With schools planning on blending in-person and remote teaching models when they reopen in August, the Hawaii Department of Education will also be relying on a new health hotline and telehealth services to serve families and students outside of the school setting.

The resources and nurse staffing coverage are already built in. The free services are a continuation of an existing DOE partnership with the University of Hawaii Manoa School of Nursing and Dental Hygiene called Hawaii Keiki: Healthy and Ready to Learn.

But what’s new is a technological framework to support remote health care services — such as a nursing triage software to perform a basic assessment of health concerns, followed by a telehealth visit with a Hawaii Keiki nurse.

Kaneohe Elementary School summer school adminstrators check kids’ temperatures as they arrive at school during COVID-19 pandemic. June 12, 2020
The Hawaii Keiki program launched a health hotline and telehealth service on May 1 to assist students and families with health needs while school buildings were closed down. Cory Lum/Civil Beat/2020

“Hawaii Keiki was already working on establishing a telehealth program. But this pandemic allowed them to work at lightning speed and get the telehealth program up and running for the summer,” said Heidi Armstrong, assistant superintendent for the DOE Office of Student Support Services.

Just because school is officially out for the summer doesn’t mean the service has gone dark. There is a summer health hotline available until July 24, staffed Monday through Friday from 9 a.m. to 2 p.m.

Deborah Mattheus, senior practice director of Hawaii Keiki and associate professor at the UH School of Nursing and Dental Hygiene, said that during the pandemic, not everyone has been able to have access to their family care provider.

The hotline “provided that means for families to connect to someone they recognize and trust — a nurse — and get those questions answered,” she said.

Not Just Health-Related Calls

When the new school year starts Aug. 4, the DOE health hotline will operate Monday through Friday from 8 a.m. to 3 p.m. Some school-based health centers may return to an on-site office while others may offer a hybrid in-person model combined with the remote option.

The Hawaii Keiki program launched in 2014 as a pilot program, placing nurses with advanced training in five school complex areas. It’s since expanded, boosted by $2.8 million in legislative funding, with 13 APRNs and six registered nurses now stationed throughout the DOE school complex areas.

There are currently 19 primary Hawaii Keiki sites throughout the state, according to the DOE.

The Hawaii Keiki program was viewed as one strategy to help lower chronic absenteeism, particularly in schools in remote or rural locations where visiting a doctor meant a child having to miss school for an entire day or two.

The Hawaii Keiki program was launched in part to address chronic absenteeism spurred by students with health needs. Waianae Intermediate had a 42% chronic absenteeism rate in the 2016-17 school year. 

In the 2018-19 school year, the vast majority of health room visits across Hawaii public schools related to student injury or illness. Of those 9,021 health room visits across the state, most students, or 86%, were able to return to class afterward.

But that will likely change in the upcoming school year, as more remote learning is incorporated into the curriculum.

More Mental Health Concerns Expected

As of May 1, 85 calls have been placed to the new health hotline. Calls have come in from all over the state, from Oahu to the Big Island to Maui.

And the concerns communicated over the phone don’t always relate to a health ailment.

Some parents want to know about the safety protocols surrounding the reopening of schools for summer programs. Others want to know about the DOE grab-and-go meals program, or immunizations needed for the upcoming school year. Other calls have come from outside the state, with families planning to relocate to Hawaii asking questions about the school transition process, said Mattheus.

“As we were going through this period of COVID, there are not as many sick kids,” she noted. “They’re not in school, they’re social distancing. Not as many sick calls. There will be more the closer we get to opening schools.”

Another huge part of the service has been the ability to provide initial support to students for mental health needs, according to Armstrong.

She said the health hotline fielded several calls from students exhibiting “significant social and emotional needs.” She also said parents called in wanting guidance on how to help their child navigate these problems and get the needed support.

“They were able to be connected with the appropriate contacts and get the help they needed,” she said.

One of the big questions when schools reconvene in August is how to assess students’ emotional state after a prolonged time of isolation, or any trauma they may have experienced in their own personal lives due to a family’s changed situation or even sickness or death of family members.

Armstrong said the DOE is providing “extensive training for school-based behavioral health counselors” and getting information out to teachers “for a referral process for the awareness that students who been away from school, they may have experienced situations that haven’t been positive.”

Results from a DOE survey distributed at the end of last school year indicate this gap. Nearly a quarter of the 8,600 student respondents in grades 6-12 said they were either “quite concerned” or “extremely concerned” about their social and emotional well being, as of late May.

About 1,200 students said they did not have a teacher or other adult from school they could count on for help if needed during school closures and nearly 2,000 respondents, or about a quarter of the pool, said teachers or counselors were either “not at all helpful” or only “slightly helpful” in supporting their social and emotional needs.

“We are on high alert, recognizing we must absolutely address the social emotional needs kids are returning to school with,” Armstrong said.

Mattheus said the advanced practice registered nurses that are part of Hawaii Keiki receive training in mental health counseling and that their education is “broad in nature.”

“The goal was to be able to provide equitable access to health services for all DOE students,” she said. “We’ll continue to have our phone line open.”

The Hawaii Keiki summer health hotline has been extended to July 24. Summer hours are Monday through Friday from 9 a.m. to 2 p.m., excluding holidays. Call (844) 436-3888 (toll free) to speak to a school nurse.

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