Policy

With eating disorders, a medical leave is sometimes necessary to protect the safety of a student. Usually this is because the student's illness is advanced enough to require hospitalization or intensive day treatment beyond the scope of University medical and psychological resources. A medical leave is also sometimes deemed necessary when an individual student's eating disorder has negatively impacted the integrity of the University's learning environment.

1. Before an involuntary medical leave is considered, efforts will be made to encourage the student to take a voluntary medical leave, thus preserving, to the extent possible, confidentiality and privacy.
2. This policy will be invoked only in extraordinary circumstances, when a student is unable or unwilling to request a voluntary medical leave of absence.

Protocol

Placing a Student on Involuntary Medical Leave of Absence

The Dean of Students or a designee may be alerted to a student's behavior-e.g., self-starvation, severe purging, or dangerously low body weight-which is believed to be either threatening to themselves or the integrity of the University's learning environment. In consultation with the Eating Disorders Team of Health Services at Columbia, the Dean of Students will gather necessary information to draw a conclusion about the student's illness. This may include a required evaluation by the ED Team (in the instance of students who are not known by the team). The student will be informed of the requirement of a mental and/or physical evaluation. The student will be further informed, in writing, of the Dean's access to information emanating from this evaluation.

If the student fails to comply with the advised medical evaluation, then the student's parent, guardian, or appropriate emergency contact may be notified and the student may be asked to leave the University. The University may take this action out of concern for the student's health and welfare.

If the Dean then deems it appropriate, upon the recommendation of the Health Services staff, to pursue a medical leave, these steps will be initiated:

1. Whenever possible and appropriate, the Dean of Students or a designee will encourage the student to take a voluntary medical leave of absence.
2. If a voluntary medical leave is not possible, the Dean of Students or a designee will notify the student that an involuntary leave is under consideration.
3. The Dean of Students or a designee will discuss with the student the implications of and procedures relating to an involuntary medical leave of absence. A copy of this policy will be provided to the student. Whenever possible and appropriate, the Dean of Students or a designee will encourage the student to take a voluntary medical leave of absence.
4. In addition to the Eating Disorders Team, the Dean of Students or a designee may choose to confer with the following individuals regarding the need for a medical leave of absence:
   • the Assistant Vice President and Medical Director of Health Services at Columbia
   • the Associate Medical Director, Primary Care Medical Services
   • the Associate Director of Counseling and Psychological Services
   These consultations will include information regarding the reasons for invoking an involuntary medical leave, specifically whether the student engages in, or is judged to be likely to engage in, behavior that poses a clear danger to themselves or others, or disrupts the learning environment.
5. Following these steps, the Dean of Students or a designee will make a final decision regarding the involuntary medical leave of absence and will provide written notice of this decision to the student (and their parents, guardians, or others if appropriate), and all members of the team who conferred with the Dean or designee.

If Involuntary Medical Leave Is Imposed

A student who is placed on an involuntary medical leave may appeal the decision to the Dean of the student’s school within three (3) business days (excluding weekends and federal and state holidays) of the decision. The appeal should be made in writing and should set forth the basis for the appeal. The Dean (or their designee) has three (3) business days from receipt of the appeal (excluding weekends and federal and state holidays) to affirm or reverse the decision, which is then considered final. The Dean (or their designee) may extend the time limits set forth above as necessary. While the appeal is pending, the original decision of the Dean of Students will stand.

Re-enrollment will require documented proof of ED treatment (both medical and psychological) during the leave as well as clear evidence of improvement of overall health status. Re-enrollment will require formal evaluation of the ED Team prior to approval.

If Involuntary Medical Leave Is Not Imposed

The Dean of Students or a designee will so notify the student, and all persons who consulted, with the Dean. The Dean of Students or designee may impose other conditions and/or requirements under which the student is allowed to remain at the University; these conditions will be included in the notification and could include regular scheduled follow-up with the clinical members of the Eating Disorders Team.

Implications of an Involuntary Student Leave of Absense for Reasons of Personal or Community Safety

Leave in Effect

Until the student complies with the mandated medical and psychological prerequisites to re-enrollment.

Duration of Leave

As determined by the Dean, but generally no fewer than two full, regular, consecutive, academic terms.

Student Must Leave Campus

Within the time frame set forth by the Dean of Students or designee.

Student May Visit Campus

Only as authorized in writing by the Dean of Students or designee, for the duration of the leave.

Notification

The Dean of Students or designee reserves the right to notify a parent, guardian, or other person if notification is deemed appropriate. In addition, the parent, guardian, or other person may be asked to make arrangements for the safe removal of the student from the University environment.

Transcript Notation

Would read “Leave of Absence.”

Request for Re-Enrollment

If a student has been on an involuntary medical leave of absence for an eating disorder, the student will be notified in writing of the procedures regarding re-enrollment. In this circumstance, the Dean of Students or a designee, in consultation with the Eating Disorders Team and the Associate Director of Counseling and Psychological Services, would make the decision regarding re-enrollment. A formal request for re-enrollment must be submitted by the student. The student’s re-enrollment request will be reviewed by the Dean of Students or a designee, who must approve it. The Dean (or designee) will consult with the ED Team and other members of Counseling and Psychological Services and/or Primary Care Medical Services to develop recommendations for maintaining enrollment (e.g., weight requirements, scheduled visits with counselors and/or medical staff, regular follow-up with Dean of Students). The Dean of Students (or designee) will notify the student if re-enrollment has been approved.

Responsiblities

The major responsibilities each party or designee has in connection with Involuntary Medical Leave related to Eating Disorders are:

Student

• Abide by the decision made by the Dean of Students or a designee to take an involuntary medical leave of absence. • Submit a formal request for re-enrollment to the University after an involuntary student leave of absence and when required, willingness to adhere to conditions for re-enrollment.

Assistant Vice President, Health Services

• If a student’s health or safety is at risk, the AVP Health Services or designee will communicate with the Dean of Students to initiate the consideration of an involuntary medical leave.

Dean of Students or Designee

• Consult with designated administrators to formulate a plan for and provisions of a student’s involuntary leave of absence. • Communicate to the student the outcome of the proceedings and the terms of the leave of absence. • In consultation with the ED Team and other relevant parties, approve or deny requested re-enrollment of a student who has been on involuntary medical leave.

ED Team

• Provide consultation for the Dean of Students or designee as requested. • Work with the student in formulating a plan for in-patient or out-patient treatment outside of Columbia University.

Associate Director, Counseling and Psychological Services

• Assist the Dean of Students and ED Team in assessing student’s need for medical leave of absence. • Assist the Dean of Students as requested in determining if re-enrollment after involuntary medical leave and treatment is appropriate.

 

8/2012