Regent Policy Documents
SECTION 23: HEALTH
23-1 BASIC HEALTH MODULE
(Formerly 78-9)
Introduction
The University of Wisconsin System recognizes that the present and future
health of its students is among the most precious of its public resources. Students’ most
pressing health concerns influence academic achievement and affect civility,
citizenship, and connectedness. Attention to important health issues
permits the university to educate and prepare learners as whole human beings.
The American College Health Association’s Guidelines for a College Health Program states that:
Although institutions differ in size and scope of services, there are universal concepts that impact upon the provision of health promotion, health protection, disease prevention and clinical care to college students. Current sociological trends, high-risk identification, public health issues, health care finance reform and changes in preventive medicine have broad institutional implications. College health programs have a unique opportunity to help meet those new challenges. (ACHA, 1999)
To this end, in this document the Board of Regents delineates a basic module of the minimum level of health care services that must be available to students at each of the UW System four-year institutions. Essential to the acceptance of the basic module is the continuation of the principle that institutional self-determination with respect to levels of health care will continue. Determination of the level of services to be provided above this basic module will be the responsibility of the Chancellor of each institution. Recommendations for increases above the level established by the Chancellor will be made by appropriate institution governance groups for consideration by the Chancellor and the Regents.
The Board of Regents does not prescribe the manner in which the basic module of services will be provided or made available. The characteristics of each institution, the community where it is located, and characteristics of the student body will result in a variety of strategies for providing the services. Components of the basic module may be the primary responsibility of the institution’s health service. The responsibilities may be distributed across a variety of institution offices. Some services may be contracted out to community service providers. Coordination and collaboration among service providers – institution or community - is critical. It is expected that the basic module of services will be readily accessible (physically and financially) and will meet accepted standards for quality.
The institution service providers must have the appropriate resources including space and personnel. The staff are expected to model ethical and professional standards, and have the appropriate professional and educational credentials and skills as determined by the institution. They should have access to and utilize outside resources or consultation to augment programming. Ongoing participation in continuing education programs should be an expectation.
Services to be provided/available
Clinical (medical and nursing) Services
Clinical Services should include easily accessible medical care for evaluation
and treatment of health related concerns, injuries, and illnesses. These
services should include diagnosis, treatment, and follow up care for acute
illness, chronic illness, and injury.
Prevention of illness to include individual health counseling and instruction
in self-care should be an essential component of the clinical visit. Physical
examinations for well women’s and well men’s care, sexually transmittable
infection screening, immunizations, and travel health consultation should
be available.
Students should be informed participants in all of their health care decisions. Educating students regarding health care utilization and discussion of insurance issues should be incorporated into clinical care visits as appropriate.
After hours care, emergency services, and hospitalization should be accessible to students as needed. Mechanisms for providing pharmaceutical, laboratory, imaging, surgical, physical therapy, dentistry, and overnight care services should be determined by each individual institution. At a minimum, these services should be available by referral mechanisms.
Mental Health and Counseling Services
Mental health is a critical factor in student success. Ongoing psychological
or emotional distress can significantly disrupt student academic progress. Each
institution should provide counseling services sufficient to address the
developmental needs of students as well as respond to unexpected crises. Services
should reflect a brief psychotherapy model and be provided by trained mental
health professionals, e.g., psychologists, social workers, counselors.
Services should include an educational component geared to helping students develop effective self-care and adaptive skills. Psychiatric evaluation and medication management should be available and accessible. Communication between the institution’s health and counseling services is essential to assure coordination and continuity of care for student patients/clients. Counseling services should develop and maintain referral sources for students with psychological disabilities that require long-term care.
Public Health
The institutions of the UW System exist both as discrete communities and
as components of the larger community where they are located. Protecting
the health of members of the institution’s community requires a robust
institutional public health surveillance infrastructure that will address
1) communicable disease surveillance/prevention through disease identification
and reporting, epidemiologic investigations, screening programs, immunization
programs, and plans/procedures for quickly responding to disease outbreak
situations; and 2) issues of environmental health and safety including
food safety, air quality, waste disposal, pest control, and water quality
including swimming pool inspections.
Each institution’s health service should play a role in addressing the core functions of public health, including assessing the health related needs of the campus, supporting policies that promote and protect the health of the campus community, and collaborating with other institution departments to assure that needs are addressed.
The institution, usually through its health service, should have strong collaborative relationships and agreements (delineating roles and responsibilities) with local (city and/or county) public health agencies. Institution health services should provide the critical link to these agencies. Each institution’s health and counseling services should be active participants in the institution’s crisis response planning.
Health Education, Health Promotion, and Prevention Services
A primary role of the institution’s health service is to provide health
education that informs students of the effects of current behavior on future
health status. There should be an emphasis on how current behavior
affects their learning environment, their performance at the university,
and their ultimate quality of life. Providing a healthy environment
that supports wellness behaviors, promotes healthy lifestyle choices, and
provides health education is consistent with the mission and goals of higher
education.
Health education is both a process and a program. Health service professionals should use every student contact as an opportunity to address key health indicators from a variety of contexts. Institution health services have the opportunity to promote positive attitudes, healthy lifestyles, and responsible self-care. Students should be encouraged to become active participants in promoting and protecting their health and wellbeing.
A systematic assessment of the target population’s needs should provide direction and highlight the most significant areas needing attention and prevention efforts. Including students as active participants in the process of identifying needs enhances the possibility of success. The American College Health Association document, Healthy Campus 2010 (modeled after the nationally recognized document, Healthy People 2010 and updated every ten years), identifies a number of high priority issues for campus settings. Health education/health promotion/prevention activities should address these significant issues:
Alcohol and other drugs
Sexual health
Social and emotional health
Coping with stress in competitive education environments
Intentional and unintentional injury
Nutrition
Psychological relationships to food
Health services costs and availability of insurance
Links between campus health services and other academic and service departments
Programming and services should use a variety of screening foci, sites, and methods, e.g. one-on-one encounters, informal group or formal classroom sessions, co/sponsored theme health events, or programming by trained Peer Health Educators who share their skills with fellow students. Methods should be developed for evaluating the quality and effectiveness of programming and services.
Access to affordable and sufficiently comprehensive health insurance
Access to the full range of health care services that students might require
during their academic experience requires adequate health insurance coverage. Institutions
must provide access to a university sponsored health insurance plan that
is reasonably priced. The plan must compliment the health services
provided by the institution. When feasible, collaboration among institutions
to develop a common plan is encouraged. Each institution’s
health service should take a leadership role in selecting the plan and
communicating its importance to students and their families. Institution
health services should encourage all students to have comprehensive, affordable
health insurance.
Quality Management and Improvement
The University of Wisconsin System is committed to the principles of quality
management and improvement and expects institutions to apply these principles
in providing health services to students. Each institution health
service providing services to students should use the American College
Health Association Guidelines for a College Health Program as the model
for designing and organizing services.
Additionally, institution health services are encouraged to seek formal accreditation
by a national health care accrediting organization such as the Accreditation
Association for Ambulatory Health Care (AAAHC). Absent formal accreditation,
institution health services should seek periodic external review of their
programs and services.
Institution health services are expected to have or participate in a quality management program that includes a process for credentialing and privileging of providers and other professional staff, a system of peer review for providers, ongoing systems for assessing/evaluating utilization and patient/client satisfaction, and a quality improvement program addressing clinical care issues, administrative concerns, and cost of care issues.
Funding Options and Strategies
Existing University of Wisconsin System and Board of Regents policies delineate
the acceptability of several options for funding the provision of health
services to students. Student segregated fees are the preferred primary
funding source for student health services and health education/wellness
programs (Student Services Funding – G15). General program
revenue funding (GPR) and fee-for-services funding are deemed acceptable. General
program revenue is the preferred primary funding source for counseling
services including personal individual, group, crisis intervention, and
AODA counseling; outreach and prevention; and consultation with faculty
and staff regarding student problems (Student Services Funding –
G15). Most campuses will use a combination of these three funding sources.
Students should play an important role in determining the balance between
segregated fee and fee for service funding. There should be a goal
of keeping student out of pocket costs at a minimum. It is important
to limit out of pocket expenses so that cost will not be a barrier to students
receiving necessary health care services.
Financial and Administrative Policy, Segregated Fee Expenditures – F20, specifically describes appropriate categories of segregated fee expenditures for the operations and activities of institution health services. These include salaries for staff including student staff, professional services, facilities/equipment/supplies/services, organizational membership fees, and debt service reduction. Regent Policy Document 19-8, Funding of University Facilities Capital Costs, specifically prohibits the use of segregated fees as a source of funding for the construction of student health service facilities. GPR funding is the prescribed funding source for construction of student health service facilities. Gift funds are an allowable/acceptable source.
References
American College Health Association, Standards Revision Work Group. Guidelines
for a College Health Program. Baltimore: American College Health Association,
1999.
American College Health Association. Healthy Campus 2010 Manual. Baltimore, MD: September 2002.
U.S. Department of Health and Human Services. Healthy People 2010. 2nd Edition. Washington, DC: US Government Printing Office, November 2000.
History: Res. 1797 adopted 12/8/78; with 1984 amendments; amended by Res. 9012, 5/05. (See also FPPP 37)
The Regent Policy Documents were adopted and are maintained pursuant to the policy-making authority vested in the Board of Regents by Wis. Stats. § 36. The Regent Policy Documents manifest significant policies approved by the University of Wisconsin System Board of Regents. This document is a ready reference for those charged with carrying out these policies. Unless noted otherwise, associated documents and reports may be obtained from the Office of the Secretary of the Board of Regents, 1860 Van Hise Hall, 1220 Linden Drive, Madison, WI 53706, ph 608-262-2324. http://www.uwsa.edu/bor/policies/