DISMISSAL OF A PATIENT AT UCSC SHS

Effective Date: 
Sat, 10/01/2011
Reviewed: 
Wed, 04/14/2021
Revised: 
Wed, 04/14/2021
Policy: 

The UCSC Student Health Services (SHS) provides safe and effective health care which is based on a relationship of mutual trust and respect between the health care provider and the patient.  Occasionally, this healthy environment and collaborative relationship may be disrupted by acts or omissions by the patient, or others, that may require the dismissal of the patient from care, and/or loss of his/her eligibility for care.  Recommendations for dismissal must be sent to the Medical Director for review.

Situations that may require the dismissal of a patient from care include:

  • Persistent refusal to follow, or a history of failure to comply with, prescribed treatments and protocols
    • Registered students will still have access to CAPS Crisis and SHS Case Management Services
  • Tampering, altering, improper or illegal use of prescriptions or medications
  • Lying, furnishing misinformation, or misrepresentation of the truth
  • Exhibiting activity that is threatening or abusive to staff members
  • Violent, aggressive, disruptive or persistently rude behavior or threats directed toward staff members, patients or visitors
  • Breaches of privacy
Procedure: 

Staff members with concerns should discuss the situation with their supervisor to determine if the matter warrants Director-level review.  Any recommendation for dismissal must include a summary of circumstances and copies of any correspondence or other documentation relevant to the situation.

Upon review of the documentation and consultation with relevant staff and advice from legal counsel and/or other appropriate University officials (if indicated), the Director will send a certified letter to the student. The letter may be a warning or a final dismissal.  The letter should deliniate what service they may access (if any).  Appeal of the decision to dismiss is submitted to the Executive Director of SHS.

The patient will receive a letter stating the dismissal from care and outlining the reasons for the action including:

  • A statement of the reason for dismissal
  • The date the dismissal becomes effective
  • A definition of the grace period that will be allowed for the patient to find alternative care with written stipulation of the circumstances and process the patient must follow if s/he wishes to be seen during that period.  The SHS must ensure the patient’s health care is not in immediate danger and must assist with outside care as appropriate
  • A statement that with the patient’s written authorization a copy of his/her medical record/s will be sent to the new provider
  • A statement of the appeal process.  A patient may appeal the decision to dismiss from care.  The appeal must be in writing and directed to the Executive Director of the SHS, who after reviewing the situation, may either grant the appeal or uphold the dismissal
  • If relevant, a statement of the duration of the dismissal and the procedure to follow to have the eligibility reinstated
  • Specifically identifies eligibility for the following services:
    • Primary Care
    • Counseling
    • CAPS Crisis
    • Case Management
    • Psychiatry
    • Pharmacy
    • Laboratory
    • Radiology
    • Optometry
    • Dietitian
    • SHOP
    • CARE
    • Student Insurance and Billing

Cases may also be referred to Student Judicial Affairs for review.  Judicial Affairs may also take necessary action as indicated by the University policies and procedures.

If the patient has UC SHIP, referrals will be provided to the patient from the SHS.

A student who has been dismissed from a service at SHS will have their EMR record updated by the appropriate Director to reflect this status.  An entry will be made in three locations in the EMR ("clinical comments" found in open chart as well, "admin alert", and "scheduler comments", found in Open Registration) with the relevant information.

A broadcast IM will be sent by the Director to the Laboratory for entering into Harvest and to Pharmacy to enter into Propharm.