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PRIVACY & SECURITY OF HEALTH INFORMATION

Effective Date: 
Tue, 05/19/2015

RISK MANAGEMENT: PUBLIC HEALTH *

Effective Date: 
Tue, 05/19/2015
Reviewed: 
Thu, 02/08/2018
Policy: 

The Student Health Services actively mitigates risk to our community through communicable disease (CD) prevention, identification and response and through on-going community emergency preparedness and response.    The chair of the Quality management committee is responsible for oversight of these risk reduction activities.  The SHS works with campus colleagues and our local community for disease prevention and response.  The SHS works closely with local, state and national health agencies to mitigate risk.  The SHS works with campus counsel and with the University of California Office of the President Risk management services on risk mitigation and response.

Procedure: 

The Quality Management Committee will hear an annual report of disease occurences, emergency preparedness activities, risk mitigation activities and incidence rates for influenza, gastroenteritis, STIs, and other CDs as indicated.

The communicable disease identification and response policy outlines specific CD management policies and procedures.
The Emergency Preparedness policy outlines on-going emergency preparedness policies and procedures.

OPTOMETRY - END OF DAY CLEANING *

Effective Date: 
Fri, 04/24/2015
Reviewed: 
Thu, 03/22/2018
Policy: 

The Optometry Department performs daily cleaning.  

Procedure: 

Certol ProSpray wipes (yellow top canister):

  • Exam chair
  • Stool

**Remove filmy build-up by wiping surfaces with plain water and paper towel as needed**

Sani-Cloth wipes (black top canister):

**Use a minimum of 2 cloths to properly wipe down all the following items**

  • Counter top and area around sink
  • Faucet handles
  • Cupboard and drawer handles
  • Keyboard and mouse
  • Inner and outer door handles
  • Retinoscope handle
  • Lamp arm

 

70% isopropyl alcohol wipes:

**To be performed in front of patient at start of every exam**

  • Phoropter forehead and nose rest
  • Slit lamp chin and forehead rest
  • Cover paddle
  • FDT forehead and nose rest

OPTOMETRY OPENING PROCEDURES *

Effective Date: 
Thu, 04/23/2015
Reviewed: 
Thu, 03/22/2018
Revised: 
Mon, 02/29/2016
Policy: 

See the Opening Procedures for Optometry below.

Procedure: 
  • Turn on main desk computer and exam lane computers. Log in to Windows and open and log in to Point and Click (PnC) EMR.
  • Open Google Chrome with the following tab: Eyemed. Log in to site so that insurance authorizations can be checked at each patient visit.
  • Check phone messages.
  • Open Master Optometry Excel log (found under Desktop, Optometry).
  • Open CL Log and Frame Log (found in Desktop, pub.optometry, My Documents).
  • Organize any glasses or contact lens orders from Optometry Technician that have been left on the desk. Bill appropriately if not yet billed. Add to Master Optometry Excel log spreadsheet. Add to Frame Log the frame that was sold, and to CL Log the CL order that was made, with the date and number of boxes.
  • In PnC, make a brief chart note for each Optometry Technician order that was left on the desk, indicating that the patient came in with the Optometry Technician and ordered glasses or CL, etc. on which date. The Optometry Technician is not able to make entries in PnC as they are not licensed.
  • Respond to Instant Messages in PnC.
  • Pick up CL or frame shipments in the Pharmacy.
  • Leave CL boxes in Pharmacy under pt’s name.
  • Place all glasses in appropriate cases with lens cloths and leave in Pharmacy under pt’s name.
  • Send secure messages to pts using PnC indicating their glasses and/or CL are ready for pickup in the pharmacy.
  • Uncover and turn on exam lane equipment.
  • Retrieve/unlock ophthalmic meds from locked cabinet and prepare for exam use.
  • Unpack any frame shipments and label with prices and stock the displays (see top desk drawer folder labeled Glasses Inventory - has inventory and price list).
  • Restock contact lens solution starter kits in upper cabinets (back exam room).

OPTOMETRY APPOINTMENT MAKING

Effective Date: 
Thu, 04/23/2015
Policy: 

Optometry appointments need special consideration and are performed by Insurance staff.

Documentation of vision insurance is required.

Attached File: 

INSTRUMENT CLEANING STEPS

Form Type: 
HC
Form Number: 
XXX

SIGNING OUT FOR MEDICATIONS FROM THE PHARMACY *

Effective Date: 
Tue, 03/10/2015
Reviewed: 
Wed, 02/21/2018
Revised: 
Wed, 02/21/2018
Policy: 

All dispensed prescription medications must be acknowledged and signed out on the signature pad at the pharmacy in the Propharm POS (Point of Sale System) with a valid signature.

If the patient is not the person signing out, then that person or the pharmacy staff member will document the name and/or other identifying information and the reason as needed, at the Pickup Signature Capture in the Propharm POS when having the person sign the signature pad.

Examples of alternate documentation:

AC - insurance rebill

RN sign out - when picking up prescriptions to administer or for patients too ill to pick up the prescription on their own

DL - Rx reconciliation - when verifying after the fact that the prescription was picked up

LG for pt - when signing out on behalf of the patient

 

PATIENT-CENTERED MEDICAL HOME *

Effective Date: 
Wed, 03/04/2015
Reviewed: 
Tue, 04/24/2018
Revised: 
Tue, 04/24/2018
Policy: 

The Student Health Center practices as a Patient Centered Medical Home.  A Patient Centered Medical Home provides comprehensive and coordinated primary care in active partnership with the patient.  A Patient Centered Medical Home provides care which is patient-centered, directed by a physician, nurse practitioner or physician assistant.  The care provided is comprehensive, accessible, continuous, and organized to meet the needs of the individual patients served.  The core principle of this practice is that the patient is empowered to be responsible for their own care.   A Medical Home provides evidence based quality care and has a quality management program which continuously monitors and improves the care delivered by assessing:  the patient/provider relationship, accessbility, comprehensiveness, continuity and quality of care.

The Student Health Center demonstrates its practice as a Patient Centered Medical Home when it meets the standards established by the AAAHC in chapter 25, sections A through K.

REFERRALS FROM CAPS TO PRIMARY CARE *

Effective Date: 
Mon, 01/26/2015
Reviewed: 
Fri, 03/23/2018
Revised: 
Fri, 03/23/2018
Policy: 

In order to facilitate timely and effective communication between CAPS and primary care providers, every effort is made to clearly communicate the urgency and relevant medical and mental health concerns.  There are two types of CAPs referrals to Primary Care:  Same Day Urgent and Non-Same Day.

 

 

Procedure: 

For Same Day Urgent referrals:

The CAPS provider will contact the Charge Nurse to request a same day appointment and provide the appointment information to the student.

The Charge Nurse will attempt to schedule a 40 minute appointment with a primary care clinician if the schedule permits. Alternatively a 20 minute slot will be used if there are no other options.

The Charge Nurse will enter the reason code as "CAPS URGENT SAME DAY REFERRAL."

The primary care provider will consult with the charge nurse prior to evaluating the patient for critical safety and follow up information. In the event there are any additional questions or the CAPS professional  (or back-up) has additional information to share, the CAPS provider and primary care provider will communicate directly. The CAPS professional should make every attempt to complete at least a draft of the clinical note detailing the relevant clinical information for the same day referral.

The primary care provider should make every attempt to CC or instant message the CAPS provider their signed note upon completion.

 

For Non-Same Day Referrals:

The CAPS provider completes the Non-Same Day Referral chart note, indicating the relevant note for the primary care provider to review.  This note is visible to all primary care staff.

The CAPS provider instructs the student to present to Primary Care Reception to schedule the appointment.

If a student presents to Primary Care Reception stating they were referred by CAPs, reception staff will review Visits/Notes in the EMR to review the Non-Same Day Referral from CAPS to SHS for instructions on visit type and priority.

It is the student's responsibility to present to Primary Care Reception to schedule the appointment

INSURANCE ELIGIBILITY *

Effective Date: 
Fri, 01/09/2015
Reviewed: 
Mon, 04/23/2018
Revised: 
Mon, 04/23/2018
Policy: 

UCSC students must all have health insurance.  The SHS Health Insurance Office tracks the health insurance option that the student maintains, in order to ensure that the students have health insurance.

Students are automatically assigned UC SHIP, University of California Student Health Insurance Plan and may waive it with proof of suitable insurance, based on UC-wide waiver criteria.  This includes students "in absentia".

Addressing inconsistencies may be required for withdrawals, leave of absences, late waivers, late enrollments etc.  For the process to address these, see the Procedure.

Procedure: 

WITHDRAWALS - also see policy on Medical Withdrawals

IN ABSENTIA - These students are required to have health insurance however they will be part of a different insurance group.  Insurance staff will document this status in the EMR and the database.  They may be seen at the UCSC Student Health Center.

PLANNED EDUCATIONAL LEAVE (PEL) does not apply at UCSC

LEAVE OF ABSENCE (LOA)

Note: A leave of absence is a type of withdrawal - with the intent and option to return.  If the leave of absence begins after the quarter starts, the Undergrad is on UC SHIP unless they request to rescind the insurance and it has not been used. If a Grad student is on leave of absence and files their leave before the first day of the quarter, or after the first day of the quarter and not enrolled, or after the first day of instruction.  They will not remain on our enrollment roster and the UC SHIP charge will be reversed.

Only students on UC SHIP the previous quarter may voluntarily enroll in UC SHIP after the current quarter, by "voluntary" enrollment through USI Insurance Services.  This is allowed for up to two ensuing quarters, once in their academic career, (Spring is combined with Summer).

Documentation of voluntary enrollment:

- Receipt of email notification of voluntary insurance enrollment by USI sent to Insurance staff

- insurance database updated by Insurance staff

- electronic medical record updated by Insurance staff as on "voluntary UC SHIP", and eligible to use SHS

If the student does not have UC SHIP or is early enough in the quarter and chooses not to keep UC SHIP

Documentation of the LOA:

- insurance database updated by Insurance staff

- electronic medical record updated by Insurance staff "not eligible" (make sure the student has been credited in AIS)

This change will automatically be updated for USI.

LATE ENROLLMENT

Make sure that the insurance database is correct and add the information to the electronic medical record.  Ensure that the student is charged the UC SHIP premium in AIS (if they do not have other health insurance or appropriately waived) if not in the next update, then manually.  The other updates should be done automatically.

For Late CruzCare enrollment, notify Billing.

Documentation for late enrollment in UC SHIP:

- Insurance Database updated by Insurance staff

- EMR updated by Insurance staff

- Checking for charge in AIS - check date; student may have a reg form from Registrar's Office that Insurance staff documents their initials and documents whether to keep UC SHIP or waive.  If student wants to waive, Insurance staff provides late waiver opportunity.

LATE WAIVER (as of closure of waiver site)

Document the waiver results in the database and update the electronic medical record.  The credit will appear in the Academic Information System (AIS) with the weekly updates.

Documentation of late waiver:

- Insurance Database by Insurance staff

- EMR by Insurance staff

- Charge the late waiver fee

NOT ENROLLED / NOT A STUDENT

When a student shows that they are not enrolled, but the rosters for UC SHIP Insurance show that the insurance is active, when the student shows up at the Student Health Center, determine that the student did not voluntarily purchase the insurance via USI.  If the student did not enroll in the UC SHIP plan voluntarily, and did not pay for insurance, insurance staff would check AIS to see if billed and paid, and if did not purchase UC SHIP, edit/document in the electronic medical record that the student is not enrolled and is not eligible for services.  If services were rendered and the insurance plan was billed, contact the insurance plan to rescind those claims.  Inform billing via IM.  If there are outstanding bills, the remittance of payment is the responsibility of the patient and the patient should be notified via secure message.

Documentation for Not Enrolled Student:

- Insurance Database by Insurance staff in the PnC Admin Notes (further updates done automatically)

- EMR by Insurance staff

- Insurance Carrier if claims need to be rescinded (by Billing staff)

- AIS if charges need to be added

REFUNDS

Our policy follows the guidelines set forth by the UCSC Registrar's Office regarding refunds.

For Withdrawals - If the student withdrew prior to the start of the quarter, then they get a full refund of the insurance premium.  If the student withdraws in the first week within the quarter, then the student will show as having UC SHIP and can petition to get off the insurance and get a refund.  If a student withdrew from Day 8 onward, they will remain on the insurance for that quarter.

For LOA's - if a student files an LOA in advance of the quarter with the absence, then they will be refunded UC SHIP premium for that quarter, independent of the timing of the beginning of the LOA.

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