[{"_1":2,"_87":-5,"_88":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},"mediaId",6347345,"mediaKeyId","2245519-e96aea170e7c6a3275a2f0cf927b024e","parentId",2245519,"title","State mental health director outlines Project AWARE, Medicaid school mental health services and workforce gaps","audioSeconds",57,"startMs",4986000,"endMs",5043000,"viewUrl","/Search/View?dp=1&key=2245519-e96aea170e7c6a3275a2f0cf927b024e&start=4986&end=5043","thumbnailUrl","https://assets.pipeline.soar.com/2245519-e96aea170e7c6a3275a2f0cf927b024e/thumbnail_4986000.jpg","articleUrl","/articles/6347345/Vermont/State-mental-health-director-outlines-Project-AWARE-Medicaid-school-mental-health-services-and-workforce-gaps","mediaUrl","https://secure.pipeline.soar.com/6347345-e9611ed3088678f6dc4bec4c36457102/orig.mp4?Expires=1771064023&Signature=o~AYk7nqwXD9JNaTMLG-uslfru8jlUjhj771kavw5WIyIv66KtmRiNB8vYsU0uVWRVGc1BfRZNOnMktMpVw87mbF7MWPTH8KF872d7BJnwY8Yf0UCflvJIJ809NWb8JlG16lNXM7O2p9v~9rK8jJPyf0p27X3K8wkEnaQJjrO089uPRJtyuQUBOKJYXdHfuJg-wAWYDLAGEdLGj9qMSg51Vc0v4bmyouafRzaplCLQ10U4B3peWttbpuhPprtLDPY6l3aBVwY8uORmp32oRcqMY-L4Vo7s4kpdwr7x9PZANWy7tCXRj9zb8DcyLjcQf3Nv5Vmi9pqurr8Ey5MlzZsQ__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-02-07T04:14:46Z","article","Laurel Lentz, director at the Department of Mental Health, told a legislative committee that Project AWARE — a five-year federal grant from SAMHSA — is being used to pilot school mental health systems in three local education agencies and to build district-community leadership teams.

“This is an exciting, federal award,” Lentz said, describing Project AWARE’s focus on universal screening, mental health literacy and improving referral pathways so students identified with social, emotional or behavioral needs can access appropriate supports.

Why it matters: Lentz and committee members noted high rates of poor mental health among Vermont students and workforce challenges that reduce the capacity of schools to deliver mental health services. Lentz said Medicaid-funded school mental health (Success Beyond 6) remains an important funding source, but that it covers only Medicaid-enrolled students and that many local contracts include positions that the designated mental health agencies are not always able to fill.

Program structure and funding

- Project AWARE: Lentz described a second iteration of Project AWARE, managed by the Department of Mental Health in partnership with the Agency of Education. The federal award runs through September 2028 and supports three district–designated agency partnerships, technical assistance (UVM’s Center on Disability and Community Inclusion is the technical assistance provider) and local coordinator positions under the grant.

- Success Beyond 6 (Medicaid): Lentz explained that Success Beyond 6 is a Medicaid-funded program that supports school-based clinical services, behavioral intervention programs and therapeutic (CERT) schools operated by designated agencies. The program depends on local agreements between schools and designated agencies; DMH contracts with the designated agencies to enable Medicaid billing for covered students.

Evaluation and data

Lentz said Project AWARE includes federal reporting requirements and state evaluation work. Federal metrics track number of partnerships, how many students are screened, how many referred, and what percentage receive services. Lentz said the DMH evaluator and a technical assistance team are working with pilot districts and that year‑one was primarily startup activity.

Youth mental health indicators and workforce limits

Lentz told legislators that roughly one third of Vermont high school students reported that their mental health was “not good most of the time or always” in the 2023 Youth Risk Behavior Survey and that rates were higher among LGBTQ students (about 54% reporting poor mental health). She and committee members said those findings underscore the need for screening, early intervention and stronger school–community partnerships.

Lentz also described workforce challenges: local agreements sometimes go unfilled because designated agencies cannot recruit clinicians, which leads some school districts to hire or contract directly outside Medicaid, shifting costs to education budgets and complicating statewide estimates of staffed positions.

What DMH is doing and next steps

Lentz said DMH and the Agency of Education maintain guidance and toolkits for school districts on social-emotional learning and school mental health. DMH is working with Medicaid policy staff and a federal technical assistance partner to assess CMS guidance and expand allowable Medicaid funding where appropriate. She offered to share evaluation data from Project AWARE and said DMH will return with additional details on other parts of the system.

Ending

Committee members thanked Lentz and said they would follow up with additional questions and request more detailed data on the number of positions, fill rates and program outcomes.","mediaType","Video","parentTitle","House Healthcare - 2025-02-06 - 9:00 AM","oneSentenceSummary","Laurel Lentz of the Department of Mental Health briefed the committee on Project AWARE (a five‑year SAMHSA grant) and the Success Beyond 6 Medicaid school mental health program, describing pilot districts, evaluation metrics, and workforce and funding limits that leave some school-based positions unfilled.","taxTitle","Health Care, HOUSE OF REPRESENTATIVES, Committees, Legislative , Vermont","taxId",30956,"location","Vermont","headline","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6347350,"UVM Health Network leaders cite budget orders, workforce shortages in explaining recent service reductions",4776,95000,4871000,"/Search/View?dp=1&key=2245519-e96aea170e7c6a3275a2f0cf927b024e&start=95&end=4871","https://assets.pipeline.soar.com/2245519-e96aea170e7c6a3275a2f0cf927b024e/thumbnail_95000.jpg","/articles/6347350/Vermont/UVM-Health-Network-leaders-cite-budget-orders-workforce-shortages-in-explaining-recent-service-reductions","https://secure.pipeline.soar.com/6347350-aae2508d20c6cfa8f4e3cc8e6e519974/orig.mp4?Expires=1771064023&Signature=BvYZfRaJ1-g386LR3uL-e9iiP0lCQcWCIR4CQ3mDccluAtatgFj8BkZ3Mid5BfRU1MO50WK~DjWH01~cEBCqfVSGav9FkOs5avcV48nEOm5zJtAqc9u2yz5w1TukkIM9RuPtoiNKXo9GpGbatg2UUXGP0lDTHepi5ODGELYuIjFULiYNuXk5wFehMrsCWZq29IDHnRiS8SPPtDMpBqp9goIra2TFf8SCYgqJlXlvurP7ALEf7deTNINZlLARhQdWsMcPg8zx5gtf3kSVANc1UKw1IULs~qo7EpucYSM7FmgusXh-w3ev5hsgj87yaz2L8OF0aAtXYERx3f8C1Pgsjw__&Key-Pair-Id=KUT5TJCACFTXG","Sunny Eapen, president and CEO of the UVM Health Network, told a state oversight committee that recent service reductions were driven by regulator-issued budget orders and by long-running workforce and payment challenges.

“The 1 reason that we exist is to serve our patients and to serve our communities,” Eapen said, adding that the system had to make “the most difficult decisions” to comply with orders while trying to preserve essential care.

Eapen and Jessica Moschella, senior vice president of high value care for the UVM Health Network, outlined a mix of financial pressures, operational changes and programs intended to reduce unnecessary hospital use and expand primary- and community-based care.

Why it matters: UVM Health Network said it operates across Vermont and northern New York, provides high-cost specialty services at low volumes in some locations, and balances loss-making services such as dialysis with higher-margin care. Network leaders told the committee that narrow operating margins and a limited pool of commercial payers constrain the system’s ability to absorb losses without reducing services.

Key facts and figures

- Network operating margin: Eapen said the network achieved roughly a 2.5% operating margin in 2024 “across the health network.”

- Population- and access-focused programs: Moschella said UVM has “just over 6,000 patients that we have enrolled in our longitudinal care management program.” The network set a goal to add slots for 8,000 more primary care patients this year and reported adding about 2,200 so far in the current year.

- Administrative and workforce changes: Eapen told the committee the network has reduced about $60,000,000 in administrative costs over two years and has increased wages to help retain staff; he said retention had improved and temporary staffing use had fallen.

- Commercial rates: Eapen reported that commercial payer rates overall were down by about 1% year over year in the largest commercial contract (Blue Cross Blue Shield), which reduces total dollars coming into the system.

- Local hospitals and cash: Eapen described accounting flows within the network and said some hospitals operate with low days cash on hand; he said Champlain Valley Physicians Hospital (CVPH) has experienced falling days cash on hand “down to like 10.”

Operational changes described

- Service reductions: Eapen said the system has reduced some services after reviewing which are unsustainably loss-making, citing dialysis as an example of a service that loses “millions of dollars a year” when provided at low volumes.

- Efficiency measures: The network is using patient self-scheduling, e-consults that allow specialists to advise primary care clinicians without an in-person visit (Eapen said specialists can start care or diagnostics in “80 plus percent” of e-consults), and embedded pharmacists and social workers in primary care.

- Behavioral health access: The network opened a mental health urgent care center in Burlington in partnership with the Howard Center and said it aims to open a similar center in Central Vermont.

Accountability, compensation and transparency

Committee members pressed the network on executive compensation and corporate structure. Eapen said executive pay is guided by an outside compensation consultant and by the board’s compensation committee; he estimated his own FY24 bonus at roughly $400,000 and said bonuses are tied partly to quality, patient experience and employee experience metrics.

Eapen also described the network as a single organization that moves cash among hospitals to smooth payroll and operations, and he said the system works to keep care local in New York when feasible so that cross-border patient flows do not unduly strain Vermont facilities.

What the network requested from the committee

Eapen and Moschella said they are ready to work with state regulators, legislators and other providers to align payment policies and regulatory expectations with the realities of rural health care. They recommended that state policy consider payment models that reward population health work and reduce incentives that force hospitals to rely on higher-margin services to cross-subsidize essential, low-margin care.

Discussion vs. formal action

The committee hearing recorded presentation and questions; there were no formal votes or committee directives recorded during the session. Eapen and Moschella described decisions already made by the network (service reductions, administrative cuts, new access programs) and said they were open to outside review of administrative costs.

Ending

Committee members thanked the network leaders and said members would continue follow-up questions and requests for additional information; the committee invited UVM Health Network to return for further briefings.","At a state oversight hearing, Sunny Eapen and Jessica Moschella of UVM Health Network described regulatory budget orders, staffing shortages and narrow operating margins as drivers of recent service reductions and said the system is pursuing population-health strategies while seeking to work with regulators and payers to preserve access.","actionData","errors"]

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State mental health director outlines Project AWARE, Medicaid school mental health services and workforce gaps

UVM Health Network leaders cite budget orders, workforce shortages in explaining recent service reductions