Student Protective Medical Withdrawal Policy

Op5.23 Student Protective Medical Withdrawal Policy

I. Purpose and Introduction

This Student Protective Medical Withdrawal Policy (Policy) provides for the protective medical withdrawal of a student who, due to a physical, mental, emotional, or psychological health condition, presents a direct threat to the health or safety of others, such that the student should no longer continue with the student’s course of study at the university.

Any protective medical withdrawal must be conducted according to the standards and procedures described in this Policy. This Policy will be applied in a nondiscriminatory manner consistent with applicable federal and state laws prohibiting discrimination based on disability and with G1.05 Non-Discrimination Policy Statement.

Any person who has reason to believe that a Missouri State University student is exhibiting behaviors addressed in this policy is encouraged to make a report (hereinafter “Report”) to the Dean of Students. Such Report may be oral or in writing (including through Missouri State University’s online reporting mechanism). Upon receipt of such Report, the Dean of Students should conduct a preliminary, informal review of the matter and determine the appropriate course of action under this or any other university policy.

II. Protective Medical Withdrawal

The process for the Protective Medical Withdrawal of any student under this policy will begin with the Dean of Students, and will involve the Behavioral Intervention Team (BIT), and the Protective Medical Withdrawal Hearing Panel (PMWHP, and as more fully described in Section II.B of this Policy), and, if applicable, the Vice President for Student Affairs.

A. Dean of Students and the Behavioral Intervention Team (BIT)

The Dean of Students or their designee will act as coordinator of the protective medical withdrawal process and as chair of the Behavioral Intervention Team (BIT). The BIT meets regularly, and on an emergency basis as necessary, to discuss issues relating to student behavioral concerns and appropriate interventions. Meetings may be attended by any university personnel deemed by the BIT to be relevant to a particular discussion, including, but not limited to, representatives of the Graduate College, Disability Resource Center, or International Programs.

B. The Protective Medical Withdrawal Hearing Panel (PMWHP)

  1. The PMWHP will be a committee comprised of a total of three (3) members selected from among the following departments:
    • Academic Affairs
    • Counseling Center
    • University Safety
    • Residential Life, Housing and Dining Services
    • Graduate School (for graduate student cases only)
  2. The PMWHP will be responsible for selecting a chair from among its three members. BIT members will not be eligible for membership in a PMWHP, nor will any one PMWHP be composed of more than one member from the same department.

C. Standard for Protective Medical Withdrawal

  1. The protective medical withdrawal process will be initiated only after reasonable attempts by the Dean of Students to secure a voluntary withdrawal or voluntary evaluation (medical or psychological) have been exhausted.
  2. A student will be subject to protective medical withdrawal if the Dean of Students, in consultation with the BIT, concludes that the student poses a direct threat to the health or safety of others due to a physical, mental, emotional, or psychological health condition and that condition is not being properly managed by the student.
  3. In making this determination, the Dean of Students, in consultation with the BIT, will make an individualized assessment, based on reasonable judgment that relies on current medical knowledge and the best available objective evidence, to ascertain:
    • The nature of the risk to the university community,
    • The duration of the risk to the university community,
    • The severity of the risk to the university community, and
    • Whether reasonable modifications of policies, practices, or procedures, or the provision of auxiliary aids or services will mitigate the risk to the university community.

D. Standard for Interim Withdrawal

  1. The Dean of Students may implement an Interim Protective Medical Withdrawal (Interim Withdrawal) at any time if, based on a report or other information, it is determined, in the Dean of Students’ reasonable discretion, that the student poses an immediate direct threat to the health or safety of others due to a physical, mental, emotional, or psychological health condition. A student placed under Interim Withdrawal is prohibited from attending classes and from living in university housing. In addition, the university may ban a student from campus or from any portion of campus if the university believes that a trespass order is warranted given the circumstances.
  2. The Dean of Students will provide to any student subject to Interim Withdrawal notice of such status and an opportunity to meet within two (2) business days from the effective date of the Interim Withdrawal in order to discuss: (a) the reliability of the information in the report concerning the student's condition and behavior, and (b) whether there exists a direct threat as described in this Policy.
  3. Based on this discussion, the Dean of Students will make a determination about whether to cancel the Interim Withdrawal. If the Dean of Students cancels the Interim Withdrawal, the Dean of Students may still initiate the protective medical withdrawal process in accordance with this Policy. If the Dean of Students continues the Interim Withdrawal, they will initiate the Protective Medical Withdrawal process in accordance with this Policy. The Interim Withdrawal will remain in effect until the Protective Medical Withdrawal process has been terminated or the student is withdrawn, under this Policy.
  4. If the student fails to attend the meeting described in this section within two (2) business days of the date of the notice, the Dean of Students may schedule a protective medical hearing based on the available evidence in accordance with this Section II.I.
  5. If, in the Dean of Students’ reasonable judgment, the student, subject to a report, meets the standard for Protective Medical Withdrawal but does not require interim withdrawal, the Dean of Students may initiate the Protective Medical Withdrawal process by holding the meeting described below in Section II.E.
  6. If, in the Dean of Students’ judgment, the student, subject to a Report, does not meet the standard for Protective Medical Withdrawal, the Protective Medical Withdrawal process will not be initiated, and the Dean of Students may take any other action deemed appropriate, including, but not limited to, recommending that the student seek treatment and/or referring the matter to the BIT.

E. Meeting with Student

  1. If at any time the Dean of Students determines that a student may meet the standard for Protective Medical Withdrawal, the Dean of Students will provide to the student notice and an opportunity to meet so that the Dean of Students can: i) convey the substance of the information regarding the student’s condition to the student; ii) explain this Policy and provide the student with a copy of the Policy; and iii) direct the student that he or she must provide an evaluation by an appropriate health professional and provide the Dean of Students with a copy of the evaluation within a specified time as set forth in Section II.F below.
  2. For any student subject to an Interim Withdrawal, the meeting described in this section should be held concurrently with the meeting described in Section II.D. If a student, not subject to Interim Withdrawal, fails to respond to the notice of the meeting described in this section within two (2) business days of the date of the notice, or fails to attend a meeting with the Dean of Students within five (5) business days of the date of the Notice, the Dean of Students may schedule a hearing based on the available evidence in accordance with this Policy, Section II.I.

F. Evaluation by an Appropriate Health Professional

  1. The university will contract with area health professionals to conduct the evaluation contemplated by this Section II.F. The Dean of Students may accept, in lieu of an evaluation, a written statement from a student’s treating physician, regarding the treating physician’s opinion of the student’s condition under this Policy. Students may be directed to the university health center for administration of laboratory testing, or other objective assessments of student health.
  2. The student will complete all necessary releases such that the health professional and/or treating physician may provide the results of the evaluation to and discuss the evaluation with the Dean of Students and the BIT.
  3. If a student refuses to undergo an evaluation, or refuses to provide a release authorizing the health professional to discuss the evaluation with the Dean of Students and the BIT, a hearing based on the available evidence may be scheduled in accordance with this Policy, Section II.I.

G. Consultation with BIT

  1. Upon receipt of the health professional’s evaluation, the Dean of Students will arrange a meeting with the BIT to review the evaluation. If, after consultation with the BIT, the Dean of Students determines that the available evidence, including the health professional’s evaluation, indicates that the student does not meet the standard for protective medical withdrawal set forth in Section II.C above, the Dean of Students will terminate the Protective Medical Withdrawal process. The Dean of Students may take other action deemed appropriate, including, but not limited to, recommending that the student seek treatment and/or referring the matter to the BIT for continued monitoring and follow-up.
  2. If, after consultation with the BIT, the Dean of Students determines that the available evidence, including the health professionals evaluation, indicates that the student does meet the standard for Protective Medical Withdrawal, the Dean of Students will attempt to arrange a meeting with the student to discuss such determination as set forth in Section II.H below by providing the student Notice of an opportunity to meet.

H. Meeting with Student to Review Dean of Student/BIT Determination

  1. If the Dean of Students is successful in arranging a meeting with the student to discuss the Dean of Students’ determination that the student meets the standard for Protective Medical Withdrawal, at that meeting the Dean of Students will notify the student of their right to a hearing before the PMWHP. The Dean of Students may discuss other options with the student, including but not limited to voluntary withdrawal from the university or probationary enrollment, as more fully discussed in Section II.N below.
  2. If, no alternative is agreed upon between the student and the Dean of Students at the meeting described in this subsection, the Dean of Students will schedule a hearing with the PMWHP in accordance with Section II.I below.
  3. If the student fails to attend the meeting described in this subsection within two (2) business days of the date of the notice of the meeting, the Dean of Students will schedule a PMWHP based on the available evidence in accordance with Section II.I below.

I. Scheduling a Hearing

The Dean of Students will provide notice to the student as to the date, time and place of the hearing, and the procedure described in Section II.J below. In no event will the hearing be scheduled less than five (5) business days from the date of notice provided to the student. Reasonable effort will be made to accommodate the student’s schedule in the selection of the hearing time and date; however, a conflict in scheduling on the part of a student’s family members, friends, advisors, or witnesses (as described in Section II.J, below, will not automatically result in a rescheduling of the PMWHP.

J. The Protective Medical Withdrawal Hearing

  1. The Protective Medical Withdrawal hearing will be closed to the public. Information and other evidence presented will be kept confidential pursuant to the Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. §1232g, and implementing regulations of the U.S. Department of Education, 34 C.F.R., Part 99.
  2. At the hearing, the Dean of Students will provide the PMWHP all evidence relevant to whether the student should be subject to Protective Medical Withdrawal under the standard set forth in Section II.C above. The evidence may include witnesses, written reports, documents or written statements, but must include the health professional's written evaluation, if available.
  3. The Dean of Students and the student may obtain witness statements or testimony from relevant individuals whose input would be helpful to the PMWHP (including but not limited to, faculty, Residence Life, Housing and Dining Services staff, or other students).
  4. The student's rights at the Protective Medical Withdrawal hearing will include the following:
    • The right to be present, unless the student disrupts the hearing.
    • The right to present relevant evidence.
    • The right to request the attendance of witnesses at the hearing.
    • The right to question all witnesses at the hearing and to comment upon all documents presented.
    • The right to be accompanied by an advisor. The advisor may be an attorney, but does not have to be an attorney. The role of an advisor is limited to conferring with and advising the student. The person is not permitted to argue, make statements or question witnesses, but may respond to questions if asked by PMWHP members to do so.
    • The right to be accompanied by family members, relatives, or friends. The student may also bring up to two family member, relatives, or friends to the hearing for companionship and emotional support. Such accompanying family members, relatives, or friends are not permitted to argue, make statements, question witnesses, or otherwise represent the student during the Protective Medical Withdrawal Hearing.
  5. The Dean of Students and the PMWHP will each have the right to an advisor who may be an attorney for the university. The advisor to the PMWHP will serve as a liaison between the Dean of Students, student, and PMWHP to the extent issues arise during the protective medical withdrawal hearing.
  6. The members of the PMWHP may also ask questions of any witness. All witnesses, other than the student, will be excluded during the examination of any other witness.
  7. The student and any witness at the hearing are required to sign an honesty statement and give truthful testimony. Furnishing untruthful testimony or failing to appear after an appropriate request may subject a witness to disciplinary action.
  8. Written statements by a witness, in lieu of appearance and testimony at the hearing, may be admitted into evidence if the witness is unavailable. For a witness to be considered unavailable, it must be clearly demonstrated that the witness’s attendance would result in significant and unavoidable personal hardship or substantial interference with normal activities. To be eligible for admission into evidence, such written statements must be signed by the individual writing the statement and witnessed by a person designated by the Dean of Students, or a notary public.
  9. Formal rules of evidence will not apply at the hearing. However, the chair of the PMWHP may exclude evidence that in the chair’s reasonable discretion is not relevant, is prejudicial, or is cumulative.
  10. All PMWHP proceedings will be recorded by the chair. The audio of the PMWHP will be made available to the PMWHP, the student (upon written request), the Dean of Students, the Vice President for Student Affairs (on appeal). Any other recording of the hearing is strictly prohibited. The audio recording will be preserved as set forth in the university’s record retention schedule.

K. The Finding of the Protective Medical Withdrawal Hearing Panel

  1. Following the hearing, the PMWHP will report its finding as to whether the student meets the standard for protective medical withdrawal as set forth in Section II.C above. The PMWHP will base its finding on a preponderance of the evidence presented at the hearing. At least two (2) PMWHP members must agree that a student meets the standard for Protective Medical Withdrawal for the PMWHP to issue a finding that the student meets the standard for Protective Medical Withdrawal.
  2. If the PMWHP finds that the student does not meet the standard for Protective Medical Withdrawal, it will so inform the student, the Dean of Students, and the Vice President for Student Affairs in writing. Notwithstanding this finding, the Dean of Students may take any other action he / she deems appropriate short of Protective Medical Withdrawal, including, but not limited to, recommending that the student seek treatment and/or referring the matter to the BIT for continued monitoring and follow-up.
  3. If the PMWHP concludes that the student does meet the standard for Protective Medical Withdrawal, the PMWHP must state this finding in a written report that will include its reasoning for this conclusion. This written report will be provided to the student, and the Dean of Students.

L. Appeal to the Vice President for Student Affairs

  1. Within five (5) business days from receipt of the PMWHP’s finding, the student may submit a written appeal of the finding to the Vice President for Student Affairs (Vice President). The finding of the PMWHP will not take affect while an appeal is pending.
  2. The appeal must separately state each ground upon which the student claims that the finding of the PMWHP should be overturned. Grounds for overturning the PMWHP’s finding shall be limited to the following:
    • Procedural Error: To determine whether the original hearing was conducted fairly, and in conformity with prescribed policy and procedures giving the student a reasonable opportunity to prepare and present information contemplated by the Policy.
    • Unsupported Conclusion: To determine whether the decision reached regarding the student was based upon a preponderance of evidence.
    • Disproportionate Consequence: To determine whether withdrawal is appropriate as opposed to a probationary enrollment under Section II.N.
    • New Information: To consider new information, sufficient to alter a decision, or other relevant facts not brought out in the original hearing, because such information and/or facts were not known to the student at the time of the original hearing.
  3. The Vice President’s review will be limited to review of the PMWHP’s recorded record, documentation submitted in connection with the PMWHP, and any additional information provided by the student in connection with the appropriate ground listed above. Failure to submit a timely written appeal will render the decision of the PMWHP final.
  4. Within five (5) business days of receiving the appeal, the Vice President will submit a Notice to the student of their decision in writing. The Vice President may (a) affirm the IHWP’s decision, (b) send the matter back to the IHWP for further review, (c) affirm the PMWHP’s findings but alter the disposition from withdrawal to probationary enrollment under specified conditions, or (d) reverse the PMWHP’s decision and reinstate the student.

M. Appeal to the President

  1. Within five (5) business days from Notice from the Vice President for Student Affairs’ decision, the student may submit a written appeal of the decision to the President. The decision of the Vice President will remain in effect while an appeal is pending to the President.
  2. The President’s review will be limited to the same grounds set forth in Section II.L.
  3. Failure to submit a timely written appeal will render the decision of the Vice President final.
  4. Within five (5) business days of receiving the appeal, the President will inform the student of their decision in writing.
  5. The President may (a) affirm the Vice President’s decision, (b) alter the disposition from withdrawal to probationary enrollment under Section II.N, or (c) reverse the Vice President’s decision and reinstate the student.
  6. There will be no appeal beyond the President.

N. Probationary Enrollment

The Dean of Students, in consultation with BIT may, at any point in this process, permit a student, including a student who meets the standard for protective medical withdrawal, to remain enrolled on a probationary basis under specified conditions which may include, but not be limited to, participation in an ongoing treatment program, acceptance of and compliance with a behavioral contract, a housing relocation, or a lighter academic course load. When making his or her determination of appropriate probationary conditions, the Dean of Students may consult on an informal basis with faculty, the Counseling Center, Residence Life, Housing and Dining Services staff, and other university personnel. The terms of such continued enrollment will be set forth in a written agreement, and Dean of Students will provide student sufficient opportunity to review and consider such terms. If the student agrees to accept the terms of the proposed Agreement, the student must sign the Agreement in the presence of the Dean of Students and the Dean of Students will sign the Agreement. The Dean of Students will retain the Agreement and provide a copy of the Agreement to the student.

III. Voluntary Withdrawal

  1. Any student, at any time (including a student involved in the protective medical withdrawal process) may voluntarily withdraw from the university by contacting the university’s Office of the Registrar. The university’s policies and procedures for academic and financial obligations, as described in appropriate university policies and catalogs, will apply to students who voluntarily withdraw with the Registrar.
  2. Note, voluntary withdrawal will terminate any action regarding the protective medical withdrawal process, but will not terminate any pending disciplinary action under the University Code of Student Rights and Responsibilities.

IV. Readmission

  1. A student who is withdrawn from the university pursuant to this Policy, must meet with the Dean of Students prior to being allowed to re-enroll or be readmitted to the university. The Dean of Students may require documentation or an additional evaluation sufficient to show that the conditions that led to the protective medical withdrawal are no longer present or have been successfully managed by the student. The Dean of Students, in consultation with the BIT, must approve the student's re-enrollment or readmission request.
  2. Re-enrollment or readmission is also contingent upon the student meeting any admission or enrollment requirements of the university and of the school or college in which he/she wishes to enroll.

V. Students Studying Abroad

  1. University students studying abroad are subject to and will be afforded all rights pursuant to this Policy, with the understanding that reasonable adjustments may be necessary to accommodate cultural, language and time differences and to allow for the distance between the study abroad site and the university. Such adjustments may include, but are not limited to, the substitution of an on-site advisor in the role of the Dean of Students where deemed appropriate and the engagement of an on-site mental health professional to conduct any requisite mental health evaluations.
  2. In addition to being subject to this Policy, university students who are studying abroad with another host institution may be subject to the protective medical withdrawal policies of that institution.

VI. Notice

Any Notice referenced in this Policy may be delivered to the student by one of the following methods campus, regular, registered, or electronic mail to the address on record in the Registrar’s office, notice will become effective immediately upon deposit in the mail, the date sent by electronic mail or, in the case of hand delivery, upon receipt by the student.

VII. Records and Fees

  1. All records concerning the proceedings under this Policy will be maintained for eight (8) years by the Dean of Students and will be kept confidential in accordance with the Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. §1232g, and implementing regulations of the U.S. Department of Education, 34 C.F.R., Part 99. Certain exceptions to the confidentiality requirements of FERPA apply, as set forth in Missouri State University’s Op5.11-1 Notification of Student Rights.
  2. The policies and procedures for academic and financial obligations, as described in appropriate university policies and catalogs, will apply to students who are withdrawn under this Policy. For graduate students, determinations about fellowship or grant refunds, as well as determinations about how withdrawal under this Policy affects time credits towards doctoral work, will be handled on a case-by-case basis.