Letter.pdf - US Merchant Marine Academy

Department of Health ServicesUNITED STATES MERCHANT MARINE ACADEMYPATTEN HEALTH CLINIC KINGS POINT, NY 11024-1699Phone: 516-726-5680 Fax: 516-773-5436 Email: medical@usmma.eduWELCOME USMMA CLASS OF 2017Dear Parents, Guardians and Plebe Candidates:Congratulations on your son or daughter’s acceptance into the United States Merchant MarineAcademy’s Class of 2017! As he/she prepares for admittance several important health-relatedtasks must be attended to prior to the scheduled Indoctrination Day of 02 July 2013. Please readthis correspondence carefully, perform all required tasks and supply the necessary documentation.Please submit all required health documents directly to the Academy’s Department of HealthServices (DHS) using the enclosed preaddressed envelope no later than Friday, May 31, 2013.Additional details regarding the Department of Health Services (DHS) can be found on ourwebsite at www.USMMA.edu and then typing “Health Services” into the search box or by clickingon “regimental life”.PRE-ADMISSION HEALTH DOCUMENTATIONPrior to arriving at the Academy, all Plebe Candidates must complete and return to USMMA, aseries of important health documents. These documents must be downloaded directly from ourwebsite using the following instructions:1. Type www.usmma.edu/academy-life/activitiesservices/health-services into your webbrowser2. Click on “Health Services-US Merchant Marine Academy”3. Locate “Related Documents” on the right side of the health services webpage4. Click on and print out each form for completionAll forms must be downloaded from our website, printed, completed by the Plebe Candidate thenreturned in the postage paid envelope accompanying this letter no later than Friday, May 31, 2013.The forms referenced as follows:1. Health Documents Checklist: This form does not need to be returned; this form is toassist the candidate.2. Notice of Privacy Practices: This form does not need to be returned; it is for your reviewand records.3. Acknowledgment of Receipt of Notice of Privacy Practices: Three copies of this form arerequired for each of the three healthcare groups in the Department of Health Services.Please download and sign all three and return with the other forms in the pre addressedenvelope provided.Page 1 of 11

4. Consent for Use and Disclosure of Health Information: This form is to allow theproviders at the USMMA Department of Health Services to communicate informationnecessary for treatment, payment activities and healthcare operations. By law a separateconsent must be signed for disclosure of protected health information to third parties suchas parents or members of other departments at the Academy. Three copies of this formare required for each of the three healthcare groups in the Department of Health Services.Please download and sign all three and return with the other forms in the pre addressedenvelope provided. Signature of parent/legal guardian is required for Plebe Candidateswho are minors.5. Authorization to Provide Health Services to Minors: If box #1 is checked, a parent orlegal guardian must sign this form to provide authorization for necessary medical anddental care to Midshipmen who are minors. The form authorizes the Academy’s ChiefMedical Officer, Senior Dental Officer and Director of Midshipman Counseling andPersonal Development to perform the required treatment services at the Patten HealthServices Clinic. In addition, it authorizes care to be provided as needed by other healthcare providers as directed by the Chief Medical Officer, Senior Dental Officer and/orDirector of the Midshipman Counseling and Personal Development.6. Pre-Admission Immunization Record Summary: This form must be completed by yourfamily physician and shall become part of your Academy health record. Thisdocumentation is necessary for the medical staff to confirm that Plebe Candidates cansafely participate in and complete Indoctrination activities. Not having these vaccinesmay place a Plebe Candidate at risk for medical injury which would render themincapable of participation in Indoctrination. Additionally, at a later time, thisdocumentation enables the medical staff to determine that a Midshipman is medicallyqualified for assignment to Sea Year Training with commercial maritimecompanies. Successful matriculation from the Academy is impossible without thisdocumentation.Primary and booster immunizations must be documented for the following vaccines andthey may be administered any time prior to arriving at the Academy unless otherwisestipulated:a. Diphtheria - Pertussis - Tetanus (DTaP) and a booster dose of Tdap (Tetanus,Diphtheria and Acellular Pertussis - within five (5) years)b. Polio (Oral or injectable Polio Vaccine – at least 3 doses)c. Measles - Mumps - Rubella (M.M.R. #1)d. Measles - Mumps - Rubella (M.M.R. #2) or Measles second dosee. Chicken Pox / Varicella – 2 doses (This vaccine is not required if you can presentdocumentation from a physician of an antibody titer or if a physician can documentthe history of Chicken Pox)Page 2 of 11

f. Meningococcal Vaccine (Menactra) booster age 16 or two-dose series. AdministerMCV4 at age 11 through 12 years with a booster dose at age 16 years. Administerone dose at age 13 through 18 years if not previously vaccinated. Persons whoreceived their first dose at age 13 through 15 years should receive a booster at age16 through 18 yearsg. Hepatitis B Series (3 doses)h. Hepatitis A (2 doses)i. Human Pappilomavirus Vaccine (HPV-Marketed as “Gardasil”) is arecommended but not required vaccine and is included in the official immunizationschedule published by The Center for Disease Control and Prevention (CDC). Thisis a 3 dose vaccine with the 2 nd dose being 2 months apart from the 1 st and the 3 rddose 6 months after the first. It is highly recommended that your familyphysician be consulted regarding the administration of this vaccine beforecoming aboard for Indoctrination dayCommercial maritime companies require several immunizations in order to meetqualifications for Sea Dear Training. Some immunizations are in addition to thosementioned in the above Pre-Admission Health Requirements & Documentation.Necessary immunizations may include, but are not limited to Typhoid, Yellow Fever &Influenza. In order to complete the series of immunizations in advance of the Sea DutyTraining, it is necessary to receive some of these vaccines soon after arrival at theAcademy. The remainders are administered just prior to sea duty tours. At a later time,this documentation enables the medical staff to determine that a Midshipman ismedically qualified for assignment to Sea Duty Training. Successful matriculation fromthe Academy is impossible without this documentation.***Questions regarding immunizations a through i listed above, or any otherimmunization related questions may be directed to our Medical Department bycalling 516.726.5680, option #1 or you can email your questions tomedical@usmma.edu ***7. Temporary Waiver for Third Molar Extractions: This form should be completed by aparent or legal guardian of a Plebe Candidate, with the assistance of a licensed dentalprovider, and returned to the Academy’s Dental Service. The recommendation by theAcademy’s dental service is that third molars (wisdom teeth) be removed at least 6 weeksprior to indoctrination if indicated. The form certifies that either the wisdom teeth havebeen removed/do not exist or the parent/legal guardian acknowledges financialresponsibility for removal if these teeth are still present and become symptomatic or aredeemed to be a potential threat for infection by the Academy’s Senior Dental Officer.8. Respiratory Protection Medical Questionnaire Form: This year, Pulmonary FunctionTesting (PFT) will be administered early in Indoctrination. Please complete this 3-pagequestionnaire carefully as a pre-requisite to your PFT.Page 3 of 11

3. If options # 1 & #2 above are not possible, Midshipmen & Candidates mustpurchase the qualifying Student Health Insurance Plan (SHIP) through TheAcademy-sponsored provider, UnitedHealthcare®. This plan meets the Academy’sminimum requirements.The plan is managed by The Allen J Flood Companies and is in association withUnitedHealthcare®.More information is available by visiting our frequently asked questions and relateddocuments links at http://www.usmma.edu/academy-life/activitiesservices/healthservices.Beginning April 15, 2013 through June 3, 2013, proof of insurance coverage must be secured.In order to secure proof of insurance coverage, you must take action between 15 April 2013and 3 June 2013 by completing one of the following two steps:1. IF YOU CURRENTLY HAVE HEALTH INSURANCE COVERAGE AS DESCRIBEDIN OPTIONS #1 OR #2 ABOVE:You are required to complete the “2013-2014 Petition to Waive United States MerchantMarine Academy Student Health Insurance Plan”. This form is downloadable from theUSMMA website in the Regimental Life/Health Services section. This form is one of thePre Admission Health Documents discussed earlier in this letter that MUST be returned toHealth Services in the provided pre-addressed envelope by 31 May 2013.USMMA recommends that you contact your insurance provider to confirm your answers tothe following questions asked on the aforementioned Petition to Waive:a. Will your current coverage remain in effect through June 30, 2014?b. Is your insurance company headquartered/operated in the United States with a USClaims address and Customer Service phone number?c. Does your current plan provide both emergency and non-emergency benefits formedical and mental health treatment?d. Does your current plan provide inpatient hospitalization, outpatient physician visits,laboratory services, radiology and outpatient mental health benefits? Coveragelimited to Emergency care does not satisfy this requirement.e. Does your plan have hospitals and providers within 25 miles of the Academy fornon-emergency care?f. Does your plan provide coverage in all 50 states and internationally?g. Does your coverage comply with all Federal and New York State regulations forstudent health insurance?Please note that you cannot waive the USMMA insurance plan if you have KaiserPermanente or an HMO Plan.ORPage 6 of 11

2. IF OPTIONS #1 & #2 ABOVE DO NOT APPLY & YOU DO NOT HAVE YOUR OWNHEALTH INSURANCE THAT MEETS THE ABOVE REQUIREMENTS OR YOURWAIVER IS DENIED:If you do not have your own health insurance through your own means that meets the USMMArequirements, then you are required to purchase/enroll in the USMMA sponsored plan bycompleting the enrollment process between 15 April 2013 and 3 June 2013. To enroll in theUSMMA Sponsored Health Insurance Plan:a. visit www.ajfusa.com/studentsb. In the drop down menu, select “United States Merchant Marine Academy”c. Click on “Enrollment Form”d. Complete the Student Enrollment Form. PLEASE NOTE in box # 10 where studentID number is requested, type in the #9, nine times as follows: “999999999”.A brochure highlighting the key benefits of the student insurance plan administered byUnitedHealthcare Student Resources, utilizing the Choice Plus network is also available at“www.ajfusa.com/students”. The premium for the 12-month period for July 1, 2013 to June 30,2014 is $1,489.00. Medicaid and Medicare will be accepted.Failure to demonstrate having a primary health insurance plan that meets USMMArequirements either by completing a waiver or enrolling in the USMMA sponsored plan by June3, 2013 may result in your son or daughter being dis-enrolled from USMMA.Please remember that should you choose to process a waiver of the USMMA sponsored StudentHealth Insurance Plan (SHIP) in favor of your own health insurance coverage, it is yourresponsibility to contact your insurance carrier and make sure all of the minimum requirementsare met.Regardless of whether you waive the USMMA SHIP in favor of your own insurance or if youpurchase the USMMA SHIP, please be sure to provide your student with a copy of theirinsurance identification card and instruct them to have it in their possession at all times. It isextremely important to provide a copy of the Plebe Candidates insurance card (both sides)indicating the current health Insurance plan which meets mandatory USMMARequirements for health insurance coverage to Patten Health Services. Please provide a copyof the insurance card, front & back along with all pre admission health documents using thepre-addressed postage paid envelope. Although not required for attendance at USMMA,Dental Insurance is strongly encouraged. If you carry any optional dental insurance, pleaseprovide a copy of that information (both sides) as well.If you have any questions about your coverage or the processing of a waiver please contact ourplan administrator prior to submitting your information. Our insurance plan administrator is TheAllen J. Flood Companies, Inc. and all coverage questions should be directed to them at800.734.9326 or email at USMMA@ajfusa.com . Information about the plan benefits, limitationsand exclusions is available at www.ajfusa.com/students. You may also send questions tomedical@usmma.edu. We will work with each and every family to ensure that each midshipman isappropriately insured. Their health and well-being is our number one priority.Page 7 of 11

to participate in Indoctrination. Plebe Candidates who do not complete Indoctrination willbe returned home to rejoin USMMA the following year.General dental care will be provided onsite USMMA. Dental Insurance is optional but stronglyencouraged since referrals to dentists or dental specialists (e.g., oral surgeon, endodontist) outsideof the USMMA Dental Clinic will require the use of private dental insurance or be an out ofpocket personal expense.As indicated in DODMERB, active orthodontic treatment (braces) is not allowed. Only removableorthodontic appliances (e.g., retainers, Invisalign®) are permitted. As the Dental Department doesnot have an orthodontist, replacement of broken appliances will require treatment outside theUSMMA Dental Clinic at the Plebe Candidate’s Expense.Please contact the Dental Department at (516) 726-5680, option # 2 to address any questions.CORRECTIVE LENSES FOR PLEBE CANDIDATES DURING INDOCTRINATIONPlebe Candidates requiring corrective lenses, who wear contact lenses, are strongly encouraged tobring glasses for indoctrination. At this time the use of contact lenses is not prohibited; howeverdue to time constraints during indoctrination appropriate lens care can be difficult. ThoseCandidates with corrective lenses who wear glasses are less likely to experience problems such aslost, torn and/or scratched contact lenses.MEDICATION POLICY FOR PLEBE CANDIDATES DURING INDOCTRINATIONTo ensure the safety and well-being of each candidate, all Plebe Candidates are instructed NOT tobring any over-the-counter medications with them unless accompanied by a note from theprescribing physician. The note should indicate the medication, dose and reason it is required. Anyover the counter medications brought without appropriate documentation will be collected from allPlebe Candidates upon their arrival. This includes but is not limited to any pain medication (e.g.Tylenol, Aleve, Advil, aspirin); allergy medications, antihistamine, decongestants, herbalsupplements or remedies, vitamins and nutritional or sports supplements. Upon completion ofIndoctrination, Plebe Candidates will be instructed to report to Patten Clinic to pick up anypreviously collected medication. Should an over-the counter medication become necessary for aPlebe Candidate during Indoc, it will be made available.Plebe Candidates should NOT bring any prescription medications with them unless themedication is specifically prescribed for them. There must be an accompanying note from theprescribing physician or dentist stating the reason why the medication was prescribed. Thesemedications will be collected, identified and be recorded in the Candidate’s health record beforebeing returned.Any medication that is not in its original container or is unlabeled will be collected and disposed ofby the Academy’s Department of Health Services without exception.Page 9 of 11

HEALTH SERVICES PROVIDED BY THE ACADEMYMidshipmen enrolled at the Academy are eligible to receive basic health care at USMMA DHSlocated in the Patten Health Clinic Building. DHS is open Monday thru Fridays except holidaysfrom 0730 to 1630. During The Indoctrination Period in July, DHS extends hours of operationsand is open 7 days a week. Generally, DHS is open 12 hours each day for the entire IndoctrinationPeriod.SICK CALL DURING INDOCTRINATION:Immediately following breakfast each morning, Plebe Candidates are given the opportunityto report any need for medical care or intervention. At that time, Plebe Candidates information are triaged by a Patten Health Clinic staff member who determines if the PlebeCandidate requires immediate attention or can be given a specific appointment time forlater in the day.AFTER HOURS CARE DURING INDOCTRINATION:In the event of injury or illness when Patten Health Clinic is closed, the USMMA DHSEmergency Medical Services (EMS) Dispatcher is notified. The EMS Dispatcher willcoordinate the appropriate response.Any care that is not of an emergent nature is to be addressed during scheduled medicalappointments or sick call as needed.DHS CARE AFTER COMPLETION OF INDOCTRINATION:During the Academic Year after Indoctrination ends, DHS operational hours are 0730 to 1630hours, Monday through Friday. Midshipmen may choose to be seen as “walk-in” patients duringmorning “Sick Call” (0730 to 0930 hours) or may schedule routine medical, dental or counselingappointments throughout the clinic day. Healthcare services available at DHS include: routine seayear physical assessments; medical laboratory procedures; immunizations (see “Pre AdmissionHealth Requirements & Documentation”); treatment of routine illnesses; procuring prescribedmedications and pharmaceutical supplies; public health prevention education; annual oralevaluations, general dentistry and dental hygiene; and individual or group counseling sessions formaintaining personal wellness. Midshipmen who require emergent health care during, or after,regular clinic hours will be transported by The USMMA DHS Emergency Medical Services to thenearest emergency room. Please visit the USMMA website at www.USMMA.edu then click on“Regimental Life” for further information regarding The USMMA Department of Health Services.If you have any questions regarding these instructions, please contact the Academy’s Departmentof Health Services using any of the following options:1. Our primary phone number is (516) 726-5680. (Please listen carefully to each option so youcan select from our menu and reach a person in the department you wish to speak with.)2. Our facsimile number is (516) 773-5436.3. Our email is medical@usmma.eduPage 10 of 11

4. Please address all written correspondence to:U.S. Merchant Marine AcademyDepartment of Health ServicesPatten Health Clinic300 Steamboat RoadKings Point, New York 11024-1699Congratulations again and we look forward to seeing you in July! Best wishes for your success.Sincerely,Rick SagerRick Sager, B.S., M.P.S.Head, Department of Health ServicesPage 11 of 11