In February, the telehealth company , including clinicians who worked directly with students and families, leaving about 500 employees. 

The company lost one of its biggest customers, the Los Angeles County Office of Education, last year. It shortened its contract with the Chicago Public Schools because of “challenges securing funding,” a spokeswoman said. And several districts across the country have also either ended their business with Hazel or have contracts that expire later this year. 

they are “restructuring” the company to put it in a better position as it pursues more stable sources of funding, like billing Medicaid and private insurance, now that the federal relief funds some districts used have expired. Company spokeswoman Emilie Fetterley said no additional layoffs are expected “at this time” and that many states and districts plan to renew their contracts. 

But according to internal memos, by a news outlet covering mental health, CEO Iyah Romm said the company was losing “too much money” to meet its goals. Since the expiration of the Los Angeles contract, the company has even, at times, absorbed the cost of services, Fetterley said. 

Some say the company faces a difficult road ahead.

There is a “massive need” to address student mental health and behavior issues, said Adam Newman, co-founder of Tyton Partners, a consulting firm focused on the education sector. Until the relief funds ran out, “there were enough dollars in the system for schools and districts to find ways to underwrite these types of programs. But the risk has always been: What’s the durable funding model?”

In Missouri, the Ferguson-Florissant district, outside St. Louis, ended its business with Hazel last year.

“They were great to work with,” said spokeswoman Onye Hollomon. Hazel served about 2,000 students in the district, which used COVID relief funds to pay for the program. “Once that phased out, we had to make that cut.”

Los Angeles spent more than $28 million in one year to make Hazel available to the county’s 80 districts, according to GovSpend, a data company tracking payments to government agencies. It funded its deal with the company by tapping a $389 million . Between March 2022 and May 2024, 804 schools in the county referred 9,337 students for services, according to data Hazel provided to the county. Of those, 4,162 students received at least one visit, with students participating in an average of six visits. Fetterley said once a student is referred to Hazel, parents don’t always follow through with a visit or may seek help elsewhere.

In addition to taking a loss on services for some students since last year, Hazel has relied on billing insurance, including Medi-Cal, the state’s Medicaid program, and contracts with individual districts. Leaders are currently negotiating contracts with districts for next school year. 

Hazel is also one of eight providers approved for a new program that allows 700 districts throughout California to be reimbursed for services by Medi-Cal or private insurers. It participates in a similar in Iowa, and in Nevada, the Clark County School District uses Medicaid funds to pay for Hazel services, but that ends in June. A spokesperson said the board has not yet decided whether to renew it.

‘Made their mark’

Telehealth programs, delivered through schools, were expanding long before the pandemic. They offer families convenient access to a remote doctor or therapist while preventing students from missing school for appointments that often turn into full-day absences. Hazel Health, founded in 2015 by health care executive Josh Golomb, was part of that growth. 

“Telehealth providers have made their mark in school-based health care,” said Nirmita Panchal, a senior policy manager at KFF, a nonprofit focusing on health policy. “They eliminate transportation barriers, where students may not be able to physically get to a provider.”

During the pandemic, when learning and work suddenly went virtual, telehealth programs for schools . of school-based health centers showed that during the 2020-21 school year, more than 80% of respondents offered telehealth services, up from 19% in 2016-17. 

The financial landscape has since changed. A lot of districts are now cutting budgets to close deficits. GovSpend, which doesn’t capture all district spending, shows a decline in payments to , a similar company, since 2023, while , another virtual mental health provider, saw a more stable influx of funds from 2024 to 2025. 

Among providers, however, Hazel Health stands out. The company, which serves 6,000 schools in 21 states, initially focused on primary health care, with physicians prescribing over-the-counter medications for routine symptoms like stomach pain or headaches. In 2021, the company broadened its model to provide mental health services and respond to “rising unmet student needs and limited access to care,” Fetterley said. 

In Florida’s Duval County schools, Brittany Beimourtusting reached out to Hazel last school year when she was going through a divorce. Her middle child, she said, was having trouble adjusting.

“It was a single-parent household all of a sudden, and I thought, ‘How am I supposed to get him to get help because I think he could use therapy,’ ” she said. The provider, she said, met with him about five times and helped him open up about what he was feeling. “It was definitely worth it.”

But when Superintendent Christopher Bernier looked for ways to save the district some money last year, a $1.4 million payment to Hazel was on the list.

‘A connected system’ 

Four years ago, the startup’s future looked bright.

It attracted over $50 million from investors, including Fiore Ventures, founded by Walton family heiress Carrie Walton Penner. As recently as last year, Hazel was still eyeing growth. It made two acquisitions, including , which offers family therapy, to further expand mental health services. 

“Together, we are building a connected system that supports children from their classrooms to their kitchen tables,” wrote Andrew Post, then �Ჹ�����’s president, in October. But he has since resigned, writing this month that it was time to turn to the “next chapter” in his career.

�Ჹ�����’s was supposed to run through the end of 2027. Now it will end on June 30. Still, district officials said the layoffs have had no impact on the services students receive. In a pilot program that began in March 2025, the district made mental health services available to 84 high schools. As of January, 420 students had taken advantage of the program, the district said.

In December, Destiny Singleton, the honorary student member of the Chicago Board of Education, told members that students don’t always feel comfortable talking to school counselors about personal issues because those staff members are often focused on academic performance and preparing for college. That’s why talking to an outsider can be helpful. But she added that students at the district’s larger high schools are often unaware that Hazel is even an option.

Some Chicago parents, however, are wary of Hazel and say families don’t always know what they’ve agreed to when they consent to allowing their child to meet with a Hazel provider. In to Chicago district leaders last year, student privacy advocates said they were concerned about whether Hazel properly secures students’ private information. 

The company’s acquisition of Little Otter, , raises red flags because Rebecca Egger, its CEO, formerly worked for Palantir, a federal contractor known for using AI to assist the Department of Homeland Security in its . 

In a response to Chicago officials, Romm, the CEO, wrote that Hazel does not “sell, share, or use student data for any commercial purpose,” and that it “does not have any relationship with Palantir, commercial or strategic.”

Fetterley, the company spokeswoman, also said Hazel is in the early stages of rolling out chatbots to “simplify administrative tasks like scheduling for parents and clinicians,” but that AI will never be a “substitute for our human providers.”

Even so, some districts see a much higher demand for in-person rather than virtual clinicians. In Broward County, Florida, where Hazel provides medical services, but not mental health support, 179 students completed a telehealth visit between August and December last year, according to district data. Over that same time period, more than 134,000 students visited a school clinic.

“Parents want nurses,” Cynthia Dominique, chair of the District Advisory Council and a parent in the district, told the school board in March. As a nurse practitioner, she questioned how a provider working remotely can diagnose and treat most common symptoms, like congestion or a sore throat.

“I can’t ask the registrar from the front desk, ‘Can you look in the kid’s mouth and tell me what you see?’ ” she told ����Ӱ��. “They don’t know what they’re looking for.”

For district leaders, however, �Ჹ�����’s ability to keep kids from missing school provided an effective selling point.

During a 2023 meeting, Duval County School Board Member Darryl Willie said the program had saved the district 4,000 “classroom hours” during the 2021-22 school year.

“We’re talking about making sure we’re focused on reading, writing and math,” he said. “The only way we can do that is if students are in school, in classrooms, sitting in seats.”

Disclosure: Walton Family Foundation provides financial support to ����Ӱ��.

It’s another hot summer Friday and another day with  — this one jeopardizing both student health and campus safety data.

And once again, the development is unfolding in the country’s second-largest school district.

Kokomo Solutions, which the Los Angeles district contracts with , disclosed a data breach after it discovered an “unauthorized third party” on its computer network. The discovery happened in December 2024, but the notice to the California attorney general’s office wasn’t made until Aug. 5.  

It’s the latest in a series of data privacy incidents affecting L.A. schools, including a high-profile 2022 ransomware attack exposing students’ sensitive mental health records and last year’s collapse of a much-lauded $6 million artificial intelligence chatbot project. 

In the news

Students at the center of Trump’s D.C. police takeover: In an unprecedented federal power grab, the Trump administration’s seizure of the D.C. police department and National Guard deployment is designed to target several vulnerable groups — including kids. | 

• The move comes at a time when crime in the nation’s capital is on the decline. But a deep-dive from June explores how the district’s failure to prevent student absences has contributed to “the biggest youth crime surge in a generation.” |��
  
• Here’s what young people have to say about Trump’s D.C. takeover. |��
  
• City police will roll out a youth-specific curfew Friday in the Navy Yard neighborhood. |��

A new Ohio law requires school districts to implement basic cybersecurity measures in response to heightened cyberattacks. What the law doesn’t do, however, is provide any money to carry out the new mandate. |  

News in Trump’s immigration crackdown: A federal judge in Minnesota has released from immigration detention a nursing 25-year-old mother, allowing her to return to her children as her case works its way through the court. | 

• The Trump administration has revived one of its most controversial immigration policies from the president’s first term: Separating families. |��
  
• Federal immigration officials quizzed an Idaho school resource officer about an unaccompanied migrant student, part of a broader national effort to conduct “welfare checks” on immigrant youth who came to the U.S. without their parents. |��
  
• Leading Oklahoma Republican lawmakers have partnered with the Trump administration in a lawsuit challenging a state law allowing undocumented students to receive in-state college tuition. |��
  
• Los Angeles community members have organized to create protective perimeters around the city’s campuses after immigration agents reportedly drew their guns on a student outside a high school. |��
  • The district announced new bus routes designed to improve student safety while commuting to school��during heightened immigration enforcement. |��

• The nonprofit Southwest Key, which for years has been the federal government’s largest provider of shelters for unaccompanied migrant children, has laid off thousands in Texas and Arizona after losing federal grants. The Trump administration dropped a lawsuit in March over allegations the nonprofit subjected migrant children to widespread sexual abuse. |��
  
• A Texas court blocked the state attorney general’s request to depose and question a nun who leads Catholic Charities of the Rio Grande Valley, one of the largest migrant aid groups in the region. |��

Microphone-equipped sensors installed in school bathrooms to crack down on student vaping could be hacked, researchers revealed, and turned into secret listening devices. |��

‘These are innocent children, sir’:��New video of the delayed police response to the 2022 mass school shooting in Uvalde, Texas, shows the campus police chief attempting to negotiate with the gunman for more than 30 minutes. |��

Kansas schools have become the latest target in the Trump administration’s campaign against districts that permit transgender students to participate in school athletics. | 

• The Loudoun County, Virginia, school board has refused to comply with an Education Department order to end a policy allowing transgender students to use restroom facilities that match their gender identity. |����
• The Education Department’s Office for Civil Rights has opened an investigation into allegations the Baltimore school district ignored antisemetic harassment by students and educators. |��

Lots of drills — little evidence: A congressionally mandated report finds that active shooter drills vary widely across the country — making it difficult to understand their effect on mental and emotional health. | 

A federal judge has blocked a new Arkansas law requiring that public schools display the Ten Commandments in all classrooms. It’s the second state Ten Commandments law to be halted this year. |  

ICYMI:��I did a deep-dive into the far-right Christian nationalists behind more than two dozen state Ten Commandments-in-schools bills nationally —��each of which are inherently identical. |��

Is Texas up next?��Civil rights groups will ask a judge on Friday to prevent a similar law from going into effect. |��

ICYMI @The74

Emotional Support

Don’t sleep on this����—��the billion-dollar industry for hypoallergenic (and floofy!) designer pups.

Most school districts only used Mississippi’s new telehealth program a few times in the 2022-23 school year, but program administrators say they are working to increase participation and have already seen positive results.

The school-based telehealth program was created by the Mississippi Department of Education, which to the University of Mississippi Medical Center to administer the program. The grant, which expires in Sept. 2024, covers laptops for video conferencing, rapid strep and flu tests, and specially equipped stethoscopes and otoscopes that transmit information to the doctors or nurse practitioners on the other end of the call.

The program, which is free to students, began under the direction of former State Superintendent Carey Wright, with the goal of increasing access to medical care and keeping children in school more hours each day. Over half of the counties in Mississippi have no practicing pediatricians according to the Office of Mississippi Physician Workforce, something this program aims to help address by decreasing the amount of time families spend traveling to access care.��

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was open to all 145 school districts in the state, and 100 signed up. Of those 100, data from UMMC shows only 34 districts had at least one visit in the 2022-23 school year. However, some visits were not assigned to a school district, making it possible that more participated.

Dr. Saurabh Chandra, the hospital’s chief telehealth officer, said he is very proud of the speed at which his team has been able to successfully roll out the telehealth program. This is the largest school-based telehealth program in the country he is aware of, adding it was implemented faster than many others. While he was pleased that connectivity did not end up being a major issue, he said the shortage of school nurses has been a challenge.

After spending the first year focused on implementation, Chandra said the goal is now increasing participation. He said nurse educators are communicating regularly with school districts to understand their concerns. UMMC has already made at least one change – allowing school nurses to call and schedule an appointment instead of doing it in the computer software – based on the feedback.

The outreach already seems to be helping: the program averaged about 150-170 visits a month last year, but August and September of this year have seen about 275 visits each month.

“(The program) is in a stage of infancy,” he said. “You have to implement the program, you have to understand the barriers, you have to do the engagement, this is a continuous work, but we are seeing good trends.”

Lauren Hunt, the nurse at Stone County Elementary School, is a regular user of the program. Stone County does not have any practicing pediatricians, but there are several in neighboring coast counties, according to the physician workforce data.

Hunt brings up the service to parents when she thinks a student could benefit and said she has had very few parents refuse. She said she “has not been able to brag on it enough” and expressed a desire for more school nurses to start using it so it can be a greater benefit to the state.

“The school nurse is really the keyholder – she is the one that has to want to implement it and use it,” Hunt said.

She also emphasized the importance of outreach to parents so they’re aware they can request visits and don’t automatically take their children to the doctor on their own. Hunt said she has seen this be effective in action, particularly for children without health insurance who have used it for ear infections and other small issues.

Parent outreach is also a priority for UMMC, but Chandra said his team depends on school districts to spread the word. He hopes as parent awareness of the program increases, their trust in it will rise as well leading to increased participation.

Jana Miller is one of two nurses covering five rural schools in the Greene County School District. Her favorite part of the program is the convenience: appointments are usually available within 30 minutes, and students are not required to check out and wait to be seen, saving parents time as well.

Miller said her district has also utilized the teletherapy portion of the program, which provides mental health services to children. The school identifies students for it based on parental requests, school staff’s knowledge of difficult circumstances, or a child reaching out for someone to talk to. She also schedules these appointments but does not participate in them like the telehealth visits.

“I was really apprehensive (of the telehealth program) at first because I just didn’t know how it was going to work, but I’m very glad we took the leap of faith and went through with it,” she said.

One district hopes to use the program more now that technical issues have been resolved. There are no pediatricians in Chickasaw County, where nurse Dawn Vance works in the schools.

“I think with a little push, maybe the nurses get a little more training and the IT stuff gets all worked out, I think it would really pick up, especially in an area like ours where there’s not many options,” she said.

Other districts have said they don’t have as much of a need for the program because of existing school-based clinics or parent preference for local pediatricians.

Hunt, the Stone Elementary School nurse, said she hopes more schools start using it so the state will have an incentive to keep funding the program after the federal pandemic relief money expires.

UMMC is looking for other grants to continue funding the project or considering turning it into a program that takes insurance, Chandra said.

“We know that there’s a need for it out there,” said Scott Clements, director of healthy schools for the Mississippi Department of Education. “We have a lot of rural areas … and in those rural areas you oftentimes don’t have the services you have in a metropolitan area.”

This first appeared on and is republished here under a Creative Commons license.

All 80 districts within the Los Angeles County Office of Education’s jurisdiction will have the authority to opt-in to services with Hazel Health, a telehealth provider that has partnered with districts nationwide to connect families with licensed care quickly and at no cost.

Their virtual therapy model removes some key barriers to accessing care from the equation, including insurance coverage, provider shortages or waitlists and transportation. Los Angeles Unified, the nation’s second largest district, and Compton Unified have already opted in.

In , nearly 70% of youth who’ve experienced a major depressive episode did not receive any treatment — 10% above national averages. 

However, the new partnership is not designed to support students long-term.

“Each student can typically expect an intake visit plus six weeks to two months of weekly sessions before being discharged from the Hazel program,” a spokesperson for Hazel Health told ����Ӱ�� by email. “The program is short-term—if your child needs long-term mental health support, we will help identify and connect you with options in your community.”

The $24 million dollar partnership with L.A. Care Health Plan, Health Net, and the L.A. County Department of Mental Health is to address the youth mental health crisis, exacerbated by the pandemic and social media. In addition, , who make up 86% of Los Angeles county schools. 

Los Angeles Unified has not yet finalized their implementation plan. It may take up to twelve weeks before sessions begin, according to a spokesperson from the county’s education office.

In December, some Compton Unified students began to access at-home services, and as of last week, two district schools began offering telehealth visits onsite. By March, the district plans to offer space for students to use at every campus.

Half of mental illnesses start by , and suicide is now the for children. Other school districts already partnered with Hazel include Clark County, Nevada’s largest, and Duval County Public Schools in Florida. 

While a enables youth 12 and up to confidentially sign up and meet with therapists on their own, Los Angeles’s partnership with Hazel will require students to be referred by a parent, guardian or school staff member. 

Over half of Hazel Health’s mental health providers are people of color and over 40% are bilingual. When necessary, clinicians use Language Line to facilitate sessions in students’ preferred language.  

“Hazel Health aligns the hiring of therapists to the demographics of its partner districts,” said Van Nguyen, Public Information Officer for the LA County Office of Education. 

The company launched its first mental health visits in the fall of 2021, which range coping mechanisms and tools for general anxiety disorder, depression, academic stress and bullying. Presently, about 22 clinical mental health positions are vacant.

“�Ჹ�����’s hiring practices involve looking for trauma-trained clinicians with deep expertise in children and teens, as well as specific passion areas and specialties (such as LGBTQ). Getting the match right is critical,” Drew Mathias, vice president of marketing, told ����Ӱ��. 

Their clinicians most often use cognitive behavioral therapy, motivational interviewing and dialectical behavior therapy approaches. 

Founded in 2015 by a pediatric emergency room doctor, K-12 educator, and former Apple software engineer, Hazel Health offers physical and mental health care visits to children at over 3,000 public schools.

Since 2020, the COVID-19 emergency — a federal declaration issued by the secretary of the Department of Health and Human Services — has driven a surge in telehealth utilization among older Americans, enabled by regulatory waivers and flexibilities from the Centers for Medicaid and Medicare Service.

The same is true for the over children and adolescents served by Medicaid, the state-run government program that helps pay health care costs for people with limited income. While states have broad flexibility to determine whether to cover telehealth services under Medicaid, now have policies that allow for the reimbursement of at least one type of service when provided via telehealth in schools; 24 states had similar policies prior to the pandemic. So while school-based telehealth is not new, catalytic advances in school-based telehealth implementation were based on the widely shared goals of protecting student health and well-being, minimizing visits to local emergency rooms — already stretched thin because of the pandemic and its financial impacts — and providing better care to children and adolescents to optimize in-person learning.

This expansion was, and remains, an important equity opportunity for students, families and schools. First, telehealth holds the promise of dramatically to, and availability of, different types of physical and mental health care, regardless of where a student lives. Second, telehealth can potentially reduce out-of-pocket costs for patients due to , particularly in rural geographies. Third, given the widespread concerns around school , telehealth represents an opportunity to maximize the impact of a capacity-limited workforce. Maybe most critically, telehealth decreases burdens on families and students, for example, by reducing transportation challenges that can hinder access to care, resulting in more time spent in class.  

Given the potential benefits of telehealth and that for some conditions, such school-based care can improve the quality and effectiveness of care, it would seem nonsensical to dramatically scale back this service that matured during the pandemic.

There are, however, lingering policy and programmatic concerns relative to school-based telehealth delivery and governance that must be addressed for it to remain a viable health care model. For instance, a recent HHS Office of Inspector General concluded that approximately $130 million billed to Medicare during the first year of the pandemic for telehealth services included practices deemed high risk. Medicare is of course, not Medicaid. That said, the provision of unnecessary services, waste and fraud that have been documented in Medicare telehealth services likely exist in state-level Medicaid programs — based on previous occurrences of —and necessitate additional safeguards if telehealth is to become sustainable in schools. Additionally, there is the potential for violations of the Controlled Substances Act. Providers have by the Drug Enforcement Agency for prescribing controlled substances improperly. As many telehealth providers are increasingly serving children and adolescent populations, the risks of inappropriate prescribing are concerning.   

The costs associated with a permanent extension of Medicare telehealth coverage pose another challenge. The Congressional Budget Office that a two-year expansion of Medicare telehealth flexibilities would cost $2.5 billion. Again, while Medicare does not serve school-age populations, it has implications for schools. Medicare’s is so significant that decisions around Medicare and telehealth will likely impact how Medicaid and private insurers reimburse school-based telehealth services. If Medicare coverage for telehealth ends next year, it is difficult to see Medicaid coverage for school-based services remaining in place without significant revisions to existing policies, well-resourced and coordinated advocacy campaigns or a significant change in the economic outlook. Given the current variability in Medicaid coverage across states, schools using telehealth have relied on additional funding streams including, private insurance, federal pandemic relief money and other state sources. The formula schools have put in place to pay for telehealth services will likely need to be altered, if not entirely rethought. 

The dynamics around an extension of COVID emergency flexibilities remain uncertain. Proposed legislation circulating in Congress would extend them, but the costs and policy concerns pose a severe challenge to any congressional action. What is clear is that the Centers for Medicaid and Medicare Service and the U.S. Department of Education need to issue guidance for states, districts and schools that outline the various Public Health Emergency scenarios and requisite actions. 
For now, district and school health leaders should ensure they deeply understand the status of emergency waivers and the flexibilities that their organizations are utilizing. They should also reorient themselves with federal and state and procedures that were in place before the pandemic. They should similarly educate partner providers and school-based health staff on the current uncertainty around the emergency’s expiration and explain the potential need for swift implementation of new policies and procedures should the emergency not be extended. This work has significant budget implications. Finally, they should ensure that any additional requirements imposed on their organizations by the emergency flexibilities that are not expiring meet ongoing regulatory requirements.