Campus Health Administrator Assessment

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Campus Health Administrator Assessment

OMB: 1800-0011

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Campus Health Administrator Assessment

The April 2014 report Not Alone, issued by the White House Task Force to Protect Students From Sexual Assault, calls for a concerted effort to effectively address sexual assault on campus, including strengthening mechanisms to support students whom are victims of sexual assault. To help achieve the goals of the report, the National Center on Safe Supportive Learning Environments will develop a resource to support college and university staff as they implement strategies to increase trauma-informed care for students who experienced sexual assault.

Responses to the following set of questions will help guide the development of a resource to ensure it meets the needs of campus personnel in positions that may serve sexual assault survivors, regardless of the size or type of institution in which they serve. Please take a few minutes to quickly respond to the following questions.

School Background

Which of the following best describe your institution? (Check all that apply.)

 4-year institution with undergraduate and graduate programs

 4-year institution with undergraduate programs only

 Residential campus

 Non-residential campus

 Community college

 Historically black college/university

 Tribal institution

 Hispanic-serving institution

 Other (please specify)

What is the total enrollment of your institution? (Include full-time and part-time students at both the undergraduate and graduate level.)

 Less than 2,500  2,500 – 4,999  5,000 – 9,999  10,000 – 19,999  Over 20,000

Student Health and Counseling Services

Are health care services provided on your campus to serve your students’ health needs?

 Yes  No

What level of health care service is available to your student body on your campus? (Check all that apply.)

 Full set of preventative, acute, emergency, pharmacy, and out-patient care services (e.g., by connection to a university’s medical school). Clinical services may be provided by MDs, Pas, NPs, RNs, residents, hospitalists, and specialists.

 Limited set of preventative, acute, emergency, pharmacy, and out-patient care services (e.g., by connection to a university’s medical school). Clinical services may be provided by MDs, Pas, NPs, RNs, residents, and hospitalists, and specialists.

 On-campus health clinic with a limited range of preventative and acute care services and occasional visiting specialists. Limited service pharmacies. Clinical services are provided by a limited number of MDs, NPs, and/or RNs.

 Campus health offices with basic health services including basic preventative and acute care with or without limited pharmacy dispensary. Clinical services are typically provided by NPs and/or RNs.

 Small campus health office with RN staff primarily used for triage and referral to the community and very limited health education.

Does your campus offer Counseling and Psychological Services (CAPS)?

Yes
No (Skip to Question #8)

(If no to Question #5, skip to Question #8.) Are these services provided by campus-employed staff or contracted vendors?

Employed staff
Contracted vendors

(If no to Question #5, skip to Question #8.) Are Counseling and Psychological Services (CAPS) physically located within your campus health services or another location on campus?

Located in campus health services
Elsewhere on campus , please specify __________________________
Elsewhere off campus , please specify __________________________

Services and Supports for Student Who Have Experienced Sexual Assault

Do you provide services to students who have experienced sexual assault?

Yes
No (Skip to Question #10)

(if no to Question #8, skip to Question #10.) What services do you provide to students who have experienced sexual assault?

_________________________________________________________________________________

Does your institution have a response plan/protocol which identifies the aspects in which your campus health center or services are to engage?

Yes
No (Skip to Question #11)

Please identify the aspects of your campus sexual assault response plan/protocol in which your campus health center staff are currently engaged?

_____________________________________________________________________________

Professional Development and Training for Staff Who Work with Students Who Have Experienced Sexual Assault

For each of the following staff positions, please indicate whether they receive trauma- informed care instruction/professional development/training and, if so, what type and the length for pres-service and/or continuing education training.

Specialists

Pre-service training

Type of Training: _____________________________________________________
Length of Training: ____________________________________________________