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New Ways to Support Community College Student Health

Dr. Sara Goldrick-Rab

A widespread health crisis is undermining American community colleges, with many current and potential students exhibit high rates of anxiety, depression, substance abuse, suicidal ideation, food insecurity, and more. The challenges predate the pandemic but were exacerbated by it. The COVID-19 infection itself also appears to have made the situation worse.

With their well-being undermined, students find it much harder to focus on learning — let alone graduate — which, combined with growing debt, puts them at risk of ending up worse off than if they didn’t attend college at all. That’s why researchers at Ithaka S&R found that three in four community college provosts rate student physical and mental health as critical to student success.

Let’s be real: it costs significant money and time to address this problem, and most community colleges lack both. Rampant funding inequities have been clear for a long time — colleges enrolling students with the most need tend to have the least staff capacity and financial bandwidth to help. Yet these institutions try to fulfill their mission, putting more pressure on a small number of campus health professionals, adopting telehealth programs (despite a lack of much evidence that they work well for students), and expressing frustration with the difficulty in doing more. Dr. Sara Goldrick-RabDr. Sara Goldrick-Rab

But two new initiatives are giving me hope that more community colleges will have additional capacity to support student health. And there are ways for you to get involved, now, to enhance their impact.

The first is a project that promises to bring more sustainable revenue for community college health programs. The Community College Medicaid Project, supported by the ECMC Foundation and the Kresge Foundation, aims to improve student health by boosting Medicaid engagement by community colleges. In other words, this effort will bring more dollars to colleges by ensuring that they get Medicaid reimbursement for the eligible services they (already) provide.

Dr. Ryan Stewart, a former New Mexico Secretary of Education, and the first African American to serve as that state’s chief state school officer, spearheads this project. Having served as regional executive director for Partners in School Innovation, executive director of the Office of School Improvement and Innovation at the School District of Philadelphia (the poorest large city in the nation), and a California math and science teacher, Ryan noticed something important: many K-12 schools provided Medicaid-eligible health services to students but — often because of a lack of awareness and/or challenges with technical know-how — they didn’t get paid for it. In other words, schools left billions of federal dollars on the table, and system leaders were often unaware.

It’s very likely that community colleges are in the same boat — unknowingly forgoing federal dollars to support work they are trying desperately to do. For example, Ryan estimates that in California just 20% of community college students attend an institution participating in the state’s Medicaid program. That’s why he is on a mission to ensure that every college has access to Medicaid funds to support student health and well-being. Increasing colleges’ participation in and optimal use of Medicaid dollars to offset costs and generate recurring federal revenues can help remove healthcare access as a barrier to completion and build colleges’ capacity to sustain student health funding.

The Community College Medicaid Project launched this year and Ryan needs your help. Please urge community colleges to participate in the first-ever national survey of their health service offerings. The survey is conducted in partnership with the Association of Community College Trustees with the goal to offer a comprehensive picture of the full range of health services offered at every community college in the country. The person who completes the survey should be knowledgeable about the health services the college provides, who provides them, how many students receive them, and any Medicaid activities the institution engages in.

Using information from that survey, Ryan’s team will develop an online data platform that will enable college administrators and policy makers to view each community college's Medicaid reimbursement data and create scenario-based projections for potential future revenues. College leaders will also benefit from a national report describing the current landscape of community college participation in Medicaid and identifying practical ways to increase community college participation.

The other new effort I’m excited about is a burgeoning partnership between St. John’s Community Health and Compton College in Los Angeles. When advocate and keynote speaker Freddy Shegog says that the word “community” in community college makes him feel seen and welcomed, this is the sort of thing to which he’s referring.

Serving a majority-minority population mainly living at or below the poverty line, Compton College’s current student health center averages more than 3,000 unduplicated patients every year. Via a partnership with St. John’s, the proposed Community Health Facility will have the capacity to serve six times as many people with 24/7 urgent care. It will support both current students and members of the community, extending the college’s impact beyond the classroom walls and improving the odds that community members will become healthy enough to attend college. This is a critical need in this community since local emergency rooms are overextended. It will be part of a broader collaboration already underway to address staffing shortages in the health professions, an engagement that also includes Charles Drew University of Medicine and Science, California State University Dominguez Hills, Compton Unified School District, and Kedren Health. Compton College President Dr. Keith Curry is asking the California Legislature for $15 million to make the new facility possible, a request that should be easy to approve — even during fiscal uncertainties — given the sizable returns on such investments.

These sorts of partnerships are not new to community colleges, but we need many more focused on student health. Building sustainable frameworks is key; simply relying on referrals to outside agencies or telehealth companies to support our students will never be enough. I hope that if you’re currently engaged in a partnership like Compton’s, you’ll let President Curry and I know so that we can learn from you. If you aren’t, why not convene a meeting with local health organizations and see if you can develop one?

And please, ask your local community college’s student health services director to complete the Community College Medicaid Survey, so that all community colleges can find more ways to maximize existing dollars to support more students.

Dr. Sara Goldrick-Rab is author of Paying the Price, College Costs, Financial Aid, and the Betrayal of the American Dream, senior fellow at Education Northwest, adjunct professor at the Community College of Philadelphia, and partner in projects led by Drs. Ryan Stewart and Keith Curry.

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