Vermont Legislature SmartTranscripts:

[Alyssa Black (Chair)]: Good afternoon. Welcome to the healthcare committee on Tuesday, February 24. Today, we're gonna talk about, this afternoon, we're gonna talk about two bills, H117, which is an act related to mental health support and substance use self prevention in schools, and H573, an act relating to the first certification of emergency examination. We're gonna run this committee a little bit different than usual today. Daisy, the ranking member has been working on this particular bill and she's gonna take the first half of the afternoon and run that part. So with that, take it away, Daisy.

[Daisy Berbeco (Ranking Member)]: Okay, we're going to look at H817 first. And since we last had a walk through with Katie on this, I've met with the Department of Mental Health and we've streamlined the bill a little bit. So Katie's going to walk us through what it looks like right now.

[Alyssa Black (Chair)]: Is this strap one one? Yes. Okay, thank you.

[Katie McLean (Office of Legislative Counsel)]: Okay, good afternoon. Katie McLean, Office of Legislative Counsel. So you should have draft 1.1 on the website. Previous version had separate sections for different pieces of this bill. A lot of that work has been consolidated into this one section. Other noteworthy change is the original draft had a lot of this language happening in Title 16, which is the education chapter. Because a lot of responsibilities that had been placed on school districts are no longer part of this draft, the language is moving to Title 18, which is our health title. The new section is Mental Health Literacy and Care Support Initiatives. We have a purpose section. This section aims to strengthen protective factors among Vermont's youth, increase mental health literacy within school communities, and expand access to developmentally appropriate peer to peer initiatives that promote early identification of mental health challenges. Subsection B is the mental health literacy training piece. To the extent funds are available, including through federal block grants, a public school may apply to DMH or designee, or a grant to provide mental health literacy training to educators and other school personnel. Mental health literacy training shall include topics related to working with youth in educational settings, such as: information about mental health conditions and symptoms, understanding common youth mental health and substance use challenges, reducing stigma and promoting supportive school environments, strengthening protective factors and help seeking behaviors, recognizing risk factors and warning signs, responding to students with empathy and appropriate boundaries, information about mental health treatments, and accessing mental health resources or services throughout the state. This section shall not be construed to require adoption of a specific curriculum or instructional program. So that is subsection B, that's the literacy piece. Then we changed gears in subsection C. This is peer to peer mental health support. It authorizes a school to establish a peer to peer mental health program that provides structured opportunities for peer connection in a supervised school setting, is overseen by a designated educator or school personnel member who is not required to be licensed, certified or a rostered mental health professional under Title 26. And that emphasizes school and community based resources and how to access professional services when additional support is needed. At the top of page three, subdivision two, CMH shall provide oversight and guidance to any school seeking to establish or maintain a peer to peer mental health program pursuant to this subsection. And then three, a program established pursuant to this section shall be supportive and nonclinical. It shall not replace mental health services provided by a mental health professional who's licensed, certified or rostered under Title 26. And then we have language in subsection D that applies to both of the two previous subsections that we looked at. So applies in B to mental health literacy. It applies in C to the peer to peer program. And this is the guidance from DMH. For any mental health literacy or peer to peer support programs established under this section, DMH shall develop age appropriate guidance that And an elementary school setting emphasizes social and emotional development, peer connection and strengthening protective factors. And in middle and high school settings, emphasize protective factors, reducing stigma and supporting students in recognizing and appropriately responding to risk factors and warning signs associated with mental health and substance use challenges, including co occurring challenges. Then we have a report back. Annually on or before January 15, the MH shall submit a report to the policy committees evaluating the effectiveness of programming established under this section, including aggregated information on top of page four, the number of schools requesting and receiving the department support, the number of students, educators and school personnel participating in programming pursuant to this section, and findings and recommendations regarding mental health literacy and peer to peer programming. You have an effective date of July, and then a new title of the bill if this were to move and act relating to mental health literacy and peer to peer supports in schools. That's it.

[Daisy Berbeco (Ranking Member)]: Any questions about the language?

[Alyssa Black (Chair)]: Okay, I think on page two, a school may establish. So that means you don't have to buy into this program?

[Katie McLean (Office of Legislative Counsel)]: It's a voluntary program, so the school could opt in or choose not to

[Leslie Goldman (Member)]: opt in.

[Alyssa Black (Chair)]: Good friend? Can you tell me everything they want to accomplish, can you tell me how they're going to put that in the peer to peer school setting? Is this a part time, full time, training? How's that going to be implemented?

[Daisy Berbeco (Ranking Member)]: So we're going to hear from folks at DMH. We're going to hear from an individual that works similar programs. But if we have any language specific questions while Katie's here, Let's get those out of the way. I think you'll have a lot

[Katie McLean (Office of Legislative Counsel)]: of witnesses to answer that question. All

[Leslie Goldman (Member)]: right. I'm not sure this is for you, but I'm just wondering the origin of the bill. Did it come from schools? Did it come from DMH? Did it come from a legislator?

[Daisy Berbeco (Ranking Member)]: Students, schools, and I've worked with DMH to draft the current outline. Thanks. All right, then we thank you. Thank you. And Perry, gonna come up? Welcome back. Thank you for having me. We were just here in your ANSP role and suggesting that we take this piece of legislation up. And now you're back. Congratulations.

[Katie McLean (Office of Legislative Counsel)]: For those And what are we currently here?

[Terry Lueders (Northeast Kingdom Human Services)]: For my second trip to the hot seat. For those who don't remember, I'm Terry Lueders. I use sheher pronouns. I am a resident of St. Johnsbury. I am a volunteer for many organizations that support mental health, and I'm an employee of Northeast Kingdom Human Services of twenty two years, currently the Training and Community Engagement Director. Again, thank you for having me back and allowing opportunities to speak more about what we are doing and the impact it's having and how this bill can further support schools. In January 2024, the model school protocol for suicide prevention was passed in response to the statewide strategic plan for suicide prevention. In the model school program, awareness and skills training for targeted groups and health standards were recommended with resource allocations. And this bill would support the model school protocols that were put in place in response to the strategic plan. We are really trying to increase protective factors for our youth as their risk factors are rapidly growing every single day. And one of the ways that we need to do that is by providing trainings and opportunities to our teachers, our coaches that our youth spend thirty five hours a week with that really, from September to June every year, the teachers and supporting staff at schools really have eyes on these students and understand what their baseline behaviors are and when they begin to struggle. But they don't always recognize subtle warning signs or warning signs that happened over time. So very much like when we take a fire safety course, we're not firefighters, right? That's a protective factor we're putting in place in the community. And most of us in our job roles and responsibility are required to do CPR as well. I am CPR certified, but that does not make me a cardiovascular surgeon by any means. It's a protective factor for individuals at risk in our community. And that's what we need to provide to our teachers and our educators is educational opportunities to increase their knowledge of what mental health struggles look like and what substance misuse struggles look like and the warning signs in youth. So I did gather some data on particular training that we offer at Northeast Kingdom Human Services, and that training is QPR. It's question, persuade, refer. It's an introduction to suicide awareness where we spend a lot of time being myth busters, talking about warning signs, protective factors, and then how to talk to somebody if they're struggling. And I pulled some data just specifically out of the school staff that we've trained in The kingdom over the last couple of years. And we're in most of our schools. We do a lot of pre services in August leading into the school year and then throughout the school year. And seventy two percent of those educators reported an increase in understanding warning signs after this ninety minute training. So an hour and a half training provided to schools, seventy two percent increase in understanding warning signs. Seventy eight percent of our educators had an increase in their comfortable ways of saying, I recognize these warning signs and I would ask somebody if they're at risk, they're struggling with their mental health. Eighty three percent knew additional resources after the trainings and were comfortable accessing the resources we shared. One of the big ones over the last few years has been 988. When I do trainings with students and teachers, I always say, raise your hand if you've heard of 988. Now, almost every hand goes up. Four years ago, well, it was +1 (800) 273-8255. So no hands went up, but they didn't know what the line was and how to access it, and it was a free, confidential resource that you could call, text or chat. And it wasn't just for you if you were struggling. It was if you were supporting someone else if they were struggling and you didn't know what to do. So in this bill, a couple of things that really stood out to me is, one, yes, this bill is needed. But we really need to make sure that we're putting evidence based and evidence informed trainings into school. And those are trainings such as QPR, youth and teen mental health first aid, youth mental health first aid is for adults supporting youth. Teens is for teens. Once 5% of school staff are trained in youth, we can actually work with the teenagers in high school. And it's the same thing. It's those risk factors, protective factors, identifying substance misuse challenges and mental health conditions. Those are a little bit of a heavier lift because for educators, it's a full day training. And then for teens, it's a six to eight week session that we work with them, but we're willing to do it. We have a great group of mental health first aid certified trainers across the state that we actually meet monthly. We all travel around supporting each other and delivering trainings in different schools and communities. So it's a wonderful support system. So some language that I would change would be making sure that anything we're offering to educators is evidence based or evidence informed to make sure we're giving them accurate information that is informed by what we know and the data. The peer support there a place in

[Leslie Goldman (Member)]: here to refer to, Cina?

[Daisy Berbeco (Ranking Member)]: Oh, I'm not changed one. I'll get it. Okay. Thank you. I

[Terry Lueders (Northeast Kingdom Human Services)]: typed on the draft and sent it over some of my recommendations, but I forgot to print it before I left

[Lori Emerson (NAMI Vermont)]: the test.

[Daisy Berbeco (Ranking Member)]: Start with you all after. That's great.

[Terry Lueders (Northeast Kingdom Human Services)]: So the other piece is the peer support. I love the idea of school of having peer support. Having a certified peer support specialist within the school community is a heavy lift. It is a heavy lift to get that peer support certification in education. So some additional language recommendation I would make is, in addition to a school support, a school staff supporting it, them not having to be certified in peer support, but have some level of mental health and substance abuse training if they're going to facilitate the group, Or they can invite a community member that is peer support to come in and facilitate. And some good examples of those is we have peer support certified individuals at Northeast Human Human Services, Journey to Recovery, Kingdom Recovery Centers. They all have peer support, certified peer support individuals that would be more than happy to go into school to help facilitate these groups. And oftentimes for youth, it's much cooler for somebody from the community to come in and hold space with them than it is from your math teacher that you see every day. So thinking about like youth perspective, they get excited when I come to school, even though they know we're going to talk about the hard stuff, they get pretty excited, maybe because I'm going to throw stress balls and candy at them too. That's a bonus side effect. So I would really like to consider inviting outside organizations to support schools and running these peer support groups, especially the ones that are the experts around mental health and substance use. So also the resource connection, asking schools to make sure they have signage hanging around their school, around the different resources that are available. Every school I go into, I bring nine eighty eight tear off posters and I put them on the inside of bathroom stalls. And I walk around usually with the principal or the guidance counselor and said, makes sense in your school? When I do trainings with the kids, I give them nine eighty eight magnets. And I said, put these on lockers, here's some stickers, put them on your water bottles. So making sure they have signage of other resources outside the schools that the youth can access and at their own time and pace when they're ready, because we give them a lot of information. And when their brain is already on overload, sometimes when they're in school, they're not ready. But at 02:00 in the morning when they can't sleep, might be when they need to remember 988 that they could call Texture Chat 988. So another recommendation would to be provided. And we actually get free resources from SAMHSA around nine eighty. Any school can go on their website and order them. The kids want this stuff. I bring stickers, magnets, stress balls, hang up posters. They like the swaggy stuff to take home mental health stickers. So my recommendation would be just a little bit of language changing, knowing that the schools are already doing the hard work and they want the support. They want the support from the outside entities to make sure their youth are safe, especially around mental health. And again, we're not trying to make our teachers mental health professionals the same way as I'm not a cardiovascular surgeon, but we need to give them the supports and tools the same way as I learn CPR. So I'll pause there for any questions.

[Alyssa Black (Chair)]: What you just talked about, your recommendations, are you going to send them into us?

[Terry Lueders (Northeast Kingdom Human Services)]: I already sent Daisy over a draft, yes. I don't

[Daisy Berbeco (Ranking Member)]: I'll have to I may have to ask you to do it in a different document, because they work on we'll connect. You'll get them.

[Alyssa Black (Chair)]: We're gonna get them.

[Katie McLean (Office of Legislative Counsel)]: Yeah, really.

[Leslie Goldman (Member)]: Leslie? I'm going turn the question for you or the room or whatever, but you mentioned this gap when school's not in session, and I'm curious about the impact on students' mental health in that gap time, and if we know anything about

[Terry Lueders (Northeast Kingdom Human Services)]: Yeah, when school is not in session, it is a very difficult time for youth. There's a lot of food insecurities. They're losing some of their support system over the summer and communities are coming together create spaces. I know that NECA runs a youth center both out of St. Johnsbury and out of Newport now, where youth can access that all summer long. So making sure that youth are aware, even during break, right now they're on February break, of the resources that they can access outside and also making sure that the staff that are in those spaces have trainings. So I know with NECA, I've done QPR training. We have a youth specific QPR training that we do, so they know the warning signs. So offering the same level of trainings to the spaces that I don't want to use the word contain, because can you really contain youth? Invite youth in in the summertime, making sure they have the same level of supports and trainings. But youth centers are great. I love both of our youth centers in the Northeast Kingdom. We also have a community hub in different places. So we want to make sure those places that students and youth gather have the same level of support and training.

[Leslie Goldman (Member)]: If I may. But that's not statewide sort of I mean, it's in your own community. We don't know what's going on statewide necessarily.

[Daisy Berbeco (Ranking Member)]: Me neither.

[Terry Lueders (Northeast Kingdom Human Services)]: Yeah. I mean, how do

[Leslie Goldman (Member)]: we go from probably something excellent to maybe there are gaps, we don't know, it could be excellent everywhere. Is there a way to think about that in here or would you rather not? But it just seems like an opportunity to think about student mental health year round rather than just when they're in school.

[Daisy Berbeco (Ranking Member)]: Yeah, so we will, I've invited Vermont After Schools to come be part of the conversation so they may have some ideas.

[Terry Lueders (Northeast Kingdom Human Services)]: Yeah, and we can also make outside of the bill recommendations to have school staff trained in some of these trainings. It is a heavy lift to become a certified trainer. But a good example is like the American Foundation for Suicide Prevention. We can train teachers to deliver It's Real Team Mental Health, which is a forty five minute training for youth. Mental Health First Aid is a three day training. It's a wonderful certification for any teacher to have to be able to support their school in both youth and teen mental health first aid. So cost is sometimes a barrier. Time is always a barrier for everybody and everything that we do. But there's also opportunity to say, who's your cheerleader in the school, right? Who loves doing trainings? I worked a lot with the guidance counselors. We do Gizmos Pass and Guide for Mental Health, which was developed by the Green, the United Way in Connecticut for Pre K through fifth, and it's a thirty minute read along. So I've taught guidance counselors how to do this read along and make it fun for kids. And now they're doing it in school. Just retaught Luedersburg School. I had sixteen first and second graders, and we did it together. So we're teaching the teachers the skills to talk about mental health and then how to follow through afterwards as well.

[Daisy Berbeco (Ranking Member)]: Great. Go ahead. Thank you

[Unidentified member (“Katie”)]: for coming back. And I'm sure I probably just missed this. What age is appropriate? I mean, are there different levels of teaching that from the schools? Preschool.

[Terry Lueders (Northeast Kingdom Human Services)]: Oh, great. We teach our kids how to brush their teeth and wash their armpits, why wouldn't we teach them what their mental health is from a very, very young age? That is upstream thinking. So then they can recognize when their mental health is failing and know how to cope with it. They don't hide toothaches and sore throats, but they hide heartaches and brain aches. Right. So if we teach them what their mental health is, what it looks like and feels like when they're struggling with their mental health, and then what their protective factors are, what they can do for themselves, with others, and who are their safe adults that can reach out when those things can work. I teach the little kids, if you can't talk about your mental health, draw a picture about how you're feeling and give it to your safe adult. And we do versions of the Stanley and Brown safety plan. I do them with every single school I go in. The little kids, it's called Gizmo's Awesome Mental Health Support Plan, which is the Stanley and Brown. It's like, these are my friends and these are the things I like to do. And I have them do it when they're mentally healthy, so when they start struggling, they can refer back to it. And I let them know that as they grow and learn, their plan can change at any minute, the same way as ours can. And the middle school and high school kids really appreciate that because they haven't always had the opportunity to identify their own protective factors and what their signs and symptoms are, except for when they're in crisis, when they can't think clearly. And that's not fair to ask anybody. Here, let's talk about a safety plan when you can't think clearly right now. So we're starting at a very, very young age, which is really upstream thinking. By the time these kiddos are my age, they're going to be mental health experts too, I hope. Really, no, I'm having a bad day. I'm struggling with anxiety. This is what it looks like, and these are some things that

[Unidentified member (“Katie”)]: I can do to help myself. Prevents crisis.

[Alyssa Black (Chair)]: What did you say

[Brian Cina (Member)]: the safety plan was called? Because I'm looking up Gizmo possum and other possums are coming up, but not the health safety plan.

[Terry Lueders (Northeast Kingdom Human Services)]: So for Gizmo, there's a page in the back. It's based off from the Stanley and Brown safety plan.

[Brian Cina (Member)]: What is it called, Gizmo?

[Terry Lueders (Northeast Kingdom Human Services)]: Gizmos, possum.

[Brian Cina (Member)]: Like possum, the animal with possum, like awesome with a P.

[Katie McLean (Office of Legislative Counsel)]: Awesome with a P.

[Leslie Goldman (Member)]: That's okay.

[Brian Cina (Member)]: Gizmos, possum.

[Terry Lueders (Northeast Kingdom Human Services)]: Yeah, like so awesome. And it makes mental health awesome to talk about. And it's an adorable, it takes thirty minutes to read a lot.

[Brian Cina (Member)]: Gizmo for mental

[Daisy Berbeco (Ranking Member)]: health.

[Terry Lueders (Northeast Kingdom Human Services)]: Look at how cute Gizmo is every now. And there's a PowerPoint version. So if schools have smart screens, I pop it up on the smart screen, and I keep the clicker in my pocket, and they're like, woah, how's she making that screen move? But I talk about Gizmo's dad, Gizmo's coach, Gizmo's uncles, and how they're all protective factors because they're adults. And it's adorable. I'm known as Gizmo's mom in most elementary schools. Not bad title.

[Daisy Berbeco (Ranking Member)]: Thank you so much

[Leslie Goldman (Member)]: for all that you're doing.

[Daisy Berbeco (Ranking Member)]: I'm the Gizmo. I like that better. All set?

[Leslie Goldman (Member)]: Yeah. Thank you. That was awesome!

[Unidentified member (“Katie”)]: Thank you so much.

[Leslie Goldman (Member)]: Not a kid.

[Daisy Berbeco (Ranking Member)]: No. They like that. Yeah, there you go. Welcome.

[Lori Emerson (NAMI Vermont)]: Bye. Thanks so much for inviting me. I'm Lori Emerson. I'm the Executive Director of the National Alliance on Mental Illness of Vermont. And we really appreciate you inviting us to testify today in support. And we are in support of Bill H-eight 17. And Vermont is a state chapter of the National Alliance on Mental Illness. And we're a grassroots volunteer organization. And NAMI Vermont operates as a peer to peer mental health organization. And we were established in 1984. So we've been around the block a little bit. And we've always been a family peer group. But we've evolved over time where we're more inclusive, where we have individuals that lived experience on our board, in leadership roles and on staff, as well as volunteers who help administer our programs that we have. And all of our programs are free that we do. Of course, it doesn't mean we don't need funding. So we get our donation, we get donations, we get grants, and to administer all of our work. And one of our key objectives as an organization is to really get people help early, right? We need to move it up to young youth. And in order to do that, you know, we're able to access the work that we do through our mission with support, education, and advocacy. And, you know, I did send along my information to everybody with my testimony. So you can read the statistics. You know, they're pretty alarming with suicide as the second leading cause of death among people between ten and twenty four. So we really need to get youth the help that they need. You know, there are 6,000 Vermont adolescents that have serious thoughts of suicide. And one of the things that we would recommend in the mental health literacy and training are some of the things that NAMI Vermont already does. We have a program called NAMI Ending the Silence for students. And we also have another version for parents and the community. So we're outreaching to not only students, but parents need information as well to help support their loved one. As well, the community needs to understand what mental health is all about. NAMI Ending the Silence program gives people information or students the information about mental health, suicide prevention, and how to help a friend. But what makes our program really unique is that we have a near peer who goes in and shares their lived experience story. That's when everybody listens, as they can really relate to that person and what they're going through. Other programs that we have to offer are NAMI Smarts for legislative advocacy. So, we want to build that next generation of advocates. And we're doing that through a program where we're identifying students who want to participate in advocacy training. They're going to identify what they feel their mental health priorities are and then practice giving testimony with legislators. So, we're working on that project right now. And as well, we have other programs, NAMI Inner Own Voice, where we share our lived experience stories. These are people that are living in recovery. And it just changes the perception of what mental illness is that anybody can live with mental illness and thrive in spite of it. As well, they share a lot about their journey. And we do this for all communities. We've even been into high schools with sharing in our own voice. Another program that we have is NAMI Vermont Family Voices. So understanding what it's like for the family perspective with having an individual in your family that you're supporting that has mental illness and what families go through. When we look at the bill, it's really hitting all the check marks with what we want to establish in a peer to peer initiative. So being able to provide a student led mental health club. This is something that a lot of other NAMI's also do. It's a program that we want to get started at NAMI Vermont. And there's a lot of different mental health clubs that are student led right now throughout The United States. And they plan what they do in the club. They help people with maybe peer support. They could start a helpline. There's lots of different things that students could do based on what they feel those priorities should be. There's also at St. Michael's College back in 2015, they started Hope Happens Here, and there's been many high schools that have started this club throughout Vermont. So what we really want to do is we want to normalize conversations in school, we want to talk about mental health, and we feel that NAMI Vermont is really good at doing that. We go in, we share our lived experience story, it makes people feel comfortable, they want to talk about what's going on with them. And we really see NAMI Vermont as being kind of that door opener, Start with that and then work through other mental health training. And our training is just one classroom, minutes time. And we've done it for entire schools in Northeast Kingdom. We've done it for their entire school with 600 students. We've also done it for classes of 15 to 20. And we really find that once we get that person sharing their lived experience story, they want to come up and they want to talk about what they're going through with that person after class. Some of the other initiatives that students could be involved in is having, you know, I know that the difficulty I think is with having those certified peers be able to do this. So having staff be able to supervise the peer led initiatives could also be guided with near peers. So a near peer is somebody who's not 18, but they're 18. They've had experience with mental health training, and they can help guide these clubs or be a resource to them, as well as NAMI Vermont could be a resource. You know, we have lots of posters and information to share. You can go to nami.org. And NAMI is doing a lot of work with being able to help youth and getting an early start. As a matter of fact, they start they do a lot of research. And in some of their research that they've that they did, they have a next gen community of practice that they established. And these were college age students who really asked their peers, what is it we need to be focusing on? And they came up with four recommendations. It was building culturally responsive approaches. So with mental health support, works better when it reflects people's culture. Youth leadership and peer support, which is exactly what this bill is all about. So, people need a voice in the process. They want to be part of the process. And also with this bill too, it would be good to hear from youth about what their thoughts are and how this would work for them. Also, health education is another recommendation that they had. People need the basic tools to be able to help them. NAMI Vermont provides a lot of those tools. Not only do we provide them to students, but we provide it to the parents of youth as well. Because we feel that it's really important that the family members get the coping strategies and other basic skills to help their loved one. Because a family member can actually make a situation better, and they could make a situation worse without the right training. So we do all of these programs year round. The other fourth recommendation is advocating for policy systems change. They want to be part of that process. They want to be able to inform you what's important to do. And this cohort was from The United States. There were 50 students that participated in this research. So it really demonstrates that this bill is really on target with what youth are wanting. Know, NAMI always does the research, and they share these reports. I do have in my references where you can access that report as well. And I just also wanted to mention about our programs. NAMI Ending the Silence is an evidence based program, as well as our NAMI Basics, our NAMI Family to Family. So NAMI National is always doing research on the programs that they administer, and we adopt a lot of those programs internally. Any questions?

[Leslie Goldman (Member)]: So I heard from Terry

[Lori Emerson (NAMI Vermont)]: and I'm hearing from you that you're both doing training programs in the Northeast Kingdom. And I'm just wondering, do you coordinate? How does that work? We do our programs statewide and ours are NAMI Signature Programs. So they're very specific to NAMI programs. And not speaking for you, Terri, but

[Daisy Berbeco (Ranking Member)]: we support,

[Terry Lueders (Northeast Kingdom Human Services)]: we offer, we collaborate, also not being supportive too.

[Daisy Berbeco (Ranking Member)]: When I said I took

[Katie McLean (Office of Legislative Counsel)]: out a few boards, not being able

[Terry Lueders (Northeast Kingdom Human Services)]: to support other programs, the peer. So it's not a competition, it's collaboration, and who's the best fit for the environment, because every school, every community is different.

[Lori Emerson (NAMI Vermont)]: And I'm always inviting Teri to other programs that we have at, Hotel Vermont is coming up again, just to let you know. And she does the suicide prevention piece, we do the mental health piece. So we're sharing our stories, our lived experience. And Terry comes in and she gives us the suicide prevention information. So we are collaborating on a lot of areas. How would that feel for me? Does this still enhance that collaboration or how does it impact? I think it could. With this bill, it would not necessarily mandate that schools do this training. We have schools that we go back to year after year after year. So, we've been doing this for about four or five years. And a lot of nurses, school counselors, or health and wellness classes usually invite us in. I think more mandating something could really help because this is optional and they don't do it, but yet kids get so much benefit out of going through the program.

[Leslie Goldman (Member)]: So would it be on page one, line 16, shall or do we want to add? I would look to Ledged Council for For sure. I'm not saying, I just want you to talk about mandating.

[Lori Emerson (NAMI Vermont)]: Yeah, but it might be hard to do that, but it could be strongly recommend.

[Daisy Berbeco (Ranking Member)]: Now Brian has a question for you.

[Brian Cina (Member)]: It was related to this particular piece, because what I was going to say is that it sounds like what the bill does is it provides greater access to resources and support for schools to provide this without creating an unfunded mandate or requiring additional work and labor of the staff. And I wish there was a middle ground where we could make a stronger incentive. I don't know, this isn't really discussion, but I mean, this is part of the question, is like, don't know how successful we would be if we required it, especially if we don't fund it. And we already don't fund things well enough. So I guess the question is sort of like, and it may be for you or for us collectively, is there a way to strengthen this bill with financial resources or other kind of connections or consolidation of work? Because there's so much going on that's not coordinated in our mental health system. So I don't know what the answer is, but that sort of get us thinking, is there a way to support this by bringing in other resources, or by better coordinating resources, or by improving funding streams without requiring something that is going to fail because there isn't the resources. Yeah.

[Daisy Berbeco (Ranking Member)]: Brian, I think you bring up a really interesting point. We're going to hear from Simone, who represents the designated agencies that contract with the Department of Mental Health. So maybe Simone can give us some sort of an idea on I know Terry mentioned mental health first aid trainings, which Vermont Care Partners facilitates. So maybe Simone can help kind of paint a picture of a more holistically what's happening in terms of trainings.

[Lori Emerson (NAMI Vermont)]: We have limited funding for our Ending the Silence project, But we're constantly having to go apply for grants to keep funding this. However we can create more funding sources, that would be great. Know, I would say ours is one of the most cost effective programs because we engage with volunteers to help with the work too. And one thing

[Brian Cina (Member)]: we might think about, I don't expect you to have the answer once again, but we collectively could think about is, what are the expensive interventions that we're currently spending money on because we fail to do this work that we might prevent? I'm just thinking about how many kids end up in psychiatric inpatient settings because they don't have support. And so their mental health languishes to the point that the only option for the kids and families is an inpatient, expensive stay, and even that doesn't solve the problem. It stabilizes people who often get discharged to a system of care that has huge gaps in it. Whereas if this program was in existence, the kids would at least have this safety net at school amongst their peers. Would create like this safety net. And so I'm wondering if there's a way to think strategically about, like maybe it's that we provide an initial funding, but then we look at savings in the system of care and how to redirect the funding. But I just put it out there because as people doing the work in different levels of the system, you may have ideas about where you see money being, I don't want say wasted, but maybe appropriated less, in ways, we might be appropriating in ways that promote getting help in a more expensive way than inoculating people from needing them. Not that there's anything wrong if you need that help, but I feel like we fail people, and then they end up needing crisis stabilization where we could be protecting them in the community.

[Daisy Berbeco (Ranking Member)]: That's why we have this bill.

[Brian Cina (Member)]: Yeah, exactly.

[Lori Emerson (NAMI Vermont)]: Bill, did

[Daisy Berbeco (Ranking Member)]: you have to protect? Brian

[Alyssa Black (Chair)]: pretty much asked about the funding and If a school in Bennington would agree to do this, what's the steps that this bill goes through? What's the steps that the school takes to start training, implementing and stuff like that?

[Daisy Berbeco (Ranking Member)]: We're getting there.

[Alyssa Black (Chair)]: We're getting there.

[Lori Emerson (NAMI Vermont)]: What we do is we provide the school with support. Our staff helps support the school. We give them posters, other information that they can share throughout the school. It goes to guidance counselors, the nurse's office. And then we work with the teacher afterwards to find out how things went, if there's areas of improvement, if there are anything else that we could do to help support the school. And being able to have that follow-up and do it year after year for every single class is what we're doing with a few schools. So it really helps. But we really need to take a holistic approach too. It's not just children. Parents need help too. When I was a parent, let me put it this way. When my sons were younger, I needed the education about mental health. And I got it through NAMI. You know, a provider told me about NAMI Vermont. And I went through their family to family class. I went to the family support group. That gave me the tools and resources I needed to be able to help my family. Because sometimes, like I said earlier, a family member can make or break a situation. So giving family members the tools they need.

[Daisy Berbeco (Ranking Member)]: Thank you for that. That's a really important point. As a parent of two young kids, I very much appreciate it.

[Brian Cina (Member)]: That just raised another question for me. And these these questions, the intent is for us to strengthen the bill. It's not I support this. It's but what you just said, the I'm just looking here, and it it doesn't really talk in the bill about what to do if a youth brings up issues to their parents. And I'm wondering if there's a way to tie into this work, and maybe it just happens already and it doesn't need to be written here, that whoever is conducting this work with the youth have the ability or resources to refer parents or do outreach to parents if things come up, or maybe we also look at doing parent groups as a pilot project. Like after, don't know how you would structure that exactly. I sit here and talk about it with you, but it's not what we're doing right now. But the idea, maybe one school district says, we're gonna do kid groups, and we're gonna have a once a week parent group.

[Lori Emerson (NAMI Vermont)]: Yeah, let's

[Brian Cina (Member)]: go And the parents can come in, yeah, parent support group, or some network of providers that all these programs have access to. So if a kid brings up, like, My mom's passed out on the couch and not feeding me, I guess she'll to make a DCF report, and they might do this work, unfortunately. But maybe before it gets to that point, you could help the parent get therapy before the kid gets involved in DCF or something. And then the other thing I realized is after I asked you the question is that we do, this might be a better question for the DMH folks, but we do have a section here on reporting, and we might be able to add in something in the report around spending in the system of care and how we can reinvest into these kinds of programs without underfunding the system of care. Because it talks about number of schools requesting, number of students, like people participating and recommendations regarding the program. Could put something more specific in about ways to sustainably fund this program and reinvestment in the system over time from the expensive interventions to prevention.

[Daisy Berbeco (Ranking Member)]: Can I just catch you up? So remember, this is stripped down from an earlier version. So like you mentioned, parental notification, that was a piece of the earlier bill.

[Brian Cina (Member)]: Notification. Well, don't know if it was parental participation.

[Daisy Berbeco (Ranking Member)]: Yeah, so just if you look at the old bill, some of this is intentionally simplified. And remember, any peer to peer education that's done for kids, it's not clinical. It's not mental health treatment. It's connecting kids to each other and to existing resources. So it's really to just existing resources, like the many things that Nami has on their website or the parent groups. So it's really to facilitate the connection. It's not intended to create another system of family supports.

[Lori Emerson (NAMI Vermont)]: But there are other resources in the community, like NAMI Vermont. And there are programs such as the bandana project, look that one up, that's where a student might tie a bandana on their backpack, and they're the safe person that they can talk to if somebody needs to talk about their mental health.

[Daisy Berbeco (Ranking Member)]: So I think one of the things is there's this highlights, to Brian's point, some of the efficiencies. And when we think about costs and streamlining some of the efforts people are making in different pockets of this space, just having intent in this bill of supporting it within each school is a way of creating those efficiencies and carving out a pathway for resources that are already existing. I want to be sure we save time for DMH talk. Leslie, do you have one more question?

[Leslie Goldman (Member)]: I just want to understand, because this is great, really important. Could it happen anyway without this bill? What is this bill, I'm just trying to understand, doing that's going

[Daisy Berbeco (Ranking Member)]: to change practice? Let's hear that from DMH. Okay.

[Leslie Goldman (Member)]: That's great. Thank you.

[Daisy Berbeco (Ranking Member)]: Thank you. Thank you, Will.

[Lori Emerson (NAMI Vermont)]: You're welcome. Welcome.

[Laurel Omland (Vermont Department of Mental Health)]: Hello, you. My colleague here to help answer questions. I'm Laura Oland. I'm the director of the Child, Adolescent, and Family Unit at the Vermont Department of Mental Health. And with me is Marianna.

[Marianna Donnelly (Vermont Department of Mental Health)]: I'm Marianna Donnelly. I am the School Mental Health Programs Manager for the Department of Mental Health.

[Laurel Omland (Vermont Department of Mental Health)]: So we really appreciate the opportunity to come here to talk about this bill and really ultimately to expand access to mental health literacy opportunities and student support programming. It's something that we feel passionate about. And we have some initiatives, which I think I've talked about before with this committee, that relate to this in schools, Project Aware being one of them, where we can take some of those lessons learned or experience from that to help inform what this might look like. But are like I said, we do appreciate the skill and the intent and the focus that it's working towards. I would say anything that we do that is bringing mental health related programming into schools, we feel a commitment to also be engaging with our agency of education partners in what that looks like and making sure that it is aligned with their existing guidance, health standards, those kind of things. So that's an important partnership that we have been fostering over the years and truly value and think can just strengthen the success of something like this. There were some things that we gave some feedback already on and that I just wanted to speak to a little bit more specifically with the bill. The first is related to the mention of the potential use of block grant funding. And I just wanted to clarify that our mental health block grant funds are not intended for universal prevention activities, unfortunately. They have to be targeted to individuals who meet the federal definitions for severe emotional disturbance for youth or serious mental illness for adults. So it is restricted in how we can apply those funds. I cannot speak to the substance use disorder block grant, and I would encourage you to connect with the Department of Health on that potential use. We have leveraged some discretionary federal funding, such as Project AWARE, which is a SAMHSA funded time limited project where we are piloting exactly some of these activities in three school districts across the state. So we're doing mental health literacy training for the adults. And then there's different programs for students to help them both learn about mental health, but also to do some of that peer engagement activities around the topic. So through that, we are learning about some of the different models that exist. We are part of some national groups, both the Project AWARE groups and learning collaboratives that happen with that, as well as the Mental Health Literacy Collaborative Marien is the representative for that, not me to really just hear, how is this working in other states? What lessons learned do we have to share with one another. And I will say there are different models for this. And so I do appreciate that this we appreciate that this bill is not naming models, but really keeping open. And I I fully support the earlier comments that it be evidence based, evidence supported, both training programs and the the student specific student focused programming, because we want to stay present with the evolving literature about what is most effective in doing this work. So naming some of the key components, we support and give some feedback on some of the language in those. With our Project AWARE, just to ground, in case some of you don't know what I'm talking about when I say Project AWARE, it's a SAMHSA funded initiative that's across the country. And AWARE is an acronym, all caps. It stands for Advancing Wellness and Resiliency in Education. And the intent is to develop sustainable infrastructure for school based mental health, programming and services, and really supporting that through mental health literacy training, suicide prevention protocol development within schools, establishing referral pathways so that they can first identify I should have mentioned also universal screening for social emotional needs. So how do you identify needs, and how do you connect students across the levels of support? So earlier intervention up through more intensive intervention, both in school and out of school. So it's the expectation within this project is to have partnership between the state mental health and education entities and the local mental health and education entities to work through those, and then for us to be considering, along with our other state partners at AoE, what can we spread beyond those three districts? So through that, we are supporting these districts in setting up district community leadership teams so that there's both in school but also community based leaders looking at their data, looking at the existing resources, and trying to figure out together gaps in how to meet those. And those are also often the entities that are considering what are the needs related to mental health? What's already happened in the school or district? What exists in the community? What could they leverage through the partnerships that we've established with those federal funds for additional training opportunities, whether it's the mental health first aid type of opportunities or suicide prevention specific ones. We have learned through that that school districts set up their professional development schedules a year in advance. And so getting into those takes some time. We want to ensure that there's leadership buy in and recognition of why is this important for the superintendent, the principals, the curriculum directors, etcetera. Do they see this as connected to their goals for their LEA? And many of them very much do see the role of addressing mental health and how that ties into helping students access their education and have success academically. So that's been an important component of the work, really joining with and how is this in support of your goals, and then how can we make this happen within the tight structures that they have available for training time with staff. So that does take that partnership across mental health and education to work through that. There has been great buy in with that, I will say. And I think the uptake of some of these trainings has been more limited by schedules than it has been by interest and wanting to move forward with this. We also have been doing some intentional work to make sure I forget which of you commented on this but to make sure these trainings aren't just a training event that is siloed and happens and then it's done. But how do you take the lessons learned from that and really start to think about how do you implement that within the school into your daily practice, ways of being and interacting with one another? So that does often have more success when there's someone who's more of a champion in that topic, so someone within the school building who shares the passion and the value of that and can help think about how else to continue to build that across just their way of work, if you will. Talk about the challenges. So I think I don't have much more to say on the mental health literacy side of it. Do you have anything to add to that piece?

[Marianna Donnelly (Vermont Department of Mental Health)]: I think just to really highlight that the talent, that through Project Aware it is mandated that they do these trainings. It is paid for. We take care of the agreements, it is just available to them to schedule and it is still incredibly difficult and not because they are not willing to or want to, but they're so limited in their time that it gets really very tricky. I

[Laurel Omland (Vermont Department of Mental Health)]: think that is something that we've heard directly from schools, but also in looking at the reporting that came out of the listening tours that AOE did, that schools some of the smaller schools, it's harder for them to develop grant applications and submit proposals and then manage that. And so I think we have learned through both Project AWARE and some other experiences with mental health literacy trainings that if it's available and all they need to do is find out when can the training happen, how do I sign our staff up, those are the things that they can handle and manage. And it is more challenging to put together and track that grant process. So that is something that we were trying to do some thinking around, does it need to be a grant application from the districts? Is there a different way to support that? So it's something to consider, and I'm sure school leaders or others could speak more directly to that. With the student peer to peer programming, I will share another experience we've had with Project AWARE is the term peer, I think, is a little p instead of the capital P in my sense that we've heard from other models of how to do this type of student led peer engagement around mental health topics, meaning it doesn't necessarily have to be a peer certified specialist who's leading this. It perhaps could be. But the intent here is that we are providing, first, a phased approach to how we do this, meaning the training for the adults in the building happens first. And then the focus on the peer programming is layered on top of that. We know students have said they want the adults who are supporting them to be trained in mental health and to address stigma and to be able to talk more openly about what they're dealing with. So that needs to be the foundational first phase before student programming. But then with that student programming, there's a range of how that is put together from some of the different evidence based programs. And we have been talking with some other states about programming that they have done. You heard some great options today. I think what we have heard from schools is it is hard for them to put the time into researching and determining is this a good one. So I think having perhaps even a menu of what are some options that we have looked at together with our agency of education and thought about how could this work in Vermont districts could be beneficial. But what we have also heard is that it can be beneficial to have, again, that champion within the school be the adult advisor and that that person is not, to use a common phrase, voluntold to take on that new activity, but that it's someone who is also passionate about this topic, is willing to take that on, has some natural inclination already to have that kind of relationship of students around the topic. And then they can be trained in how to support these student peer to peer activities. Just ask

[Daisy Berbeco (Ranking Member)]: a quick clarifying question. So you're suggesting that instead of using any external adult who has some sort of mental health training, someone within the school be trained up first and this be added as an additional? It could be either. And so I think what we're suggesting is to not limit it to one or the other, because there are different models of programming that leverage those different ways of doing it.

[Laurel Omland (Vermont Department of Mental Health)]: So to say it needs to be led by a peer certified specialist restricts. To say it has to be someone within the school also restricts. So I think it is about we want an adult. It could be there can be great models of having an external entity come in. Another school district might have someone in house that they wanna offer that training to and have it led that way. So, I think it's how the legislation is worded might put limitations onto what kind of program meets that.

[Leslie Goldman (Member)]: Got it. So we'd to keep it broad.

[Laurel Omland (Vermont Department of Mental Health)]: Just wanna look at my notes to see what other things. Can I ask a little

[Daisy Berbeco (Ranking Member)]: bit more about Project AWARE? How many years has the state had a grant for Project AWARE? So this is our second

[Laurel Omland (Vermont Department of Mental Health)]: round of the award. The first round, it was held by Agency of Education in partnership with DMH, so they had the grant. We were their partners. That ended in '20

[Marianna Donnelly (Vermont Department of Mental Health)]: It was 2018. 2018 to '23.

[Laurel Omland (Vermont Department of Mental Health)]: Sorry. And now we're in another round. We just started our third year, and it goes to fund '28. And this time, Department of Mental Health is holding the award in partnership with our agency of education. And so we learned a lot in that first five year period that we then used to inform what we were proposing to do in this next one. And it is still limited by what the federal government's expectations are for how the funds are used. And so we had to respond to their notice of funding opportunity, all the different elements that were required, meaning that it did mean committing to participating in all kinds of things, even if we then were doing a needs assessment with each LEA where they maybe had already done some of those phases. It has taken some nuancing for how to layer this in with their existing I'm just looking at the NOFO or the

[Daisy Berbeco (Ranking Member)]: Yeah, it's the NOFO from Project AWARE. The purpose of the program is to develop a sustainable infrastructure for school based mental health programs and services. And we've been doing that since 2018? Yes. Okay, so then I'm close to reinvent the wheel. So can we get the findings of the years of Project AWARE that you all have done. I think we'd

[Laurel Omland (Vermont Department of Mental Health)]: be glad to come back and share what lessons we have learned from it and where we are trying to take it further. As I was saying, one big part of it, especially that we learned in the first year, first round, was there is not a clear structure around that referral pathway within schools. It's often held by certain people in their roles. And so wanting to both help schools, and we're actually using some national technical systems around this, how do you establish that to identify both from the student need, lower levels to more intensive, how are they then accessing different supports, and how are we tracking that? There aren't existing structures for that tracking. It's often just manual ways of tracking. So those are the infrastructure type of things that we are testing out and seeing, how does this work within each school system, to then think about what could this mean for a broader approach. And then I guess

[Daisy Berbeco (Ranking Member)]: that's different from this in that this is not clinical, not necessarily referring anybody to anything except existing resources. Part

[Laurel Omland (Vermont Department of Mental Health)]: of Project AWARE is about mental health literacy. And so we have results of how many people were trained, what was the impact on their knowledge, attitude, and beliefs around mental health awareness and suicide prevention. So those have been core components to Project AWARE also. But again, just within those three districts, because that was what the funding could support. We have other the state, I should say, has other federal awards that also support suicide prevention training, awareness training. That's typically how those activities have been supported, through these discretionary awards. If I can add one last piece to the section I'm sorry.

[Daisy Berbeco (Ranking Member)]: No. I just look at Leslie because I know she has a question. But I just want you to finish what you're saying.

[Laurel Omland (Vermont Department of Mental Health)]: It's just the last section on developmentally appropriate guidance. AHS and its departments, which is us as well as Department of Health, have some roles in this. We are an agency of education. We're continually engaged in collaborating around how can we promote social emotional mental health and wellness in schools and across the system, so thinking about families, communities, as well as schools. So we know that Agency of Education has been undergoing tremendous reorganization within their agency. And they actually are establishing some new positions, one of which will focus on school mental health that we will be partnering closely with. And we do see that as the next phase, if you will, around infrastructure sustainability with Project AWARE activities. So how that role with us can continue to further some of these guidance documents and other supports in responding to schools and their needs. That's exciting. Very excited to see that.

[Daisy Berbeco (Ranking Member)]: Can I ask Leslie? I'm just curious.

[Leslie Goldman (Member)]: I've looked through one of your thank you for interesting work, really great work. So you mentioned that there

[Daisy Berbeco (Ranking Member)]: are three LEAs involved, and that's because that's what funding would support. And how much is that funding that supports three years? It's $1,800,000 a year over five years. So each year, you get 1 point And 8,000,000 how is that being invested now? I'll just add,

[Leslie Goldman (Member)]: how does this bill change what you're going

[Laurel Omland (Vermont Department of Mental Health)]: to do, or does it? Great question. I would be glad to come back and talk about Project AWARE in more depth. It does support a grant management position at Department of Mental Health and then a coordinator position at Agency of Education. And that's a requirement that we have roles at the state level. And then within each of the LEAs, it supports a project work coordinator and then within the designated agency paired with that LEA.

[Daisy Berbeco (Ranking Member)]: Are So the eight positions? Yes.

[Laurel Omland (Vermont Department of Mental Health)]: Yep. And so the local teams are doing that, what I mentioned, the district media leadership team, really trying to dig into their data, establishing a universal screening process, looking at their protocols, a lot of on the ground work. And there's some creative activities that are coming out of what they're doing locally. The funding also supports five different training entities that address the requirements that we had, as well as some of our Vermont goals around this. So addressing mental health literacy, suicide prevention, technical assistance around protocol for suicide prevention, so helping these schools really take a look at their current protocols and aligning it with the model one, and then making sure that it is understood across their districts and how they carry that out. Some student focused initiatives looking at their own school or district data and what are students recommending, activities that could happen related to that, etcetera. We have an external evaluator as required by the Trauma responsive school or transforming trauma within schools, some training around how districts can understand and respond to trauma in students. So it is many different goals and many different activities and some complex expectations of a single school district to take on. And that's happening in three different ones, in different practical state. So North is you know, the Caledonia Central is one. Berry Unified Union is another. And then the Southern Vermont

[Leslie Goldman (Member)]: Southwest Vermont. Southwest Vermont. Yeah. I happen to have your slide up.

[Daisy Berbeco (Ranking Member)]: That's all good. So then the

[Laurel Omland (Vermont Department of Mental Health)]: question is, how does this bill impact what you do? So both this one and the Garrett Lee Smith suicide prevention grant held by the Department of Health, they are focused in specific regions of the state. And so that's where the trainings are occurring. For Project AWARE, the trainings are occurring in those three districts and their communities, if you will. I think what this can lay out is for others who are interested in this, is setting up a pathway for how they can access it.

[Leslie Goldman (Member)]: Access Project Aware Fund? No.

[Daisy Berbeco (Ranking Member)]: That's a Training. Training. Yes. But it could be anywhere.

[Leslie Goldman (Member)]: It could be NAMI. It could be whatever. Yeah. I mean, this But it's not going change what you do, is what this bill. I'm interested in the impact of this bill on DMH.

[Laurel Omland (Vermont Department of Mental Health)]: My understanding from my read of this is it would set an expectation that the department manage, through available resources, opportunities for schools to access medical literacy training and student peer to peer support programming.

[Leslie Goldman (Member)]: But it wouldn't be Project AWARE, it'd be some other fund. Correct. Got it. Thank you.

[Daisy Berbeco (Ranking Member)]: Is there an opportunity to inform this using what you have learned from Project Aware? Because one possibility is that as this build becomes circulated and crystallizes in terms of the products in it, that funding mechanisms can be more easily identified. And so I wonder, at some point, there should be intent to scale up stuff that we're learning from Project AWARE. Is this a vehicle that you could do that

[Laurel Omland (Vermont Department of Mental Health)]: with? I think it supports those two aspects of Project AWARE, Yes. A

[Marianna Donnelly (Vermont Department of Mental Health)]: big piece of Project AWARE is that the designated local mental health agency and the local education agency are sitting together, looking at their data, understanding what the need is in their region, what they have available to them, as well as other community partners and trying to figure out where are we putting our resources? Does it make sense? Do we need to think about adding? Do we need to think about taking things off the plate? And so I think that that's such a big piece of what we're doing with AWARE and mental health literacy is sort of a bullet point under that as a suicide prevention, these other pieces. But the main goal of AWARE is really bringing these two entities together to start working together and understanding their systems. Informed by the literacy, those things. Those are foundational

[Laurel Omland (Vermont Department of Mental Health)]: components that help them then and there, looking at existing resources gaps. What other partnerships can they develop? Or how do they align resources to Karen? Address

[Unidentified member (“Katie”)]: This is Katie. Thank you for being here. I was wondering which three communities are interacting with Aware at this point. And was it the first same with the first five years as now this second iteration? Three different regions. Okay.

[Laurel Omland (Vermont Department of Mental Health)]: And they were identified through opening it up to different school districts who was interested and ready and being really clear on what the activities were going to be. So they were the Bear Union, Caledonia, Central Supervisory Union, and Southwest Vermont Supervisory Union. So that's Bennington area. That's the second three. Oh, what were the first three? My apologies. Orleans South, Rutland. Which Rutland?

[Marianna Donnelly (Vermont Department of Mental Health)]: Oh, you're really testing my memory now. Okay.

[Simone Rueschmeyer (Vermont Care Partners)]: Where was our other one?

[Laurel Omland (Vermont Department of Mental Health)]: How quickly we have moved off with the

[Daisy Berbeco (Ranking Member)]: work. That's okay. We can answer that separately.

[Leslie Goldman (Member)]: Yes, six different.

[Daisy Berbeco (Ranking Member)]: I assume from those experiences, you've evaluated the impact in those six different or in the process? We are. Yes, we have an external evaluator.

[Laurel Omland (Vermont Department of Mental Health)]: There are certain metrics that we have to report to SAMHSA, but we also have our own interest. I will say one of our other significant learnings from the first round of AWARE was that there might be suicide prevention protocols in schools or even support protocols for what do we do if someone expresses a mental health need. But not necessarily everyone knew they existed or how to use them. And so it's taking that to the next level of, great, let's update these. Let's review. Let's have a team. But also, let's make sure that anyone who's engaged with students understands how to do that. And again, that's not a criticism of districts. It just is there's so much that there is to be managed with that. And then the data tracking is one of the others.

[Daisy Berbeco (Ranking Member)]: So we'll have them come sometime to talk about Project to Work, because that is not part of this bill.

[Unidentified member (“Katie”)]: And so and I don't know if this is part of the discussion either, but we've heard some great descriptions of brain health in women's school, and like just starting it pretty cool, and having that just be part of how you go about being a person, a student, all those things. And I don't know how this interfaces with that concept. Well, think that's why

[Laurel Omland (Vermont Department of Mental Health)]: we want to ensure we're partnering with the Agency of Education, because they do have some standards around what's in health education curriculum across the age grades, grade levels. But also, what are their expectations around social emotional learning, that type of curriculum? I have children also who are coming through the school system and have seen some of those curriculum and what they're doing and the engagement with families through that. So I think it's what already exists, where there are needs from different districts around support to identify curriculum or programming, but also going beyond that standard curriculum, like how do we engage the adults in the building to also have that mental literacy component of it? And then I do think that this furthers it with that peer to peer support program. So I think it's taking it to that next level. But there are very creative, and again, you've heard some today, ways of doing this with the younger elementary school age, with middle school, and then with high school. Because there are different needs, fairly different learning engagement opportunities.

[Daisy Berbeco (Ranking Member)]: Thank you both so very much for your many years of service to Vermont families. Thank you. You. Appreciate the opportunity to be here. Simone, can we power through?

[Marianna Donnelly (Vermont Department of Mental Health)]: Are you Okay with

[Daisy Berbeco (Ranking Member)]: that? Yes. We've to be powered through. Thank you for your patience.

[Unidentified member (“Katie”)]: Yeah, of course.

[Daisy Berbeco (Ranking Member)]: So many thoughts along the way. Tell us what you think.

[Simone Rueschmeyer (Vermont Care Partners)]: Thank you for having me. For the record, my name is Simone Rischmeyer, executive director of Promont Care Partners. We represent 16 of the state's designated and specialized service agencies. Thanks for having me back. First of all, I just want to say really excited about this bill. It's so important that we work on strengthening protective factors that we focus on prevention and early intervention and peer to peer initiatives and mental literacy. We've focused a lot on the crisis continuum, which is important. Prevention, early intervention, establishing norms is essential. So I appreciate that. As you know, the designated agencies provide a number of mental health services in schools across the state. And so someone was talking about before the referral pathways and resources that are available. So where they are in those schools, that's pretty baked in, which is very helpful in a lot of ways. They also do a lot of the training and education, and so really looking at mental health literacy. Also working with families, which was brought up before as well, so I just wanted to mention that. Vermont Care Partners holds currently Well, we've been doing Mental Health First Aid in Vermont since 2014 and have trained about 12,000 Mental Health First Aders across the state, which is pretty significant. We currently hold three grants, and I'm bringing this up for a reason. One is a SAMHSA grant that goes directly through us, and that is for adult, youth, and teen mental health first aid. We've had that for three years. It's ending in September. It's really broad. So we can do youth mental health first aid trainings for community members. We can have open ones, or we could be doing it within schools, teen mental health within schools. We also are part of SAMHSA AWARE in the three areas that they were just talking about. And then we also are part of the Garrett Lee Smith grant through Vermont Department of Health that allows for teen and youth mental health first aid trainings in four counties. And it's a little bit flexible so that if other counties want to be involved, they can be as well. I will just say, in the last year alone, we trained approximately 1,200 mental health first aiders. And close to 2,500 youth and adults were supported by those mental health first aiders. Ninety seven percent in our follow-up evaluations, ninety seven percent said that they had an increase in their knowledge, attitude and belief through the training. So it was really pretty significant. One of the things we're working on with VDH is a sustainability plan granted is just for mental health first aid, but a sustainability plan for when the grants run out, because they will. And I think we've also talked at large about, could there be a one place in the state where schools could come to and say, how do I access these different trainings? Talk to me more about what they are, which one's right for me. There is a one pager that VDH, I believe it was VDH, maybe in concert with DMH, I can't remember. But that outlines a number of the different trainings so that schools can kind of look at them and say, Okay, we've done this one. Is this one necessary? Is it overlap? Is it duplicative? Or would it be beneficial for our schools? So that's a I think the more we can do to explain what the different trainings are, the better, and how to access them. Right now, I've learned a lot just today, but there's so many different opportunities, and they're all funded through grants, pretty much. And how do we make it more of a sustainable platform for schools and families and communities? As Terry was saying, we do have, as part of our Mental Health First Aid grant through SAMHSA, we have a statewide infrastructure, and we do come together monthly to talk about the different trainings and what people are doing. And so that's been really helpful. I think that just trying to think quickly, Daisy.

[Daisy Berbeco (Ranking Member)]: Was trying to read what do

[Simone Rueschmeyer (Vermont Care Partners)]: I really want to say? I I think one of the things that I'd love to see is, and one recommendation I'd like to make, is whether it's before this goes through or during, that we do an environmental scan, that we really get a sense of what schools are receiving now, which schools are really involved, which aren't at all, and what some of the gaps are and needs in the community. I think that would be really helpful. And if we then have that understanding, we could bring together a group of folks from DMH and AOE and the agencies and legislators and others to figure out then how do we meet those gaps? How do we fill them? I do find that as I'm approving trainings, which I do on a weekly basis, I see a lot of happening a lot in the same areas. So I want to also make sure that we are reaching out to the communities where we're not seeing the trainings taking place and better understand why. Is it a resource issue? Is it an interest issue? Is it a need issue? What might it be? I also really think the involvement in students in all of this is essential. I've been working with the Busy Head Foundation. We had a great summer retreat where we talked a lot about youth and students and what we could do to support them. And there were a lot of people in the room. Best ideas came from the students, and they know what they need. So that was very, very helpful and a recommendation I would make. Think those are the biggest pieces. We don't want to recreate the wheel, and I do feel like right now it feels very piecemeal to me across the state. And if there's a way to centralize it, I think that would be helpful for instructors. It would be helpful from a funding perspective, and it would be helpful for schools and communities trying to access the trainings themselves.

[Unidentified member (“Katie”)]: It's very helpful. Yeah, go ahead. Well, I just learned recently the other day that not all the DAs are interacting with the schools in all places in the state. And that was news to me because I thought that was something that was happening everywhere. And I guess it isn't.

[Simone Rueschmeyer (Vermont Care Partners)]: All DAs have contracts with schools, all the mental health DAs have contracts But with how they function and the percentage of schools in their area

[Unidentified member (“Katie”)]: varies. Yes. Because I was informed, again, I just learned it the other day, that maybe some don't utilize the DH to the extent they could. But anyways, I love your idea of having a

[Simone Rueschmeyer (Vermont Care Partners)]: clearinghouse for all the schools. Clearinghouse, that's a better term.

[Unidentified member (“Katie”)]: I just wonder what it would take to stand that up, because that just seems like a brilliant idea and important given the fragmentation we're hearing.

[Simone Rueschmeyer (Vermont Care Partners)]: Well, I'll say I'm really good at big ideas and that

[Katie McLean (Office of Legislative Counsel)]: is important, but I don't

[Simone Rueschmeyer (Vermont Care Partners)]: think it would be that complicated given the expertise around the state. I mean, we all know what's out there and what we're doing. And I think as long as we're coming together and we have the different partners, as Laurel was saying, having AOE at the table, VMH, and I just think that we could probably figure it out. It's a small state. And we're all committed to this. It's so important. And Terry's one of the best instructors ever, so just a quick shout out. I love it. Thank

[Daisy Berbeco (Ranking Member)]: you. Thank you. Appreciate the opportunity.

[Leslie Goldman (Member)]: Leslie? My questions are really for you, only the comments that you made, which sort of reflected what I was feeling, was it does feel fragmented. The environmental scan is an interesting idea. I'm wondering about putting some kind of language in this pill about that. So if you've thought about that, or if that's appropriate, or any

[Daisy Berbeco (Ranking Member)]: I'll take more testimony on it. Thank you so much. Thank you. Appreciate it. Okay.

[Alyssa Black (Chair)]: All right, that takes care of what we're going to do on H17.

[Daisy Berbeco (Ranking Member)]: Can I ask a question then, May I?

[Lori Emerson (NAMI Vermont)]: Oh, you mean to get

[Leslie Goldman (Member)]: this through before crossover? Okay, great.

[Daisy Berbeco (Ranking Member)]: That or it dies.

[Leslie Goldman (Member)]: Yeah, that's the point.

[Brian Cina (Member)]: I would hope anything we're working on right now is something we're trying to do for crossover.

[Alyssa Black (Chair)]: All right, let me answer that, here it's really absolutes. Yeah. I know that for sure. So we're all done with week 17. Unfortunately, we cannot get people that are scheduled to come earlier.

[Brian Cina (Member)]: That's not unfortunate, we get a break.

[Alyssa Black (Chair)]: Well, it's gonna be a pretty good break too. Yes. Okay, so we're gonna be back at 03:00. Sharp. Sharp.