Utah Admin. Code R590-239-4 - Findings

Pursuant to Subsection 31A-1-103(3)(d), the commissioner makes the following findings.

(1) Many institutions establish a student health center to provide limited health care to an eligible recipient. A student health center arranges for health care services to be provided by employing a health care provider at the student health center, or by contracting with a health care provider for health care services at the student health center or another facility that may be located in close proximity to the institution's campus. The student health center may also contract with a specialist to come to the student health center on a periodic basis, or to provide a service off-campus when the student health center provides a referral to that specialist.

(2) The operation of the student health center is paid at least in part from funds generated by the tuition of an eligible student or from a fee for that express purpose that each eligible student is required to pay. In return, the eligible student is entitled to limited health care services at the student health center during the ensuing quarter, semester, or school year. An eligible student usually pays a nominal fee each time they use the facility.

(3) A student health center does not provide all basic health care services required of a health maintenance organization but does enter into arrangements with some of the persons listed in the definition of a limited health plan to provide health care services to the institution's eligible recipients. While a student health center is not a health maintenance organization, it does come within the definition of a limited health plan. Unless exempt from regulation by statute or administrative rule, a student health center must comply with Title 31A, Insurance Code.

(4) An institution has an interest in providing an eligible student with basic health care to reduce the possibility that progress toward a degree will be impeded by unattended medical needs. In addition, an institution has an interest in mitigating the potential economic hardships placed on a health care provider directly, and the public in general, from an institution's eligible students receiving medical services and then not being able to pay for those services.

(5) An institution may establish a student health center to meet the basic medical needs of a student, and reduce any potential negative impact on a local health care provider and the public. Other than treating a visitor on campus occasionally on an emergency basis, a student health center provides health care services only to an eligible student or another eligible recipient. Providing a health care service or arranging for a health care service for a student is not the primary purpose of an institution; it is only incidental to the institution's primary purpose, which is to educate those that matriculate with the institution. A student health center is not established to enable the institution to make a profit from providing health care services at the student health center.

(6) An institution is either a state institution under the direct control of, and supervised by, the Board, or it must be accredited by a regional accreditation organization. To be accredited, an institution must meet strict accounting standards, and be able to demonstrate it is financially solid. An institution must therefore comply with the strict accounting and financial requirements of the Board, or of a regional accrediting entity, which would include the need to reflect on the financial statements of the institution the liability for any risks the institution assumes, or costs the institution may incur, for its student health center. Any shortfall in providing health care services at the student health center would become the obligation of the institution. The institution can and must protect itself from financial shortfalls that could cause the providers to be left unpaid, and the students without health care services at the student health center; the institution does this by fixing the institution's liability either by employing the health care providers, or by contracting with health care providers for a fixed fee for the number of hours the health care provider is at the student health center, regardless of the number of patients or students the health care provider might see during that time. Since only limited health care services are provided at the student health center, there is little or no likelihood the institution will need to cover expenses such as major surgery, or extended hospital stays.

Notes

Utah Admin. Code R590-239-4

Amended by Utah State Bulletin Number 2023-02, effective 1/10/2023