Maui students lose
program for
mental care

Health advocates say the loss
of the program could hurt
special-needs children

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By Crystal Kua
ckua@starbulletin.com

Mental heath advocates are complaining that Maui special-needs students could fall through the cracks because of the loss of a hospital program designed to help adolescents having mental health crises.

Starting tomorrow, the state Department of Education takes over delivering many of the mental health services for special-needs students now provided by the state Department of Health.

The switch has left Maui Memorial Medical Center without the state contracts it needs to continue a program that allows adolescents who are having serious mental health crises to go on with their education while their condition stabilizes.

For the past two years, the Maui hospital program has provided a place where up to eight teens diagnosed with depression, bipolar disorders and other mental illnesses and who are in crisis can undergo intense medical oversight while also continuing with their education.

Colleen Wallace, executive director of the Mental Health Association in Maui County, and other advocates said the program has been a lifeline to teens with emotional and behavioral problems, some of whom are potentially suicidal.

"For seriously mentally ill students, this is a great loss. These are programs that have kept them in their homes and in the communities on Maui," said Wallace, executive director of the Mental Health Association in Maui County.

"This is really a cutback for Felix children with mental health needs on Maui."

But DOE officials said they are concerned that children placed in the program will be "parked" there indefinitely, preventing them from being mainstreamed back into the public school setting, which is the goal of the consent decree and federal law.

"I would be concerned about the institutionalization of the child," said Douglas Houck, the DOE's Felix compliance director.

Currently, the DOE provides hospitals with a teacher and an educational aide while the DOH pays for a psychiatrist, psychologist, social worker, occupational therapist and registered nurse under contract.

A school bus drops off the students at the hospital where they are schooled for the day while doctors, nurses and other mental health professionals monitor their condition and their medication. Houck said the service is expensive -- $250 a day or $60,000 a year per student.

The DOE has not yet offered the hospital a contract to continue providing educational services during the next fiscal year, which begins tomorrow.

The DOH has offered a contract for only partial hospitalization, which entails a child to be assessed and treated to address medical and psychiatric needs within 10 days, said Deputy Health Director Anita Swanson.

That is down from the current three-month maximum stay.

"Generally, it's where the child would not be able to function school-based," Swanson said. "It's not an educational setting," Swanson said.

Kathy Bauer, nurse manager for the hospital's behavioral health unit, said: "What will happen at day 11? That's the question."

Any educational services would now need to be provided by the DOE, she said.

Swanson said the four children already in the program will remain until their individualized educational plan allows them to be transitioned. But the hospital will not be able to take on new students in the program.

Swanson said any student identified needing the kind of services that Maui Memorial had been providing will still be able to get those services on Maui. "We can still meet the needs," Swanson said. "We add services to (other) day treatment or add services to home life environments."

The Health Department will continue to provide mental health services for so-called high-end children, those with severe emotional and behavioral disabilities.