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

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.