School-Sponsored Health Insurance: Planning for a New Reality

Oh, no! You won't be getting a printed SCUP–45 Preliminary Program in the mail this year. Instead, SCUP is going green and regularly updating this digital version (PDF), which you can download at any time. It's updated every two weeks.

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SCUP Link

College-sponsored health plans are in the news, all of a sudden, and it's not all good news. Of course, we all know that with the passage of the health care reform legislation, things are going to change. This week, the New York attorney general's office released the results of an investigation into such health plans as they now exist - and it's not a flattering report, suggesting that some practices may be illegal. How timely, then, that the current issue of SCUP's journal, Planning for Higher Education, has an intriguing Viewpoint by Bryan A. Liang, that is right on topic. Liang, who is a triple threat - PhD, MD, JD - has titled his essay School-Sponsored Health Insurance: Planning for a New Reality. Here's also a link to a report on the New York investigation in The New York Times. From that article:

The insurers who run the plans, and profit from them, face the most potential legal liability. The attorney general’s investigation does not suggest that college administrators are lining their pockets with the kind of kickbacks that were common in the office’s investigation of student loans, but rather that they are making poor decisions in an area where they have little expertise.

Complicating the issue in some cases is the involvement of insurance brokers, who often try to negotiate with colleges to create plans that pay out as little as possible to students. Brokers also entice smaller colleges with incentives to help make plans more attractive. Brokers paid Pace more than $80,000 in such benefits, more than half of which went toward an athletic department golf classic.

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SCUP's Planning Institute: Enjoy the F2F company of your colleagues and peers while you engage in one of the three SCUP Planning Institute Steps. In addition to being offered on demand, on campuses to teams of campus leaders, the institute steps are also offered to all professionals at varying times and venues. Currently scheduled are:

• May 22–23, Ann Arbor, MI - Step I
• July 10, Minneapolis, MN - Step I (in conjunction with SCUP–45)
• October 2, Ann Arbor, MI - Step I
• January 21–22, Tuscon, AZ - Step II and Step III

Embedding Nature in the Built Environment

The designers among us will want to read this article. We wish we had time to follow the links in it.

In a recent Yale University podcast, Steve Kellert, professor at the university's School of Forestry and Environmental Studies and editor of the book The Biophilia Hypothesis, speaks of biophilia as an essential part of sustainable design. The general concept of sustainable or green design focuses on minimizing or avoiding the harmful effects on the natural environment. Kellert's argument is, “that [it] is necessary but not sufficient to achieve sustainability. That if you achieve that effect in a building—a hermetically sealed skyscraper where people are working in windowless environments—that won't be sustainable because basically those environments do not produce physical and mental wellbeing.” (http://www.healthcaredesign magazine.com/YalePodcast)

Because physical and mental wellbeing is top concern for a hospital, exploring the biologically based bond between humans and nature is especially important in these environments where medical technology and products seem to be an antithesis to nature.

Nurses Organize Around the Planning Table

After a conference in 2005, a bunch of nurses got together and decided to create some reosurces to enable better input from nurses into the design of health care facilities.So they created the Nursing Institute for Healthcare Design (NISD). We have to wonder if this kind of initiative might work for other professionals with an interest in ther design of the built environment?

First of all, nurse leaders are being invited to the table, and the chief nursing officer is now considered one of the executives of the hospital. So now, instead of a director of nursing, there are chief nursing officers who are considered higher-level executives making higher-level decisions. They get to the planning table and don't have the information and preparation they need because we didn't have anything about healthcare construction in nursing school.

Through the online resource they can be inspired by knowing that there are nurses out there who are knowledgeable and could be a resource on this subject. “NIHD Connect” is where we pull together basic healthcare design and construction information—articles, videos, books, and links—we find about such topics as patient room design, hospital unit design, noise in the work place, and safety features. A lot of those design features deal with patient safety and infection control. You know, my mother knows you should put the sink by the door, but is this being done everywhere? So by reading some of this basic information about healthcare design and construction, the nurse leader will be equipped so she or he at least knows what to advocate for at the planning table. Or, if something doesn't ring true, they know where to go and dig deeper into the topic.

Oberlin: Where does the nurse-designer collaboration process need improvement?

Hayes: I think architects still have a tendency to discount the nurses' views, and sometimes that is because the nurses may not be giving the best answers. For example, I might ask a nurse at one hospital and they might tell me one thing, and then I ask a nurse at another hospital and she tells me the complete opposite. So if the architects are not getting good answers from the nurses, they may decide not to pay attention to them and only include them as a courtesy. And the problem may be that the nurses are telling them different things because of the way they are using the space or because of a lack of knowledge that, yes, you do need to put the sinks by the door.

Cost/Benefit for Sustainable Design

A design time in 2008 has a lot more options than before to find sustainable design applications (and LEED credits) that don't cost a ton of money. Paying attention to site selection, for example, can gain credits early on and no additional cost. Another factor is to ensure that whenever you're going to have to conform to environmental regulations anyway—such as local runoff water regulations—be sure to get those related credits. In this 5-minute video from Healthcare Design magazine, James Moler covers some of this ground.

ACE's "Solutions for Our Health"

The American Council on Education (ACE) has created a new Web resource of note:

Colleges and universities have had a hand in nearly every major medical breakthrough, a record of innovation that has had real, positive implications for the health of our nation. As the baby boomer generation ages and Americans live longer than ever, our institutions of higher education are training the health professionals who will care for us, seeking cures for debilitating diseases and creating cutting-edge medical technology.

I encourage you to visit our newest Solutions for Our Future web site, Solutions for Our Health (www.solutionsforourhealth.org). There, you’ll be able to learn about the work being done at colleges and universities across the country to improve and advance health care.

Can't Manage What You Don't Measure?

The Global Health and Safety Initiative (GHSI) and others is working on a very complicated system to accurately measure all pertinent inputs and outputs to the ecological footprint of an entire healthcare system:

“There are many different models and calculators out there, but they tend to only look at pieces of what a full footprint would be, like energy or CO2 carbon emissions,” says GHSI Executive Director Bob Eisenman, PhD. “What we are ultimately interested in is tracking most of the ways that hospitals and healthcare impact the environment. So eventually we are trying to pull together energy, carbon, toxic gas emissions, waste stream issues, water, transportation, and more. But we haven’t seen a tool like that yet, particularly with toxic and hazardous materials, which healthcare uses often.”