As millions of students plan to return to college campuses amid a pandemic, the ability of university health services to safely care for students will be tested as never before.

To assess the landscape of student health services at roughly 1,700 four-year residential campuses, The Washington Post interviewed more than 200 students, parents and health officials and examined thousands of pages of medical records and court documents and 5,500 reviews of student health centers posted on Google.

Here are The Post’s biggest takeaways:

1. Many college health services appear unprepared to handle a pandemic.

College students reported they commonly waited days or weeks for appointments and were routinely provided lackluster care at campus clinics. Dozens of students ended up hospitalized — and some near death — for mistakes they said were made at student health centers.

While university leaders are lobbying for federal protections from coronavirus-related lawsuits when they reopen, college health officials are privately discussing insufficient stockpiles of personal protective equipment, inadequate access to coronavirus testing on campus and a short supply of rooms to quarantine students, according to interviews, emails and presentations reviewed by The Post.

2. Student health centers are like the Wild West of medical care.

There are no national regulations for student health centers, and most are not licensed by states. Only about 220 campus medical clinics out of the thousands nationwide are accredited by outside health organizations as meeting best practices. Georgetown University stated on its website that its student health center was accredited but removed the claim after being asked about it by reporters.

3. Risks increase for HBCUs.

College and health officials worry about the consequences of reopening historically black colleges and universities without adequate access to testing, contact tracing and general medical care. While covid-19 disproportionately hits black communities, many of these institutions have less funding and smaller endowments compared with other schools to invest in critical health-care infrastructure: About 12 percent of HBCUs that offer bachelor’s degrees have no campus clinics, according to a Post review of the roughly 80 institutions. And of those that provide health services, about 70 percent do not have a full-time physician on staff.

4. Some students can’t afford care at on-campus health centers.

Many students, including low-income individuals on Medicaid, said they avoided seeking treatment altogether because the care was too costly at campus clinics. Some had trouble affording care on campus because they were uninsured or their plans weren’t accepted at the clinics.

5. The pandemic has set off a financial crisis for student health care.

Budget cuts and efforts to limit student fees have strained resources available for campus medical clinics. Almost three-quarters of 200 schools surveyed close student health centers on the weekend, and two-thirds provide no evening hours at the clinics during the week.

It’s getting even worse with the pandemic. Some institutions have furloughed medical staffers. Oregon State University closed its pharmacy in June, and the University of North Dakota is cutting a physician assistant along with shuttering its pharmacy at the student health center.

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