An email sent June 13 announced that mental and sexual health visits provided by the Ithaca College Hammond Health Center will no longer remain free. Previously, mental and sexual health visits at Hammond were based on a no-charge visit model. Now, students will be charged a copay for each visit.

These visits at Hammond are provided via the Cayuga Health System network, which is different from the Center for Counseling and Psychological Services (CAPS). CAPS will remain free.

The decision caused concerns within the college community over the confidentiality of the services at Hammond and whether or not the payment would deter students from getting the mental and sexual health care that they need.

CAPS services

On June 20, an email was sent out to clarify that CAPS was not part of the mental health changes being made at Hammond.

Without knowing that CAPS is independent of the Hammond Health Center, multiple students misunderstood the announcement. Sophomore Sophie Glassman said she had originally ignored the email and when she read it, she found it confusing. 

“I saw posts on social media and I was like, wait, maybe I should actually read the email,” Glassman said. “I read the email, I read it again and I still did not know what it was saying.” 

Brian Petersen, director of CAPS, said he never wants students to think CAPS would charge for counseling because no student should have a cost barrier preventing them from receiving mental health care.

“Unfortunately, when that communication came out, it did not clearly differentiate between what they were doing and what CAPS does, and so predictably, we’re now in a situation where a lot of students are very concerned that their CAPS services are now going to be billed to insurance and that is completely not the case,” Petersen stated. “All CAPS services will remain free of charge, free of insurance and nothing has changed for our services.”

Petersen said if there is an increase in students who need completely free mental health services after this change, CAPS will accommodate that. 

“I want the student community to understand that CAPS is committed to that no-cost, confidential model,” Petersen said. “A college counseling center doesn’t succeed if students are afraid to go to it or students don’t have 100% surety that their information is going to be confidential or private.”

Though CAPS and Hammond are independent of one another, CAPS counselors cannot prescribe medication. Any student who requires medical help for their mental health is referred to Hammond by CAPS. CAPS counselors are not psychiatrists and cannot prescribe medication for students.

Mental health services at Hammond

The mental health services at Hammond are part of an Integrated Behavioral Health model. This model provides mental health screenings with every visit to the health center. If a student has a cough, they will be treated for the cough and their physical health, but also checked for their mental health.

If a physician or member of the clinic thinks a student could use support, they can refer that student to a social worker. From there, the social worker will assess the student’s needs and work with them to find applicable resources.

Costs for these services would be higher, but the college subsidizes over $2 million of student medical costs a year to keep it more affordable. Tim Downs, chief financial officer and vice president for finance and administration, said the college will gain funds from the new system that will bill per visit, but these collected funds will be invested in the expansion of services at Hammond.

“Every year, we’re going to continue to have conversations and say, what is it that we should stop doing, start doing and continue doing,” Downs said. “The world is going to continue to change and our services need to continue to change, so the billing for the ‘sensitive visits’ is allowing us to continue offering the services and expanding into that area at a rate with which, financially, the institution can continue to do.”

The email announced the Health Insurance Navigator position, a new service that includes intrauterine contraception and pre-exposure prophylaxis as well as general expansions like increased hours for mental health visits and screenings at Hammond.

Sexual health services

Though sexual health visits at Hammond were free, any labs or tests that were needed by visiting students were still charged to insurance. Medications from either the psychiatrist or the physician were also charged to insurance. This meant that students receiving sexual health care were paying for the service, but the copay was waived.

Glassman said the change might negatively impact students because worries about copay costs might outweigh health and wellness concerns.

“It’s also dangerous if people aren’t going in for STD tests because it costs more money now because then what if they still have the STD and continue to spread it?” Glassman added. 

For students who need services free of charge, CAPS is an option for mental health counseling and there are also multiple locations that provide free sexual health care in downtown Ithaca. Planned Parenthood of the Southern Finger Lakes and The Southern Tier AIDS Program offer free STD screenings. The Ithaca Free Clinic also provides free health care services. 

Confidentiality concerns

Insurance bills use codes instead of direct descriptions for medical services. While this adds a layer of privacy, parents with access to their child’s insurance can look up these codes, potentially revealing sensitive information about the student’s medical visits that they might not wish to share. 

Jennifer Metzgar, director of Student Health Services, said the change does not have a big impact on the confidentiality aspect of billing insurance because most visits via Hammond had some form of bill already.

“At no time is any protected health information shared,” Metzgar stated. “When you’re seen for a visit, it gets sent to your insurance company with a code and it doesn’t say a diagnosis, so anything that is personal or detailed in the notes is completely confidential.”

Metzgar said she wants students to know they can talk to the staff at Hammond if there are any barriers they are experiencing that could prevent them from getting care.

“Our doors are open and we are happy to talk to you,” Metzgar said. “If there are circumstances and nuances that feel challenging, we can probably help work through them, so please reach out to us.”