How to Handle an International Student or Scholar Medical Crisis

1. How to Handle an International Student or Scholar Medical Crisis NAFSA: Association of International Educators 2012 Annual Conference Houston, Texas June 1, 2012

2. Presenters Elaine del Rossi, HTH Worldwide Insurance edelrossi@hthworldwide.com Ellen Dussourd, State University of New York at Buffalo dussourd@buffalo.edu Trisha Marrapese, University of Texas-Austin trisha@austin.utexas.edu Chair: Patricia A. Burak, Syracuse University paburak@syr.edu

3. Case Study I Two students from an upstate New York university have a car accident in Wyoming during winter break. They are taken to a local hospital. The driver is okay, but the passenger is in critical condition. He needs to be flown to a critical care facility, but is not stable enough to be airlifted. Since his condition is life-threatening, the hospital contacts the University Police, who contact you.

4. What do you do now? Whom do you contact? Why? How? When?

5. Case Study #1 (cont.) • You try to reach the student’s parents, but there is no answer. • The hospital tells you that the student won’t survive the night. • The hospital tells you that the driver has been sobbing uncontrollably since arriving at the hospital. • Many of the student’s friends are phoning your office to find out about the student.

6. What do you do now? • What can you do to reach the student’s parents? • Who needs your support? How can you provide it? • Whom do you keep informed? • What do you tell the student’s friends who are calling?

7. Case Study #1 (cont.) • You find out from the student’s friends that his parents should be at home. Although it is late at night, no one answers the phone. • You talk to the driver. He is distraught, but aware and coherent. He tells you that he and his roommate flew to California to pick up the car from his sister and then drive it to New York State.

8. What do you do now? • What other ways can you use to reach the student’s parents? • Whom else will you contact?

9. Case Study #1 (cont.) • Your Student Assistant searches online for the phone number of the police in the student’s hometown. She calls them, explains the situation and asks them to go to the student’s house to inform the parents. They agree to do so. • You ask the driver for his sister’s contact information, call her and ask her to go to Wyoming to support her brother.

10. Case Study #1 (cont.) • The police find the parents at home and inform them about the accident. • You call the parents to tell them to expect a phone call from the hospital. You find that the father speaks some English. • The student dies. The hospital calls the parents and informs them. • The hospital tells you that the father is worried about how to get his son’s body home.

11. What do you do now? • Who needs to be informed now? • Who can help with the repatriation? • Who needs support now? Who can provide it?

12. Case Study #1 (cont.) • The driver’s sister flew to Wyoming and is now driving through a snowstorm to the hospital. • The medical evacuation company has started making arrangements for the student’s body to be repatriated. • The student’s father wants to come to Wyoming to bring his son’s body home. • The pastor of the son’s church in New York State is flying to Wyoming.

13. What do you do now? • Who needs support now? • Who should communicate now with the father? • What concerns you now?

14. Case Study #1 (cont.) • The student’s father, pastor and driver’s sister are all in Wyoming. • There is no recrimination. The student’s father had a talk with the driver and told him that his son’s death was not his fault. • Arrangements to repatriate the student’s body are coming along very slowly. You receive conflicting information from the medical evacuation insurance call center.

15. What do you do now? • How will you speed things up? • How will you resolve the conflicting information from the call center?

16. What did you learn? • Follow campus protocols (e.g. notification). • Carefully document what happens. • Obtain contact information each time you talk to someone. Create an easy-to-reference list of contact information. • Take advantage of services offered by the insurance company. • Don’t do it all yourself. Accept help from others who can help. • Be mindful of FERPA.

17. Health Insurance:What you need to know to help Medical evacuation: howdoes it work? • Escort to home country • Family member travelling to U.S. Repatriation: where do you begin? HIPAA requirements: what is needed? “Release of Information” Consent Form

18. HIPAA Privacy Authorization Form

19. Practical Considerations • Cultural sensitivities, taboos, language related to illness and medical practices • Support networks in the community • Information sharing within the institution: FERPA & HIPAA considerations • Hospital visitations – special issues

20. Case Study #2 • It is International Education Week. • A sponsored student studying for her Ph.D. qualifying exams has symptoms resembling a seizure and passes out in her apartment. • Her roommate calls University Police. They find the student unresponsive and give her CPR. • The student is taken to the hospital. • University Police inform you.

21. What do you do now? Who do you contact? Why? How? When? Do you go to the hospital?

22. Who do you contact? Student’s Family National Group Friends

23. Who do you contact? Student’s academic department Incident Team/Crisis Team/Students of Concern Team Dean of Students Student Health Center Director

24. Who do you contact? • Will any off campus/community entities be involved? • Should the Embassy/Consulate be notified?

25. Case Study #2 (cont.) • The student is admitted to the ICU. • She undergoes many tests. There is no clear diagnosis • The student’s sister drives to upstate New York. • Her Ph.D. advisor and classmates visit her regularly. • She is on her sponsor’s medical insurance. You aren’t familiar with the company.

26. Case Study #2 (cont.) • The sister stays in the hospital around the clock. She is not happy with the care her sister is receiving or the lack of diagnosis. • The family wants the student to be transported to a hospital close to the sister. The doctors won’t permit any travel. • One week later, there is still no diagnosis. Everyone is becoming more frustrated.

27. What do you do now? • Do you visit the student? • What do you do to relieve the frustration? • Help with the impasse?

28. Case Study #2 (cont.) • You ask the student to sign a release so your Student Health Center physician can communicate with the doctor. She refuses because she doesn’t want to offend her doctor. • The doctor believes she has a brain tumor and wants to operate. • The student and her sister refuse.

29. Case Study #2 (cont.) • The Ph.D. advisor helps obtain a second opinion. It is identical. • The family agrees to the surgery. • The doctor operates and discovers that she had a stroke.

30. Case Study #2 (cont.) • The student is moved to a post-surgical floor. The nurses are not nearly as attentive. • The student suffers an allergic reaction to the anti-seizure medication, which causes burns all over her body. • She is moved to the burn unit. 

31. What do you do now? Continue to share information

32. Case Study #2 (cont.) • She eventually recovers, but it takes a long time and she suffers greatly along the way.

33. What do you do now? What can you do to support her during her recovery? Who could be involved?

34. Advising Her to Return Home • Why would you do this? • Who should be involved?

35. Health Insurance: What you need to know to help • Medical evacuation: how does it work? • Escort to home country • Family member travelling to USA • HIPAA requirements: what is needed?

36. FERPA Release/HIPAA Release • HIPAA • FERPA

37. Checklist Medical Checklist

38. Comprehensive Resource on Crisis Management for the International Student and Scholar Services Office NAFSA Website

39. Crisis Management in aCross-Cultural Setting

40. Resource Bibliography International Student Resources bibliography.docx

41. This PowerPoint is posted at http://international.syr.edu/ may be used with the permission of the presenters.