Vermont Legislature SmartTranscripts:

[Sen. Virginia "Ginny" Lyons (Chair)]: You're welcome. All right, good morning. It's Senate Health and Welfare, Tuesday, March 24, and we're looking at S-one 193, our little amendment. When I took it into judiciary, they discovered one phrase that might be best left out and then another word change. So, Eric, why don't you just show us what that is, show the committee what that change is? Yeah, sure. It's Eric Fitzpatrick with

[Eric Fitzpatrick (Office of Legislative Counsel)]: the Office of Legislative Counsel. As the chair indicated, after some discussions in the Senate Judiciary Committee on S-one 193, which is the Forensic Facility Bill, the Judiciary Committee proposed a couple of very minor changes. I have one version highlighted here, which I can pass around if everyone wants to look at it. You'll see very minor, just a couple of words. Remember that the language had some requirements as to how the forensic facility would be operated and certain principles that were going to guide the operation of the forensic facility. Judiciary Committee and you were making clear that when the facility was being operated, that it would include provisions that would allow the facility to be, have people who were committed there to be divided on the basis of sex. The senior chair committee proposed to add sex or gender, that's all. So that the facility could be not required, but could be, have the option to be divided up among people who are committed on the basis of gender, so have sex. And additionally, there was another piece providing that the facility would be able to be divided up into multiple buildings. Remember that piece? Because that's a big point of discussion. And there was a qualifying clause in the language that came out of this committee that said, have you considered dividing the facility up into multiple buildings if it was if presented by the person's qualified person's conditions at the very bottom. Those don't do change in our paper. I'm gonna try to add them. So the judiciary committee just proposed removing that length. So in other words, it would just be that as a general matter, the committee, I'm sorry, the facility, the Department of Corrections, pursuant to their management of the facility, would have to consider whether or not this ought to be done in separate buildings separately. So without any sort of limitation or qualifying language on their requirement that DOC think about that, just generally would be something that they would be required to consider. So pretty straightforward, none, I wouldn't describe it as hugely substantive changes. But that was it. Otherwise, the that the Secretary Committee took out was identical to what this committee looked at last week.

[Sen. Virginia "Ginny" Lyons (Chair)]: So we took out that one phrase at the bottom of the page.

[Eric Fitzpatrick (Office of Legislative Counsel)]: Exactly.

[Sen. Virginia "Ginny" Lyons (Chair)]: It said, if required by the clinical needs of transfer from persons, and the agency was fine with it, and then the addition of gender. Does anyone want their name taken off the amendment?

[Eric Fitzpatrick (Office of Legislative Counsel)]: No, we're good. Leave it. All right, I think institutions is gonna look at it this afternoon at 01:30, and then the senate district is supposed to look at it tomorrow. So Perfect.

[Sen. Virginia "Ginny" Lyons (Chair)]: Get close. We're on a glide path. That's it. Hopefully. Thank you, Eric.

[Eric Fitzpatrick (Office of Legislative Counsel)]: Yes. Thank you. Thanks for squeezing me in real quick. Thank you, people.

[Sen. Virginia "Ginny" Lyons (Chair)]: I'm gonna leave, and Senator Gulick is here. And Doctor. Tully, thank you for being here today. Know we've looked at Saluna before, if you can help us, remind us what this does for mental health prevention issues for youth, that would be terrific.

[Dr. Tully (Soluna program representative)]: I can do that, absolutely. And I think I might have some visual aids.

[Unidentified committee member]: Yeah, I'm just gonna share a request. Can I share my screen?

[Eric Fitzpatrick (Office of Legislative Counsel)]: Yeah, you're good.

[Dr. Tully (Soluna program representative)]: Alright, let's go to the, the page. This one. Okay. Can I stand up and and look at

[Sen. Martine Larocque Gulick (Vice Chair)]: the screen? You wanna go up?

[Dr. Tully (Soluna program representative)]: Hey. Hi, everyone. I hope to tell you. Nice to see you again. Good to see some familiar faces. Thank you for the opportunity to return and speak. I want to begin by acknowledging all of your support and your leadership on this issue and a long standing commitment to payroll health and use wellness. When I joined you last session, we spoke about the scale of these mental health crisis and the need for solutions that extend beyond traditional care models. At that time, much of what I shared was reflected in what we believed was possible, you know, even starting some of these initiatives across the country.

[Sen. Virginia "Ginny" Lyons (Chair)]: And what I'm here today to tell

[Dr. Tully (Soluna program representative)]: you about is what there's proof in the pudding. We've got a bunch of data, and now we know that the solution works. So just as a quick reminder, Soluna is a digital mental health service. It is not an app. It is a health care service that you access via any Internet enabled device. And what it does is it helps young people process feelings, learn coping techniques, explore content related to unique challenges, and chat with trained professionals one to one. That breaks out into four sources of support shown here on these squares. The first one is our resources and coping tools. This is a self guided source of support. So seeing informational articles on everything from what does it feel like in my body to be anxious to how do I manage my finances as a young adult to what do I do after graduating high school to navigating geopolitical upheaval in the modern world. It's not just mental health topics. It's everything that a young person is experiencing as they move through the world and move into adulthood. Those topics are cocreated with young people for young people so they remain relevant. The coping tools, these are evidence based, standardized interventions that any mental health professional is providing to their clients, and many of you in this room will already be familiar with. Think breathing exercises, mood tracking, journaling, goal setting, etcetera. So that's our resources and coping tools. We then have our safe peer community support. This is a forum, community forum, where young people on the platform can help each other. So it looks very similar to what you're used to seeing on Internet forums like your Facebook or your Reddit, the amount of people in the post, and then other people will respond to that post with advice and questions, etcetera. It's very different from what you're used to seeing in other Internet forums because we've made a very simple but effective change to the order of operations in terms of moderation to keep it safe. So what you see on Reddit or Facebook is that a person will post, and then a moderator comes along and says, you violated our community guidelines. It's unsafe it's unsavory. I'm removing it, which is great, but doesn't undo the harm done to anyone that saw it before it was removed. So what we've done is we've simply reversed that order of operations. That moderation happens before the post goes live. And that moderation happens by real humans. There is no artificial intelligence feature in Seluna at all. It's all about human to human connection and human oversight. All of it gets reviewed before it goes live so that there's no chance of any anything unsafe or unsavory being seen by any young people on the platform. That's

[Unidentified committee member]: I'm

[Sen. Martine Larocque Gulick (Vice Chair)]: just gonna say, yes, please. I'm just gonna ask that question. So I'm really happy that you you gave us more detail on that. So, I really appreciate it.

[Dr. Tully (Soluna program representative)]: Yeah. Thank you. Yeah. Very important to us. Safety is our number one priority. We're observing young people. They're often very vulnerable and we're doing it in an ongoing space. It is paramount that we created a safe space for them and our pre moderation is just one of the things that we do to keep them safe. So the third source of support is our professional support. So this is connecting young people to certified mental health professionals. That could be a certified coach, coaching, which is really a kind of one at a time solution focused, drop in, get what you need, off you go approach, or they can engage with a licensed counselor, which is more of a sort of you meet with that counselor a few times in a row to address past an issue that you might wanna talk about more opportunity. Both are available in Saluna. You can drop in to talk to those coaches at any time, in which case you're matched with the next available coach, or you can book an appointment with a coach of your choice based on whatever it is that you want to talk about, maybe a scenario of expertise that they have, or some background, some shared lived experience or shared cultural background that allows you to connect with them. You can book an appointment with a counselor, and you can knit and match. So the young person has a lot of flexibility on how they engage with the mental health professionals, which is what they asked for when we designed the platform. They wanted that flexibility. They didn't necessarily want to commit to seeing someone weekly. They didn't necessarily have the ability to commit to a certain primary need. They just wanted this opportunity and drop in when they needed it, get the help, and pop out again. So that's the professional support. And then finally, we have the fourth source of support, which is our connection to local services and resources. So we have an extensive database of local, no cost, low cost, or insurance covered resources that address the full social determinants of mental health. It's not just about finding a therapist or a psychiatrist. It's about finding your local food bank, housing resources, financial support, figuring out how to go to community college. Can I get a bus pass from my city, and everything in between? So a young person can use our local services database to find what else they need in order to meet their goals in life. So all of that together is what Saluna offers. So it is a comprehensive service, not just chatting, not just community, not just coping tools. It's everything in there that a young person might need. Let's go to the next page.

[Unidentified committee member]: Got a question.

[Dr. Tully (Soluna program representative)]: Yes, please.

[Unidentified committee member]: Since it's not by appointment, and it's just so they can enter it at any point, what's your experience? Are you finding that there's a wait time that, or you have sufficient staff that they can immediately deal with? Calvisat,

[Sen. Martine Larocque Gulick (Vice Chair)]: what do you think?

[Dr. Tully (Soluna program representative)]: This is such a great question. So you are able to do either. You can drop in or you can book an appointment. For our drop in, we guarantee that we can match you with the next available coach within thirty minutes. And I'm very proud to say that in 2025, in our California contract, where we're serving a 160,000 plus kids, our average wait time in 2025 was three minutes. So it's almost immediate. And for the scheduling appointments, we guarantee that you can schedule with a coach of your choice within three calendar days. And, again, we were able to handily meet that guarantee in 2025. And the reason we can do this is that our service delivery team do a really beautiful job of using service utilization data to predict when do we need to staff up and have more capacity versus when are things more quiet. And we build a service delivery team that's really flexible. So it's kind of a mix of boats that have the ability to meet those different shifts and different demand fluctuations. Does that answer your question?

[Unidentified committee member]: Yes. I have one follow-up on that. Is the is the service twenty four hours a day, seven days a week?

[Dr. Tully (Soluna program representative)]: Obviously, the platform itself is available twenty four seven. Our coaches are available in California, and it does vary by state depending on what the state wanted. In California, our coaches are available from 10AM to 10PM, seven days a week, three hundred and sixty five days a year. And in New Jersey, they're available until 9PM. And we can you know, we work with the states to determine, like, what's the service that makes sense for your community? What we do see is that about 45% of our coaching sessions are happening after nine to five hours. So it is very clear that there is a need and that people want to use it in the evenings. We don't see a lot of demand super late. And so we think that ten to ten is a reasonable coverage, but it's it's catching people in the majority of the time that they don't. That answers your question. Yeah, these are good questions. Actually, from that, it's a nice segue. I just want to talk a little bit about who the providers are because that's another way that we keep folks safe, is we make sure that the providers are high quality, certified, well trained. So remember, we have two kinds of providers. We've got coaches and counselors. Coaches are certified mental health professionals. They fall into three buckets. About 50% of our coaches are certified peer support specialists. So these are individuals who bring lived experience of mental health recovery or other social challenges. And they've gone through a state certification process to learn how do I do mental health coaching support and leave that lived experience in so they can really connect with the person on that shared experience. Because what we know from research is that that lived experience, that peer to peer connection of yes, I understand because I went through something similar is a very effective way of reducing psychological stress. Just to do a time check, we're supposed

[Sen. Virginia "Ginny" Lyons (Chair)]: to end it in Alright, three minutes

[Dr. Tully (Soluna program representative)]: let's put it through. Thank you for the time Let's go through I talked a little bit about safety already. This top bullet we've talked about, I do want to highlight another bit of safety here, which is that service users cannot directly message each other. There is no ability for one to one private interactions on Sileuma. So the only way service users are interacting is in that community forum, which of course is pre moderated, so there's no possibility of unsafe or unsavory reactions. How do you get paid in, is this

[Sen. Martine Larocque Gulick (Vice Chair)]: a Medicare, is this a

[Dr. Tully (Soluna program representative)]: Medicaid type program? Typically, our model is to work with government agencies to be able to provide the service at no cost to the service user, so making it as low barrier as possible. So for example, in California, it's the state legislature that have put funding behind it to make it available at no cost to every

[Sen. Martine Larocque Gulick (Vice Chair)]: So, it's going to be general fund dollars?

[Dr. Tully (Soluna program representative)]: That is how California has done it and a similar mechanism in New Jersey. Yeah, these are new senators to this committee, they weren't here last session, what we talked about. Funding sources. Good. And we've had a variety of conversations with other states around how do we, you know, what does this look like and how to get rid of them. So I know that that's a discussion that can happen as a follow-up. So just to close the loop on safety, what I like to say about Salerno is we've taken everything that's good about the Internet, which is community and information, and we've left everything that's bad about the Internet outside it, which is misinformation, disinformation, and dangerous relationships. We know young people are going online. Quite frankly, all of us are going online for information and community. How do we direct them to a safe, credible space? That's what Saluna has been designed to be. Young people want to be online. That's why they want to find their community and their information. Saluna's been designed to do the same for them to do that. Okay. Let's close out with some data. Alright. We'll start with California. So we launched in California two years ago. We're now in all 58 counties across the state. And as you know, California is actually an extremely rural state. So this this is I thought this was really important for you all to know because of the rural nature of Vermont as well, that we have been able to reach youth in these underserved rural areas. We've got over 160,000 youth on the platform, over 57,000 coaching chats delivered. This means young people are using it. And we know that the people we're reaching aren't just your middle class insured people. 57% are from under resourced communities. 50% identify as a member of a black, indigenous, or other community of color, communities that have historically faced systemic barriers, and 48% identify as Latina and Hispanic, which, of course, is a big marginalized community in California. And you can see the heat map on the right there, sort of where we're at in the state. Let's go to the next slide very quickly. These data tell you that not only do young people use it, but they like it, it has increased access to care in meaningful ways, and it's making them feel good. So I already shared the 44% of coaching sessions outside of nine to five. These two data points here, one in two wouldn't have access to mental health support at all if Saluna didn't exist. And additionally, 50% say this is their first ever access. Back in the math here, 50% of our service users say, if this didn't exist, I wouldn't have anything. This is the first time. That tells me that in just two years, Saluna has opened the door to services to kind of 80,000 youth in the state of California who previously couldn't walk through that door or hadn't walked through that door. That is delivering on the promise of digital. People are feeling better. 86% say they can better support somebody else. 87% say Saluna got them what they wanted. 86% say they land their not alone. 98% of young people would recommend Saluna to a friend. And today, somebody said, oh, it's passed the cringe factor. It's passed the cringe test. If young people like it, young people want to use it, that is a good thing. And finally, 85% say they've had at least one of their needs bad during a coaching session. What is not here on the slide is some hot off the press clinical outcomes data, which is the very last thing I need to say. We partnered with Northwestern University in Chicago, which has the Digital Lab for Scalable Digital Mental Health led by Doctor. Jessica Schleider, the internationally recognized researcher for evaluating digital tools for you. Her team did an independent evaluation of Soluna. They measured psychological distress at baseline, one month, and three months. We found that at one month after using Soluna, significant and meaningful reductions in psychological distress, and most impressively, that those reductions were sustained at three months. So kids felt better, and they continued to feel better. There's more work to be done on clinical outcomes, but this is a really solid indicator that young people use it, young people like it, young people feel better when they use it. Done.

[Sen. Martine Larocque Gulick (Vice Chair)]: Thank you. Thank you. That was great. Thanks so much for the data.

[Dr. Tully (Soluna program representative)]: Yeah. Any questions or thoughts? Things I didn't clarify?

[Sen. Virginia "Ginny" Lyons (Chair)]: No. We did something good. Yeah. That was really helpful. Thank you so much.

[Dr. Tully (Soluna program representative)]: Yeah. Don't hesitate to reach out, and there's a lot more here in the testimony for you also. Great. And that'll be on our web page. Should be in the. I think we've got copies of the slides as well that we were giving folks Yeah. Thank you very much. Thank you. A pleasure to be here. I appreciate the invite.

[Sen. Martine Larocque Gulick (Vice Chair)]: Yeah. Absolutely. That's great. Thank you.

[Unidentified committee member]: You're welcome.

[Sen. Martine Larocque Gulick (Vice Chair)]: We can adjourn. I have

[Sen. Virginia "Ginny" Lyons (Chair)]: my girl I wasn't sure if

[Dr. Tully (Soluna program representative)]: that was just for the chair or.