Background

In my Key Insight, Discovering Vulnerabilities, I speak about my volunteer experience at the Community Medical Clinic in Kershaw County, South Carolina. This non-profit medical clinic offers free health care to qualifying Kershaw County residents. The patients we serve are uninsured and often unemployed. We helped many patients with acute illness such as colds and respiratory infections as well as helped clients take control of their chronic illnesses (diabetes, hypertension). It often goes unnoticed the number of community residences that are in poverty and cannot afford health care in a surrounding community, but especially in Lancaster, South Carolina. According to the United States Census Bureau, nearly 20% of residences are below the poverty line in Lancaster County South Carolina. This is roughly 18,000 residences (Census Bureau, 2018). These disparities can include disability, low income, poverty, and being underinsured. In Discovering Vulnerabilities, I discussed how economic disparities can lead to people not being able to properly care for their health. Therefore, leading to health vulnerabilities. Health vulnerabilities are often health conditions that can advance into something as serious as death due to a person’s inability to afford health care. For example, during my beyond the class experience volunteering at the Community Medical Clinic, I had met many homeless clients who were nearly dead with severe hyperglycemia (high blood glucose levels). The clinic was able to help treat the clients, educate the clients, and provide them with free medications and insulin until they had their glucose levels under control. Without the help of the free medical clinic, these residents could have died from their chronic health condition, due to their economic disparities (homeless, unemployed, uninsured).

 

Unfortunately, some of the above vulnerabilities are seen in the college student population as well. Almost one-third of young adults (age 18-24) do not have health insurance. In fact, members of this age group are nearly twice as likely to be uninsured compared to members of the general population under age 65. This has been the case since the mid-1980’s and the uninsured rate continues to increase every year (Institute of Medicine, 2001). Lancaster is a small, rural campus. A majority of the students that USC Lancaster serves are rural students. Rural students often face barriers to healthcare such as being long distances from providers, lack of reliable transportation, poverty, lack of health insurance, and just the high costs of health care (Rural Health Information, 2018). It is often difficult for many students to afford healthcare. Many students will avoid making health care visits unless it is absolutely necessary due to the increasing cost and inability to afford it. This is why the lack of affordable and accessible health care for USC Lancaster students is a concern.

 

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Issue

            A major issue with Lancaster County’s increasing vulnerabilities is USC Lancaster’s lack of affordable, accessible on-campus health care for students. Most universities have student health centers for their students. A survey given to college students found that 65% of respondents found student health centers were critical to their physical and mental health (College Parents of America, 2014). USC Lancaster is a small, rural, satellite campus and therefore does not have a student health center. As a result, when students become sick and do not have health insurance, they may be hesitant to see a physician.

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            As reported in the National College Assessment (n.d.), some of the most common illnesses that occur on college campus among students include mental health conditions (stress, anxiety, depression) and conditions such as colds, flu, and sore throats. Mental health, in particular, has become an increasing health condition in the US. In fact, a record number of college students are seeking treatment for depression and anxiety (Georgetown University, n.d.). Transitioning into college is a big change for students and can further worsen someone’s mental health. Students should have easier access to help for illness and mental health conditions such as mentioned above.

 

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General Recommendations

            To help provide USC Lancaster students with more readily available healthcare I would recommend opening a student health center on the Lancaster Campus. This would be a small primary care clinic to provide students with basic primary care and mental health help. As a volunteer at the Community Medical Clinic, I was able to personally see how a small primary care clinic was able to assist so many underprivileged residents to improve their physical and mental health when they could not afford a visit to a primary care provider or emergency room. Residents were able to control chronic illness such as diabetes and hypertension as well as get help for their daily stresses and anxieties. I believe a small student health center on Lancaster’s campus could benefit so many individuals both physically and mentally.

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            All Bachelor of Science in Nursing (BSN) faculty at USC Lancaster are nurse practitioners that work at different clinics in and around Lancaster County. This would be a wonderful work opportunity for these BSN faculty as providers. In our BSN program, the Population Health Course (431), requires students to complete community service hours. Being a very small, rural campus it can be very hard to find community service opportunities. This student health clinic would be a perfect opportunity for students to get community health experience, but to also get community service hours on campus for their within the classroom assignments. BSN Nursing students could get the privilege and experience of helping other peers improve their physical and mental health as well as improving their mental health through service to others. I speak about this in my Key Insight, Psychological Benefits of Community Service. A student health center on the Lancaster campus would benefit numerous people, including the students, faculty, and staff.

 

 

 

 

 

The Implementation

            Opening a student health clinic is a very large project. It would include much research beforehand to present to the college and other involved parties. After getting the approval of all involved, I would need to get all of the required documents to begin the student health clinic. I would also need to find an approved place to host the clinic where students can easily access it on campus. After finding a location I would need to find funding for the clinic, funding for the equipment, and funding for medical record programs. I need to create documents advertising the clinic and formal documents of what services the clinic can offer. One of the last things that would need to be determined before the clinic can open is determining a schedule for the clinic and what workers would be needed at each hour. Realistically, I would need a team to help me complete this because it is such a big responsibility. Accomplishing this would take more than myself to be successful.

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            The first step I would perform is the initial research. I would begin by researching the general college aged (18-24 years) population in Lancaster County and the economic disparities that are common amongst them. I would determine things such as living environments, employment status, insurance, education status, and common health conditions. I would then go to the Dean of USC Lancaster, Dr. Walt Collins, and ask how I can find these statistics for USC Lancaster alone. I would like to compare USCL statistics to national statistics. Secondly, I would like to research different student health clinics at both large campus universities and small rural campuses to determine what kind of impacts they can make on campuses. After I complete my research I would compile it into a document and presentation to present it to appropriate parties. 

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            After compiling research and making a presentation with supporting educational handouts, I would present it to the campus faculty and staff. I would present it to the Dean, the Associate Dean, the Office of Academic and Student Affairs, the Office of Admissions, the Business Office, the Office of Career, Counseling and Disability services, and any other interested faculty or staff. The goal of this presentation is to share my findings in hopes that the campus would all agree on my idea to start a campus student health clinic. This would be the very first step in the process of a successful student health clinic, campus support.

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            To gain the full support of the campus I would need to orchestrate a plan and gather a team together. First of all, I would need to determine what documents I need to be allowed to start an on-campus student health clinic. This would include documents through Department of Health and Environmental Control (DHEC), as well as health and medical insurances. I would work on this with the help of nursing faculty at USC Lancaster. One of the BSN professors, Dr. Leigh Pate, completed her dissertation on creating a campus student health services. I would collaborate with Dr. Pate on what documents I will need, what insurance I will need to acquire, and what state and governmental agencies I will need to contact. Dr. Pate and I will also work together to create a document listing all the services that the clinic will provide, what health care professionals we will need available, a schedule for the clinic, and equipment we will need to make the clinic successful. I would like to offer services such as flu vaccinations, primary care for simple conditions such as allergies, upper respiratory infections, colds, mental health clinic, nutrition counseling, contraception education, and more. Mental health is also a major concern in college populations. USC Lancaster has mental health counselors but these counselors are not used often enough. I would love to collaborate with the Office of Counseling and Disability Services to have a mental health wing of the student health clinic available for students as well.

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            I would have a second team that is responsible for finances. This team would determine the most realistic and appropriate ways to help fund the clinic. The team could look for hospital funding from MUSC Lancaster Medical Center or business funding such as from Nutramax in Lancaster. They could also look into applying a yearly fee to student tuition bills. USC Lancaster has nearly 1,600 students. If each student paid $100 a year on their tuition bill for health services, that would be an estimated $160,000 a year for the clinic. This team could also research different grants that could assist in starting the student health clinic. I could assist the team with grant writing as I have had experience grant writing at USC Lancaster for my research experiences.

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            Lastly, we would probably need a team more experienced in construction and remodeling as we would need someone to help draw a plan for the center when a location is determined and to set the clinic up. The most reasonable location would be in the Carol Ray Dowling building located on campus because it is accessible to students to walk to while they are on campus. After a location is selected this team would be responsible for any needed construction, painting, demoing, decorating and other needs as a plan is developed. This would be done after finances are determined so the team will have a base budget.

 

 

 

 

 

Evaluation

            The listed plan above is only the beginning of the student health clinic. This would be a long process and a multiple step plan. To evaluate the success of the student health center would first be obtaining the approval of the college itself and all require state and governmental agencies. After researching the required topics and gaining approval the process of the student health center can continue.

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            The next stage of success would be having the student health clinic built, stocked with supplies, staffed, and prepared for students. This would be a very long process but after it is all complete and the clinic is prepared for use, this is when campus students can begin to be positively impacted both physically and mentally.

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            The last stage of evaluating our success would be determining if the clinic is successfully serving students. This could be done in many ways. USC Lancaster health care providers could ask students to complete a survey after their visit and we could use these surveys to determine what we are doing well and what needs to be improved. The student health clinic would also create a system of student medical records. This information would be kept confidential but could be reviewed by clinic providers to determined how many students were provided services. If the clinic could provide services to at least 25% of students during the first year of services, I would consider this very successful. Further success would be increasing the number of students provided for each year.

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            I have full confidence that a student health clinic on the USC Lancaster campus could be a successful addition to benefit students, faculty, staff, and even the community. It would take a team to work through the steps and support from many of the campus staff. Though a long timeline, with the support and help provided I believe this project can be very successful.