Rural Ohio school district telehealth project could be blueprint for region

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A stethoscope on a computer keyboard.

A long commute is an inconvenience. But when you’re one of two behavioral health counselors for a school district, with eight buildings spread across 536 square miles, it’s more than an inconvenience. It’s a serious hindrance to your work.

Add in limited cell service and other connectivity problems, and you have a pretty good idea of what things looked like for counselors at Switzerland of Ohio Local School District. Until recently.

This year, the district has been the site for a telehealth pilot project that could be replicated by other school districts across the state. The project is increasing broadband infrastructure and other equipment and facilities so that counselors can meet with students in different buildings, virtually.

The project is connected to the Ohio Broadband Strategy and is a $1 million effort funded by Ohio Medicaid. The state broadband office released an initial blueprint, Sept. 1.

“They were a very difficult use case for this,” Lt. Gov. Jon Husted said in a Sept. 1 press conference.

District

Lydia Brodegard, director of special education for Ohio Valley Educational Service Center, said the district is the largest geographical district in Ohio, covering all of Monroe County and parts of Belmont and Noble counties. Some of the district’s schools are only a few minutes apart, but others are upwards of an hour-long drive.

There isn’t much behavioral and mental health support in the area. Students who needed support often used to miss a half day or whole day of school to travel to Columbus, Marietta or Wheeling, West Virginia.

The school brought in two full-time counselors in 2018, as part of a new healthcare plan. The counselors work at different buildings in the district on different days.

If a student at one school needed immediate counseling on a day there was no counselor at that school, a counselor would have to drive there, losing scheduled time with students at other schools. If a student needed counseling twice per week, but a counselor was only at that school once each week, it was hard to get two sessions in.

And sometimes, limited cell phone service added to those challenges. Brodegard recalled a day when the phones at one school went down, and the lack of cell phone service left the school unable to contact counselors.

Priority

Getting involved with the project was a “no-brainer,” Brodegard said.

Brodegard was the behavioral specialist and coordinator of prevention and wellness with the school district at the beginning of the project. She now works with the Ohio Valley Educational Service Center, which also serves the district, but she is continuing to oversee the pilot project.

“It was a priority to us,” Brodegard said. “This was something our students needed, and something we needed, as a district, to meet the needs of our students.”

The suicide rate in Monroe County is fairly high, Brodegard said. Right before the project was announced March 9, there were three deaths by suicide in the community. All three people were related to students within the district.

Teachers with the district have gone through mental health first aid with Ohio State University Extension. Brodegard said between that and other prevention programs, the district is hoping the schools are better equipped to catch and prevent mental health crises. The project will also allow the schools to provide better care to students.

On track

The project was formally introduced at the same press conference Ohio announced its first COVID-19 case.

“I will never, ever, ever forget my first visit to the statehouse,” Brodegard said.

But despite the pandemic, the district is right on track. The schools in the district already had broadband through the Ohio Academic Resources Network. Brodegard said the district’s IT director has kept the district updated and made sure that all students have Chromebooks.

Over the summer and spring, once they were able to get back in the buildings, IT staff worked on setting up equipment and other infrastructure to make sure broadband connections were solid.

“This isn’t just something on paper,” Brodegard said. “Prevention is not just saying, it’s doing … we’re in the ‘doing’ part already.’”

The infrastructure is there. By December, the project should be in full swing, with rooms for virtual counseling at all schools set up as welcoming spaces for students. But, for now, it’s already functional.

“If they need to connect … it’s there. Is it exactly the way we want it to be? Is it perfect at this point in time? Not yet … but if we need to use the equipment right now, we can,” Brodegard said.

Expanded access

The biggest goal for the project is for students to be able to connect with counselors more often. But there could be other benefits for the community.

The blueprint mentioned possible additional fiber-optic lines being added in Monroe County to help connect the schools directly to the district’s behavioral health provider, so that students have access to more care. These lines could also bring better access to underserved parts of the county.

Brodegard said the county is currently working with the Appalachian Region Committee and the governor’s office on a possible additional grant to increase broadband access and possibly cell phone service in the community. Since it is still in the works, she was unable to give details, but said if it happens, it would be a three-year project.

The blueprint is still a work in progress. It is publicly available at innovateohio.gov/broadband, but will be updated as the project continues.

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