12 - Health Coaching position integrated into SHC model
$2.3 trillion is spent on healthcare, yet only 2% goes towards prevention. The SHC must take on a new task: working with patients to ensure that they understand, agree with and participate in the management of their chronic conditions. A Health Coach is one way to accomplish this function.
Health Coach's role can be defined as helping patients gain the knowledge, skills, tools and confidence to become active participants in their care so that they can reach their self-identified health goals. Coaching involves a paradigm shift from a directive to a collaborative model so that the SHC team and patients pursue an active partnership, instead of patients being passive recipients of care.
Less than 3% of doctor visits are spent discussing nutrition. Doctors don't always have the time or resources to help their patients build healthy lifestyle habits, so Health Coaches are needed to fill the void in our current healthcare system. A Health Coach is a supportive mentor and wellness authority who works as the conduit to help clients feel their best through food and lifestyle changes. Instead of prescribing one diet or way of exercising, Health Coaches tailor individualized wellness programs to meet their clients' needs. Relationships, exercise, career, and spirituality are just as important to your health as the food you eat. Health Coaches understand this and take a holistic approach to supporting the whole person.
None.
SHC is budgeted through categorical-like funds that are supported by the Health fee (AB982) with the District bearing the costs not met by that fee.
Health Fee revenue Allocated $564,157
Supply and Services revenue Allocated $ 20,000
Allied Health Immunization service Projected $8,750
| Original Priority | Program, Unit, Area | Resource Type | Account Number | Object Code | One Time Augment | Ongoing Augment |
| Description | Supporting Rationale | Potential Alternative Funding Sources | Prioritization Criteria | |||
| 1 | Student Health Clinic | Personnel | 12-342-710-1-644000 | 52110 | $0.00 | $20,000.00 |
| Extension of Nurse Practitioner to 12 month position | Summer health services directly correlate with unit plan prioritization. Summer Connection students, Academy cadets, welding students and early football training session students need access to medical care throughout the summer. Also, the Allied Health programs require physicals and immunizations prior to the start of the program. The SHC is instrumental in keeping costs down for all students and is instrumental in student success from this standpoint. |
|
|
|||
| 2 | Student Health Clinic | Personnel | 52390 | $0.00 | $20,000.00 | |
| Salary support for Mental Health Specialist | We are asking the District to fund $20,000 to cover a portion of the Mental Health Specialist salary as the SHC can no longer support it. |
|
|
|||
| 3 | Student Health Clinic | Equipment | $10,180.00 | $0.00 | ||
| Modification of Front Door for ADA Compliance | To purchase and install a disabled power lock operator for the Student Health Clinic door, as well as a panic door operator in the event of an emergency such as a lock down. With the varied medical needs of our students and limited physical limitations, the campus community needs to be able to access the front door of the Student Health Clinic. Recently, a student in a wheelchair was found by a Student Health Clinic Nurse Practitioner attempting to access the Student Health Clinic. Unfortunately, the student was unable to open the door (door opens out) while trying to maneuver his/her wheelchair. As another example, this could have also been a student in a wheelchair who was quadriplegic – resulting in being unable to open the door without an actuator. In addition to an actuator, it is important to include a panic door operator. This is needed in an emergency situation in order to prevent the door from being opened by an actuator. With the latest community college shooting incident, staff need to be able to secure the door for protection. This project is important to fund for the access of our campus community for health care needs and protection of our campus community during a crisis. |
|
|
|||
| 4 | Student Health Clinic | Operating Expenses | 12-000 | 55630/6411 | $0.00 | $11,500.00 |
| Medicat Hosted Electronic Medical Records | Medicat’s hosted system avoids the cost of purchasing the software, the servers and the IT staff . It provides support required to maintain the servers, provide redundant backups, coordinate software updates and upgrades and monitor database security. Our Student Learning outcomes are based on the data received from students on specific health care topics. We gauge how effective we are in educating students. Our Medicat system is a critical component of data collection and analysis, as well as the providing quality medical charting and documentation. |
|
|
|||
| 5 | Student Health Clinic | Personnel | 12-342-710-1-644000 | 52390 | $0.00 | $40,000.00 |
| Part-time Nurse Practitioner (Professional Expert) | In order for the SHC to operate at full capacity, a part-time Nurse Practitioner is needed to cover when a care provider needs time off for illness or vacation. One Nurse Practitioner is not capable of seeing the number of patients the clinic sees alone. Those times when additional coverage is needed creates an extra work burden and stress to the remaining staff, and significantly decreases the ability to see the number of students that need care. The clinic census has grown to the point that the current providers are unable to support the needs of all students coming to the clinic. |
|
|
|||
| 6 | Student Health Clinic | Personnel | 12-342-710-1-644000 | 52120 | $0.00 | $21,000.00 |
| Part-time Clerk II- Medical Records Clerk | Currently there are only 2 permanent staff members in the front office area while our patient census has increased over 350%. The handling of confidential medical records is currently completed by a trained Student Assistant. It is important to maintain consistency and efficiency when working with confidential materials and should be held by a classified employee.The Union is aware of this, the board is aware of this and due to inadequate staff we are forced to use our Student Assistants in a non-authorized manner. Having this Medical Record Clerk will provide needed staff power in the front office and maintain HIPAA regulations. |
|
|
|||
| 7 | Student Health Clinic | Personnel | 52100 | $0.00 | $105,000.00 | |
| Full-time Mental Health Therapist | The student demand exceeds our ability to help the numbers of students seeking help. We would like the District to consider funding the hiring of a second therapist for the campus, because the need is so great. Maureen can only work twenty eight (28) hours per week as a Professional Expert,or 960 hours for the fiscal year. We propose that the District hire a second therapist full time to help fill the needs of our 14,000 students. The Chancellor’s office has established a commission to address this problem. |
|
|
|||
| 8 | Student Health Clinic | Personnel | 123427101644000 | 52120 | $0.00 | $6,500.00 |
| Expand Back Office Medical Assistant Position, 10 month to 12 month. | Critical need to expand Back Office Medical Assistant from 10 month to 12 month due to increase of students accessing clinic for health and wellness needs. Increase in academies result in physicals and immunizations needed for program participation. Continuity of care critical. |
|
|
|||