In dire straits, Health Center proposes increase to mandatory student fee
Since 2017, the Student Health Services programs at Santa Monica College (SMC) have struggled with budget deficits, understaffing and making ends meet. This spring, the college’s medical practitioners are attempting to make changes.
Staffers from the Student Health Center are proposing the college raise the mandatory Health Services fee from $26 to $27. More revenue, they argue, will balance the college’s budget for Student Health and Wellness, amid district budget cuts and forced reliance on reserve spending.
“The last thing I want to do is raise fees for students,” said Dr. Susan Fila, dean of Health and Wellbeing and a Licensed Clinical Social Worker (LCSW).
But the budget restoration, the staffers said, is the first step in uplifting the Health Center out of dire straits. Without it, the remaining financial reserves are slated to last a maximum of three more years.
To enroll in credit classes at SMC, students must pay a Health Services fee, enabling access to the Health Center and the Center for Wellness and Wellbeing.
The Health Center is equipped with three health assistants, two registered nurses and one nurse practitioner. Services unlocked with the student fee include first aid, nursing assessment and intervention, vital sign testing, vaccinations, nutritional support, over-the-counter medications and topicals, and referrals to hospitals, urgent care and low-cost clinics.
Per the state Education Code, the health fee is waived for students in “bona fide” religious sects that depend exclusively upon prayer for healing, and students that attend college through approved apprenticeship training. Otherwise, the fee is mandatory.
Currently, the health fee is $26 during Fall and Spring semesters, and $22 during Summer and Winter intersessions.
In spring 2025, the Chancellor’s Office of California Community Colleges (CCC) raised the maximum allowable student health fee from $26 to $27.
Section 76355 of California’s Education Code permits community college districts to charge fees for health, parking and transportation, and increase those fees by the same percentage increase as the Implicit Price Deflator for State and Local Government Purchases of Goods and Services published by the U.S. Department of Commerce. The CCC Chancellor’s Office calculates the percentage increase every January; per the code, the resulting increase is capped at $1 per calculation.
Fila and her colleagues are proposing that SMC raise the Fall and Spring semester health fee to $27 in accordance with the new maximum.
“In short, we are running a deficit right now, and so we do rely on a very limited amount of reserves that we have collected over many, many, many years to cover… that deficit. We’ve had a deficit since 2017,” said Fila.
Though Fila doesn’t believe the deficits have taken tolls on the services themselves, the money shortages have been made apparent in other ways.
“I don’t really impose it on staff in a way that makes them feel like they need to short-change services. But there’s an awareness,” she said. Though both centers are desperately understaffed, she said, “we can’t hire anybody else.”
Through partnerships with the Venice Family Clinic, Westside Family Health, and dermatologist Dr. Ava Shamban, the Health Center is able to provide some services at absolutely no charge, including sexual health services and Narcan distribution.
The Center for Wellness and Wellbeing provides short-term counseling and therapy for students, as well as referrals, but they experience their own deficits. The center has three part-time therapists, two covered by the health fee and one paid for with a mental health grant from the Chancellor’s Office.
The rest of the therapists are interns, taken from Masters of Social Work (MSW) graduate school programs through community partnerships. Their services, says Fila, “the health fees don’t even pay for.”
“We find ways to try to provide the level of services that we know you all should get, that you deserve, with a very limited budget,” said Fila.
“The worry about services, if nothing is done, if there is no $1 increase, and reserves are tapped, eventually you’ll see a decline in services,” said Thomas Bui, associate dean of Student Life.
If reserves run out, SMC Health will be forced to rely on the district alone for funding.
“Right now, any program leaning on the district is not a good thing, because the district doesn’t have the ability to hold a lot, right, because they’re struggling with their own budget,” said Fila.
In the 2013-14 school year, the revenue generated by the health fee surpassed the college’s estimation by $51,331. In the 2014-15 year, and every successive year until 2021, the fee’s revenue fell short of projections, with deficits ranging from $10,628 to $133,305.
With an optimistic surplus of $176,076 in the 2020-21 year, the college adopted a zealous budget of $1,423,347 for the health fee, and subsequently ran into the highest deficit yet of $164,106. Since then, with a tighter budget, the revenue has surplused, but both the budget and revenue have slimmed considerably over the same time frame.
Overall, in the 2023-24 school year, the Health Services budget showed a loss of $82,217, according to the Board of Trustees.
Along with increases in costs for salaries, benefits, services and supplies, these numbers have forced Student Health to repeatedly plunder from reserves.
“Reserves are there for a reason,” said Bui. “They’re there for rainy-day funds… Right now they’ve been touching their reserves, and the hope is to try to get away from doing that, so that when a disaster or emergency does happen, they have the funding to support you.”
To be implemented, SMC’s Board of Trustees must approve the increase. Fila and her colleagues plan to propose the increase at the Board meeting on April 1, where she “do(es)n’t anticipate it will be controversial.”
According to Fila, every time the fee maximum increases, the Board has approved and ratified the change. Potential backlash could arise during Public Comments, in which members of the public are given three minutes to speak on agenda items, or on general concerns.
“There’s always a possibility somebody goes and makes a Public Comment against it,” said Fila. “I haven’t had that happen yet, but we don’t want that to happen because we don’t want it to be controversial.
“We want everyone to be in support and understand fully the breadth of services that this fee goes toward,” she said.
The Health Center’s goal with the increase is maintenance. However they might dream, with projected enrollment trends, the dollar increase wouldn’t be enough to sustain additional hires. “The projection I did just puts us balancing the budget,” said Fila.
“We really just ask for the minimum amount so we don’t see a deficit for the year on our budget for student health and wellness,” said Fila, though in the case of an exceptional spur in enrollment, “anything is possible.”
The Student Health Center is located in the northeast corner of the Cayton Center by the cafeteria and open Monday through Thursday from 8 a.m. to 4:30 p.m. and on Friday from 8 a.m. to 2:30 p.m.
The Center for Wellness and Wellbeing is in room 75 of the Pearl Annex, formerly the Math Complex, and is open from Monday through Thursday from 9 a.m. to 12 p.m. and from 1 p.m. to 5 p.m. A 24/7 Emotional Support hotline can be called anytime at 800-691-6003.