HSACCC

1. HSACCC November 15th, 2002 Community College League of California HSACCC

2. Today’s Presenters • Kate Hartzell, Cabrillo College • Susan Quinn, Santa Rosa College • Wende Rehwald, Sierra College • Loraine Brault, Fullerton College • Naomi Kitajima, Foothill College • Francis Capili, Santa Clara County • Micah Lieberman, Foothill College HSACCC

3. Kate Hartzell The Best Deal on Campus: What students can get for 80 cents a week. HSACCC

4. What are California Community College Health Services? • Clinical Care • Mental Health • Support Services • Special Services to Students HSACCC

5. Why are these services important? • UC Berkeley study (1999) • Santa Monica College(1997) • Glendale Community College (2000) HSACCC

6. How are these services provided? • Nurse Directed Clinics • College Nurse Service • Community Contracted Services • No Health Services HSACCC

7. Wende Rehwald The Best Deal on Campus: Accreditation HSACCC

8. Sierra College and Accreditation • What is accreditation • To certify as meeting certain set standards, Webster’s New World Dictionary • Committed to advocating high quality health services in ambulatory health care organizations through the development of standards and survey and accreditation programs, Accreditation Association for Ambulatory Health Care (AAAHC) HSACCC

9. Sierra College and Accreditation • Why seek accreditation? • Accreditation is the highest form of recognition a health care organization can receive for the quality care it provides. • Encourages development of new ways to improve care and services offered • Develop better risk management programs • Increase efficiency and reduce costs • Encourages the delivery of high quality patient care HSACCC

10. Sierra College and Accreditation • Eight Core Standards • Rights of patients • Governance • Administration • Quality of care provided • Quality management and improvement • Clinical records • Professional improvement • Facilities and Environment HSACCC

11. Sierra College and Accreditation • How does it affect our students? • Ongoing quality assurance programs to identify problems and successes; • Peer review of charting • Laboratory quality assurance • Patient satisfaction surveys • Benchmarking with other Community Colleges HSACCC

12. Sierra College and Accreditation • Benchmarking • A report card detailing performance or outcome measures appropriate to the organization and based on state and national standards • Systematic and ongoing data collection • Data is compared with other, similar organizations • Strive for a reduction in gaps over time from the benchmark norms HSACCC

13. Susan Quinn The Best Deal on Campus: Measuring Outcomes in Student Health within California Community Colleges HSACCC

14. Health Outcomes • Traditional health outcomes are measured in terms of mortality and morbidity. Educational Outcomes • Traditional educational outcomes measured in terms of student success and learning outcomes. The Challenge • Measuring the impact of college health programs in the language of educational system outcomes. HSACCC

15. Measuring Student Success Outcomes in Student Health • Retention • Transfer • Certification • Degree Completion • GPA • Academic Performance HSACCC

16. Example 1:Statewide Statistical Analysis HSACCC

17. Example 2: Statewide Student Satisfaction Survey • In 2000-2001, 18 colleges asked students that used Health Services these questions: “Student Health Services assists my staying in school and working toward my goals.” • N = 1699 • Yes = 78% “Is the Student Health Services clinic your only resource for obtaining health care?” • N = 1702 • Yes = 44% HSACCC

18. Example 3: Santa Rosa JC Research Projects in Psychological Services • Study 1: Three groups of students: 1) students receiving SPS services 2) students on a wait list for SPS services and 3) control group, students not requesting SPS services . Compare changes in GPA and other outcome variables using demographics as covariates. • Study 2: Assess effects of SPS services on coping skills and optimism 6 months after therapy has ended, and compare with baseline. Coping skills and optimism have shown to positively affect academic success. HSACCC

19. Example 4: Academic Performance and Health, The Santa Rosa JC process • Student Health Services Survey at Santa Rosa Junior College in 2001, 13 questions overlapping with NCHA. • Step One: Determine Health Conditions with greatest impact on Academic Performance • Step Two: Determine what programs are considered most important by students • Step Three: Extract other priority health issues from survey data • Step Four: Analysis and Programming Response • Step Five: Follow up data collection to measure changes HSACCC

20. Step 1: Determine health conditions with greatest impact on student successas self reported HSACCC

21. Step 2: Determine what programs are considered most important by students. HSACCC

22. Step 3: What other priority health issues can be extracted from survey data? HSACCC

23. Step 4: Analysis and Program Responses • Increased HIV testing services by the County on site • SPS contract services for 2002-2003 included increased crisis drop-in services • Began in-house flu vaccine program • Subscribed to on-line mental health screening and educational services for students • Endorsed, and developed local marketing strategy for CCLC’s statewide Health Insurance plan HSACCC

24. Step 5: Follow up survey Use of Internal Databases for Outcome Measurements and Program Analysis HSACCC

25. Database Functions • Appointment types and utilization data • Enhanced demographic data collection such as Health Insurance status, BOG waiver status • Diagnostic data • Service data, including treatments, medications, labs, immunizations, tuberculosis tracking, referrals, and special services • Reports – Annual, Semester, and on-the-fly • Data collection for external funding, such as the MediCal Administrative Activities program HSACCC

26. Example 1: Measuring changes in functional status • Increased SRJC Student Psychological Services (SPS) use of MediCat system software • All psychologists and interns use the “Global Assessment of Functioning” (GAF) tool to assess students during their service intake appointment, then again at their last visit. • GAF range 1-100, is Axis V of a complete DSM diagnosis. • MediCat codes set up in the database for both • 1) initial GAF status, and • 2) change in GAF • Once this data is entered, reports on the impact of SPS services are available HSACCC

27. Measures of GAF - SRJC Fall 2002 Students receiving SPS services HSACCC

28. Change in GAF from beginning of SPS services to discharge from therapy HSACCC

29. Example of Benchmark Criteria: Top 10 Diagnoses Seen in Practice HSACCC

30. Measuring Clinical Outcomes Related to Student Learning Objectives for Health Interventions • Antibiotic Effectiveness (understand appropriate use of antibiotics) • Asthma Control (fewer acute episodes, medication use) • Morning After Pill (follow up counseling) • Anxiety and Depression Management (ability to self-observe) • Follow up on Sexually Transmitted Disease Exposures (communication skills with partner) HSACCC

31. Loraine Brault The Best Deal on Campus: Research and Program Planning HSACCC

32. Why Consider Research • Determine priority student health needs • Assess the impact of health & behavior factors on academic performance • Identify high health risk behaviors on your campus • Determine what health interventions would be most appropriate in clinic and as outreach activities • Measure effectiveness of the programs selected HSACCC

33. Practical Applications of Research • Determine Health Services Advisory Committee review • Accreditation Self-Study Review process • Classroom presentations on specific topics • College-wide awareness campaigns • Clinician Practice implications • Education, support and advocacy • Faculty, other service areas • Local County and community agencies • Statewide advocacy re:student health status and program preferences. HSACCC

34. Selection of Test & Methodology • CC and FC selected the ACHA National College Health Assessment (NCHA) • Reliability and validity tested • Sample sizes pre determined based on # of students on campus • Ability to compare to colleges and universities nationwide • Disadvantage: Cost is about $1.00/ test HSACCC

35. Survey Sample HSACCC

36. FC CC JC Female 56 57 57 Male 44 43 43 White 44 68 73 Latino/Hispanic 29 19 11 African-American 3 2 3 Asian-Pac. Islander 12 7 6 Native American 2 1 2 Other 9 4 6 Demographics HSACCC

37. Believability of information from health center HSACCC

38. Affected Academic Performance In the last 12 months HSACCC

39. Alcohol HSACCC

40. Did something they regretted HSACCC

41. Had an HIV Test * Note: JC was reference within the last year HSACCC

42. Felt so depressed it was difficult to function HSACCC

43. Actual BehaviorversesPerceived Behavior Social Norming HSACCC

44. Used Alcohol Daily & Perception HSACCC

45. Multiple Sex Partners & Perception HSACCC

46. Campaigns Social Norming • Social Norms health campaigns highlight and promote moderate and protective (wellness) behaviors already practiced by MOST students in order to increase those behaviors in ALL students. HSACCC

47. Best Outcomes • Demonstrates the impact of health risks on academic performance • Develops dialog with faculty and administration regarding student success and retention • Perception data allows campuses to tailor health programs and awareness messages with their own students data HSACCC

48. Naomi Kitajima Francis Capili Micah Lieberman The Best Deal on Campus: Foothill College’s Smoking Cessation and Tobacco Education Program HSACCC

49. Web Audio Visual Education Foothill College Smoking Cessation and Tobacco Education Program“See Through the Smoke” HSACCC

50. 4 Components of the WAVE WAVE — “See Through the Smoke” • Santa Clara County Tobacco Prevention and Education Program • WAVE, Web Audio Visual Education • Smoking Cessation Program and Campus Social Norming • Campus Policy HSACCC