How to Handle an International
Student or Scholar Medical Crisis
NAFSA: Association of International Educators
2012 Annual Conference
Houston, Texas
June 1, 2012
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
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 lifethreatening, the hospital contacts the University
Police, who contact you.
What do you do now?
Whom do you contact?
Why?
How?
When?
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.
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?
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.
What do you do now?
• What other ways can you use to reach the
student’s parents?
• Whom else will you contact?
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.
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.
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?
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.
What do you do now?
• Who needs support now?
• Who should communicate now with the
father?
• What concerns you now?
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.
What do you do now?
• How will you speed things up?
• How will you resolve the conflicting
information from the call center?
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.
Health Insurance:
What you need to know to help
Medical evacuation: how does 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
HIPAA Privacy Authorization
Form
HIPAA Privacy Authorization Form
**Authorization for Use or Disclosure of Protected Health Information
(Required by the Health Insurance Portability and Accountability Act, 45 C.F.R.
Parts 160 and 164)**
I, Patient’s name, authorize Name of Facility/Physician to use and disclose the protected health
information described below to HTH Worldwide and/or its representatives including Name of University if
applicable. This authorization for release of information covers the period of healthcare from: 3 Month
time span.
I authorize the release of my complete health record (including records relating to mental healthcare
communicable diseases, HIV or AIDS, and treatment of alcohol or drug abuse). This medical information
may be used by the organization I authorize to receive this information for medical treatment or
consultation, billing or claims payment, or other purposes as I may direct.
This authorization shall be in force and effect until Date from Above, at which time this authorization
expires. I understand that I have the right to revoke this authorization, in writing, at any time. I understand
that a revocation is not effective to the extent that any person or entity has already acted in reliance on
my authorization or if my authorization was obtained as a condition of obtaining insurance coverage and
the insurer has a legal right to contest a claim.
I understand that my treatment, payment, enrollment, or eligibility for benefits will not be conditioned on
whether I sign this authorization. I understand that information used or disclosed pursuant to this
authorization may be disclosed by the recipient and may no longer be protected by federal or state law.
Signature of patient or personal representative:
________________________________________
Patient’s Name
Date: ___________________________________
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
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.
What do you do now?
Who do you contact?
Why?
How?
When?
Do you go to the hospital?
Who do you contact?
Student’s Family
National Group
Friends
Who do you contact?
Student’s academic department
Incident Team/Crisis Team/Students of
Concern Team
Dean of Students
Student Health Center Director
Who do you contact?
• Will any off campus/community entities be
involved?
• Should the Embassy/Consulate be
notified?
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.
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.
What do you do now?
• Do you visit the student?
• What do you do to relieve the frustration?
• Help with the impasse?
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.
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.
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.
What do you do now?
Continue to share information
Case Study #2 (cont.)
• She eventually recovers, but it takes a
long time and she suffers greatly along the
way.
What do you do now?
What can you do to support her during
her recovery?
Who could be involved?
Advising Her to Return Home
• Why would you do this?
• Who should be involved?
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?
FERPA Release/HIPAA
Release
• HIPAA
• FERPA
Checklist
Medical Checklist
Comprehensive Resource on Crisis
Management for the International
Student and Scholar Services Office
NAFSA Website
Crisis Management in a
Cross-Cultural Setting
Resource Bibliography
International Student Resources
bibliography.docx
This PowerPoint is posted at
http://international.syr.edu/ may be used
with the permission of the presenters.