Policies

Any student, faculty member, or member of the Lawrenceville community known to have a blood transmittable illness such as HIV/AIDS and Hepatitis must inform the Headmaster and the Medical Director. These individuals will remain a part of the Lawrenceville community for as long as it is safe for him/her to do so. Only those people with an absolute “need to know” will have knowledge of any particular situation. Any information communicated about such individuals will be maintained with strict confidence, subject only to legally mandated disclosure requirements.

The purpose of this policy is to protect the confidentiality of patient medical information within The Lawrenceville School’s Health and Wellness Center. Generally speaking, medical professionals have a professional and legal obligation to maintain the confidentiality of patient information and may not disclose such information without appropriate consent.

Handling of Medical Information:

In most cases, information within the Health and Wellness Center will fall into one of the four categories below, which will control how the information is handled.

Confidential Medical Information

This category includes all personally identifiable medical information (except that which is restricted confidential medical information), including but not limited to medical histories, medical charts, treatment, visit, appointment, rehabilitation, and diagnosis data, patient account records, medication records and any such information contained in computer form. Within the Health and Wellness Center, access is limited to medical professionals who are directly involved in the care and/or treatment of the patient.

Confidential medical information shall not be released outside the Health and Wellness Center unless a fully executed Release Authorization is received, and only then in accordance with the terms of the Release. See Section II, Medical Release Authorization. The Medical Director may authorize release of confidential medical information without a release in certain extraordinary situations.

Confidential medical information should only be discussed in private areas, in a low voice, and speakers should avoid proximity to unauthorized listeners.

Confidential medical information may not be transmitted by email or other electronic means either internally or externally except by the Medical Director pursuant to appropriate consents.

If confidential medical information is distributed by mail pursuant to a Release Authorization, it shall be prominently labeled confidential and sent by a trackable delivery service.

If confidential medical information is sent by facsimile, a coversheet prominently labeled confidential must be attached, advance telephone notice must be provided to the recipient, and the sender must confirm receipt by the intended recipient.

Restricted Confidential Medical Information

This category includes pregnancy-related treatment, treatment for sexually transmitted diseases, treatment for sexual assault, drug or alcohol treatment, AIDS or HIV infection treatment, and any other highly sensitive treatment.

Access to restricted confidential medical information must be limited to as few medical professionals as possible who are directly involved in the care and/or treatment of the patent and only on a need-to-know basis. This information is extremely sensitive and should be closely controlled.

Restricted confidential medical information should only be discussed in private areas, in a low voice, and speakers should avoid proximity to unauthorized listeners.

Restricted confidential medical information may not be transmitted by email or other electronic means either internally or externally except by the Medical Director in emergency situations.

If restricted confidential medical information is distributed by mail pursuant to a Release Authorization, it shall be prominently labeled confidential and sent by a trackable delivery service.

Restricted confidential medical information may not be sent by facsimile except by the Medical Director in emergency situations. In those cases, a coversheet prominently labeled confidential must be attached, advance telephone notice must be provided to the recipient, and the sender must confirm receipt by the intended recipient.

School Community Information

This category includes information that is generally available to the school community—for example, newsletters, bulletins, notices and blank forms. There is no restriction on distribution of this type of information within the school community as appropriate.

Internal Non-Medical Information

This category includes non-medical correspondence, memoranda, internal policies and procedures, and demographic information. This information should only be disclosed internally to those who have a legitimate business reason to know.

All students must have health insurance while in attendance at The Lawrenceville School. A copy of a current medical insurance card and prescription card must be kept on file in the Health and Wellness Center. Changes in medical insurance information must be updated immediately by contacting the Health and Wellness Center (609-896-0391) or notification in writing or fax (609-895-2056).

International students and national students who have state (Medicaid) health insurance coverage or non-US based health insurance policies must obtain the comprehensive student health insurance policy offered by The Lawrenceville School. Student Health Insurance Policy information and application is available from the comptroller’s office (609-895-2027).

Students who have limited US based managed care health insurance requiring primary doctor referrals may experience delays in receiving needed diagnostic procedures and are encouraged to consider the additional coverage provided by the supplemental student health insurance policy. Supplemental student health policy information and application is available from the comptroller’s office (609-895-2027).

Under the New Jersey State Department of Health statutes and The Lawrenceville School’s requirements, all students are required to have a completed record of immunizations against certain vaccine preventable diseases as a condition of enrollment. Immunizations are mandatory and must be up-to-date according to the recently published “2009 Immunization Guidelines.” If documentation is not available, re-immunization or blood titer immunity determination will be required. Students may not enroll, attend classes or participate in school programs unless immunizations are complete.

Some of The Lawrenceville School programs offer voluntary travel experiences to students during school vacations. Many of the opportunities may require additional travel immunizations following CDC travel immunization guidelines. Students participating in any of these programs and School sponsored travel opportunities will be required to have the necessary travel immunizations as recommended by The Lawrenceville School’s Medical Director.

The treatment for certain medical and psychological conditions and behaviors are best handled outside the boarding School setting. Severe depression, eating disorders, suicide attempts, and substance abuse are examples of such conditions and generally require more treatment, support, supervision, and guidance than the boarding School can provide. In some situations, these conditions and behaviors may also create undue disruption in the classroom and the residential life of the School. Should such a situation arise, the School reserves the right to require a medical leave of absence or a medical separation. A voluntary or mandated medical leave of absence may be authorized by the Medical Director, the Dean of Students, and the Form Director in consultation with the student’s Housemaster or Day Advisor to address physical or emotional illnesses that in their judgment cannot be adequately treated in the School setting. These same officials will determine whether and under what conditions that student should return to the School.

There are generally three forms of medical leaves:

Short-Term
An approved absence from the School for health reasons lasting no more than two weeks. Once a medical leave decision is made as outlined above, the office of the Dean of Students will notify the student’s teachers. It is expected that Section Masters and the student will communicate during the period of the medical leave to assure adequate maintenance of course work. The responsibility of keeping up with the course work lies with the student.

Long-Term
An approved absence from the School for health reasons lasting longer than two weeks but no more than one academic year. Often this may require the rest of the current term plus one additional term for stabilization of the student’s condition. The Form Director will consult with Section Masters and department heads to determine the academic consequences of such a leave and will communicate this information to the student and parents.

Medical Separation
A voluntary or mandated absence from the School for health reasons requiring more than an academic year. This leave is reserved for the student who has demonstrated efforts to adjust but for health reasons cannot meet the requirements of the School community, academically or socially. While it involves the loss of the student’s space in the School, it is distinguished from a withdrawal or dismissal in that it leaves open the possibility of application for readmission to the School.

Return from Medical Leave or Separation
Prior to a student's return to School, the Medical Director, the Dean of Students, and the Form Director will determine the exact timing of that return in consultation with the student’s Housemaster or Day Advisor. The student and his/her parents must provide the Medical Director with information and access to the treating professionals, as well as reports of social and academic function in the alternate School. The decision regarding return will be communicated to the student and his/her parents by the Dean of Students, Form Director, and Registrar will determine an appropriate academic program.

Students taking a medical leave or absence from the School for a number of days for whatever reason should contact the Form Director to make arrangements regarding a temporary program of studies.

Yearly updated medical registration forms, including signed permission to treat, are required before students are allowed to register, attend classes, or participate in athletic events. These records are kept confidential in the Health and Wellness Center and are prohibited from release unless specific written permission is given. Parents should inform the Health and Wellness Center promptly of any new or changed medical treatment at home during the academic year, particularly if such treatment includes prescribed medications.

Required Medical Forms.

The Lawrenceville School’s Medication Policy requires that the Health and Wellness Center be notified of all prescription and non-prescription medications for both boarding and day students. Arrangements must be made with the school’s physician for the administration of all medications to boarding students. Prescription or non-prescription medications, including antibiotics and nutritional supplements may not be mailed directly to students, but must be mailed or delivered directly to the Health and Wellness Center. Medications given to students during school vacation breaks must be delivered to the Health and Wellness Center within 48 hours of arrival back on campus. Failure to comply with these steps can be grounds for a students required withdrawal. The Health and Wellness Center must be informed of the name, dose, amount, and prescribing physician of any medication used by a student so that interactions with other medications may be avoided and side effects recognized. All psychotropic medications such as Ritalin, Adderall, Antidepressants, etc. must be kept under lock in the Health and Wellness Center and will be dispensed to a student as determined by the school’s physician. A complete list of all medications and supplements to be taken must be provided including the name, dose and time of day to be taken.

Psychotropic Medical Policy

Psychotropic medications are being used with greater frequency in the adolescent population. Such medications include, but are not limited to, drugs used for treating attention deficit disorder (ADD/ADHD), depression, anxiety disorders, eating disorders, and seizure disorders. School policy, and in many cases federal and state regulations, mandate that the Al Rashid Health and Wellness Center be notified in writing by the prescribing physician of the medical diagnosis, medication, dose, and dose schedule before a student may take such medications while at School. All psychotropic medications must be kept at the Health and Wellness Center. Following review by the Medical Director, an appropriate dispensing schedule will be arranged. Students in possession of such medications and who are not in compliance with School policy may face disciplinary action. The sharing or selling of such medications by students with other students is dangerous and illegal and will be treated as such. Students who abuse these medications will also face disciplinary action.

In a serious non-life-threatening injury (see definition below), the medical and nursing staff will evaluate and consult with the school physician before initiating further action. If the school physician cannot be reached, the patient’s injury should be stabilized and then transported to the nearest hospital by ambulance or emergency transport.

A serious non-life-threatening injury is an injury such as a possible fracture, dislocation, spine or neck injury, conscious head injury, serious orthopedic injury or medical illness.

Referral and transportation to local off-campus specialist are provided upon request and as clinically needed for evaluation and treatment. Diagnostic studies may also be scheduled and arranged with a doctor’s prescription.

1. The right to inspect and copy their child’s protected health information and any other information contained in the medical record file.
2. May not inspect or copy psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal or administrative action or proceeding; and protected health information that is subject to law that prohibits access to protected health information.
3. In some circumstances, you may have a right to review a decision that denies you access to information.
4. The right to request a restriction on the use or disclosure of their child’s protected health information for the purposes of treatment, payment, or healthcare operations.
5. The right to request in writing that any part of their child’s protected health information is not to be disclosed to family members or friends who may be involved in their child’s care.
6. If the Al Rashid Health and Wellness Center’s medical/counseling staff is not required to agree to a restriction if it believes it is in the child’s best interest to permit use and disclosure of the child’s protected health information, the child’s protected health information will not be restricted.
7. If the medical/counseling staff does agree to a requested restriction, they may not use or disclose the child’s protected health information unless it is needed to provide emergency treatment for the child.
8. The right to request to receive confidential communications of their child’s protected health information from the Al Rashid Health and Wellness Center by alternative means or at an alternative location.
9. The right to amend their child’s protected health information. In certain cases, the medical/counseling staff may deny the request for amendment.

Severe Acute Respiratory Syndrome, also known as SARS, is a respiratory illness that is spread by close contact via droplet transmission, most likely through coughing or sneezing. The incubation period for SARS is typically 2-10 days. The illness begins generally with fever sometimes accompanied by headache, malaise, aching muscles and mild cough or nasal congestion. After 3-7 days, a lower respiratory phase begins with a more significant cough, usually dry and nonproductive. This sometimes progresses to difficulty breathing, requiring the support of a mechanical ventilator.

The Centers for Disease Control defines a suspected case of SARS as:

• Symptoms of a respiratory illness (e.g. cough, shortness of breath and difficulty breathing)
• Fever (temperature greater than 100.4°F or 38°C)
• Either travel within 10 days of onset of symptoms to an area with suspected, current or recently documented community transmission of SARS* or close contact** within 10 days of onset of symptoms with a person known to be a suspected SARS case.

*Areas with suspected or current or recently documented community transmission of SARS are Hong Kong, Mainland China, Toronto and Taiwan. Please see the CDC website for the case definition of SARS at www.cdc.gov/ncidod/sars/casedefinition.htm
**Close contact is defined as having cared for, having lived with, or having direct contact with respiratory secretions and/or body fluids of a patient known to be suspect SARS case.

Instructions for Students of The Lawrenceville School from SARS Areas

1. Students of The Lawrenceville School who are coming from or have traveled in a designated SARS area over the summer should leave that area 10 days before arriving at the School.
2. Students who have been in a designated SARS area and who experience respiratory symptoms (e.g. cough, difficulty breathing, or nasal congestion) or fever (temperature greater than 100.4°F or 38°C) should postpone their arrival on campus until at least 10 days after resolution of their symptoms.
3. Students who have postponed their arrival for reasons one or two outlined above should call the Health and Wellness Center for clearance before coming to campus and will require a physical evaluated in the Health and Wellness Center before moving into student housing.

Instructions for Faculty, Staff, and Families of The Lawrenceville School from SARS Areas

1. Faculty, Staff and Families of The Lawrenceville School are temporarily discouraged from elected travel to endemic SARS areas (Mainland China, Hong Kong, Toronto and Taiwan). HYPERLINK "http://www.cdc.gov/ncidod/sars/travel.htm" http://www.cdc.gov/ncidod/sars/travel.htm
2. Faculty, Staff and Families who elect to travel on their own to these areas should receive medical clearance and advice from the Medical Director before reentering the School community and are encouraged to leave the affected area 10 days before returning to campus or observe a self-quarantine for 10 days after returning directly to campus.
3. Faculty, Staff and Families who have been in a designated SARS area and who experience respiratory symptoms (e.g. cough, difficulty breathing, or nasal congestion) or fever (temperature greater than 100.4°F or 38°C) should notify the Medical Director and postpone their return to campus until at least 10 days after resolution of their symptoms.
4. Faculty, Staff and Families who are expecting visitors to the campus from the affected areas should contact (or have the guests contact) the Medical Director prior to arrival.

Instruction for Visitors to The Lawrenceville School from SARS Areas

1. Visitors to The Lawrenceville School campus who have been in a designated SARS area and who experience respiratory symptoms (e.g. cough, difficulty breathing, or nasal congestion) or fever (temperature greater than 100.4°F or 38°C) should postpone their visit until at least 10 days after resolution of their symptoms.
2. Visitors who have been exposed to a person with SARS should postpone their visit until at least 10 days after that exposure.
3. Visitors who have postponed their visit for reasons one or two outlined above should call the Health and Wellness Center before coming to campus for clearance.
4. Visitors who have traveled in a designated SARS area within 10 days of their visit and who develop respiratory symptoms or fever while at Lawrenceville should consult the Health and Wellness Center immediately.
   
   1. If off campus at the time, please call the Health and Wellness Center by telephone.
   2. If on campus, please report to the Health and Wellness Center but tell the nurse on duty immediately upon arrival why you are there.
   3. Visitors will be evaluated and advised about the appropriate next step.
   4. Visitors who have mild symptoms but do not meet the case definition of suspect SARS will be asked to remain stay away from campus until they are both symptom free and have been cleared to return to campus by the Health and Wellness Center staff.

1. The right to expect a response to request for services, including evaluation and/or referral, within the school’s health service capacity.
2. The right to be treated with respect and dignity.
3. The right to privacy during physical examinations, treatments, discussions, and consultations.
4. The right to complete information, to the degree known, concerning their diagnosis, treatment and prognosis in terms they can reasonably understand, to the extent permitted by law.
5. The right to refuse treatment to the extent permitted by law and to receive information about the medical/psychological consequences of this action.
6. The right to expect continuity of care, including knowing your health care or counseling professional by name, and to be made aware of continuing requirements following your care.
7. The right to expect that all medical/counseling information shared with their health care providers will be treated confidentially, to the extent permitted by law. If possible, the patient and their parents will be notified before confidential information is released.
8. The right to receive information of any fees charged regardless of the source of payment, including what services may involve additional charges.
9. The right to know what Al Rashid Health and Wellness Center rules and regulations apply to their conduct as a patient.
10. The rights to receive prompt life-saving treatment in an emergency without discrimination on account of economic status, or source of payment and without delaying treatment for purposes of prior discussions of the source of payment unless such delay can be without material risk to their health.
11. The right to informed consent to the extent provided by law.

The Student Patient’s Responsibilities include:

1. To show courtesy and respect to the medical and counseling staff, personnel and other patients.
2. To follow the rules and regulations of the Al Rashid Health and Wellness Center regarding proper conduct as explained and posted by the Health and Wellness Center staff.
3. To provide full information about their problem or illness necessary to properly evaluate and treat.
4. To ask questions and express any concerns about their diagnosis and/or medical/psychological treatment and what is expected of them.
5. To communicate to the medical/counseling staff if their condition worsens or does not follow the expected course.
6. To not give to others any medications prescribed for them.
7. To keep appointments and to notify either the health care professional or the Health and Wellness Center as soon as possible if you are unable to do so.
8. To respond promptly when they receive a communication from the Health and Wellness Center or health care professional.

Questions concerning a student’s patient rights and responsibilities should be directed to the Medical Director, Director of Counseling, or the Director of Nursing.