Health Services

I want to introduce myself, I’m Madonna McDermott I’m the Executive Director for Health Wellness and Counseling So, we’re going to talk today about the health of your student and how we can help support him or her and as well how you can I always start my presentation with this very old quote, it’s from 300 BC “When health is absent, wisdom cannot reveal itself, art cannot manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied.” I believe very strongly that unless there’s a really good foundational health of a student, it’s really hard for them to achieve academic success So, we work in a very holistic manner to make sure that happens So, it’s not just the physical health that’s important but we also look at the spiritual, the emotional, our community and environment What are we doing holistically to make sure that your student stays healthy and is able to succeed academically We’re committed to advancing the overall health and well-being of your student and the entire community These are educational opportunities for your students to learn lots of things about how to manage their own health, how to live a long healthy life, some new healthy lifestyle behaviors, as well as how to become wise consumers of healthcare resources, and how to maneuver a pretty complicated system I mean it’s complicated for domestic students as well as for international We also function on a pretty broad scale We also adhere to the Institute for Healthcare Improvement Triple Aim to make sure that the care that we provide is high quality, cost effective, and safe So, we want to make sure that your students if they do seek care here, that’s just within the health services, the clinical care that you know it’s a high quality, cost effective, and safe So, we work from prevention, it’s along the spectrum So, prevention, early detection, care of acute and chronic illness, and then also coordination of care Sometimes students end up in the hospital, end up with having appendicitis or ACL repair So, there’s lots of things that need a little bit more help in terms of coordination of care and that’s a part of what we do as well, but health is a prerequisite for academic success So, making sure that you know what’s available to you So, basically we are your students clinic while they’re here I think it’s around 75 percent of our students identify health services which is the acute care It’s our medical clinic here on campus as their primary care facility Many of your students are graduating from their pediatrician or their family practice They’re here the vast majority of the time Some are still within the community during the summertime and we’re still open in the summertime So, we become their primary care We use electronic health records, we communicate with them using a secure message So, it makes it pretty easy to have the ongoing care even when they’re not on campus We’re located right here on campus, the North end of campus The skywalk between Morrison and Brady, we’re right underneath that So, you come in from the outside, students can make appointments We can show you that one by a number of ways, they can call, they can walk in, they can schedule online If they’re not seeing the time or what they want to be seen for, they can call, and sometimes it’s just that we’re full of the walk in or the same day appointments I wanted to show a little bit about our team because in college settings, and the campus health service can be anything from a nurse-run clinic, where there’s really limited resources to a full service clinic which is what we have Our medical director is an internal medicine physician So, very skilled, very knowledgeable, had worked in the Aleena system here for many years before coming here We have a number of nurse practitioners which I also am So, I see students a couple half days a week as well Then our other nurse practitioners, we have a full time RN psychiatrist We also have a psychiatric nurse practitioner, we have physical therapy, we have a dietitian, and then we have some support staff, medical assistant Kim Brunette sorry, is at our front desk She’s the voice and face of our clinic Kathie St. Mary, we do use third party billing So, insurance is how we pay for the services that we use here Just as you would any other clinic,

your student needs to have their insurance card when they come to the clinic If they’ve forgotten it, no problem We just remind them, they still get their care, submit to the insurances, and then whatever’s left on that from your copay et cetera is put on to the student bill You will get your EOB or the estimation of benefit so you’ll know what to expect We just found out yesterday that we will be able to use HSA, the health savings account So, your student, if you have that will be able to get that taken off your bill using that method by the fall In addition to this, we also work really closely with counseling and psychological services You heard Steve talk a little bit about transitions a little bit ago We work with all of that staff as well So, he has a five staff psychologists, three doctoral interns, three practicum students, and that’s to address the mental health of your student That happens in a number of ways both in the counseling services location which is the third floor of Murray Harrich They always have crisis hours every day It’s for short term therapy So, making sure that they’re getting the care that they need whether it’s here on campus or referred out, and coordinating their care They also do a lot of outreach So,they do a lot of education to faculty and staff, to residence life to make sure that your students are getting the type of care that they need We work a lot in the health services So, the clinic again with referrals, many of that is happening in-house right at St. Thomas When you think about why should I have my student go to health services, the reason is that we are experts in college health We know how the system works here We know what the students are experiencing We know when finals are happening, when the high stress periods are happening, we understand the majors, music is a really hard major I hadn’t realized that before coming to higher ed, and engineering So, we know those that have extra stressors We know students that are OTC, that are in athletics We also have all the referrals in-house that we work very closely with, the dean of students office, campus ministry, academic counseling, career services Basically, any organization that’s here on campus will interface with If we’re seeing a student multiple times, and we get the sense that they’re extremely isolated, that they’re anxious, they’re not connecting well with other students, we will help them find on the website Where are the clubs and organizations? How can you get involved? So, the questions that the providers ask are very different than you would get in another facility When we talk about academic impact, I think Steve probably talked about that six to eight weeks, the students is really exciting those first few weeks It’s a time of the honeymoon period, this is all new and exciting And then about six weeks into it, eight weeks into it, the honeymoon wears off, and all the midterms or do, you might be getting that tearful phone call saying, ”I don’t know what I’m doing here, I don’t like it here, I want to come home.” We also know about that We talk with students and parents about grief and loss Many of us know about grief and loss because of death and dying, but we don’t think about grief and loss, what our students are experiencing Think about when they’re moving away, granted it’s all really exciting, but they’re, what they’re losing or what the grief process is about They don’t longer are sleeping in their own bed They don’t get to see you every day They don’t have the same food, they don’t have their dog They don’t have their music, their car, their friends, everything that’s familiar to them, is no longer there, so they really are adjusting to a grief and loss process And for you, when you see or hear from them that midterm time, is just saying, ”What you’re experiencing is normal, and I know you’re going to get through it.” It’s hard, just reinforcing what their experience’s normal and that there are lots of resources to help support them The other thing that we’re expert in is Community Health We stay very in tune with what’s happened nationally and internationally, when University of Lowa had their mumps outbreak, we’re aware of that When University of Minnesota had a Meningitis outbreak, we know about that If we have any unusual outbreak here, we’re working very closely with the Minnesota Department of Health, and so we’re kind of public health hats many times, we’re wearing those And our responsibility is protecting and maintaining the health of the entire community If we’re seeing that we have a lot of gastroenoritis, so diarrhea, nausea and vomiting, did they just get back from a study abroad someplace? Is it happening in our cafeteria? Are they on a particular team and it’s something that they’re all sharing? So we do a little bit of that work as well So these are just some of the services I thought I’d throw up

making sure that people know that it’s pretty extensive from preventative, so we do a lot of physical sports, physicals, just regular pre-Op physicals We do dietary consultation, a lot of that has to do with folks who may have some disordered eating, or history of disordered eating. Got to go back here Skins cancer screening, you’ll see a little photo here in a few minutes that shows a new service that we’re providing which is damascopy and what we know now is that young adults were seen more malignant melanoma earlier and part of that has to do with our ozone, has to do with using tanning beds, a lot of different things, so we used to think of that’s something that happens only later in life Well, that’s not We had a student who graduated last year, where Gail kept on pushing me, you got to go get that figured out, you have got to have that seen Finally, he did after graduating and it was a melanoma So merrily, the internist, our medical director has gone on for extra education and is now doing a lot of that first step of taking a look at it, screening and biopsies, setting off, and then going from there Vaccines, we do a lot of vaccines We have flu shot clinics, we’ll start with, we’ll start at the end of October of September We do about 10 or 12 outreach, so we come over to this building, nurses are in a lot of the other buildings, there’s a library, in the clinic, wherever they are, we’re going to be welcome weekend, no, homecoming weekend, we’ll be doing that as well So you can see some of those acute care I just put acute illness up there, the number one is upper respiratory as you can imagine So this year what we’re trying to do because we know that more and more people have a high deductible and that can be a pretty big expense, so what we’re trying to do, is shift and at least have some more screening done, we’ve moved, hired a new medical assistant, freeing up the nurse so that she can see more of, ”Okay, I have a sore throat.” ”Well it’s only been four hours, have you tried this, this and this Therefore, so they don’t have to see a provider and have that charge incurred Concussion management We also do a IV, hydration Some of our students, we do see a lot of mono This is just that age group, is a communicable disease, and sometimes it just takes a day or two of a little extra fluid, a little bit extra care Allergy shots, we see a lot of students for allergy shots, they’ll need to have a consent for that and work with Bethy RN And so these are just some of the other ones Mental health, like I said, we work very closely with the counselors here, and the psychiatrist and making sure that your student is seeing the most appropriate provider Most times it’s collaboratively that they get a better outcome, if they’re seen both a counselor and a medical provider ADHD, If your son or daughter has ADHD or ADD and is on medication, if they’re in the area we, it’s easier probably if you just continue on However, if they’ve had all the testing that we have on our website, and they’d like us to take that over for them, we can do that, because it’s kind of a hassle, they have to have a medication every month ordered So these are just some of the services We’re very student centered, what we’re about is about your student, and that’s why we’re all here Out of the staff that I work with, trying to think, at least three of us, me included, I have a sophomore here now Another one is a freshman, another one’s a sophomore, so three of the providers have students here at St. Thomas, and we treat your student as we want someone to treat our student, so they are well taken care of If it’s an emergency, we’re going to contact you Otherwise, they are protected under the hip laws of privacy laws So if you call us and ask us, ”Have they been seen there,” we can’t say even yes or no However, if it’s an emergency, if we call for an ambulance, we’re going to call you If they’re pretty sick, we’re going to pick up ask them, ”Would you like us to give your parent or a family member a call, let them know what’s going on?” If they say, ”No, I can handle it,” fine If not, we’ll go ahead and do that Easy access, we start the day with many of the slots open, so it’s an open access By the end of the day, they’re full So we try to see as many of the students as we can, same day, triage those that really need to be in Low cost, we are at about the 15th percentile, so we’re lower than the Allina, and the other clinics around town It doesn’t mean that it’s free, so that’s sometimes surprising As I mentioned, high quality, the folks that are caring for your son or daughter are really exceptional, and safe So these are the ways that they can to make an appointment, they can do it online I talked about insurances billed, and co-payments or other deductibles will be put on the student’s account This is some of the marketing that you’ll see in the fall or your son or daughter will see,

and so, one of the examples is the flu clinics We want to make sure that your student is immunized so that they don’t become ill and infect other people The first year that they had the law school built, we had an outbreak over in the law school, and they had like a handful of students that were missing, and if you develop influenza, you’re sick, you’re out of class usually for three, four, five, sometimes longer, and it’s hard to do as an undergraduate, it’s hard to do as a law student So, we offer lots of opportunities for faculty, staff, and students to be immunized This was one of the marketing that we did for the new dermoscopy Again, Dr. Votel Coval handles that She does a great job with it So, if they have any lesion, we know that it can take months and months to get in to see a dermatologist, this is a way that they can get in quickly It also may take months, and months, and months to get into see a psychiatrist We can usually get them in to see our psychiatric provider within a couple of weeks So, what are some of the benefits of having an on-campus clinic and having your students seen at either the health services or counseling services? Well, first and foremost is improved health We can keep them and promote them to a better level of health whether that’s emotional or physical Increased class attendance We do what’s called a patient experience survey and it’s about 23 percent of students say that they are able to avoid missing classes because of the care that they’ve received at health services It’s comparable to that at counseling Increased academic success We’ve asked students a question about whether or not it allowed them to stay in school Again, about the same, 20 percent say that it actually helped them stay in school So, it’s important that they be able to get their health needs addressed quickly, and I think nearby Many times what the provider will do if you came in and they’re still worried about you, they’ll give you a call, they will follow up They’ll say, “Why don’t you swing back and see me just for a few minutes tomorrow or the next day.” Just making sure that they’re going in the right direction So, it’s that little extra care that you’re not going to get in the community Increased retention Increased self care When I talk about the whole spectrum, the wellness center is the other arm of that, that’s our health promotion and illness prevention, we’ll talk a little bit more about that They do a lot of work on sleep; healthy sleep behaviors Also a lot of work on alcohol reduction efforts Just those behaviors that will help them have a more healthy lifestyle Sleep, alcohol, stress reduction, just self awareness and increase knowledge of how to utilize a healthcare organization effectively and cost effectively Especially, that many of you I imagine have provided all that for your student, and now they wake up, they’re ill, and you’re not there So, what do they do? So, if they can call and talk to a nurse, help them figure it out or they can come in and say, “You know, this is what I think you need Let’s move along with this plan of care.” They’ll also sent to them electronically which is the summary of the care that they’ve received So, again, in summary is that we’re here to help your students stay healthy and to have a healthy long life It is a prerequisite to academic success and an important part of how well they do here So, we want to make sure that you know we are here to support your student in many, many ways not just caring for them when they’re acutely ill but on prevention, early detection, and coordination of care If your son or daughter has a chronic condition, we care for lots of folks with diabetes, asthma, malignancies, pots, lots of cardiac stuff We work with those experts in the community so they will probably continue to have their endocrinologist, and their other sub-specialists, and we’ll coordinate with them If they’re receiving therapy over the [inaudible] we’ll be the ones drawing the lab, sending it over to them, and coordinating the care along with them so that they’re not just trying to figure this out all by themselves Then, I wanted to make sure we had a few minutes at the end of this to see what are other folks concerns or thoughts about their students health and well-being I just want to make sure that you said that polio had the same turning Yes. We’ve been working on that for a few years so we finally will have the ability to access that for folks But to keep it off their bill and [inaudible] Yeah Kathy, the insurance specialist hasn’t gone through the training yet So, exactly what that looks like, I’m not sure yet but she’s working on gaining that expertise

You take all insurance or do we have to call ahead of time? No. We do bill all insurances What I would suggest, we have contracts with a lot of the major folks here in the community: Blue Cross, Blue Shield, Cigna, Medica However, if you have a sub-specialised plan you may want to call them and say, “I want to make sure we’re not out of network or my son or daughter is at college and this is where they’re going to be Can we make that be part of the network? ” So, that’s a good thing to look into Prescriptions that they, sorry [inaudible] These are good questions Prescriptions. So, I have a son He has HIV and he takes medicine He has been told he doesn’t probably need to see the doctor because I’m talking about taking him off it next year, depending on how this year goes Well, let’s just say they want to increase it and see someone here Can you get a prescription filled here or do they have to go off campus to get it filled? If you have a standing prescription, we don’t have a pharmacy on campus The closest one there is a CBS about five blocks away So, that’s within the area where public safety will also give a ride if it’s junior and 20 below I also just found out today that’s also part of the debit card express dollars has CBS on it If they’re wanting to increase it, they can call it in or send it to that CBS and he can just get it If he’s coming to see us, we can send it any place that they want electronically We work with any of them. We have Walgreen, etc Sometimes when I’m on my way home and I live up North, can you send it to this one? Yes. We can do that. Or there’s the St. Paul corner drug, it’s a smaller owned one They deliver. So, we worked with them on deliveries So, there’s options There’s lots of options. Yeah. Yeah Can you do vital signs on a weekly basis, and if the vital signs become what, which, how long do you let the heart rate go and stuff before you have the ambulance come in and which hospital would they go to? Okay. So, yeah. We can do and we do that for a number of faculty, and staff, and students Do monitoring of certain types of vital signs, blood pressure, pulse, etc and sometimes it depends on what their provider, their outside provider has recommended Like if they’re seeing somebody for hypertension or for a hypotension like pots, it may ill be tipped depending on them They’re given a card with all of it written down with the dates and times as well as they’ll have access to it electronically Then we would depend on what the situation is So, if you have somebody who’s there normally running around a 50 for their pulse, which is pretty low but not if you’re a long distance runner and they say, “Oh, that’s what I’m normally I’m there.” We would do anything But if it’s somebody who are normally in the 80s and, I mean, the 40s, then we probably would be calling for an ambulance So, it is highly variable Where do they go from there? What hospital are they them take to? We’re fortunate in that we have a lot of amazing hospitals here in town, and we really have sent students to all of them We work closely with regions in St. Paul United Hospital in St. Paul There’s HealthEast University of Minnesota Those are the ones that we tend to use, but we will go any place that somebody wants to go, and especially if they have a preexisting relationship with that facility Good questions. Yeah So, should I send my son to school with an extra insurance card? Yes, absolutely. They should have that anyway If they were in a motor vehicle accident or anything like that they should always have their insurance card on them if they don’t have it, it’s so easy anymore, we’ll just say,”We’ll call a parent and get a picture of it and send it to us, and it’s taking care of that way.” Can we just send one to you so you have it on file? [inaudible] You could do that, and you could do health services. That’s mine On the website there is a place to send it It would be to the insurance office Yeah. All right Any other questions? Well, thank you and I know the day is getting long, and you’re doing great, and you’re almost there, so hang in there Vacation. So what do you have here? Our youngest is coming here in the fall Once in a while Well, the other is junior year now too Okay. So, you got two here? Yeah I have a sophomore here. She’s going to be in Spain this year though Junior is going to be in Rome in the fall Rome. Oh. Is it fun? Yeah She’s working hard to save up for money because I said, “I’ll pay for your room and board But rest is for you.” Yeah Your tattoos are beautiful. They really are