The Trump administration on Monday said Michigan State University will provide chaperones during “sensitive” medical exams and make other changes to resolve a civil rights investigation tied to Larry Nassar, the former university employee and U.S. gymnastics team doctor who molested women and girls under the pretense of providing treatment.

The university will provide appropriate gowns during examinations and private dressing areas to ensure privacy, as part of a voluntary agreement with the Health and Human Services Department.

The MSU HealthTeam, a university medical practice that is being folded into an “MSU Health Care” nonprofit, must post information on how patients can file a grievance or complaint with HHS related to sex discrimination, including harassment or abuse.

Also, the university must train all staff on appropriate behavior and submit biannual reports to HHS during the three-year agreement.

HHS will conduct on-site audits and interviews during those years to ensure the policies are being implemented.

The agency scrutinized MSU practices amid widespread news coverage and direct complaints about Nassar, an osteopathic physician and associate professor who was accused of using his position to abuse hundreds of women and girls.

“This is a heart-wrenching case,” said Roger Severino, director of the HHS Office for Civil Rights.

The scandal reverberated across U.S. gymnastics and caused a personnel shakeup at the university in East Lansing.

Tearful testimony from victimized gymnasts dominated prime-time newscasts during Nassar’s court proceedings last year, and a former MSU dean — William Strampel — was sentenced last week to up to a year in jail after his conviction on charges related to the scandal, including a neglect of duty in monitoring Nassar.

Nassar, meanwhile, is expected to spend the rest of his life behind bars.

HHS said its review of MSU policies was intended to ensure compliance with Title IX, which prohibits discrimination on the basis of sex at educational institutions, and Section 1557 of Obamacare, a provision that prohibits discrimination at health care institutions and thus students and non-students alike.

Under the agreement, patients must consent to a sensitive examination — cases in which the patient is partly or fully disrobed and the breasts, genitalia or rectum are exposed — from the MSU HealthTeam.

The use of a chaperone at such an examination must be documented, and the patient may request a chaperone of the same sex.

If a patient refuses a chaperone, the university doctor must document it and the patient must sign a waiver.

In a statement, the university said the HHS agreement will “further enhance” many of the policy changes it made on its own in the wake of the Nassar scandal, including consent-to-treat forms, protocols to review all allegations of inappropriate behavior and a chaperone policy — initiated April 2017 — to ensure oversight at sensitive exams.

“We must always look for ways to do more for those who trust the university with their health and safety,” said MSU President Samuel L. Stanley Jr.

Severino said HHS felt the need to include a chaperone requirement in its agreement because it wasn’t enough for the institution to claim it was policing itself.

He said Strampel’s conviction stemmed in part from the failure to follow through on the university’s own stated policy on chaperones.

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