1. Billing for injuries sustained during training are not always reimbursed by the health fee. WHY? Do I have to receive my health care at Hall Health??
 
 
 
 

Answer

Health Science students are not considered employees while they are engaging in education-related activities at clinical sites. Should injury (for example, trips and falls) or exposure to illness (for example, meningitis) occur during a clinical rotation, insurance coverage, either via a family member or a policy such as the UW International Student Insurance Plan (ISHIP), the Graduate Appointee Insurance Program (GAIP), or a Marketplace health plan may cover the care you may need that is not covered by the Health Fee’s blood borne pathogen program.

UW-Seattle students who pay the quarterly Services & Activities Fee along with their tuition receive some services at Hall Health Center, the student health center on the Seattle Campus. These include consulting nurse visits, reproductive health counseling, access to a wellness resource center, limited crisis intervention counseling, and one visit per quarter for acute illness/injury (excludes routine physicals and annual women's exams).

Fees are charged for preventive care visits (such as routine physicals and annual exams), follow-up visits, and specialty services including Mental Health, Nutrition Services, Physical Therapy, Travel Clinic, lab, x-rays etc.

Hall Health is open to non-students as well, and services are covered by many health and insurance plans according to contracted benefits. Hall Health's website includes information about the Affordable Care Act, obtaining insurance, and the specific plans that are accepted there.

UW students who are not on the Seattle campus may have access to services at an affiliated student health center if they are currently attending classes on another campus. Check with your campus' facility to find out what services may be available to you. The Health Care Resources page of this website offers information and links to clinics and pharmacies that are available to the general public in many of the communities where UW students are located.

Please note that if you choose to receive care at Hall Health or any other clinic/provider's office, such as immunizations, TB screening, or titers (lab tests), you will need to obtain your HIPAA-protected records showing documentation of any service received and submit it to HSIP. This will allow you to maintain your compliance with HSIP requirements and avoid a registration hold.

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How can I obtain a copy of my HSIP record? Will you send it to my clinical site or new employer? Can I obtain a copy through E-care at Hall Health or another UW Medicine Clinic?

Answer

If you would like a copy of your HSIP immunization record, please send a request via email to myshots@uw.edu. Be sure to include your full name and UW student ID number. HSIP will send the record directly to you, and you can then share it further. 

HSIP does not routinely send any records to outside persons, per FERPA regulations. As needed, we share your HSIP record only with your UW health sciences program staff before and during your clinical or practicum placement, as indicated on the HSIP release form you signed at the start of your health sciences program.

Hall Health’s E-care is part of the personal electronic medical record (EMR) used by Hall Health/UW Medicine. It will show only the immunizations received at that facility, and the immunizations you asked your provider to document in your personal health record, if you are a patient there.

Hall Health and HSIP are completely separate, and HSIP does not share student records with Hall Health, per FERPA regulations. Likewise, Hall Health does not share your patient information with HSIP, per HIPAA regulations. Therefore, if you would like to have your HSIP immunization record in your personal medical record (at Hall Health or elsewhere), you should request your records from HSIP at myshots@uw.edu and then share it with your healthcare provider.

 

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How secure are my records? Are they kept confidential?

Answer

Email Security: Students are encouraged to submit the HSIP form and supporting documentation via email at myshots@uw.edu. We recommend students use their UW net ID account (@uw.edu) to increase the security of electronic communication with HSIP.  We do receive HSIP forms from students who use gmail or other outside accounts, but as a rule, we reply to and use students’ UW email addresses whenever possible.

Records Security: Records are stored on a secured UW Medicine database server. Our IT Services has established and manages a comprehensive Security Program to be in compliance with the HIPAA Security Rule [45 CRF Parts 160, 162, and 164], RCW 42.17 [Public Records – Personal Information – Notice of Security Breaches], and various other federal and state security laws. 

Records Confidentiality: Documentation occurs in a combined student/employee electronic database. Records are kept and maintained under the auspices of FERPA, federal law governing educational records.  Where these laws do not conflict, these records are also maintained in compliance with HIPAA. Information submitted to HSIP may be discussed, communicated, and/or shared with the students’ school/program on a need-to-know basis prior to and during placement at practicum or clinical sites of practice.

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I had a 3-dose Hepatitis B series many years ago. I just had the titer and it came back negative (nonreactive, or not immune). What should I do now, repeat the series or get one dose? Why does this happen?

Answer

Many individuals lose the “circulating antibody” within a few years after receiving their last dose of Hepatitis B vaccine. We do not check antibody levels for the general public because we assume that this highly effective vaccine has worked. But for health care professionals we take the extra step of checking a quantitative titer to ensure immunity in case of future exposure to Hepatitis B in the workplace (i.e. a blood borne pathogen exposure).

We recommend you receive one dose of Hepatitis B vaccine now, to boost your antibodies to a detectable level. This usually takes about a month. Then, 4-6 weeks after the booster dose, you should have the QUANTITATIVE Hepatitis B Surface Antibody titer blood test drawn. Usually with this method there is a positive result (≥ 10 mIU/mL), and the documentation on the lab report should be adequate to prove your immunity to Hepatitis B for the rest of your health care career. This method of boost and titer is explained by the CDC in their latest guidelines (published in 2013) and summarized in this online algorithm: http://www.immunize.org/catg.d/p2108.pdf

Please send in your paperwork now (after the booster dose) with a notation that the titer is pending. As long as we know that something is “in process” you will continue to be in “compliance”. Send your titer report to us as soon as you’ve received the result. If the re-titer is negative then you may need to be tested for the Hepatitis B Surface Antigen (“carrier” status, or prior exposure to Hepatitis B disease). Or, perhaps you need to continue on with receiving the 2nd and 3rd doses of another Hepatitis B vaccine series. There are some individuals who need two series before they will achieve a positive antibody titer.

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I just started the Hepatitis B series and it will take about 6 months for me to finish it so I can’t meet the deadline. I won’t be able to finish all the pre-entry immunization requirements by the time I’m supposed to send the paperwork in. What should I do?

Answer

Please put a note on the form under the Hepatitis B section that says “Dose #3 and titer pending”` (or whatever the case may be). We will be able to tell by the dates on the documentation that you send in, when the next items are due. We’ll give you a “temporary” waiver of the requirement that lasts until the next item due date. As long as you keep sending us documentation when you complete each item, you will continue to be compliant. Our tracking database will report you as compliant to your school or program as long as we receive the further documentation from you on time. The CDC recommends that students complete their three-dose series prior to contact with patients or body fluids.  This means you should start meeting the requirement as soon as possible after admission to your program. Please put your name, student ID number, and school/program on all correspondence to us.

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I thought I had the chicken pox in the past, but my titer didn’t come up positive (it was negative, or it may have been equivocal). Why would this happen? Should I just get one dose of vaccine since I know I already had the disease, or would I need 2 doses of vaccine given at least one month apart since the titer isn’t positive? Do I need to have the blood test again after the vaccine?

Answer

It sounds like either you had a light case that did not prompt your immune system to build permanent immunity, OR, perhaps the lab test just wasn’t sensitive enough to pick up your immunity.

If you have never had the chicken pox vaccine before, then you will need documentation of TWO doses. You can send us your documentation after receiving one dose and write “Dose #2 pending” on the required immunizations form. There is a minimum wait period of 1 month in between the two doses. If you forward the documentation of the second dose 4-6 weeks later then we’ll consider you to have remained compliant with the requirements. 

Please note, you should NOT repeat the varicella titer after receiving the immunizations. The CDC has stated that the currently available titer test may not be sensitive enough to detect immunity for individuals who have received the vaccine. The current standard of “immunity” is EITHER positive titer OR two doses of vaccine. So if you can show documentation of two doses of vaccine there is NO REASON to have another titer again.

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What is the waiver process? I don’t want to (or can’t) receive one of the required vaccines.

Answer

Our waiver procedure is detailed in the “Requirements for Compliance” Policy posted on our website. HSIP grants waivers only for documented medical conditions for which there is a vaccine contraindication, based on the standards of care at the University of Washington. 

Students must submit a signed statement from a medical doctor (MD) stating what vaccine is contraindicated, the reasons with documentation for the contraindication, and the duration for which the vaccine is contraindicated. The HSIP medical director will review and determine if the standard for medical contraindication is valid, and the student will be notified. If the standards are not met, the student will need to comply with the requirements. 

If the standards are met, the student and school/program are notified. Students may be limited in clinical sites/situations where they can be placed with a waiver but if possible, the school/program accommodates the student based on their particular need. 

Waivers for non-medical (personal) reasons are outside the scope of HSIP. In general, most schools/programs do not allow personal waivers. However, students who wish to discuss personal waivers of certain requirements should speak with the compliance officer or contact person for their particular health sciences school/program. Each school/program has different policies in place and may or may not allow the waiver of a specific requirement.

 

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Answer

In the USA, receiving BCG vaccine is not considered a contraindication to TB skin testing. TB skin testing occurs unless there is documented evidence of a prior positive PPD test. Chest x-rays are not interchangeable substitutes for a PPD. A CXR is only obtained in the event of a documented positive PPD test. A negative Interferon gamma release assay (IGRA) blood test IS an acceptable alternative for an annual TB skin test.

Some students have had a positive TB skin test in the past but are unable to obtain the documentation. In those cases, provider verification of (verbal) history is acceptable. A provider must complete the HSIP form with this information and sign for authentication to meet the documentation guidelines for our program.

 

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Why doesn’t the HSIP provide clinical services for the vaccine requirements for admission to a Health Science School or Program?

Answer

Some students start interacting with patients, clients and community members within 2 weeks of arriving on campus. We need to ensure a safe environment for these students and the patients and clients they serve, and this is a difficult goal to meet if students do not arrive with the immunization requirements having already been met. In addition the legal affiliation agreements between the practicum/clinical sites of practice and the University state that health sciences students will have already completed all health care personnel (HCP) immunization requirements.

Even with insurance coverage, some costs following accidental exposure to blood borne pathogens (i.e. needle sticks) can be denied for reimbursement when claims are made. We have determined that it is more cost effective to use health fee funds to provide gap coverage in these instances, rather than to use these funds for pre-entry immunizations that are more likely to be covered by health insurance plans.

 

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