THE COVID-19 PANDEMIC’S EFFECT ON CAMPUS HEALTH SERVICES A Snapshot of Operating Status and Response, April 6–9, 2020 THE COVID-19 PANDEMIC’S EFFECT ON CAMPUS HEALTH SERVICES A Snapshot of Operating Status and Response, April 6–9, 2020 This report has been collaboratively created by the following members of the ACHA COVID-19 Task Force: ACHA COVID-19 Task Force Survey Sub-Committee Survey Sub-Committee Chairs Anita Barkin, DrPH, MSN, NP-C, FACHA Geraldine Taylor, MS, APRN-BC, FACHA Survey Sub-Committee Members David Anderson, PhD Jean Chin, MD, MBA, FACP, FACHA Micah Griffin, PhD, MS, MHA Giang T. Nguyen, MD, MPH, MSCE, FAAFP For additional COVID-19 information and resources for campuses, visit ACHA’s COVID-19 Resource page: www.acha.org/COVID-19 Purpose As college health and wellness professionals are called upon to provide guidance to their campus communities regarding their response to the pandemic, it is critical that there is access to timely, ongoing benchmarking data to measure the effect of the pandemic on college health services as well as their response to the crisis. To that end, the American College Health Association (ACHA) developed and administered a survey to collect critical data to assist in the study of the COVID-19 pandemic event. The results included in this report represent a snapshot of the status of college health services from April 6 through April 9, 2020. Methods Representatives of 728 ACHA Member Institutions (RMIs) were asked to complete an online survey developed by the ACHA COVID-19 Task Force. Responses were collected between April 6 and April 9, 2020, using the Qualtrics platform. Respondents were asked to answer questions on current conditions on their campuses. A total of 380 usable surveys were collected, representing a response rate of 52%. The Sample The sample of 380 institutions is comprised of predominantly four-year institutions, with nearly half in urban settings. The breakdown of public/private schools and total student enrollment are fairly evenly distributed. The regions of the U.S. are equally represented in the sample, except for the western U.S. Of the 377 participating schools in the U.S., 9 (2.4%) are HBCUs, and 98 schools (26%) are religiously affiliated. Institution Type Institution Type 5.5% 4-year 47.9% 2-year 52.1% Public Private 94.5% THE COVID-19 PANDEMIC’S EFFECT ON CAMPUS HEALTH SERVICES – A Snapshot of Operating Status and Response, April 6–9, 2020 Page 1 The Sample—continued U.S. HHS Geographic Area 1.1% 16.1% 25.0% Northeastern U.S. Midwestern U.S. Southern U.S. Western U.S. Outside the U.S. (Canada and 32.9% U.S. Territories) 25.0% Locale 3.2% 21.6% Urban Suburban 49.2% Town Rural 26.1% THE COVID-19 PANDEMIC’S EFFECT ON CAMPUS HEALTH SERVICES – A Snapshot of Operating Status and Response, April 6–9, 2020 Page 2 The Sample—continued Basic Carnegie Level 3.2% 3.2% 5.5% Doctoral Masters 37.1% 18.7% Baccalaureate Associates Baccalaureate-Associates Special Focus 32.4% Total Student Enrollment 20.5% 24.7% Less than 2,500 2,500-4,999 5,000-9,999 10,000-19,999 19.5% 20,000 or more 18.7% 16.6% THE COVID-19 PANDEMIC’S EFFECT ON CAMPUS HEALTH SERVICES – A Snapshot of Operating Status and Response, April 6–9, 2020 Page 3 SURVEY RESULTS Did campuses tap the expertise of our membership? Is there a representative from health, counseling and/or health promotion services on your institution's emergency response team? 5.8% 94.2% Yes No Three hundred twenty-six schools (94%) indicated that they had representation from health, counseling, and/or health promotion services on their campus emergency response team. Of the health, counseling, and/or health promotion services representatives on campus emergency response teams, approximately 80% hold the title of director of health services. Other representatives identified include medical directors, nurses, and student affairs officers. Some respondents reported having more than one representative from health services on their campus emergency response team. How are campuses generally operating? What is the current operating status of your college/university? (select all that apply) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Operating normally 1.1% Distance/virtual learning (no faculty, non-essential staff, or students on campus) 77.4% Distance/virtual learning (faculty, staff, and students are allowed on campus) 9.7% Residence Halls are closed—no students living on campus 7.6% Residence Halls are open—only for those students granted exceptions 69.5% Residence Halls are open—no restrictions 4.5% Campus is closed to everyone except essential personnel 38.2% Other 9.5% THE COVID-19 PANDEMIC’S EFFECT ON CAMPUS HEALTH SERVICES – A Snapshot of Operating Status and Response, April 6–9, 2020 Page 4 Of the responding schools, 87% (77.4% + 9.7%) reported that they were using distance/virtual learning. This includes 10% that permitted non-essential faculty, staff, and students to be on campus despite using distance learning. Two hundred seventy-seven schools (73%) indicated that they had students living in residence halls during the data collection period (April 6 to April 9, 2020). Most schools (n=260; 68% of the sample) allowed only those students who were granted an exception to remain on campus. A small number of schools (n=17; 6.1% of sample) indicated that their residence halls were open with no restrictions. Residence Hall Occupancy Rates (n=252 schools) 15.1% 52.8% 32.1% < 5% occupancy 5-10% occupancy 11-42% occupancy Occupancy data were provided for 252 schools, with nearly 50,000 students in residence across these campuses during the data collection period. The total residence hall capacity was pulled from the Integrated Post- Secondary Education Data System (IPEDS) in order to compute an occupancy rate for each campus. The largest group (52.8%) of the 252 schools had less than 5% occupancy, and 32.1% of the schools had between 5% and 10% occupancy rates. The mean occupancy was 6.4% and the median was 4.5%. The range was <1% to 42%. The schools with residence halls open with no restrictions had higher occupancy rates than those that only allowed students to stay by exception. THE COVID-19 PANDEMIC’S EFFECT ON CAMPUS HEALTH SERVICES – A Snapshot of Operating Status and Response, April 6–9, 2020 Page 5 How are campus medical services currently operating? Medical Services Operations Status 0% 10% 20% 30% 40% 50% 60% Normal operations—business as usual 5.4% Face-to-face triage and urgent care only 7.0% Telemedicine with limited face-to-face visits 49.1% Telemedicine only 23.9% Currently providing no medical services 14.8% Most schools (n=272) reported utilizing telemedicine to deliver health services. Of those, 183 schools (49%) were also providing limited face-to-face visits. For those offering telemed services, which students are eligible? Which students are eligible to use your telemed services? (n=268) 0% 10% 20% 30% 40% 50% 60% Only those students currently residing on campus 6.0% Only those students residing in the same state as the institution 17.9% Only those students residing instate and in states where telemed reciprocity has 18.3% been approved All eligible students regardless of location 52.2% Other students (Please specify): 5.6% Of the 272 schools offering telemedicine services, about half are offering care to all eligible students regardless of location. Another 36% are limited to whom they can provide services due to interstate licensure issues. THE COVID-19 PANDEMIC’S EFFECT ON CAMPUS HEALTH SERVICES – A Snapshot of Operating Status and Response, April 6–9, 2020 Page 6 What is your current staffing for medical services? The survey asked whether the school had physicians, nurse practitioners, physician assistants, nurses, and administrative support staff working on site and/or remotely. Many schools had staff working in both capacities; therefore, totals for each position do not equal 100%. Medical Services Staffing 90% 84.6% 80% 69.1% 70% 67.7% 62.7% 62.6% 58.8% 60% 51.8% 50.3% 50% 40% 30% 20% 10% 0% Administrative Support Staff (n=258) Nurses (n=346) Advanced Practice NPs or PAs (n=328) Physicians (n=308) Working on site Working remotely How are campus counseling/mental health services currently operating? Counseling and/or Mental Health Services Operations Status (n=372) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Normal operations—business as usual 0.0% Face-to-face triage and urgent care only 0.3% Telecounseling and/or telepsychiatry with limited face-to-face visits 15.9% Telecounseling and/or telepsychiatry only 82.0% Currently providing no counseling and mental health services 1.9% The overwhelming majority of schools (n=364) reported utilizing telecounseling or telepsychiatry to deliver mental health services. Of those, 59 schools (16%) were also providing limited face-to-face visits. THE COVID-19 PANDEMIC’S EFFECT ON CAMPUS HEALTH SERVICES – A Snapshot of Operating Status and Response, April 6–9, 2020 Page 7 For those offering telecounseling/telepsychiatry services, which students are eligible? Which students are eligible for telecounseling and/or telepsychiatry services? (n=356) 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% Only those students currently residing on campus 0.6% Only those students residing in the same state as the 22.2% institution Only those students residing in-state and in states where 29.5% telehealth reciprocity has been approved All eligible students regardless of location 41.6% Other students (Please specify): 6.2% Of the 364 schools offering telecounseling/telepsychiatry services, about 42% are offering care to all eligible students regardless of location.