Student Medical Withdrawals

I. Introduction

St. Mary’s University prioritizes the health and well-being of its students and understands the importance of accessible support services for students who may encounter challenges during their time as a student. The University also recognizes that students exhibiting significant medical and or psychological distress impacting their ability to fulfill their responsibilities as a student need to be presented with options and general guidance that attends to the welfare of the individual student and the University community.

This policy describes 1) Procedures for Student Initiated Medical Withdrawals; 2) University Initiated Medical Withdrawals and the types of behaviors and emergency scenarios that the University may address in turn; 3) Procedures to return to the University after any medical withdrawal; and 4) Additional considerations, such as academic credit, tuition, housing, and financial hardship.

A medical withdrawal differs from the general University withdrawal in that it is tied specifically to documented physical or mental health concerns, it may fall outside the normal withdrawal timeframe, and it carries with it certain financial considerations that may be unique to these types of withdrawal (see Section IV A).

II. Procedures

A.  Student Initiated Medical Withdrawals (Undergraduate and Non-Law Graduate Students)

Students facing extreme or unexpected medical/mental health situations may choose, after consultation with appropriate campus staff (Academic Deans, DOS, Student Counseling, Student Accessibility) and/or medical authorities, to withdraw from their courses during the current term. A student’s proxy (i.e., parent, guardian, spouse, academic advisor), as identified by a power of attorney or conservatorship directly related to the named student, may request the withdrawal on behalf of the student if the student is incapacitated. A request for a student-initiated medical withdrawal is submitted, along with medical/mental health documentation in support of the request, to the Dean of Students Office. The Dean of Students Office will coordinate with the Executive Director of Student Health and Wellness Programs, who will review the request and the medical documentation submitted.  Once the student-initiated medical withdrawal is approved, the student is considered “on leave” and, if applicable, must officially check out of student housing within 48 hours of withdrawal approval.

A medical withdrawal differs from the general University withdrawal in that it is tied specifically to documented physical or mental health concerns and may fall outside the normal withdrawal timeframe and University refund policy. (see Section IV A).

1. School of Law

Students in the School of Law facing extreme or unexpected medical/mental health situations may choose, after consultation with appropriate campus staff and/or medical authorities, to withdraw from their courses during the current term. A student’s proxy (e.g., parent, guardian, spouse, etc.), as identified by a power of attorney or conservatorship directly related to the named student, may request the withdrawal on behalf of the student if the student is incapacitated. A request for a student-initiated medical withdrawal should be submitted, along with medical/mental health documentation supporting the request, to the Assistant Dean for Law Student Affairs. Once the student-initiated medical withdrawal is approved, the student is considered “on leave”.

J.D. and LL.M. students should consult their respective student handbooks for any applicable deadlines to complete their degree program. If applicable, a student who is approved to withdraw must officially check out of student housing within 48 hours of withdrawal approval.

If a student-initiated medical withdrawal is denied due to a lack of medical documentation or other circumstances, the student is not precluded from withdrawing from courses prior to the term’s withdrawal deadline, using the traditional withdrawal process.

• Appeals of Student-Initiated Medical Withdrawals

Any appeal of the decision regarding the medical withdrawal must be submitted in writing to the Vice President of Student Development (VPSD) within three (3) business days of receiving the denial.

B. University Initiated Medical Withdrawal

In rare circumstances, the Executive Director of Student Health and Wellness Programs, in consultation with the Behavioral Intervention Team (BIT) and appropriate staff (e.g., Dean of Student’s Office, Office of Residence Life, Law Student Affairs), may determine that the university must initiate a medical withdrawal for the student. Those who are medically withdrawn for any health reason are not allowed to participate in any University activities, attend classes, reside in or visit University residential facilities, and may not be on campus except to attend meetings or hearings related to his/her case until formally readmitted. Examples of situations in which a University-initiated medical withdrawal could occur include the following:

• A known condition has deteriorated, rendering the student to be in imminent danger or incapable of functioning as a student. In most cases, these situations can be handled through student-initiated medical withdrawals; however, if the student is unwilling to pursue a student-initiated medical withdrawal or if the situation has proved to require more than a withdrawal from courses (i.e. “Direct Threat” [1] remains), the Executive Director may invoke their right to initiate a medical withdrawal on behalf of the University. In these cases, the Executive Director will consult with the Vice President of Student Development and other appropriate individuals related to a specific case. The Executive Director will recommend assessment and/or treatment conditions needed in order for the student to return to St. Mary’s University. The student must follow the procedures described in Section D before his or her return can be considered.

1) Addressing Behaviors and Emergencies

The University reserves the right to initiate a medical withdrawal of a student under the following, but not limited to, conditions:

• Acute decline in physical health;
• Suicidal ideation, plan, intent and/or behavior;
• Self-injurious behavior (e.g. cutting, burning);
• Homicidal ideation, plan, intent and/or behavior
• Destructive, threatening, or other disruptive behavior;
• Drug and alcohol abuse, including overdose or misuse of over-the-counter or prescription medications;
• Eating disorders that are not treated or are not responding to current treatment, and/or posing safety concerns;

Any physical or mental health problem that points to possible imminent or foreseeable danger to oneself or another member of the University community or requires intensive monitoring to prevent such danger (e.g. psychosis).

2) Authority

The Executive Director of Student Health and Wellness Programs (hereafter referred to as Executive Director) may receive information from any source of a student’s behavior or emergency situation that needs to be addressed. The Executive Director, in consultation with the Behavioral Intervention Team (BIT), will determine what role, if any, the University may need to take to assure the health and safety of a student(s) or the University community and reserves the right to any or all of the following:

• Require the student to provide existing medical documentation as pertinent to behaviors that the student is currently exhibiting. within a specified period of time (typically 10 days). Based on the information provided, the Executive Director/University may require the student to commit to a treatment plan as a condition for continued enrollment.
• Invoke a University-initiated medical withdrawal. (see III B, below).
• Notify the student’s parent(s), guardian, spouse or other designated individual and appropriate University officials (e.g., the student’s professors, Registrar’s Office, UPD) about a mental or physical health or safety emergency. Note: University notifications will respect the student’s privacy, and share limited information only on a need-to-know basis. This is not a FERPA violation.
• Take any further action, including contacting local law enforcement officials, to prevent harm to self or others, or require any further action on the part of the student that is deemed necessary or desirable under the circumstances. All requirements and conditions will be outlined in writing, and delivered to the student via University email.

3)  Appeals for University-Initiated Medical Withdrawals

In rare cases, if a student believes that a decision for a university-initiated medical withdrawal was made by the university based upon a procedural error or if new facts that may materially affect the decision are identified, the student may appeal. Once notified of the university-initiated medical withdrawal, the student has three business days to submit their appeal. The appeal must be made in writing to the Vice President for Student Development and the student requesting the appeal must show that the grounds for an appeal request have been met. The original determination will stand if the appeal is not timely or is not based on the grounds listed above, and such decisions are final. The original determination is presumed to have been decided reasonably and appropriately.

The VPSD (or their designee) may convene an Appeal Review Panel (which may not include any individual involved in the original decision) to consider the appeal and prepare a written statement documenting the Panel’s recommendation, the information cited by the Panel in support of its recommendation, and any information the Panel excluded from its consideration and why. This report must be submitted to the VPSD within two business days of the end of their deliberation.

The VPSD will normally render a written decision on the appeal within five (5) business days from receipt of the Appeal Panel’s statement.

Once an appeal is decided, the outcome is final; further appeals are not permitted.

III. Return Procedures for all Medical Withdrawals

Any student who has been away due to a student or university-initiated medical withdrawal must complete the following procedures before being allowed to return to the University. The procedures are designed to ensure that a health emergency no longer exists and a treatment plan for continuing good health and safety is in place, and to achieve the following goals: 1) support the student in their transition back to the University, 2) support University students, faculty, and staff during the student’s transition back to the University, and 3) ensure the safety of the student and the University community.

1. The student must complete the Readiness to Return form, along with presenting medical documentation (see documentation guidelines for examples of appropriate medical documentation) confirming care during the time student was away, for the condition that precipitated the withdrawal. The medical documentation should include evidence that the student is now in better health and is ready to return to the University. Medical documentation should be completed by the appropriate external professional who provided care to the student. This professional should be a licensed mental health provider if evaluating mental health concerns, or a licensed medical provider if the evaluation covers other medical concerns. Further, all providers must be unrelated to the student and have specialty/credentials appropriate for the condition or concern (e.g., an eating disorder specialist or substance abuse/recovery specialist).

The external mental health or medical professional must provide written recommendations regarding: a) the student’s readiness to return to the academic and appropriate co-curricular demands of University life as represented in the STMU Catalog and Code of Student Conduct, and/or Law Student Handbook; b) the student’s readiness to live in the on-campus residential community, as applicable; c) ongoing treatment or testing needs; d) any recommended conditions or restrictions that the University should impose, and e) the student’s readiness to return to competitive sports, if the student is an intercollegiate athlete.

• Once the medical documentation has been provided, the student must meet with the Executive Director of Student Health and Wellness Programs, and the Assistant Director of Student Integrity and Welfare for a re-entry meeting. School of Law students must meet with the Executive Director of Student Health and Wellness Programs and the Assistant Dean for Law Student Affairs. The re-entry meeting is designed to discuss the documentation provided and the student’s own perception regarding readiness to return. The discussion will also include needs and plans for treatment and how the outside provider’s recommendations can be implemented.

• The Executive Director reserves the right to require the student to comply with a treatment plan recommended by an external and/or St. Mary’s physical/mental health professional as a condition of returning to the University community. Review and monitoring of the student’s required treatment plan may be assigned to a University designee identified by the Executive Director.
• There may be instances in which the Executive Director, in consultation with VPSD and the Assistant Dean of Residence Life, may decide that a student can return to school with augmented campus participation opportunities to preserve a student’s health and wellbeing, or that of the community (i.e.: restrictions related to living on campus).

• Note: These procedures may also apply in the event that the University learns that a student has been hospitalized for a mental or physical health emergency in the absence of any student-initiated medical withdrawal or University-initiated medical withdrawal.

IV. Additional Considerations

A. Academic Credit, Tuition and Housing

For all medical withdrawals, the student shall receive “WX”s on their academic transcript for the course(s) in which the student is enrolled for the current term, and any subsequent semester course registration may be dropped and a registration hold will be placed on the student’s account Notation of medical withdrawals will take place within Registrar’s Office and DOS Office files (and Office of Law Student Affairs, if applicable).

For Undergraduate and for Non-Law Graduate Students: The Dean of Students office will determine whether the student may be eligible for a tuition refund and pro-rated for housing based on the student’s official withdrawal date and the University’s Refund policy. A request for any tuition refund will be sent to the student’s designated Associate Academic Dean for student concerns of each school for consideration. If approved, the Registrar, the Office of Financial Assistance, and the Business office will manage updates to a student’s academic, financial aid, and business accounts.

Financial Aid Recipients: are not eligible for a refund until all financial aid programs are reimbursed in accordance with federal, state, and University guidelines. Students who received Financial Aid are asked to speak to as Financial Aid advisor as part of the withdrawal process.

Return of Title IV Funds (R2T4)

If a student withdraws, drops out or is dismissed on or before the 60 percent point in time of the period of enrollment, which is calculated using calendar days, a portion of the Title IV Federal Funds awarded (Pell Grant, FSEOG, Perkins Loan, federal Stafford Loans – subsidized and unsubsidized – and federal PLUS loans) must be returned, according to the Federal Formula for Return of Title IV funds.  This situation could result in the student owing aid funds to the University, government or both.

For School of Law students, the Associate Dean for Law Student Affairs, in consultation with the Vice President for Student Development and the Executive Director for Student Health and Wellness Programs, shall make the determination regarding proration and refund of tuition and non-housing related fees.

Tuition and non-housing related fees for the semester in which a medical withdrawal occurs may be prorated from the date of withdrawal on a case-by-case basis.   

B. Financial Hardship

Every effort will be made to consider a student’s financial situation and health insurance coverage in making referrals for treatment or evaluation. Students who may need additional financial assistance or other consideration in meeting the medical care requirements may apply for emergency assistance through the Student Emergency Fund through the Dean of Students office.  

C. Review and Revision

This policy shall be reviewed and updated as needed by the Executive Director and Vice President for Student Development.  

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[1] Note: “Direct Threat” Test: To rise to the level of a direct threat, there must be a high probability of substantial harm and not just a slightly increased, speculative or remote risk. In a direct threat situation, a college needs to make an individualized and objective assessment of the student’s ability to safely participate in the college’s program. This assessment must be based on a reasonable medical judgment relying on the most current medical knowledge or the best available objective (non-medical) evidence.  The assessment must determine the nature, duration and severity of the risk; the probability that the potentially threatening injury will actually occur; and whether reasonable modifications of policies, practices, or procedures will sufficiently mitigate the risk. (U. S. Department of Education, Office of Civil Rights)