Administrators

For more than 30 years,* student health insurance has been our focus. Now, more than ever, we're passionate about working with you to help keep your students healthy and productive. To that end, we're proud to offer our suite of products and services. They give students the economic protection of insurance while they work toward their academic goals.As one of the largest student health insurance plan administrators in the country, we offer:

Excellent customer service
You'll have an experienced Aetna team servicing your account. They can help in many ways including plan enrollment, IT integration, marketing and communications to help engage your students, and more.

Administrative capabilities
Our program implementation begins with an organized enrollment system with online enrollment/waiver processing. Plan selection is easier for students, plus your paperwork and administrative time is reduced.

Ways to contain costs
We educate members and health care providers on best practices to help cut your costs. We'll also help you increase efficiencies in enrollment, policy management and health center billing.

Strong national provider networks
Our networks are strong with more than 1 million** health care providers nationwide.

Quality and safety
We use advanced technology to analyze information from all of our plans and programs. This helps ensure that drugs are used safely so students can achieve their best health. It can also help save money. For example, point-of-service (POS) safety edits alert network pharmacies of situations such as therapeutic duplication.

Health care reform information
We're a leader in keeping our customers informed about health care reform requirements.

Account Services
The benefits of working with one of the largest health care organizations include:

• Experienced team focused on servicing your account
• Online enrollment/waiver system
• Flexibility to customize online enrollment/waiver for specific student groups
• Experience with standard or unique bursar systems
• Real time claims activity monitoring
• Customized audit options

The benefits and services that we offer include:

• Medical plans that feature 24/7 coverage anywhere in the world, with no out-of-area limitations
• A national network of more than 1 million health care providers including more than 650,000 primary care doctors and specialists and more than 5,600 hospitals*
• Access to discount programs including vision and fitness programs. Also includes natural products and services (such as acupuncture) as well as fitness and weight management
• Informed Health® Line**, which allows students to talk directly to a registered nurse
• Access to emergency travel assistance services

Additional products to give your students even more health-related benefits:

• Insurance products that complement our student medical health insurance plans
• Discount programs that offer immediate savings on vision, dental and pharmaceutical-related services
• The Guardian Angel Program to help fight opioid addiction
• Our Student Assistance Program (SAP) and more

Ancillary Products PDF

Aetna Health^SM App: Access information about your plan, search for and connect to care, manage and pay claims, and more—so you can make the most of your benefits and take control of your health. Download on the App Store or Google Play today. Learn more about the Aetna Health app, and download on the App Store or Google Play today.

Digital ID Cards: Your students can find their digital ID card on their member website. It’s easy to print one, too. Or they can save it to their picture collection from any mobile device, so it’s ready to share at their next doctor’s visit. For more information, review the PDF below:

Digital ID Card Flier for School Administrators

JIN OAK HA: Today's session will be hosted by our Chief Medical Officer Dr. Wendy Shanahan-Richards, and will provide an update in terms of our COVID-19 response, including how we are supporting our students through the pandemic as well as a facilitated discussion about how our schools are responding to the pandemic as well as planning for the post-pandemic in this COVID-19 environment in our path back to campus. We will also be joined by Peter Diniaco, who is our Head of Sales and Account Management, who will be on the line with us today and will share a high level overview of our CVS Health offerings for our schools as they plan their return back to campus. And I would also like to take this opportunity to reinforce CVS Health and Aetna’s commitment to supporting our schools providing not only support and solutions but also our support supporting student health, customers and members during these unprecedented times. So with that I will hand off the webinar to our Chief Medical Officer Dr. Wendy Shanahan-Richards. Dr. Wendy?

DR. WENDY SHANAHAN-RICHARDS: Yes, can you hear me. Can everyone hear me, okay?

JIN OAK HA: You're good.

DR. WENDY SHANAHAN-RICHARDS: Excellent, okay. Well I'm going to say good day to everyone because I know people are participating from different time zone. And I also would like to express my thank you to everyone for spending time with us today. I’m going to, if you can see the - we'll be pulling up the agenda here momentarily and you'll see that, you know, we have quite a busy agenda here. But we are definitely planning to allow for time to hear from you about your strategy for recovery and path back to campus. And we will also allow adequate time for you to ask questions. So the approach that Aetna Student Health as part of the CVS Health Organization has deployed to support our members, our providers and our schools during the pandemic has been to really focus on making it easier for members to receive care and utilize their benefits appropriately. And of course for providers to deliver care in the midst of this pandemic. For the next 15 minutes or so, I will cover at a very high level some of the many ways that our organizations have supported our members, our schools and providers during these challenging times. Afterwards, we’d like to hear from you and we'd also like to invite you to ask us questions. I'm going to start off with talking a little bit about the benefit liberalizations around testing and telemedicine, our international students, how Aetna and CVS Health are helping to fight against COVID-19. We'll then move on to talking about some of the policy liberalizations that our organization has instituted during this time. I'd like to address case management outreach to support and education that has been really enhanced during the pandemic. And then we'll finish with just a very high-level overview around transparency and communication. And then finally, we're going to talk a little bit about what the path forward looks like, the path toward recovery, and this is where we really want to hear from you because, you know, you're living this every day as you plan, you know, for fall and going forward. And then we will take questions. So let me start off with benefit liberalizations, you know, what I'm going to say here is not all inclusive and, you know, timelines have shifted and evolved as the pandemic has progressed. But again, at a high level around benefit liberalization, you know, one of the very prominent topics has been around COVID-19 testing, both the viral or antigen testing as well as the antibody testing. And I'm sure that you're all aware that the cost share to members has been waived for this testing and is still continuing to be waived. For telemedicine, which has become, you know, it's just an incredible resource for your students, our members to receive care, we have also waived the cost share for the telemedicine services from our in-network providers. We've expanded coverage of telemedicine services. So you may remember some of you have had students that, you know, needed to continue their physical therapy, occupational therapy, speech therapy during the time when they were not able to see their providers in person. So we've expanded the services covered around telemedicine. We've also made it possible to adjudicate the claims for international telemedicine in line with international plan coverage. And finally, we have allowed student health centers to bill for telemedicine visits. And we know that this is really, really important to you and to your students because many of your students have had, you know, a working relationship with your student health center, and we wanted to make sure as I know did you, that this did not diminish as much as possible during the pandemic. So the billing has been facilitated to take place either through a fee for service or through health center billing agreement. Acute inpatient admissions. You know, in this particular area that I'm going to talk about, this has been so serious across the country, across the world. Many, many admissions, people having various experiences with this virus. And so we have waived the cost share and copay for all COVID-19-related admissions at all in-network and out-of-network facilities. In terms of pharmacy, CVS Health and Aetna Student Health, of course, have permitted a 90-day prescription supply and refills at retail, as well as provided free home delivery, which again is incredibly important during this time. And for members outside of the United States, particularly covered students studying abroad we've made sure that they were covered at 100% for COVID-19 testing. And finally, for international students, expanded coverage for eligible plan medical services at in-network benefit levels for students that are traveling outside of the United States. I know specifically in terms of our clinical team we have worked with some students who were traveling abroad, they were studying abroad when all this started and they were not able to come back to the United States at that time. And so we wanted to make sure that, you know, they were able to be treated and that this would be at the in-network medical level. And now I’m going to move on to policy liberalization and, you know, this is an area that I've been very, very involved with the Aetna/CVS Health enterprise. Making sure that we had a voice at the table because we do know that our students' needs are sometimes different than the typical, you know, adult employee population. So one of the first things that occurred was that for approved pre-certification for some of our ambulatory services the end of the timeframe for which that precertification was valid. And, you know, it's usually six months from the time that the provider calls in and ask for the precertification and the approval is good, if you will, for six months; we extended that to nine months. Also too, for acute-care admissions in select states, we made sure that the facilities who were just in many cases not just busier than usual but bordering on being overwhelmed, especially back in March and April. Made sure that they just needed to notify us for that admission, they did not need to send clinical information, they didn't need to talk with our utilization management staff every other day to provide clinical. Again the focus was on, you know, making it easier for the students to receive care and for the providers to render care. We also know that some of the students, and numbers just in general, depending on how acutely ill they were, you know, when they were admitted, some of them did need to progress to a lower level of care before they were ready to go home. And so we make sure that the policies around notifying and getting approval for that transfer was altered so that it was again not dealing any kind of transfer of students from the acute level to sub-acute. I’m going to talk a little bit now about case management. So many of you that I have spoken with, you know, or that your Aetna Student Health account management representative has spoken with in the past know that we have a very, very active case management program in Aetna Student Health. This includes medical as well as behavioral health. And so we wanted to make sure that for all the members that we had been working with in case management for any reason since late last year, even if they were not in active case management that we would reach out to them, see how they were doing. Determine where they needed support, answer their questions. And so our team really had a huge rally of outreach calls and, you know, engagement with the members. Each and every member that was hospitalized either with confirmed or potential COVID-19 was outreached upon discharge so that they could, again, get additional support and ask their questions. And this again was very well received by the students. If any member called customer service and self-reported outpatient care for COVID-19 we also reached out to them because they didn't have the benefit of having, you know, clinical staff in a facility to help them with their discharge planning. We wanted to make sure that they were getting the resources that they needed as well. And finally, we know that this pandemic has had a very large impact on students and members who have various medical and behavior health diagnoses that might put them at higher risk of COVID-19 or related issues - and particularly in the behavioral health arena. And so we reviewed all of our data and we reached out to members who, you know, we are aware are challenged with various diagnosis, and we made reach-out calls to them as well. Another really important resource that we are able to leverage during this time has been Resources For Living (RFL), which is a component of Aetna behavioral health. They have provided a very, you know, wide ranging, but very comprehensive list of support organizations, community organizations. They also provide online access to a toolkit, which gives very relevant and current up-to-date information on COVID-19. So all of our clinicians that were speaking to members for any reason during this time, if they had a sense that the member needed more information and that they needed additional support they're able to refer them to the Resources For Living. Talking little bit about CVS MinuteClinics. So they have played an important role during the pandemic as well. They have and they continue to offer e-clinic visits where the nurse practitioners and physician assistants that are part of the MinuteClinic organization were covered under telemedicine benefits and also included the member cost share waiver that students that would be working with clinicians in any other venue of telemedicine would have. CVS MinuteClinic also provided video visits, which were staffed by Teladoc physicians, again covered under the telemedicine benefits including the member cost share waiver. I’m going to talk a little bit now about testing support that has been offered and the first one I'll mention here is the rapid drive-through testing, which is very large scale. It is by appointment, it's seven days a week. There are five large scale testing locations in various states, and the process includes a self-administered nasal swab and the whole process is really under the supervision of the CVS MinuteClinic providers. The process takes about 30 minutes from the time the specimen is collected to the availability of results. This has been very, very popular and heavily utilized throughout the time of the pandemic. You also have drive-through testing available at CVS Pharmacy locations, again by appointment. And by the end of May, we reached over 1,000 locations including Washington D.C. and more than 30 states. The same process is in place with the self-administered nasal swab and the process is under the supervision of MinuteClinic staff. So again, many times when there are questions during the testing or some anxiety during the testing process, it’s just very, very important to have clinicians that, you know, can help people understand what the testing processes is and, you know, when the results will be coming in, and what their next steps would be. The specimens in this case are sent to an independent third party lab and the results are available in about three days. So again, depending on the needs there are a couple of options that have been available. And speaking of other options at this point I'd like to turn the presentation over to Peter Diniaco, one of my colleagues at Aetna Student Health and he's going to address the new opportunity that CVS Health and Aetna Student Health are offering to customers. So Pete, I'll turn it over to you.

PETER DINIACO: Thank you, Dr. Wendy. Good day, everybody. So as Dr. Wendy mentioned CVS has developed a comprehensive solution set, which offers flexibility in the location of testing as well as the timing of results. All wrapped with a robust data and analytics reporting package. We understand the need for flexibility and the sense of urgency as you look to safely reopen your campuses. So it is designed to be highly configurable. It's a turnkey end-to-end offering that enables your school to choose who to test from symptomatic, asymptomatic, those that have been exposed and recovery validation. It allows you to choose where to test whether it'd be on-site or even prior to the students returning to school as well as the speed and the frequency of testing. This is a really important distinction to note. This is not insurance coverage or part of an insurance plan. This is a separate offering. It's a separate standalone program for you to consider that allows for the proactive screenings and frequency. It can also be comprehensive to include faculty and administration. So there's two models. The first model is on-site testing. On campus, utilizing the Abbott ID now rapid result machine. The results using this machine are available in about 5 to 15 minutes and each machine has the capability of doing about 30 tests in an eight-hour shift for a machine. The second model is taking advantage and utilizing the 1000 locations that have the drive-through capability to do the nasal swab and send with the PCR tests to an independent lab. And the result takes anywhere from two to four days to get the results of the test. I also did want to mention that each of these testing models use our antigen test, not antibody test. And, you know, in the spirit of the configurability of the offering, a school could choose to deploy a hybrid model and you utilize both the on-site as well as the drive-through if that works in your particular case. You know, in a little bit more detail on the on-site in that case, it is turnkey where CVS would come in and basically provide two clinicians per machine to administer and counsel the students with results. They come in and actually build out the space that's provided to ensure that it's compliant and suitable as a testing environment. In addition to providing the space, the other primary task we would need from the school is to provide an eligibility file for the populations you choose to test. So that would be both for on-site but in particular, if you were going to use the drive-through function. The other convenience of the drive-through is it’s a direct bill model. So there's no exchange of money, you know, for everybody that goes on to the scheduling -- the CVS scheduling tool -- a student there would be a charge back to the school for those that actually go through and get tested. And the cost of the program just to give you some ideas based on, you know, which model you deploy and for the length of time. But just to give you some guidance the on-site is $200 – it breaks down to about $200 per test. The drive-through model is $165 per test. So I just, I know that was a real quick overview and I want to do this quickly and just to give you that overview but we're available to do a much deeper dive with those who are interested in learning more and exploring how this could fit your return-to-campus strategy. So with that in the interest of time Dr. Wendy, I’ll turn it back you to continue, please.

DR. WENDY SHANAHAN-RICHARDS: Thank you, Peter. So a few other areas that I'd like to cover before we move to our next section is we did offer a special enrollment period during April. So many of us in many ways were I guess you could say, you know, turned around a bit by this pandemic. And so for students and their eligible dependents who have previously waived coverage or who had a qualifying life event, we wanted to make sure that they had the opportunity to enroll during our special enrollment period. I'm going to, you know, finish by talking a little bit about transparency and communication. You know, I've heard from a lot of people and I felt this myself and I am sure many of you have as well that as we have had to practice social distancing and during the various states’ stay-at-home orders, we've had to learn new ways of communicating. You know, we don't see each other in person as often nearly as we did in the past and we are hoping those days will come back relatively soon. So transparency and communication with our schools as well as our students have been very, very important to us in terms of what our focus has been. And I will just mention a few areas that have been deployed. So, CVS Health has had, I think, it has an excellent COVID-19 resource center. We will be providing a link later if you don't have it. This link will be going out after the meeting; it is publicly accessible, it's updated very regularly and I use it myself for a variety of reasons. I think it's a great resource. In terms of the Aetna Student Health and team and how we have been fostering transparency and communication, our leadership team meets every day. We formed a multiple-disciplinary team back in March to address emerging topics and questions that you our schools, our members, and our providers have. As I said, we meet every day and we make sure that we have a central repository for all questions from our schools as well as our members so that our team, our entire student health team, from customer service to account management are able to provide consistent updated current responses and information to you and to your students when those questions arise. We also have been very fortunate to have a very comprehensive FAQ document around the virus and it's regularly updated. Our account team has access to it. And I know that they utilize this resource very heavily when they're responding to your question. And I would be remiss certainly not to mention the account teams; they and customer service both are the face of Aetna Student Health. And I know that both the customer service and the account teams have been working very, very hard during the pandemic to make sure that they're available for you, to make sure that they have the answers to the questions that you need, you know, very quick answers to. And so they've been, again, excellent partners with the leadership team and we really appreciate all of their work. We also, you know, are fortunate to have our network manager that is linked in to the CVS Health Network teams. Many questions coming in from providers around benefit coverage and she has been able to field those questions and bring a lot of valuable information not only to the provider but back to us so that we can understand really the line of sight that we need to have in the challenges that they are experiencing during the pandemic. And then finally, monitoring our metrics through analytics; you know, there's a lot of data out there. We see the data – we see reports from the CDC. And, you know, frankly, I can get overwhelmed by that sometimes – a lot of good data, a lot of good reporting. But we wanted to really focus – while we certainly pay attention to what's going on in the world, in the country, and our very state, we wanted to focus on our Aetna Student Health analytics and data. And so we have developed a daily dashboard that we use amongst our team to monitor and track our metrics related to the virus – around the services such as testing, telemedicine, inpatient hospitalization. How are these services being utilized? Do we need to make more adjustments in terms of our communication about them? And then finally in May, the Aetna Student Health DASH reports that many of you are familiar with for each of your schools began including COVID-19 specific reporting so that you could have more line of sight into, from an analytics standpoint, the impact that the virus may be having on your student population. And so now, I've really completed my prepared remarks, but what I'd like to do is under Recovery, "What does the path forward look like?" This is where we really want to hear from you. Like I said earlier, you know, you live and breathe this every day. And I know that there are huge challenges that you have been confronting and we're looking forward to hearing more about how you were approaching the return to campus in the recovery process. I think as our country gradually opens up during the pandemic, our schools as well as employers are grappling with decisions around returning to campus and returning to work. We are hearing a lot from our schools that they are focused on a number of key areas as they contemplate their next step on the path back to campus. And these I'm sure are very obvious to you but, you know, testing for the virus, viral testing versus antibody testing. Vaccine availability timeline, you know, we hear different things around the timeline, depending on the day of the week and the month that we're in. And we're all very hopeful that that timeline can be accelerated, but we just don't know at this point. Also hearing about managing on-site learning versus distance learning, the challenges that has and will continue to provide. Athletic events, campus events, you know, things that we're all used to that are traditionally, you know, part of the higher ed experience. What are next steps with that? How can we help the students still have access to various activities when we can't all be there in person? And then, you know, we've heard from our school that models under consideration are full return to campus, or completely maintaining distance learning, or various types of hybrid approaches. What I would like to do at this point in time is to turn it over to Jin Oak. So we did invite our participants to submit questions prior to the webinar. We did receive some questions that we would like to go ahead and review those first and then we will open up the lines for Q&A. So Jin Oak, I’d like to turn over to you, please.

JIN OAK HA: Thanks, Wendy. So we received a number of questions and I'm hoping that, you know, these are general enough for pre-submitted questions and if not feel free that ask more detailed questions but let's get started. So to Dr. Wendy. "So as schools are planning for various scenarios for this fall semester, what is Aetna planning to support for their customers and their schools by way of benefit liberalizations?"

DR. WENDY SHANAHAN-RICHARDS: Okay, thank you. Thank you, Jin Oak. So, you know, I talked a lot about the benefit liberalizations, you know, during my remarks. But I wanted to make sure that there have been a lot of different benefit liberalizations, kind of they all fit together. Some examples would be, you know, waiving cost shares for testing and treatment, certainly for telemedicine, waiving referral requirements as well as expanding coverage for international students. And we have extended our telemedicine coverage at no member cost share through the fall because again we do not, as I know you don't, either want students to have to delay care because they are not able to go in and see their provider in person. So just a brief summary of what we have been doing.

JIN OAK HA: Great, thank you, Dr. Wendy. Another question: "There has been an unprecedented use of telemedicine during the pandemic. Can you speak to how Aetna has supported members with telemedicine options and access and how Aetna now has been working with the student health centers on expanding telemedicine access?"

DR. WENDY SHANAHAN-RICHARDS: Sure. I'd be happy to. So just as national experience has shown us there has been a very, very large increase in telemedicine utilization for both medical and behavioral health care. I think it’s unprecedented just like this pandemic is, it's unprecedented for so many providers to have had to move to the telemedicine model in a very, very short period of time to continue to provide, you know, consistent care to their patients and again certainly that includes the clinicians at our schools’ campus health centers. And so we wanted to make sure that whatever we could do in our role that we could make it easier for that to happen. And so we did liberalize telemedicine benefits by waiving the cost share and particularly we've seen a very, very large increase in behavioral health telemedicine usage. We've also – I think I mentioned this during my remarks too – we've also made sure that it was going to be as easy as possible for the students to receive telemedicine care through their student health center in the event that, you know, that was the area they had been receiving care prior to the pandemic.

JIN OAK HA:Thanks, Dr. Wendy. Another question: "Aetna is covering costs for COVID testing and treatment. Are ancillary services tied to COVID testing and treatment included in coverage?"

DR. WENDY SHANAHAN-RICHARDS: Absolutely. So under federal mandate, we certainly have been covering – the various states have had orders to cover inpatient care without member cost share. But we've also made sure that on the outpatient side any services that are tied to COVID-19 testing are covered with no member cost share. Because, again the last thing we want people to worry about when they believe they may have been exposed to the virus or they're having symptoms of the virus that they're thinking about, Oh, let's see, what's my deductible, or wondering what I'm going to have to pay out-of-pocket. We want to make sure that wasn't going to happen, and of course it just goes without saying but, you know, we follow very closely and adhere completely to any kind of federal or state mandates, regulatory requirements for all health care services, and certainly that includes COVID-19-related healthcare services.

JIN OAK HA: Thanks, Dr. Wendy. Peter, here's one for you: "As schools are planning for various scenarios for the fall semester, what is Aetna planning to support for their customers by way of testing capabilities?"

PETER DINIACO: Yeah, just as, you know, a quick recap I think that the program that I described, which I think I failed – the name of the program is Return Ready. So the level of support is really around the on-campus capability with the rapid result machine or if the school has proximity to one of the 1,000 CVS drive-in locations, that could be an option as well. Or, you know, that could also be something that schools ask students to get tested before they return to campus by utilizing those. So those are the two levels of support in that regard, Jin Oak.

JIN OAK HA:Thanks, Peter. So one last question, Dr. Wendy, for you: "Aetna has expanded case management outreach to members during the pandemic. What community-based outreach support and interventions can Aetna offer to schools in their recovery efforts on their path back to campus?"

DR. WENDY SHANAHAN-RICHARDS: Excellent question. So our case managers have provided outreach and engagement with members, you know, as I had mentioned before. And I also mentioned Resources For Living, also called RFL, that our case managers have tapped into those resources to share with our students. We occasionally will have a situation where, you know, someone has contracted COVID-19 and they're halfway between their housing on campus and getting back to their family. And they're not sure what to do, you know, traveling wise. They also may be finding themselves, you know, needing resources for food. So we have made sure that we take full advantage of the Resources For Living contact. We also have, you know, the ability to refer them to the assistance plan where they can speak with a counselor. We've made heavy use of this when it comes to, you know, stress related to the pandemic. And, you know, kind of what's going to happen going forward, you know, family members that have had COVID-19 and their home environment is very, very stressful. There's a lot of different things that RFL provides and again we tap into that and make sure that we share that information with the students. Many of them are community resources [inaudible]. That really is all that we have for you today. We will be sending out a link to a recording of the event shortly. You'll be able to relisten and share that with colleagues. There will also be contact information for any questions that you may have about today’s topic. We want to make sure that if afterwards you start thinking about the webinar today and have additional questions or concerns that you have the opportunity to share those with us. At this point in time I'd like to say that I hope everyone will stay well and safe and we’d all like to thank you so much for attending our COVID-19 webinar "The Path Back to Campus". Thank you and have a great day.

Maureen Flynn: Welcome- before we get started I want to remind everyone that this webinar is being recorded. The Q&A portion will not be recorded.

Welcome to the Aetna Student Health webinar, “Unique Challenges and Strategies for the 20/21 Academic Year”. Today we will host a panel discussion followed by an open Q&A session. Please hold your questions until that time. Now I would like to introduce Jin Oak Ha, President of Aetna Student Health. 

Jin Oak Ha: Good afternoon I am excited to be here today to talk about the 20/21 school year during this time of COVID-19. We know that this year is presenting many unique challenges whether you are back on campus or learning remotely. There is no roadmap for college health during times like these but we hope that we can all learn from what our panelists are doing and how all of you are managing during this time. Our hope is that you leave this webinar today with new ideas and strategies for your campus. 

Now I would like to turn the call over to our Chief Medical Officer for Aetna Student Health, Dr. Wendy Shanahan- Richards. 

Dr Wendy Shanahan- Richards: Welcome everyone, and thank you for joining us today

As the world has now passed the 6 month mark of the COVID-19 pandemic, we have moved from Spring to Summer, and now to Fall

Along with the change of seasons during these challenging times comes a brand new academic year for colleges and universities – complete with challenges the likes of which most of us – and perhaps none of us – have never experienced before

Today, Aetna Student Health is very excited to be joined during this next hour by three panelists who have agreed to share with us their experiences, insights, and strategies for supporting the students enrolled at their schools

We have three questions that we have posed to our panelists, and we look forward to their insight

Now I would like to briefly introduce our three panelists

Dr. Sarah Van Orman (University of Southern California)

Dr. Sarah Van Orman, MD, MMM, FACHA; Associate Vice Provost for Student Health; Chief Health Officer, USC Student Health; Clinical Professor of Family Medicine, Division Head College Health – University of Southern California

Sue Prochazka (Rice University)

Sue Prochazka; Director of Benefits, Human Resources – Rice University

Kathleen Coughlin (Syracuse University)

Kathleen Coughlin; Director of Operations Health & Wellness – Syracuse University

Dr Wendy: What considerations were factored into your school’s decision to adopt its Fall Semester learning environment? 

Dr Sarah Van Orman – Good afternoon everyone thank you for joining us this is a very important question and I will start the conversation by putting this in a framework, the decision for each school the right modality to have instruction, in person, hybrid or off campus is really a complex with the conditions at the school and in the community the school is located in. We know that the institutions of higher ed need to be prepared to support the communicable disease aspects of COVID-19 such as testing, contact tracing, quarantine, isolation; but we also know that institution sits context sits within their community. And where that institution is located and the public health infrastructure of where they are located is a critical factor in determining whether institutional factors will be effective. For many of our institutions that is going to play a role, is the incidence in the community where the institution is located low enough and what measures can be effective. Nature of the university is important as well a residential university has a different set of impacts vs all commuter students where we are dealing with  a student population that looks like the community around it. Those are the two big sets of considerations, there’s lots of details under that. I will start with that to frame out how we thought of it and here and how many institutions thought of it as they were thinking about the fall semester.

Dr Wendy: Thank you Sarah. I will now ask Sue from Rice University for your response to this question.

Sue Prochazka: To be true to their values and maintain fidelity to their mission and that was at the center of our decision for the regarding our learning environment for the fall. Our university’s mission is to be a leading research university with a distinctive commitment to undergraduate education to aspire to path breaking research, unsurpassed teaching and contribution to the betterment of this world. Because of this mission we thought it was necessary to have an on campus presence. To fulfill the mission and so using the concepts that Sarah mentioned we got acclimated to working from home and learned to use zoom we started working to get students back on campus. We didn’t all believe at the time it was going to happen but started working towards the goal. All of the information we relied upon to make the decision has been science based such as direction from CDC, our own university experts and once we were convinced that we could get students back on campus safely we have to put policies and procedures and process into place and then communicate the policies very, very clearly. For us every student had to sign a commitment to care pledge and student government and school employees had to monitor this and any infractions. Knowing that we have faith in our students and their desire to come back- because they really wanted to come back. That has gone a long way and their ability to maintain the pledge has gone  a long way to make that possible

Dr Wendy: Thank you Sue. Kathleen from Syracuse University I will ask you to respond. 

Kathleen Coughlin: At Syracuse University and I will echo some sentiments from my copanalists. One of the biggest things we were looking at was what our community in Syracuse looks like. One of the things I pride myself on and shared with out students, this is also my home and the same people I see at the grocery store and if it wasn’t safe to bring students back I would not have wanted to support the idea at all because this is the community I love. Luckily in Syracuse we had a low disease rate we are far from NYC. We felt comfortable after polling students, faculty and staff about if they wanted to return to campus students overwhelmingly wanted to return to campus. We had some students that never even left campus. International students who didn’t return to their home countries and wanted to stay on campus instead so we had a baseline level to try out some of the things we wanted to do in the fall during the spring and summer to see what would work well. NY state was unique in terms of coming back NY state and several other states decided to designate several other states as “hot states” that you had to quarantine if you were coming from. We had to set up pre arrival quarantine sites for students to do 2 weeks of quarantine before moving into campus housing if they were coming from hot states. We had to set up accommodations, pre arrival testing and pool testing. We wanted to make sure we could set up a strong enough plan for students to come back safely. We had to set up a compliance system to show they had completed their quarantine and attest to it, uploading hotel or Airbnb receipts to show they had been quarantining or in a cool state for 2 weeks before coming to campus, completed their pre arrival testing and continued pool testing. All of these decision points we made over the summer of could we make a strong enough plan to allow students to return to campus safely. We have been able to put together things so far that have been positive, I will stress things like the Student Pledge that we have put in place so that all students are aware of the requirements so that there are no surprises somebody may question if you post something on Facebook that shows if you went to a hot state over the weekend and returned to classes, some of these policies are not just Syracuse University but are NY state policies so if you go to a hot state and do not quarantine for 2 weeks after it is a $2,000 fine.  It made it easier and took away the burden of Syracuse University requires this since it is NY state requiring this. We really had a challenge of not only rolling out our own policies by explaining to students from other states what the requirements for Syracuse and NY state were going to look like. 

Dr Wendy: Thank you so much Kathleen. And now we are going to move on to the next question. How is your school keeping  in touch with/supporting your international students? I’m going to start with Sarah.

Sarah Van Orman: I think international students had challenges in several areas. First of all, for all international students incredible uncertainty they have faced and continue to face for the last 6 to 9 months in terms of making really important decisions about whether they should go or they should stay, or if they could even go and if they go can they come back? I think one of things we really have tried to do as a university is to be as transparent and open with international students about what we know when we know it and really just acknowledging the high level of uncertainty that’s been in place for our students. We also know that we have a group of international students who opted to stay in the local area, in many cases providing housing in March when many of the campus operations shut down. Those students have been challenged with just the isolation of not having the student community present anymore, and again managing the uncertainty of what the fall would look like and should they stay or return. And then finally, like many institutions, there are a lot of international students that did return home and are now navigating the challenges of online education in a different time zone and without access to the same student support services that might be available to them. So, in addition to the transparency that I mentioned, some of the things we’ve done have really been focusing on making sure the academic experience remains accessible in terms of asynchronous modes, looking at when classes are scheduled particularly for students that we know we have a higher proportion of international students. While we are not able to provide mental health services across state lines or even internationally, we have set up innovative programs like drop-in, non-clinical sessions with our mental health staff that are available to students across the nation and across the world. So, students can get that individually or in groups as informal support from our trained professionals. That’s been really valuable, especially with some of our counseling and mental health staff that are multilingual. Having the ability to continue to feel connected to the university and to get those services from us, even though they are not in the local area. We’ve also looked at innovative ways to connect students to mental healthcare while they’re abroad. Finally, we’re starting to think about when we have more on-campus activity, what does reintegration look like? What will it look for our students if we have more on-campus classes available coming up, but some our students are not able to return? The needs of international students have remained at the forefront for us as we move forward. Even simple things, like making sure our students that have to fly back have quick access to the testing and documentation that is required for them to re-enter a certain country. Those are just a handful of things that we have done to support our international students.

 Sue Prochazka: Like the other two schools, we have had some students that have never left. They remained on-campus when we shut down operations in March and stayed all through the summer. Maintaining support for them, a place to live, dining hall activity, that kind of thing certainly was our first concern to take care of the most basic needs. Our dean of undergraduates and graduates’ dean have been in constant contact with all of the students, including the international students. They have done this with frequent group emails, virtual townhalls, individual emails, all sorts of contact, lots and lots of communication. Also, the office of international students and scholars have been in touch to assist as much as possible in their efforts to return to the U.S. for school this semester. Every student completed a “Return to School Plan,” either for virtual learning or on-campus learning. Given that 25% of our students are international that’s a big chunk of students we needed to consider and there have been some barriers we were concerned about from a legal perspective. We joined in support of the Harvard & MIT lawsuit to block the directive from immigration and customs enforcement that would’ve required international students to leave the country if their courses were all online. We did that by filing an amicus brief. Fortunately, that directive was rescinded which I think was a big relief for all the international students. We felt that it was really important to support them by supporting what would be in their best interest. When all of that came up, we sent a letter to every international student letting them know we are supporting the effort of Harvard and MIT, and we really wanted them back if at all possible. We decided in support of all that to do the “hybrid” style of education and advocating definitely for our international students. So that’s how we’ve been showing our support. Realistically though, many of international students are not on-campus this year for a variety of reasons, so we are offering every course at least in an electronic capacity so they can take advantage of those. We are recording everything so the students can listen to the classes if they don’t participate in-person, because the time zone is problematic. They can go back and listen to all of those classes. And those that want to participate virtually have that option as well. I think we’re supporting them by offering a variety of different learning opportunities has also been really important. 

Kathleen Coughlin: So, I won’t review the things Sarah and Sue have already mentioned. I’ll go off on things that Syracuse is doing a little bit differently. We’re lucky enough to have a campus in Shanghai. So, while I think about 20-25% of our students are also international a large population of that group come from China, so we were able to transition the Shanghai campus for our first-year students. So instead of starting their fall semester here, they are starting their fall semester in Shanghai. Originally the hope was to transition them in the spring, but as we are becoming realistic with ourselves it might be not transitioning until the fall of 2021, but wishful thinking. Hoping that it’s going to work. We also made available our campuses in Florence and Madrid and London to international students, so students that couldn’t come back to the U.S. were funneled into our study abroad locations, because our domestic students have not been able to engage in a traditional study abroad option this year. Since we have these facilities abroad, we have decided to open them up to allow students to study there for their first semester or possibly two semesters before transitioning to camps. It’s actually been very wonderful to have those students in a physical campus. There’s been a lot more communication, a lot more updates, more interactions with the university, so those students are hearing from us a lot more and being made aware of what’s going on and have the ability to get immediate feedback from somebody that represents the university. I think it was Sara who mentioned it, unfortunately we are not able to offer traditional counseling sessions to the students who are in other countries, but we have been trying to keep up with our other lighter offerings. In a recreation space, we do a lot of online, Zoom-based, Zumba workouts, things like that and those have been very well-received by our international students. They have asked for additional things they can do. Again, it’s not life or death but it’s something that keeps them engaged with the university. The other thing that has been hugely popular is we do have a robust e-sports club and gaming room here, and so students have been able to join together online and sort of build a community through gaming that has been extremely popular this semester with everybody, because it’s something safe that students can do individually while still feeling connected to their campus at large. So, we’ve been happy with some of the formal ways of keeping communication and these more informal, more lighthearted, more fun ways of keeping connected with the international students. And as was mentioned, we do have a significant number that never left and that we were working with all summer long and spring long and continue to stay here and supporting them with all the things going on in the political climate that’s being touched on. It’s an ongoing challenge to make everyone feel connected and make sure they are excited to come back to main campus in the spring or next fall. 

Dr Wendy: What is your school seeing in terms of impact on your students’ behavioral health and what is your approach to address?

Sarah Van Orman: I think this is an area that many have identified early as being important. Through our Office of Health Promotion Strategy, which does a lot with population-level monitoring, added a module in May with a routine survey about the impact of COVID-19 and the pandemic on our students. We were seeing data even in May indicated that significant number of students were experiencing uncertainty, financial distress, academic disruptions, higher levels of anxiety, and for our Asian and Asian American students experiences of discrimination and behaviors on the basis of race or ethnicity. One of the first things was to get an early view on what’s happening. We have continued to see that and what we see here are several good data sets coming out. Recent data from the CDC and MWWR that really demonstrate that across our general population we are seeing rising levels of anxiety and depression, particularly among younger individuals and particularly among people that have to be in the workforce as essential employees. We also see that in some of the data coming from national college data sets. So, we are continuing to monitor that in our students and what is being seen across the general U.S. population is really echoed in our college student population. We are working to address it. One of the challenges that many of our universities face is patchwork to access to telehealth that’s really determined by the state-level barriers. Early on in the pandemic there was federal regulations aimed at clearing the way for some of that, but it really didn’t remove some of the state issues. One of the things we worked hard on is rapid expansion of telehealth so that we could really provide robust services to all of students that were located within our state, but also then working with our insurance carrier to ensure that we had access to behavioral health across our network, really making sure that we had access to telehealth. We found some unique in-country providers where we had a high population of students. And as Kathleen mentioned, making sure we are provided students with other opportunities to connect and be part of the student community. So, I really think it’s about working across that spectrum of assessment, understanding what the population needs are, working from a prevention lens, facilitating connection and discussion, and also where we can making sure students have access to behavioral health services. It is challenge anytime in student health when our population is mobile and many times need the boundaries of our state, but one of the things that’s exciting about where we’ve been over the last 6 months is our experience, and many campuses’ experiences, with telehealth. We actually hope to extend our ability to provide year-round care for our students even when we’re through this immediate period. There may be more opportunity that emerges from this, particularly as all of us grapple with the growing behavioral health needs of our young adults.

Sue Prochazka: I echo what Sarah said about the importance of telehealth and growing importance of telehealth. We are seeing it on the student’s side. We are seeing it on the employee’s side. It is very very important. I think it was important to maintain programming so people can stay connected. I think that’s a big part of the challenge that folks have is that everybody went home for spring break and they didn’t come back. It was really a jarring experience for many. It was important from the outset to keep people connected and that really was a big focus of the dean of undergraduates and the graduates’ dean which was giving students access to some sense of normalcy even when they were away. Having them back on campus has been the best thing for their mental health, having a sense of normalcy, being able to see their friends even if only from a distant. That was one reason why we strived so hard to have folks back on campus, because we knew that there would be a lot of folks that would be in a better place if they were together. The other thing we’ve done is put a focus on how we can change. We have a very social campus and how we could change the social gatherings into something that could still be fine and reflective of the traditions people like to do but do it in a safe way. We invested quite heavily in our infrastructure to have places where people could congregate but be separate. Outdoor spaces that are covered, and in the Houston heat, air-conditioned. That was important as well. Giving them the support, they need to be together but apart. One of the things from a mental health perspective that we’re all facing is we have a significant number of students that are specifically anxious about their safety. It gives them anxiety. The complete and total commitment of the university to social distancing, to having everyone wear a mask, to everybody’s agreement to their commitment to culture agreement, makes everyone feel safer and reduces that level of anxiety. Also, regular testing so they know themselves that they’re not sick and that they know those around them aren’t as well goes towards reducing that level of anxiety.

Kathleen Coughlin: Being outside of New York City, we still have a lot of students who come to Syracuse from New York City and the number of students who were directly impacted by COVID was very saddening, so our counseling center really set up support groups in the summer continuing into the fall for students that have lost parents or loved ones due to COVID. It’s sort of a unique situation where you have students who are scraping by getting here, first generation, and then you have students who really looked at COVID as this kooky different change in scenery. It’s such a drastic difference coming back. Some students feel like they’ve lost a parent and make changes to their lifestyle, and some people have come back and it’s not impacted their life in the same way. So there’s been a lot of thought in supporting those students who have been directly impacted by the death of a loved one, so our counseling center has been really focused on trying to support those students, especially students of color that have been directly impacted by then pandemic. I won’t even get into on top of that the Black Lives Matter movement. There’s just been so much to support and so much to talk through on campus, so the behavioral aspect of not only the pandemic, but the current social climate has been a lot of work for our therapists and behavioral health staff, and they’ve done a tremendous job even though there’s still more work to do this semester. I will also echo the teletherapy. Between teletherapy and telemedicine, I am sure everyone else said the same thing, we must’ve made that transition in 4 days. So, something I never thought I would be able to move the providers towards entertaining we did in under a week and even the people that swore they would never do it have come to embrace it. I was happy to hear my colleagues say they’re hoping to continue to use it in the future. We do have a few staff members for whom it’s not safe to be physically in the office to see patients who can be at home to do the Zoom telehealth and teletherapy calls, and it has worked extremely well. We have been very happy with Aetna Student Health Benefit that allows students to do it without a copay. We have gotten so many students who have mentioned how much they appreciated it we have had so many family members with which we were happy to tell in the spring that this is something we will still be able to offer to their student when literally no one wanted to go to the doctor or to see their therapist anymore. It was a wonderful benefit for us to use. Talking in general about that physical distancing versus social distancing, and echoing what Sue said, but there are tents all over and 6-foot circles drawn all over campus so that people can safely lay on the lawn and not be too close to one another, and that has worked well to continue to build our community. We have the opposite issue. The snow is probably going to start to fly in two weeks, but right now it is beautiful outside, so we want people to be outside and to be doing all of that. Our cautionary tale was that we built all of these tents and outdoor spaces, and the first night all the first-year students congregated in the quad and there were hundreds of them not physically distancing. I guess if you build it they will come, but you also need people watching them and making sure they are acting responsibly. That was one of our learning lessons this year. And then finally, I was going to end on isolation and quarantine. We have manageable numbers so far, knock on wood. We have been getting little clusters of disease but nothing too tremendous, but the number of concerns around behavioral health, mental health, and isolation and quarantine have been shocking. I think as a unit we have probably spent more time on people’s mental health than their physical health during the pandemic. We had one sorority where 23 women lived in the house and 13 of them ended up in isolation, which is a former residence hall we repurposed. Both the women and the parents were devastated, and there was finger-pointing and “who started this?” We ended up having to do behavioral health sessions with students in isolation. We had to do separate sessions with parents to calm parents down and explain to them that there is no “scarlet C” if your child is the one who has COVID or happened to share it with her sorority house. Those are all the basic concerns people have about the pandemic, but for the students in isolation and quarantine, to tell students they can’t go outside, that they can’t be physically seeing their friends has been really challenging and we have had to build up a whole new system on the fly to support those groups, because parents are in California, they are in Florida, they are in Texas, and they can’t support their child in-person or feel remotely close to them. That was something we didn’t realize how much of an impact it was going to have. I wish we had spent more time ahead of time building what that was going to look like, but we’ve gotten there now.

Dr Wendy: Anything else our panelists would like to add before we head into the Q and A portion of today’s program? Ok It’s now time to take questions from our audience

Jin Oak: I would like to thank everyone for participating in today’s webinar. I hope that you have all learned new strategies and ideas for coping with the challenges that COVID-19 has brought to your school this year. We will be sending out a link to the webinar so that you can share with colleagues who were unable to attend. Thank you for your time today.

Maureen: This concludes the Aetna Student Health webinar Unique Challenges and Strategies for the 20/21 Academic Year.