Building Opportunities for Your Nurse-Directed Health Center Presented by Shari Shapleigh, BSN, RN, MS, FNP

Building Opportunities Building Opportunities for Your Nurse-Directed for Your Nurse-Directed

Health CenterHealth Center

Presented by Shari Shapleigh, BSN, RN, MS, FNP

Welcome!Welcome!

Goals for the DayGoals for the Day

Understand the challenges that most nurse-directed health centers have in common

Discuss the sources of these challengesIdentify tactics to address these

challenges

IsolationLack of resourcesCompliance issues Conflict

Sources of challengesSources of challenges

ChallengesChallenges

IsolationIsolation

Due to resources Day to day operations occupy all resources Difficult to make time to network and build

bridgesDue to location

Rural settings physically isolated Often fewer local providers and other health care

resources in area Physical isolation on campus

IsolationIsolation

• Population served:• uninsured or underinsured student

• 28.1% of students age 18-24 are uninsured• Minorities and older students even more likely to be uninsured• HSACCC survey found 36% of 25-29 year old community college

students were uninsured• Many more students are underinsured• Often not able to refer to outside providers• Pressure to perform more services in-house, stretching resources

further

IsolationIsolation


IsolationIsolation

Lack of Resources

Lack of Resources

Manpower Often services begin with just one nurse provider Limited monies for staff, esp. if budget solely from

student health fees

Lack of Resources

Lack of Resources

Monetary◦rising health care costs◦budget cuts◦small student base

Lack of Lack of ResourcesResources

Lack of Lack of ResourcesResources

Challenges Challenges

IsolationIsolation

Lack of Resources

Lack of Resources

Compliance Issues

Compliance Issues

Immunization Compliance:

Another facet of resource shortages◦too time consuming for small staff◦health center doesn’t have budget to automate

No administrative support

Compliance Issues

Compliance Issues

IsolationIsolation

ChallengesChallengesCompliance

IssuesCompliance

Issues

Lack of Resources

Lack of Resources

ConflictConflict

Scope of Practice◦defined by State law◦advanced practice or nursing only?

Services Provided◦primary care or referral?◦dispensary or OTC?◦CLIA waived labs?

ConflictConflict

For whom?◦Faculty/staff◦students only?

ConflictConflict

Other challenges?

IsolationIsolation


Compliance Issues

Compliance Issues

Lack of Resources

Lack of Resources

ConflictConflict

Finding SolutionsFinding

Solutions


Solutions


Solutions

Develop a Support Network

Support Networks: Professional

◦Regional College Health Association◦Nurse directors’ group◦Student Health Center listserv◦Local professional group


Solutions

The National Nursing Centers Consortium (NNCC) “….are health centers managed by nurses in partnership with the communities they serve. They provide direct access to nurses and high quality health services, which may include comprehensive primary health care, health promotion, education and health protection and disease prevention.”


Solutions

Support Network: Campus

StudentsAcademic Departments

Athletics

Admissions

Public Safety

Support Network: Local Entities

-Department of Health-Hospitals/Walk-in Clinics-Planned Parenthood-Nearby Colleges-Educational Resources


Solutions

IsolationIsolation


Compliance Issues

Compliance Issues

Lack of Resources

Lack of Resources

ConflictConflict


Solutions

Support NetworkSupport Network

Secure Extra

Resources

Secure Extra

Resources

Secure Extra Resources: HumanStudents

◦nursing◦business administration◦public health

Interns◦nurse practitioner◦nursing◦health education◦massage therapy


Solutions

Finding Finding SolutionsSolutionsFinding Finding

SolutionsSolutions


SolutionsSolutions

Secure extra resources: Human

Contractual agreements with local providers


Solutions

Secure Extra Resources


Solutions

Secure extra resources: Time

BenchmarkingAutomate


SolutionsSolutions

IsolationIsolation


Compliance Issues

Compliance Issues

Lack of Resources

Lack of Resources

ConflictConflict


Solutions




HumanHuman

TimeTime

Strategize and

Advertise

Strategize and

Advertise

Strategies to Increase Opportunities


Solutions

Promote your health center on campus – build its profile:

peer educators promotion work with Public Relations department on campus for

inclusion in campus newsletter/on Web site guest lecture in specific classes present to Board of Trustees


Solutions

Promote your health center on campus:Value points:

◦your services help the under-served◦more cost effective than traditional models◦nurses spend more time educating students


Solutions

IsolationIsolation


Compliance Issues

Compliance Issues

Lack of Resources

Lack of Resources

ConflictConflict


Solutions




HumanHuman

TimeTime

Strategize and

Advertise

Strategize and

Advertise

Create a Business

Case

Create a Business

Case

Create a Business CaseIdentify exactly what you wantGet an audience with decision makersSpeak their language and make a good

pitch! ◦include return on investment (ROI), profit margin,

quality assurance and operating costs in your analysis

◦ include figures from benchmarking to back up your argument


Solutions

College Director Clerical Physician NP/PA RN PopulationOnondagaCC 1 1 0 0 1 10,000*LaGuardiaCC 1 0 0 3FT/2PT 10,000Hudson ValleyCC+

1/1clinical coordinator

2 1 1FT/1PT 2 12,000

FingerlakesCC 1/1Immunization coordinator

1 1 5,100

BroomeCC+ 1(NP) 1 1(PT) 1 6,000CayugaCC 1(RN) 1,000SullivanCCC 1(RN) 1 1,400**MonroeCC 1 2 0 1(?) 5 17,500

IsolationIsolation


Compliance Issues

Compliance Issues

Lack of Resources

Lack of Resources

ConflictConflict


Solutions


Secure Extra

Resources

Secure Extra

Resources

HumanHuman

TimeTimeStrategize

and Advertise

Strategize and

Advertise

Create a Business

Case

Create a Business

Case

MoneyMoney

Where’s the money?

Grants Doing it all by yourself is difficult

◦find out about grants through networking◦research using Web sites such as grants.gov ◦partner with your grants research office within

your institution, if you have one, so they actually write the grant


Solutions

Where’s the money?

Refocus priorities so services aren’t so stretched

Investigate student health insurance options


Solutions

Challenges and Opportunities Challenges and Opportunities Need to BalanceNeed to Balance

IsolationIsolation


Compliance Issues

Compliance Issues

Lack of Resources

Lack of Resources

ConflictConflict


Solutions


Secure Extra

Resources

Secure Extra

Resources

HumanHumanTimeTime

Strategize and

Advertise

Strategize and

Advertise

Create a Business

Case

Create a Business

CaseMoneyMoney

Questions?Questions?

ReferencesReferences

Atwater, Janet, Director of Health Services Hudson Valley Community College, Troy, NY. Personal interview, May 11, 2009.

Dalton, Brenda Director of Health Services and Women’s Health Nurse Practitioner, Spelman College Atlanta, GA. Personal interview, January 2009.

DeNavas-Walt, C.B. Proctor, and J. Smith. Income, Poverty, and Health Insurance Coverage in the United States: 2007. U.S. Census Bureau., August 2008.

Health Services Association California Community Colleges Survey, spring 2007. http://www.hsaccc.org/NCHASpring2007_Overview.pdf

Hurley, Janet. “The History and Practice of College Health.” University Press of Kentucky, 2002. pp 154-160.

Perry, Jayne, College Nurse Jeffersen Community College, Watertown, NY. Personal interview, March 2009.

Torrisi, D.L. and Hansen-Turton, T. “Community and Nurse Managed Health Centers: Getting Them Started and Keeping Them Going” National Nursing Centers Consortium Guide. Springer Publishing Company. New York, 2005.

Thank You!Thank You!

Shari T. Shapleigh, Director of Health ServicesDryden, NY [email protected]

Documents

Building Opportunities for Your Nurse-Directed Health Center Presented by Shari Shapleigh, BSN, RN, MS, FNP