B.2.g. Student Health Policies
Emergency Preparedness: Required Evacuation Plan
Center for Health and Wellness
The Center for Health and Wellness supports the learning environment of Middlebury’s vibrant and diverse academic community by providing readily accessible and confidential health care to students within an inclusive, collaborative, and integrated treatment framework. Our multi-disciplinary staff are here to work with students and make referrals to community resources as needed.
We strive to create a safe, affirming, and nonjudgmental environment that embraces human diversity, including differences in race, color, ethnicity, national origin, religion, sex, sexual orientation, gender identity and expression, age, marital status, place of birth, and disability status. We are committed to respecting the uniqueness and complexity of student identities and life experiences.
1. Required Health Forms
The following forms and documents are required and must be completed and/or uploaded to the student health portal prior to arrival on campus for all new undergraduate students:
- Health History Form
- Confidentiality and Consent to Treat Form
- Emergency Contacts Form
- Tuberculosis Screening
- Images of the front and back of your insurance cards including primary, secondary, dental, and pharmacy if you have separate policies
- A copy of your immunization record(s) provided to you by your health care provider(s)
- The Athlete Physical Exam Form (required within 6 months of start of season for students participating in intercollegiate sports, club rugby or crew)
The following forms and documents are conditionally required and must be completed and/or uploaded to the student health portal prior to arrival on campus for all new undergraduate students for whom they apply:
- Consent Form for Treatment of a Minor for students who will arrive on campus under the age of 18
- Physician TB Form for students who are determined to be at risk for tuberculosis based on the Tuberculosis Screening form in the student health portal
- Provisional Admittance Form for students who will not be in compliance with Vermont regulations for immunizations by their deadline matriculation
The following forms and documents are recommended to aid in the provision of comprehensive services and should be uploaded to the student health portal prior to arrival on campus for new undergraduate students:
- Physical Examination Form
Forms and documents are due:
- June 15 for September matriculation
- November 15 for February matriculation
First-time student athletes are also required to meet conditions and complete forms listed in the First-Time Athlete Athletic Clearance Procedures.
All required forms and instructions are available on the student health portal under “My Forms” or the Center for Health and Wellness’s Forms website.
2. Commitment to Confidentiality
a. Understanding Your Health Record/Information
Each time you visit the Center for Health and Wellness offices (Counseling, Health Services, Health and Wellness Education, Integrated Care and Sports Medicine), communicate with Center staff, or when staff have an interaction with a third party about you, the information is documented in a secured, password protected electronic health record that is accessible only to Center for Health and Wellness staff, you, and those you provide written permission to access. Typically, this record contains a summary of your presenting concerns and symptoms, physical exam and/or other intake information, test results, diagnoses, progress notes, treatment summaries, referrals to other resources, and plans for future courses of treatment if appropriate. This information makes up your health record or personal health information, and serves as a:
- Basis for planning your care and treatment;
- Means of communication with other health professionals who contribute to your care;
- Legal document describing the care you received;
- Source of information for public health officials charged with protecting the health of this state and the nation (only under very restricted circumstances);
- Tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.
You are entitled to access your health records or request that we prepare a summary for you. Your records are accessible to you at all times through the student health portal and you may request printed records or summaries by emailing chw@middlebury.edu. To release your records to a third-party healthcare provider or designee of your choosing, you must complete an Authorization for the Release of Personal Health Information available on the Center for Health and Wellness’s Forms website and bring it to a Center office in person, email it to chw@middlebury.edu, or upload it to your student health portal. Center for Health and Wellness staff are available to review your records with you at any time.
i. Confidentiality
Health records at the Center for Health and Wellness are confidential and are completely separate from all other College records. Students have the right to revoke or restrict authorization to share health care information, and Center for Health and Wellness staff will not release any information about you without your written or electronic permission, except under the following conditions:
- As authorized or required by law (i.e., when we are presented with a valid court order requiring us to release records);
- As necessary to protect you or others from a serious threat to health and safety, or to protect property from a serious threat of damage;
- As necessary to notify guardian and/or College officials when you have a serious mental or physical health problem and are unable to assume responsibility for notifying others;
- Under some circumstances when legal guardians may have the right to access the records of a minor.
In addition, Center for Health and Wellness staff confer with one another as needed to provide integrated care for you. We also work with the University of Vermont Health Network’s Porter Medical Center (PMC) and the Counseling Service of Addison County (CSAC) to ensure continuity of care options for students including urgent and emergent situations.
Middlebury’s Confidentiality and Consent to Treat Form includes consent for Center for Health and Wellness staff to share personal health information with these important community partners to ensure high-quality, informed care for students. When students receive treatment from multiple providers and/or in multiple locations, we exchange only such information as is needed to maintain continuity of care. Students may make requests to the Center for Health and Wellness, PMC or CSAC to revoke or restrict authorization to share such information at any time.
Middlebury College and the Center for Health and Wellness are not subject to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and therefore are not required to comply with the various federal regulations relating to the use and disclosure of health information. Middlebury College and the Center for Health and Wellness are, however, subject to the Family Education Rights Protection Act of 1974 (FERPA) which classifies your health records as treatment records and confers similar protections related to privacy.
This policy should not be interpreted as creating any contractual rights and Middlebury College reserves the right to make changes to this policy at any time without prior notice.
ii. Confidentiality for the Treatment of Minors
According to certain provisions of Vermont State law, legal guardians must provide permission for some forms of healthcare for individuals under the age of 18 (minors). These provisions also allow for certain exceptions. In these situations, a legal guardian’s permission is not required:
- Minors of any age will be cared for in emergency situations that necessitate immediate treatment;
- Minors of any age may receive outpatient mental health counseling without consent of a guardian, but not prescription medications;
- Minors 12 years of age and older may obtain treatment for sexually transmitted diseases, substance dependence and abuse;
- If a minor requires hospitalization for treatment of sexually transmitted diseases, substance dependence, or abuse, the legal guardians must be notified of the hospitalization;
- Minors of any age may obtain treatment for the termination of a pregnancy, or receive medical treatment necessary to obtain contraceptive devices and medications;
- Minors of any age may obtain medical treatment related to rape, incest, or sexual abuse. Health care providers are required to report such incidents to the Department of Children and Families within 24 hours;
- Minors 14 years or older may voluntarily admit themselves to a hospital for mental health related treatment if they give informed consent in writing;
- Minors under 14 may admit themselves to a hospital for mental health related treatment by providing their own written informed consent and a written application from a parent or guardian;
- Minors who are married or have ever been married, minors on active U.S. military duty, and minors emancipated by court order may give informed consent to their own health care.
Center for Health and Wellness staff are available to provide an initial consultation with students who are under 18 years of age in order to review the need(s) for guardian consent for treatment(s) as stipulated by Vermont State law.
iii. Grievance Process
If you have concerns, needs, or questions that were not (or could not be) addressed by staff members directly involved in your care, you may contact the Associate Vice President for Student Health and Well-being at 802-443-5361 or bmccall@middlebury.edu. You may also contact the Vice President of Student Affairs at 802-443-2465 or sruzicka@middlebury.edu.
Most professions in the Center for Health and Wellness are also governed by laws and/or professional organizations that define a scope of practice, professional conduct and/or codes of ethics. Healthcare consumers who have inquiries can obtain a form to register a complaint with the State of Vermont and can also call 802-828-1505 or contact:
Secretary of State’s Office
89 Main Street, 3rd Floor
Montpelier, VT 05620-3402
3. Vaccines
a. Required Vaccines under Vermont Law
Vermont law requires that all students submit an up-to-date immunization record, including proof of vaccination or positive titers (when applicable) for:
- Measles, Mumps, and Rubella
- Meningitis
- Hepatitis B
- Tetanus, Diphtheria, and Pertussis
- Varicella
b. Medical and Religious Exemptions
If you have any religious or medical exemptions, please complete the Vermont College Immunizations Exemptions Form as applicable and upload to your student health portal as an Immunization Exemption.
Please be advised that unvaccinated students may be asked to miss class or leave campus in the event of a communicable disease outbreak.
c. Recommended Vaccines for Global Travel
Some students, including those who travel abroad will benefit from:
- Hepatitis A vaccine series
- Typhoid vaccine
Other travel vaccines depend on destination and can be determined at a travel visit with Health Services.
Due to the length of time some vaccine series require, it is recommended that all students considering travel abroad also consider receiving the Hepatitis A vaccine series prior to matriculation.
4. Required Personal Departure Plan in the Case of Evacuation or Emergency
Because of the potential need for a quick departure from campus related to a personal, family, or community emergency or in response to an outbreak of communicable illness, all Middlebury College students are required to develop a personal departure plan for emergencies and/or situations that require evacuation, submit it to their program, and update it on an annual basis.
Students should alert any family members, friends, or trusted acquaintances that are a part of their plan at the time of submission and annual review. Students may not be allowed to attend classes, register for classes, or otherwise fully participate in their program until they have provided a plan that meets the minimum required elements as stated within each program.
5. Records Retention Policy
The Center for Health and Wellness, in order to establish guidelines for the maintenance, retention, preservation and disposal of medical records that are created or maintained by it, hereby adopts the following policy for preserving those records.
Policy
The Center for Health and Wellness engages in the following actions in order to appropriately maintain, retain, preserve and purge treatment:
- retain treatment records for the period of time required by applicable law and regulation as indicated in these guidelines;
- purge of treatment records promptly, in the appropriate manner after they have satisfied their required retention period, unless they are the subject of a Litigation Hold;
- preserve treatment records subject to a Litigation Hold, if the records would otherwise be purged.
Retention Guidelines
Treatment records are to be retained for the time periods indicated as follows. The medical records may be maintained in paper or electronic format, as appropriate and may be stored on-site or off-site, in accordance with the need to access the records. The creator or receiver of the medical records is responsible for retaining the record.
RECORDS | RETENTION PERIOD |
Treatment records - Adults (over 18) | 7 years from last date of treatment or graduation, whichever is the latter. |
Treatment records – Minors (under 18) | The longer of 7 years from last date of treatment, graduation, or until the patient is 25, whichever is the latter |
Former students who have graduated from Middlebury or otherwise departed from the community who would like to request a copy of their records should email chw@middlebury.edu and include their name, date of birth, and Middlebury ID number.
Some records are not subject to any retention period and can be discarded when they do not have administrative value. Other documents are not considered “records” within the meaning of this policy and need to be maintained only as long they have administrative value. Documents that are not considered “records” include: duplicate copies of correspondence or other documents, blank forms, and transitory messages used for informal communication of information only, such as voice mails, and self-sticking notes. Documents that are not “records” may be discarded when they do not have administrative value.
Purging Guidelines
Records should be purged promptly if they do not need to be retained in accordance with these guidelines. Records must be disposed of in a manner that safeguards confidential, sensitive or proprietary information contained in the records. Ordinarily, physical records will be securely shredded and disposed of while electronic records will be purged from the electronic health record.
Litigation Hold Guidelines
The Associate Vice President for Student Health and Well-Being shall be notified immediately if an employee receives notification of any claim or complaint that could lead to litigation or governmental investigation. The Associate Vice President for Student Health and Well-Being will evaluate the information and communicate with the appropriate employees to assure that all evidence and records relating to the matter are preserved until the litigation or investigation is complete. No employee should discard any document subject to a Litigation Hold.