HARVARD UNIVERSITY HEALTH SERVICES (HUHS)

David S. Rosenthal, MD, Director
75 Mt. Auburn Street
Appointments: 617-495-8414 or 617-495-2001
Nights, Weekends, and Holidays: 617-495-5711; TTY: 617-495-1211
www.huhs.harvard.edu

Harvard University Health Services (HUHS) provides high quality, comprehensive, confidential health care to students, staff, faculty, and their dependents 24 hours a day, 365 days a year. Primary care and counseling services are available at the main health center, located at Holyoke Center in Harvard Square, as well as at satellite clinics on the Business, Law, and Medical School campuses. Behavioral health and academic counseling services are also provided at the 5-7 Linden Street location in Harvard Square. A range of other medical and surgical specialty services are available at the Holyoke Center location, including allergy; dermatology; ear, nose, and throat; general surgery; nutrition; obstetrics and gynecology; ophthalmology; orthopedics; pediatrics; physical therapy; and laboratory and radiology services. Also on-site are a comprehensive dental service, a pharmacy, an optical shop and a wellness/health education center.

Harvard University Student Health Plan Member Services
Holyoke Center, 1st floor 617-495-2008
mservices@huhs.harvard.edu

The Harvard University Student Health Plan has two parts that work together:

1. The Student Health Services Fee (SHF) covers most services at the Harvard University Health Services (HUHS).
2. Blue Cross Blue Shield PPO (BCBS) is designed to complement the healthcare benefits available under the SHF and covers hospitalization, emergency care, and some services and procedures not available through HUHS.

Those students who have coverage under a different health plan that meets the Commonwealth of Massachusetts requirements may be eligible to waive the BCBS portion of the Harvard University Student Health Plan. All waivers must be completed on-line by September 30 for the fall and March 31 for the spring; no waivers will be accepted after these deadlines. Before making this important decision, please review the Harvard Student Health Plan summary of benefits, limitations, and restrictions and the Commonwealth of Massachusetts requirements, available on the HUHS website (click "Student Insurance"). If you are unable to access the HUHS website and need to request printed forms, or if you have questions, please contact a Member Services representative.

Confidentiality and Consent

The confidentiality of all records and other medical information about patients at HUHS is protected to the full extent of the law and follows the ethical practice guidelines of the medical, psychiatric, and psychological professions. Patient records from the Mental Health Service and student records from the Bureau of Study Counsel are kept separate from general medical records (see also Bureau of Study Counsel, page 493). Records of all types are kept in secure locations and are available only to the HUHS staff members directly involved in a specific case. Written authorization from the student is necessary to release record information to any third party except in highly unusual circumstances as required by law, or as indicated in the following paragraphs. More specific information about the privacy and security of medical records held by HUHS can be found in the HUHS Notice of Privacy Practices, www.huhs.harvard.edu/privacy. Any questions or concerns about issues of confidentiality or patient rights at HUHS should be addressed to the Patient Advocate at 617-495-7583 or patadvoc@huhs.harvard.edu, and students can also consult the Harvard Student Health Insurance Handbook on this topic.

The College may call upon professional staff at HUHS or the Accessible Education Office (AEO) for consultation regarding the impact of a student's physical or emotional health on residence, on the necessity of a medical leave of absence, or on special academic or residential arrangements or accommodations (see also "Effect of Health Issues on Dormitory or House Residence" on page 421, "Medical Clearance for Return to Residence" on page 425, and "Attendance, Absences, Reading Period, Examinations, and Extensions" on page 67). If, as part of the consultation, the College requests medical information from HUHS about a student, then that information may be provided, in ordinary circumstances, only with the student's permission. Where permission is given, only relevant information about the impact of a physical illness, disability, emotional difficulty, or other health condition on a student's residential and academic life is discussed; information that is not relevant to the arrangements of residential and academic adjustments under consideration will not be disclosed. When a student chooses not to allow HUHS to provide such information to the College regarding pending academic or residential arrangements or accommodations, then the College will proceed to make decisions in the absence of this information. It is also always possible for students to initiate a consultation between their health care providers at HUHS and College administration.

In certain circumstances it may not be possible or advisable for professional staff at HUHS or AEO to obtain a student's consent to a disclosure of medical or mental health information. Three such circumstances worthy of note include the following:

Danger to self or others

One exception to obtaining a student's consent is the rare instance in which a student's medical condition or behavioral disturbance poses a danger to the student or threat to others or to the community. HUHS or AEO professional staff may then disclose any relevant information to any appropriate person, including College officials, for the purpose of protecting the student, others, or the community from harm. Generally, even in this situation, every effort is made to notify the student of the need to disclose and the reason for such disclosure.

Stillman Infirmary

It is generally useful for the College to know when a particular student has suffered a serious injury or illness for such purposes as arranging academic relief or assuring that the student can return safely to residence. For this reason, it is the College's policy that HUHS will normally inform the College (via the student's Resident Dean or other responsible administrator) when a student is admitted to or discharged from Stillman Infirmary. Only information regarding the fact of the admission/discharge, general medical condition, and prospects for return to residence is shared; information regarding diagnosis or treatment is not shared. This procedure is intended to alleviate the concerns of College officials as to a student's whereabouts and safety, and to allow communication with parents in the event that the parents have been unable to locate the student.

Rarely, a student may go to HUHS for urgent care who refuses to disclose his or her name for fear of privacy concerns. HUHS will make every effort to assure that student that the confidentiality of any medical records generated by such care will be fully safeguarded. If admission to Stillman is medically indicated but the student refuses to divulge his/her identity, HUHS will be unable to admit that student to Stillman. In such circumstances, the student will be transferred to a local emergency department. Thereafter, the student will need to follow the standard University policy on return to residence.

Treatment at area hospitals or medical facilities

It is HUHS' policy to notify the College of student transfers to local emergency departments. Such notification is provided to the appropriate Resident Dean, and is documented at HUHS in the Transfer Tracking Log. Exceptions to this rule include transfers for the purpose of services that cannot be provided at HUHS (e.g., suturing of lacerations or obtaining radiographs after hours) or the need for collection of evidence by a Sexual Assault Nurse Educator (in which case notification is provided to the Office of Sexual Assault Prevention and Response rather than to the Resident Dean). If a Resident Dean, other residential official, or College administrator has reason to believe that a student is not in residence and may be in a medical facility, he/ she may contact HUHS regarding a student's whereabouts. The HUHS clinician will disclose only that the student is safely in care. When in a HUHS clinician's medical judgment, a student is in a life-threatening condition, or is medically or psychologically unstable, or has sustained an illness or injury that will likely result in a hospital admission or require care after discharge, that clinician will notify the student's Resident Dean, residential official, or College administrator. Only information regarding the fact of the admission/discharge, general medical condition, and prospects for return to residence is shared; information regarding diagnosis or treatment is not shared. Students returning from emergency care or hospitalization at area facilities ordinarily will be referred to HUHS for assessment regarding suitability to return to residence, and to AEO for consultation regarding the need for follow-up services and accommodations.

When a student who has been hospitalized or received emergency treatment decides to leave a medical facility against medical advice, a HUHS clinician may apprise that student's Resident Dean or other appropriate College official of this decision, if in the clinician's judgment the student's decision may pose a significant risk of physical or emotional danger to the student, to roommates or suite mates, or to members of the residential community. Depending upon the circumstances, the clinician may inform a College official of the student's location, decision to leave a facility against medical advice, risk of further injury or relapse, or possible threat to the student's own safety or to that of others.

Patient Advocate
Holyoke Center, 1st floor
617-495-7583
patadvoc@uhs.harvard.edu

The Patient Advocate is available to assist patients in navigating the healthcare system, including

1. assisting individuals with arrangements for special needs
2. interceding on behalf of patients who feel they have encountered a problem
3. answering questions and concerns

All requests are welcome, including positive comments and recommendations for improvement, and all communications are kept in the strictest confidence. Comment Forms may be submitted to any of the suggestion boxes located throughout HUHS or through the HUHS website at huhs.harvard.edu/PatAdvoc.

Special Needs

HUHS is prepared to meet the general and special health care needs of students, faculty, staff, and retirees with disabilities. Early contact with a primary care clinician is advised to establish a base for continuity of care during a student's active stay at Harvard. A variety of access services are available through the Access and Disability Services Office, including sign-language and oral interpreters. Wheelchair-accessible restrooms are located throughout HUHS at Holyoke Center, and Stillman Infirmary shower and bathroom facilities are fully equipped for patients with limited mobility. The Patient Advocate (617-495-7583) is available to provide orientation to HUHS on an individual basis, assist individuals with arrangements for special needs, and answer any healthcare-related questions or concerns

Primary Care Services
Holyoke Center, 3rd floor
Internal Medicine 3 East: 617-495-2001
Internal Medicine 3 North: 617-495-8414
Mon.-Fri., 8 am-5:30 pm

* summer hours vary

HUHS is committed to providing each student with complete, coordinated health care through a working relationship with a particular primary care team, comprised of a primary care physician (PCP), nurse practitioner, registered nurses, and health assistants. Our teams work closely with students to provide high-quality outpatient healthcare services in a friendly, comfortable atmosphere. These include

• physical exams
• office gynecology (tests, screenings, contraception)
• evaluation of acute illness and injury
• continued care of chronic medical conditions
• immunizations and travel consultations
• health promotion and disease prevention
• education referrals to HUHS specialists

Physicians at HUHS are experienced board certified or board-eligible internists or family physicians who provide high-quality preventive and acute care. Nurse practitioners (NPs) hold advanced degrees and are board certified in family or adult medicine, and are trained to evaluate and treat many acute and common conditions, write prescriptions, order diagnostic testing and provide preventive care in consultation with the PCP. Registered nurses (RNs) provide initial assessment for medical problems, help to facilitate appointments and navigate the health care system, provide routine immunizations, and offer advice on common health concerns and questions. PCP team members also help to coordinate any necessary specialty services both at HUHS and in the Cambridge/Boston area.

Students are encouraged to choose a primary care team if one has not already been assigned (as with new students) and should consult the HUHS website for a complete listing of primary care clinicians. Clinicians may be changed at any time for any reason. Students with chronic medical conditions are advised to establish a relationship with the primary care team early in the academic year. It will be helpful to provide copies of medical records of health care received at other facilities.

Appointments

Students may schedule routine and non-urgent appointments by calling the PCP team directly during regular business hours. HUHS makes every effort to accommodate any student who wishes to be seen on any given day for a medical concern or illness, and appointments are reserved each day to accommodate urgent medical concerns. Students may also wish to speak with a nurse prior to making an appointment to determine appropriate care and treatment.

Cancellations must be made at least 24 hours in advance of a scheduled appointment by contacting the Primary Care team. HUHS reserves the right to charge for "no-shows."

Students needing to renew prescriptions are advised to call the Primary Care team at least 48 hours in advance to allow time to process the request.

Emergency Services

Any student experiencing symptoms of a medical emergency (e.g., chest pain, severe shortness of breath) should call 911 immediately. After-hours and weekend care for non-routine, urgent medical concerns or symptoms is available through the After Hours Urgent Care Clinic (see below).

Immunizations and Travel Health
617-495-5182

Required Immunizations

All students are required to comply with the Massachusetts immunization law prior to registration. Team/triage RNs are available to administer routine immunizations, and students may term bill or pay by cash or credit card for any immunizations required. Complete information regarding required immunizations is available on the HUHS website.

Travel Health Immunizations and Information

HUHS provides immunizations and related services prior to foreign travel, including

• expert counseling and advice
• review of CDC recommendations for travel
• review of individual immunization needs
• vaccinations
• prophylactic medication prescriptions

HUHS recommends scheduling travel health appointments six to eight weeks in advance of travel.

After Hours Urgent Care Clinic (AHUCC)
Holyoke Center, 5th floor
617-495-5711, TTY: 617-495-1211
Weekdays: 4 pm-8 am
Weekends and Holidays: 24 hours

The After Hours Urgent Care Clinic (AHUCC) is open nights, weekends, and holidays for 24-hour urgent care throughout the year. A physician and one or more nurses are on duty and other clinicians and technicians are on call; a mental health clinician and a psychiatrist are also on call 24 hours a day. Whenever possible, students are encouraged to call their primary care team or mental health provider for advice during regular office hours (8 am to 5 pm). Ideally, students should use the AHUCC for issues that cannot wait until regular clinic hours. Students who feel that they need medical or mental health attention but are not sure as to the urgency of the situation are advised to call first to obtain advice from the nurse on duty. The entrance to the AHUCC is midway down the parking ramp beneath Holyoke Center, accessible from both Dunster and Holyoke Streets; students who require transportation to the AHUCC are advised to call the Harvard University Police at 617-495-1212.

Stillman Infirmary
Holyoke Center, 5th floor
617-495-2034
24-hour care

Stillman Infirmary, the inpatient division of HUHS, is a licensed 10-bed hospital accredited by the Joint Commission on Accreditation of Healthcare Organizations. The infirmary is designed to provide short-stay care for uncomplicated medical and mental health problems, and certain post-operative cases. Admission to the Stillman Infirmary is based on clinical indications as determined by a student's primary care team and/or the After Hours Urgent Care Clinic staff.

Anonymous HIV Counseling and Testing Service
Holyoke Center, 5th floor
Appointments: 617-495-2139; Information: 617-495-9629

Anonymous HIV counseling and testing is available at HUHS at Holyoke Center; no identifying information is required to make an appointment. A $10 fee for anonymous HIV antibody testing covers both preand post-test counseling appointments, but no student will be turned away due to inability to pay.

Confidential HIV testing is also routinely performed by HUHS primary care clinicians, often in conjunction with an overall risk assessment for other sexually transmitted diseases (STDs). Call your primary care team to schedule an appointment or to discuss HIV testing or other STD screening.

Dental Service
Holyoke Center, 1st floor
617-495-2063
Mon., Fri., 7:30 am-6 pm; Tue., Wed., Thu., 7:30 am-8 pm;
Sat., 8 am-12 Noon

Good oral health care is essential to overall well-being. The Harvard University Dental Service is conveniently located on the main campus and is open to all students on a fee-for-service basis. The Dental Service is a 12-chair practice staffed by general dentists, as well as specialty Board certified dentists and dental hygienists. It is a full-service practice offering

• diagnostic and preventive care
• restorative care (including prosthetic, implant and cosmetic dentistry)
• endodontics (root canals)
• oral surgery pediatric dentistry periodontics

Emergency care is available every day of the year. Please call or visit the HUHS website for additional information and special offers for students.

Optical Shop
Holyoke Center, 5th floor
617-495-5728
Mon.-Fri., 8:30 am-4:30 pm

The HUHS Optical Shop offers a range of products and services including

• Prescription eyeglasses and sunglasses
• Protective prescription eyewear for work, sports, and recreation (safety glasses, swim goggles)
• Computer glasses
• Adjustments and repairs

The Optical Shop operates on a walk-in, fee-for-service basis, and is open to all those presenting a valid HUID card. Payment options for students are term-billing, cash, check, Visa and MasterCard.

HUHS Pharmacy
Holyoke Center Arcade
617-496-6661; Refill Line 617-495-8468
Mon.-Fri., 8:45 am-7 pm; Sat., 9 am-1 pm;
Closed on Sundays and University Holidays

The HUHS Pharmacy is located in the Holyoke Center Arcade, adjacent to the main HUHS entrance. The Pharmacy can fill prescriptions written by a HUHS clinician, and offers a wide selection of non-prescription items at very competitive prices. The HUHS Student Health Fee includes coverage of most prescription medications with various co-payments. Limits do apply; for additional information please visit the HUHS website (huhs.harvard.edu).