Article 7: Student Wellness Table of Contents

Article 7.1  Student Health Insurance

Article 7.2  Personal Responsibility

Article 7.3  Infection Control

Article 7.4  Institutional Policy on AIDS

Article 7.5  Standard Precautions

Article 7.6  Student Health - Health Requirements and Services

Article 7.7  Training

Article 7.8  Student and House Staff Mental Health Service

Article 7.9  Substance and Alcohol Abuse Policy

Article 7.1  Student Health Insurance – Baylor College of Medicine believes student wellness is essential to academic progress and requires that all individuals enrolled in any Baylor academic program maintain medical coverage through the program or are enrolled in alternative coverage that meets the coverage requirements established by the College. The program ensures students have access to health and dental insurance to cover the costs of routine care and/or unexpected illness or injury.

Information regarding the student health insurance program, including enrollment requirements, eligible dependents, costs of coverage, benefits, and coverage during leave of absence is available at https://www.bcm.edu/education/schools/medical-school/md-program/student-handbook/health-wellness/student-insurance.

Article 7.2  Personal Responsibility – Learning and practicing medicine has always involved exposure to infectious agents. Personal risks can be minimized by intelligent attention to immunizations, standard precautions and other preventable measures. Each student must take personal responsibility for being aware of his/her status and taking proper precautions.

The College subscribes to the American Association of Medical Colleges’ statement of responsibility in treating patients with HIV: students, residents, and faculty have a fundamental responsibility to provide care to all patients assigned to them regardless of diagnosis. Failure to accept responsibility violates a basic tenant of the medical profession to place the patient’s interest and welfare first.

Article 7.3  Infection Control – Students exposed to or with infectious or communicable illnesses including chicken pox, diarrheal illness, measles, tuberculosis, group A strep infection or draining lesions on the hands must see their primary care physician or consult a physician in the Family Medicine department. In addition, students with such circumstances should consult with the infection control office in the institution where the infection occurred or where the student is doing a clerkship about the advisability of working with patients to be sure that he or she is following the local regulations. When caring for patients with TB, students should adhere to local regulations. Precautions may include wearing appropriate masks, or custom fitted masks.

Article 7.4  Institutional Policy on AIDS – The risk to health care workers of acquiring Human Immunodeficiency Virus (HIV) infection in the routine performance of duties is quite low. Students, house officers, faculty, and staff will be expected to care for patients so infected as they would any patient suffering from other potentially communicable diseases in accordance with the recommendations of the Center for Disease Control (CDC) and existing hospital policies.

Students, house officers, faculty, staff with HIV infection will be handled as any other medical problem in that restrictions on activities will be based on the advice of that individual's physician and guidelines set forth by the CDC.

The College does not have routine, mandatory testing of HIV for students. However, the State of Texas requires health care workers who know they are infected with HIV or hepatitis B to seek a fitness for duty evaluation from the institution. Students who are known to be infected with HIV, hepatitis B or hepatitis C must seek an evaluation with the Occupational Health Program to determine whether restrictions on activities are necessary. Restrictions on activities, if any, will be based on the advice of that individual's physician, standards of medical practice and guidelines set forth by the CDC.

Article 7.5  Standard Precautions – Baylor College of Medicine students (“Students”) are expected to provide the appropriate level of care to all patients while following standard precautions to prevent the spread of infectious diseases due to exposure to human blood or bodily fluid. Information regarding standard precautions, needle stick injuries, and exposure to blood or bodily fluids is available at https://www.bcm.edu/education/schools/medical-school/md-program/student-handbook/health-wellness.

Article 7.6  Student Health - Health Requirements and Services. Before registration, all students must complete the Student Health Assessment, and show proof of immunizations/serologic confirmation required by the Texas Education Code and BCM:

Tetanus/Diphtheria, Measles (rubella), Hepatitis B, Meningitis, Tuberculosis*(PPD/Mantoux), Rubella, Mumps, Polio, Varicella (Chicken Pox)

*If positive, a chest x-ray is required.

Health care services are offered by primary care providers chosen by the student at the time of registration. The Occupational Health Program Office consults with students in regard to safety and health related issues pertinent to all health care professionals and conducts TB testing annually. All student health records are maintained in accordance to guidelines specified by the Health Insurance Portability and Accountability Act (HIPAA) of 1996.

The program director, medical director and principal faculty of the PA Program are not allowed to serve as healthcare providers for any student enrolled in the PA Program but may provide health care to students of other programs seen in the provider network setting in which the principal faculty member practices.

Article 7.7  Training - The Office of Environmental Safety requires that all students view the annually updated OSHA Bloodborne Pathogens (BBP) Training Film and be trained to prevent transmission of tuberculosis. Students may consult with a dean in the Office of Student Affairs in regard to all available health care service options in the Texas Medical Center.

The Office of Corporate Compliance Programs requires that all BCM students, visiting students and Observers complete the on-line training in regard to HIPAA.

Article 7.8  Student and House Staff Mental Health Service.

Wellness Intervention Team.  The Baylor College of Medicine (BCM) Wellness Intervention Team (WIT) effectuates a coordinated institutional response to a health or wellness crisis causing student distress, when the student is referred by the Dean or Designee such as a Dean of Students or Program Director. WIT does not provide emergency services or immediate, direct intervention with students purported to be in distress, but primarily coordinates an acute care assessment of the health and safety of students and links them with necessary resources to promote mental, emotional, psychological, or physical wellness and well-being. The School Dean or Designee will activate the WIT to initiate one of these primary functions, as appropriate:  Acute Care & Crisis Management, Access to Academic & Non-Academic Support Resources, or Processing of Long-Term Leave of Absence (LOA) Requests & Returns from LOA.  Students referred to WIT may register  dissent or concern regarding the WIT process by filing a Grievance, as described in the Student Appeals and Grievances Policy (23.1.08). For further details about the WIT purpose and process, contact your School Dean or studentserivces@bcm.edu.

The Student and House Staff Mental Health Service. Directed by the Department of Psychiatry & Behavioral Sciences, provides confidential, free counseling for students, spouses, significant others, or couples. Students and spouses interested in obtaining counseling may call (713) 798-4881. An appointment will be made to see a BCM faculty psychiatrist, or other professional, usually within two or three days. The telephone line has a 24-hour answering service. Through the service, consultation, counseling (including marital counseling), crisis intervention or psychotherapy up to 12 sessions are provided free of charge.

Information given to the counselor will be treated as confidential. It will not be available to the administration, faculty, or any committee of the College. Limited information may be given with the permission of or at the request of the student. No claim will be made against medical insurance.

The counselor will not participate in any academic decision concerning students. If a psychiatric evaluation is requested by the school administration to aid in decisions concerning admission, leave of absence, disciplinary issues, etc., such matters will be referred to psychiatrists who do not serve as counselors.

In the event of a psychiatric emergency or when a faculty psychiatrist cannot be reached immediately, a student may go directly to Houston Methodist Hospital or Ben Taub Hospital emergency rooms.

For extended treatment of psychiatric problems requiring hospitalization, a student may be referred to other specialists in the Department of Psychiatry and Behavioral Sciences or to one in the community. For psychiatric treatment in these instances, there will be fees which will come under the provisions of the student's health insurance policy and the student's own resources. One option among these is the BCM Psychiatry Clinic, where a student or spouse can be seen for ongoing psychotherapy by a Psychiatry resident at the clinic's minimum fee. In addition, if a student needs ongoing psychotherapy in order to remain enrolled and cannot afford to pay for it, BCM will pay for the treatment-which will be provided by a voluntary faculty psychiatrist as often as once a week for up to one year. This will be available only to a few students at a time and will be determined on the basis of financial need.

Students also have access to WellConnect, a service that provides a 24/7 hotline for crisis counseling: (www.wellconnectbysrs.com)

Article 7.9  Substance and Alcohol Abuse Policy

Purpose. The federal Drug-Free Workplace Act is the foundation for the BCM Substance and Alcohol Abuse Policy (Number 02.5.34). Particular areas of emphasis in this Act are:

Publishing a policy statement notifying BCM Persons of prohibitions against the use, possession, distribution, dispensing, or manufacture of any Prohibited Substance in the workplace and on BCM premises and against the excessive consumption of alcohol in the circumstances described in this policy. Establishing an ongoing drug-free awareness program that periodically informs BCM Persons of the dangers of drug abuse and explains our drug-free workplace policy, possible penalties for policy violations, and of the available drug counseling, rehabilitation and assistance programs. Establishing a mechanism for reporting suspected violations of this policy.

Creating a healthy and safe work environment is a top priority of BCM. This substance and alcohol abuse policy has been established to help keep BCM Persons healthy, productive, and free from injury. Compliance with this policy is a condition to continued employment, enrollment, or association, as applicable, of all BCM Persons.

The term “BCM premises” includes any and all property owned or leased by BCM, hospitals, clinics, and any other practice site affiliated with BCM, and any vehicle engaged in BCM operations.

The term “prohibited substance” includes illegal drugs, controlled substances being misused, and prescription and over-the-counter drugs with abuse potential when taken in amounts not in accordance with the prescribed or recommended dosage.

Prohibited Substance. All BCM Persons are strictly prohibited from engaging in the use, possession, distribution, dispensing, manufacture, or sale of any Prohibited Substance while BCM premises, while BCM business, or while representing BCM in any educational, research, clinical, or community service activity. Any BCM Person who comes to work or class, as applicable, under the influence of any Prohibited Substance will be subject to discipline, up to and including dismissal and referral to law enforcement agencies.

In situations in which a supervisor of a BCM Person at work or in class has a reasonable suspicion that such BCM Person may be using a Prohibited Substance, BCM may require the person to submit to testing. A reasonable suspicion of use does not necessarily imply a reasonable suspicion of impairment. A supervisor is either defined by an approved job description or identified by title as a Chair or Section Chief or similar title.

Circumstances that may create reasonable suspicion of use include, but are not limited to, physical symptoms of impairment; observable phenomena, such as direct observation of drug use or possession; a pattern of abnormal or erratic behavior; arrest or conviction for a drug-related offense, or identification of an employee as the focus of a criminal investigation into illegal drug possession, use or trafficking; or reports from reliable and credible sources.

Alcohol. BCM persons found to have consumed alcohol in excess of the applicable legal limit while on BCM premises, while on BCM business, or while representing BCM in an educational, research, clinical, or community service activity, also may be subject to testing and/or discipline under the terms of this policy. Any BCM person who comes to work or class, as applicable, under the influence of alcohol or in excess of the applicable legal limit will be subject to discipline, up to and including dismissal.

If authorized in advance by the Office of Public Affairs, alcohol may be consumed on BCM premises.

Additional Guidelines. Vendors who appear at BCM under the influence of any Prohibited Substance or under the influence of alcohol will be removed from the premises and possibly prohibited from doing future business with the College.

BCM persons convicted of a criminal drug offense that occurred on BCM premises (or while the Person was engaged in BCM business) must notify BCM in writing of the conviction within five (5) days thereof and satisfactorily complete an approved rehabilitation program.

BCM will establish such procedures as it deems necessary to effectively enforce its substance and alcohol abuse policy. Refusing to cooperate with these procedures may be cause for disciplinary action, up to and including dismissal.

BCM will make every effort to keep the results of drug and alcohol tests confidential. The BCM Person’s supervisor will be notified of the test results, and other management personnel may be notified of the test results. BCM Persons should be aware that test results may be used in administrative hearings and court cases. Results also may be sent to state and/or federal agencies as required by applicable law.

BCM persons who perform activities in BCM affiliated institutions are also subject to the substance and alcohol abuse policies of each such affiliated institution.