The University of Wisconsin System recognizes that the present and future health of its students is among the most precious of its public resources. Students’ most pressing physical and emotional health concerns influence academic achievement and affect civility, citizenship, and connectedness. Attention to these important health issues permits the university to educate and prepare learners as whole human beings.
“Health is best understood as capacity – the presence of conditions that enable individuals and communities to work, learn, participate as citizens, and have strong human relationships. Health, in other words, embraces many elements of life: it is not simply the absence of disease or injury, and it is not just a medical, or clinical, quality. Among students in higher education, health supports the capacity to learn; when health is compromised, learning is constrained. Health problems among students include the universe of personal, developmental, social, physical, and mental issues that reduce their capacity to learn – from disruptions in relationships or stress to chronic, intrapersonal, physical or psychological illnesses” (Fabiano, Keeling, and Viele, 2006, p.69).
To this end, in this document the Board of Regents delineates a basic module of the minimum level of physical and mental health care that must be available to students at each of the UW System two and four-year institutions. Essential to the acceptance of the basic module is the continuation of the principle that institutional self-determination with respect to levels of physical and mental health care will continue. Determination of the level of services to be provided above this basic module will be the responsibility of the Chancellor of each institution. Recommendations for increases above the level established by the Chancellor will be made by appropriate institution governance groups for consideration by the Chancellor and the Regents.
The Board of Regents does not prescribe the manner in which the basic module of services will be provided or made available. The characteristics of each institution, the community where it is located, and characteristics of the student body will result in a variety of strategies for providing the services. Components of the basic module may be the primary responsibility of the institution’s health and mental health services. The responsibilities may be distributed across a variety of institution offices. Some services may be contracted out to community service providers. Coordination and collaboration among service providers – institution or community – is critical. It is expected that the basic module of services will be readily accessible (physically and financially) and will meet accepted standards for quality.
The institution service providers must have the appropriate resources including space and personnel. The staff is expected to model ethical and professional standards, and have the appropriate professional and educational credentials and skills as determined by the institution. They should have access to and utilize outside resources or consultation to augment programming. Ongoing participation in continuing education programs should be an expectation.
Services to be Provided/Available
Students should be informed participants in all of their health care decisions. Educating students regarding health care utilization and discussion of insurance issues should be incorporated as appropriate. Services not available on campuses or services beyond what campuses can provide should be available by referral mechanisms. After hours care, emergency services, and hospitalization should be accessible to students or available by referral.
Clinical (medical and nursing) Services
Clinical Services should include easily accessible medical care for evaluation and treatment of health related concerns, injuries, and illnesses. These services should include diagnosis, treatment, and follow up care for acute illness, chronic illness, and injury. Prevention of illness to include individual health counseling and instruction in self-care should be an essential component of the clinical visit. Physical examinations for well women’s and well men’s care, sexually transmittable infection screening, immunizations, and travel health consultation should be available. Mechanisms for providing pharmaceutical, laboratory, imaging, surgical, physical therapy, dentistry, and overnight care services should be determined by each individual institution. At a minimum, these clinical services should be available by referral mechanisms.
Mental Health and Counseling Services
Mental Health and Counseling Services Mental health is a critical factor in student success. Ongoing psychological or emotional distress can significantly disrupt student academic progress. Each institution should provide counseling services sufficient to address the psychological and developmental needs of students as well as respond to unexpected crises. Services should reflect a brief psychotherapy model that is time sensitive and goal oriented. The services should be provided by licensed mental health professionals, e.g., psychologists, social workers, counselors.
Services should include an educational component geared to helping students develop effective self-care and adaptive skills. Psychiatric evaluation and medication management should be available and accessible. Communication between the institution’s health and counseling services is essential to assure coordination and continuity of care for student patients/clients. Counseling services should develop and maintain referral sources for students with psychological conditions that require more intensive care.
Health Education, Health Promotion, and Prevention Services
A primary role of the institution’s health and counseling services is to provide health education that informs students of the effects of current behavior on future health status. There should be an emphasis on how current behavior affects their learning environment, their performance at the university, and their ultimate quality of life. Providing a healthy environment that supports wellness behaviors, promotes healthy lifestyle choices, and provides health education is consistent with the mission and goals of higher education.
Health education is both a process and a program. Health and counseling service professionals should use every student contact as an opportunity to address key health indicators from a variety of contexts. Institution health and counseling services have the opportunity to promote positive attitudes, healthy lifestyles, and responsible self-care. Students should be encouraged to become active participants in promoting and protecting their health and wellbeing.
A systematic assessment of the target population’s needs should provide direction and highlight the most significant areas needing attention and prevention efforts. Including students as active participants in the process of identifying needs enhances the possibility of success. The American College Health Association’s Healthy Campus document (modeled after the nationally recognized Healthy People documents and updated every ten years), identifies a number of high priority issues for campus settings. Health education/health promotion/prevention activities should address significant issues such as:
- Alcohol and other drugs
- Sexual health
- Social and emotional health
- Coping with stress in competitive education environments
- Intentional and unintentional injury
- Psychological relationships to food
- Suicide Prevention
- Health services costs and availability of insurance
- Links between campus health services and other academic and service departments
Programming and services should use a variety of screening foci, sites, and methods, e.g. one-on-one encounters, informal group or formal classroom sessions, co/sponsored theme health events, or programming by trained Peer Health Educators who share their skills with fellow students. Methods should be developed for evaluating the quality and effectiveness of programming and services.
Each institution’s health and counseling services should play a role in addressing the core functions of public health, including assessing the health related needs of the campus, supporting policies that promote and protect the health of the campus community, and collaborating with other institution departments to assure that needs are addressed.
The institutions of the UW System exist both as discrete communities and as components of the larger community where they are located. Protecting the health and safety of members of the institution’s community requires a robust institutional public health surveillance infrastructure that will address 1) communicable disease surveillance/prevention through disease identification and reporting, epidemiologic investigations, screening programs, immunization programs, and plans/procedures for quickly responding to disease outbreak situations, 2) issues of environmental health and safety including food safety, air quality, waste disposal, pest control, and water quality including swimming pool inspections, and 3) identification and intervention of at risk students and situations, for example: educating the community, behavioral intervention teams, threat assessment, and suicide prevention programming.
The institution, usually through its health service, should have strong collaborative relationships and agreements (delineating roles and responsibilities) with local (city and/or county) public health agencies. Institution health services should provide the critical link to these agencies. Each institution’s health and counseling services should be active participants in the institution’s crisis response planning.
Access to Affordable and Sufficiently Comprehensive Health Insurance
Access to the full range of health and mental health services that students might require during their academic experience requires adequate health insurance coverage. Institutions must provide access to a university sponsored health insurance plan that is reasonably priced. The plan must complement the health and counseling services provided by the institution. When feasible, collaboration among institutions to develop a common plan is encouraged. Each institution’s health and counseling services should take a leadership role in selecting the plan and communicating its importance to students and their families. Institution health services should encourage all students to have comprehensive, affordable health insurance.
Quality Management and Improvement
The University of Wisconsin System is committed to the principles of quality management and improvement and expects institutions to apply these principles in providing health and psychological counseling services to students. Institution health services are encouraged to seek formal accreditation by a national health care accrediting organization such as the Accreditation Association for Ambulatory Health Care (AAAHC). Mental health counseling units should use the International Association of Counseling Services Accreditation Standards (IACS). Both health services and mental health services may want to consider The Council for the Advancement of Standards in Higher Education (CAS) as a model for designing and organizing services. Absent formal accreditation, institution health and counseling services should seek periodic external review of their programs and services.
Institution health and counseling services are expected to have or participate in a quality management program that includes a process for credentialing, privileging and/or licensure of providers and other professional staff, a system of peer review for providers, ongoing systems for assessing/evaluating utilization and patient/client satisfaction, and a quality improvement program addressing clinical care issues, administrative concerns, and cost of care issues.
Funding Options and Strategies
Existing University of Wisconsin System and Board of Regents policies delineate the acceptability of several options for funding the provision of health and psychological counseling services to students. Student segregated fees are the preferred primary funding source for student health services and health education/wellness programs [UW System Administrative Policy (SYS) 822, Student Services Funding (formerly G15)]. General program revenue funding (GPR) and fee-for-services funding are deemed acceptable. General program revenue is the preferred primary funding source for counseling services including personal individual, group, crisis intervention, and AODA counseling; outreach and prevention; and consultation with faculty and staff regarding student problems (SYS 822, Student Services Funding). Segregated fees and fee for non-crisis services funding are deemed acceptable. Most campuses will use a combination of these three funding sources. Students should play an important role in determining the balance between segregated fee and fee for service funding. There should be a goal of keeping student out of pocket costs at a minimum. It is important to limit out of pocket expenses so that cost will not be a barrier to students receiving necessary health care and counseling services.
UW System Administrative Policy 820, Segregated University Fees (formerly F50), specifically describes appropriate categories of segregated fee expenditures for the operations and activities of institution health and counseling services. These include salaries for staff including student staff, professional services, facilities/equipment/supplies/services, organizational membership fees, and debt service reduction. Regent Policy Document 19-8, Funding of University Facilities Capital Costs, specifically prohibits the use of segregated fees as a source of funding for the construction of student health and counseling service facilities. GPR funding is the prescribed funding source for construction of student health service facilities. Gift funds are an allowable/acceptable source.
History: Res. 1797 adopted 12/08/1978; with 1984 amendments. Res. 9012, adopted 05/06/2005; Res. 9701, adopted 12/11/2009. Res. 10835, adopted 03/09/2017, authorized technical corrections.
SYS 820, Segregated University Fees (formerly F50)
SYS 822, Student Services Funding (formerly G15)
[UW System Administrative policies are included for reference and are separate from Regent Policy Documents adopted by the Board.]