Vermont 2-1-1 warns funding cut could hinder new Epic ‘closed‑loop’ referral work with UVM Health

United Way of Vermont’s Vermont 2‑1‑1 on Monday briefed a legislative committee on the service’s statewide role, a proposed $332,000 reduction in state funding and a new “closed‑loop” referral connection with UVM Health Network’s Epic electronic health record intended to improve how clinical screening connects patients to community services. Allison Lamagna, executive director of United Way of Vermont and Vermont 2‑1‑1, told the committee that 2‑1‑1 provides free, 24/7 access to community resources by phone, text and an online database and is nationally accredited.

Lamagna said the service’s database contains more than 11,000 listings and that in 2025 Vermont 2‑1‑1 responded to more than 61,000 contacts and made over 22,000 referrals, with housing among the most-requested topics. “A fully funded Vermont 2‑1‑1 is essential to keeping Vermont’s social‑support system strong,” she said, warning that the governor’s proposed cut of $332,000 “would directly impact our core services and thus limit our ability to advance initiatives like this closed‑loop referral.”

The committee pressed for details about the cut and whether other systems—such as the 988 crisis line—were expected to absorb services. Lamagna said the FY26 state funding level that supports core services is $1,638,029 and that the state has not specified alternative coverage for the proposed reduction. She said the agency is examining whether to reallocate staff hours to match peak demand, noting the busiest call window is about 4 p.m. to 10 p.m., while maintaining the service’s 24/7 online database.

Dr. Keith Robinson, vice chair of quality improvement and population health at UVM Children’s Hospital, described the clinical rationale for integrating 2‑1‑1 with Epic. Robinson said health systems screen patients for social drivers of health—food insecurity, housing instability, transportation and other factors—but clinicians often lack a reliable, local referral mechanism. “We ask validated questions. And then from there, we have to fax or place a phone call or give a number to a patient or family and then have them call 2‑1‑1,” Robinson said, describing the current workflow as fragmented and burdensome.

Robinson and Kristen Fontine of UVM Health Network said a grant-funded automated referral will send confidential referrals from Epic to 2‑1‑1 and return information into the patient record so care teams can see whether a household connected to an offered resource. They said the closed‑loop design aims to give clinicians better visibility into which community services are effective, reduce clinician moral distress from screening without follow‑up, and inform investment decisions to address upstream needs.

Presenters emphasized that the closed‑loop model is a first use case that could be replicated across other electronic health records and community clinics if proven effective. Lamagna said she expects health systems will help support the service component the integration directly benefits, but she underscored that core 2‑1‑1 services should remain state funded so the agency can maintain emergency response capacity and day‑to‑day coverage.

Committee members also asked about the role of artificial intelligence in this work. Robinson said AI has productive uses—such as translating visit notes or assisting workflows—but urged caution when AI touches sensitive social‑needs data, stressing confidentiality and accuracy and insisting on human oversight. “I don’t think… reducing this to AI… I’m cautious at this point,” he said. Lamagna added that AI can help staff be more efficient but will not replace the human-centered assistance 2‑1‑1 provides.

The session closed with committee members expressing support for 2‑1‑1’s evolution into a data‑driven partner for health systems, and with Lamagna reiterating that the organization seeks level funding consistent with FY26 to retain capacity for core services and to pursue innovations like the Epic integration.