Student Transmissible Disease Policy

To whom this policy applies

University of Nevada, Reno School of Medicine (UNR Med) Students

Who needs to know this policy

UNR Med students, faculty and staff, residents and visiting medical students, UNR Med patients and their families, UNR Med health care team members and community partners

Purpose/Background

The purpose of this policy is to develop a framework in which to review, evaluate and respond to any instances of students who have chronic infections caused by the Human Immunodeficiency Virus (HIV), Hepatitis B (HBV), Hepatitis C (HCV), and/or any other potentially transmissible chronic disease that could impact patient-care activities. This policy establishes the convening of the UNR Med Transmissible Disease Expert Panel to manage the impact of the chronic infection on the students' education.

Policy

Students who are infected with HIV, HBV, HCV, and/or any other potentially transmissible chronic disease will not be excluded from participating in patient care activities, or restricted in their access to patient care services or facilities because of their health status, unless medically-based judgments in individual cases establish that exclusion or restriction is appropriate for the welfare of the student, patients and other members of the patient care community. Any and all rights and actions described herein will comply with the Americans with Disabilities Act.

• Any student engaged in patient care activities who knows, or has reasonable basis for believing, that they are infected with HIV, HBV, HCV and/or any other potentially transmissible chronic disease is required to be under the continuous care of an appropriate health care provider about their health status and is obligated, ethically and legally, to conduct themselves responsibly in accordance with such knowledge for the protection of patients and other members of the community.
• Any student who knows, or has reasonable basis for believing, that they are infected with HIV, HBV, HCV and/or any other potentially transmissible chronic disease prior to matriculation must notify and report this to their program as described below within 10 business days of the first day of their program's orientation.
• Upon knowledge of or forming a reasonable belief that they are infected with or are at high risk of infection with HIV, HBV, HCV, and/or any other potentially transmissible chronic disease, a student must desist immediately from performing such exposure-prone procedures as outlined by the U.S. Centers for Disease Control and Prevention (CDC) and must notify and report said disease to their program as described below.
• If an individual other than the student has reason to believe that a student is infected with HIV, HBV, HCV, and/or any other potentially transmissible disease, the notification and reporting requirements outlined above are applicable to that individual.
• The UNR Med Transmissible Disease Expert Panel shall make recommendation(s) on whether or not a student may continue to perform exposure-prone, patient care activities related to the educational process, and/or whether any other modification and/or restriction to the student's academic activities is necessary.
• A student who does not share that information as provided in this policy may be subject to disciplinary action, up to and including dismissal from UNR Med schools and programs.

Definitions

CDC: CDC stands for the U.S. Centers for Disease Control and Prevention.

UNR Med Transmissible Disease Expert Panel: An expert panel made up of various individuals appointed by the UNR Med Dean to provide oversight of issues related to transmissible disease.

Exposure-prone procedures: As outlined by the U.S. Centers for Disease Control and Prevention (CDC).

HBV: Hepatitis B, which is one type of viral Hepatitis.

HCV: Hepatitis C, which is one type of viral Hepatitis.

HIV: Human Immunodeficiency virus, the virus that causes Acquired Immunodeficiency Syndrome (AIDS).

Orientation: as defined by each program (e.g. MedFIT for MD students)

Patient care activities: The activities that have a direct influence on the care of a patient.

Universal Precautions: As outlined by the U.S. Centers for Disease Control and Prevention (CDC), including the appropriate use of hand washing, protective barriers and care in the use and disposal of needles and other sharp instruments.

Responsibilities & Procedures

Notification and Reporting Requirements

The student must notify, in writing, the following individuals from their respective program per the policy above.

• Medical Students
  • UNR Med associate dean for admissions and student affairs
• Physician Assistant Students
  
  • PA students, the PA Program Director
• Speech Pathology and Audiology Students
  • SPA Safety Officer

The associate dean for ASA, PA program director and SPA Safety Officer shall then notify the senior associate dean for academic affairs who will convene the UNR Med Transmissible Disease Expert Panel for discussion and, if necessary, the formation of a recommended action plan(s).

Confidentiality

UNR Med recognizes the importance of protecting, to the greatest extent possible and within the bounds provided by the law, the confidentiality and privacy of any student infected with HIV, HBV, HCV, and/or any other potentially transmissible disease. Accordingly, such information will be handled by the UNR Med and university employees who come into possession of this information with the same degree of care and sensitivity accorded to other types of highly confidential medical information.

• Due to the responsibility that UNR Med also has to protect patients, employees, and students from the harmful acts and/or conditions of its students, there cannot be a guarantee of complete confidentiality that may interfere with this responsibility.
• It is a condition of enrollment that students subject to this policy agree to the disclosure of information regarding their HIV, HBV, HCV, and/or any other potentially transmissible disease infection as provided hereafter and for the purposes set forth herein.

UNR Med Transmissible Disease Expert Panel Membership

The UNR Med Transmissible Disease Expert Panel shall be appointed by the UNR Med dean and/or their delegate.

The UNR Med Transmissible Disease Expert Panel standing membership shall be comprised of, but is not limited to: senior associate dean for academic affairs (convener), a representative from the UNR Student Health Center; a physician specializing in infectious disease, an infection control specialist, an ethicist, and a compliance specialist; Additional members from the various programs will be added as needed depending on the specific students involved as follows:

• MD students, the associate deans for ASA and OME
• PA students, the PA Program Director
• SPA students, the SPA Safety Officer

All members of the Panel must be current UNR faculty (including community/adjunct faculty). The UNR Med general counsel will advise the panel.

UNR Med Transmissible Disease Expert Panel Responsibilities

The responsibilities of the UNR Med Transmissible Disease Expert Panel are to: maximize the protection of patients from exposure to HIV, HBV, HCV, and/or any other potentially transmissible chronic disease transmission by the individual; maximize the protection of the student from infectious exposure; and, maximize the confidentiality with respect to all matters related to the individual.

• The UNR Med Transmissible Disease Expert Panel shall make recommendation(s) on whether or not a student may continue to perform exposure-prone, patient care activities related to the educational process, and/or whether any other modification and/or restriction to the student's academic activities is necessary.
• The UNR Med Transmissible Disease Expert Panel recommendations shall be based on and consistent with established/published guidelines as outlined by the U.S. Centers for Disease Control and Prevention (CDC) and other documented resources, information and/or research deemed appropriate by the UNR Med Transmissible Disease Expert Panel.
• Recommendations issued by the UNR Med Transmissible Disease Expert Panel are final and binding, and shall be followed by all parties involved including, but not limited to: students and faculty.
• If the UNR Med Transmissible Disease Expert Panel and/or UNR Med determines that no reasonable accommodation exists that would enable the student to perform their academic activities without posing an unacceptable risk to patients or to themselves or others, UNR Med shall modify, restrict, or discontinue the academic activities of a student infected with HIV, HBV, HCV, and/or any other potentially transmissible chronic disease in accordance with this policy.

UNR Med Transmissible Disease Expert Panel Protocol

The UNR Med Transmissible Disease Expert Panel shall meet at least once per academic year in addition to a case-by-case basis to assess, reassess and, where appropriate, to modify its original recommendations as circumstances warrant.

• Upon notification as outlined in Notification and Reporting Requirements, the designated school/program official presents to the UNR Med Transmissible Disease Expert Panel any and all reports received for discussion.
• The UNR Med Transmissible Disease Expert Panel will review the report and, if necessary, formulate a recommended action plan.
• The UNR Med Transmissible Disease Expert Panel will issue recommendation(s) within a reasonable time frame.
• Recommendations of the UNR Med Transmissible Disease Expert Panel may include, but are not limited to postponement of, modification of, or discontinuation of a student's educational process.
• The designated school/program official shall notify the student and all appropriate parties in writing of the determination of the UNR Med Transmissible Disease Expert Panel. Said notification shall include a copy of the Panel's recommendations.
• The student must comply with the recommendations of the UNR Med Transmissible Disease Expert Panel. Failure to do so may result in the discontinuation and/or restriction of the student's activities related to the educational process; or, dismissal from UNR Med schools and programs.

Alternative patient care and career opportunities

Students whose educational activities are modified because of their HIV, HBV, HCV, and/or any other potentially transmissible chronic disease infection status should, whenever possible, be provided opportunities to continue appropriate patient care activities.

Students, whose educational activities are modified because of infectious chronic disease, should be reevaluated periodically to determine whether their infectious chronic disease status changes are due to resolution of infection or as a result of treatment. Career counseling is encouraged to promote the continued use of the student's talents, knowledge and skills.