The recipient entity's physical address:
           8300 Esters Blvd, Ste 900 Irving TX, 75063

The recipient entity's mailing address (if different):
           8300 Esters Blvd, Ste 900 Irving TX, 75063

Type of Entity (for instance, a nonprofit corporation):  Corporation

If the entity is a corporation, list the names of the incorporators:
          Josh Golomb
Nick Woods
Cheryl Kim

The last four digits of the entity's taxpayer ID number:  0409

What is the dollar amount of the request?  $500,000

What type of request is this?  General Appropriation

Is this entity in good standing with the Secretary of State?  Yes

Provide the name of each member of the recipient entity's governing board and officers:
           BOD: Mary Ann Christopher (8300 Esters Blvd, Suite 900, Irving, TX, 75063)
BOD: Victor Patterson (8300 Esters Blvd, Suite 900, Irving, TX, 75063)
BOD: Jeremy Delinsky (8300 Esters Blvd, Suite 900, Irving, TX, 75063)
BOD: Mike Krupka (8300 Esters Blvd, Suite 900, Irving, TX, 75063)
BOD: Josh Golomb (8300 Esters Blvd, Suite 900, Irving, TX, 75063)
BOD: Jeannie Chen (8300 Esters Blvd, Suite 900, Irving, TX, 75063)
BOD/CEO: Iyah Romm (8300 Esters Blvd, Suite 900, Irving, TX, 75063)
Secretary: Jeff Sinko (8300 Esters Blvd, Suite 900, Irving, TX, 75063)
Treasurer: Abigail Andrews Flinn (8300 Esters Blvd, Suite 900, Irving, TX, 75063)
President: Andrew Post (8300 Esters Blvd, Suite 900, Irving, TX, 75063)

Provide a summary of the project or program:
           In partnership with St. Tammany Parrish School District, Hazel Health, is launching a pilot telehealth program aimed at expanding access to mental health services for students.
Key Objectives:
• Provide timely mental health services to students directly in schools via secure telehealth technology and/or at-home.
• Reduce absenteeism and improve academic performance by addressing behavioral health concerns quickly and efficiently.
• Support school staff and families by offering an accessible, school-based healthcare solution.
Implementation:
• Launch targeted for the beginning of the 2025–2026 school year.
• Services to be delivered by Hazel Health’s team of Louisiana licensed providers in coordination with school personnel.
• Student referrals will be based on clinical need, with parental consent and consideration of family preferences such as language and cultural fit.
• A phased rollout will allow for feedback, refinement, and scale.
This pilot reflects a collaborative effort between state leaders, school district officials, and healthcare partners to innovate student health services and ensure every child is ready to learn and thrive.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $0
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $500,000
          Other Charges. . . . . . . $0

Does your organization have any outstanding audit issues or findings?  No

If 'Yes' is your organization working with the appropriate governmental agencies to resolve those issues or findings?
          Not Applicable

What is the entity's public purpose, sought to be achieved through the use of state monies?
          Hazel Health’s public purpose is to expand access to mental health care for students by delivering services directly in schools or at home. The program is designed to reduce barriers to care and ensure students have timely access to high-quality mental health support.

State funding allows Hazel to offer these services at no cost to families in St. Tammany Parish, supporting student success and reducing strain on school staff. Services are available to all students, regardless of insurance status, and are delivered by licensed providers. All care is delivered through a secure platform that is fully HIPAA- and FERPA-compliant.

What are the goals and objectives for achieving such purpose?
          Hazel Health’s goal is to partner with schools and families to provide high-quality virtual mental health care that helps students stay engaged in learning.

Key objectives include:
- Provide timely access to therapy during and beyond the school day.
- Support students with short-term, goal-focused care tailored to their individual needs.
- Refer students to additional services when more support is needed.
- Keep families involved and informed throughout the care process.
- Track progress and adjust care to support strong student outcomes.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           Hazel Health’s model is designed for fast and effective implementation. Typically, schools are fully operational within 8-10 weeks of contract signature and milestone alignment.

If any elected or appointed state official or an immediate family member of such an official is an officer, director, trustee, or employee of the recipient entity who receives compensation or holds any ownership interest therein:
     (a) If an elected or appointed state official, the name and address of the official and the office held by such person:
                 N/A
    
     (b) If an immediate family member of an elected or appointed state official, the name and address of such person; the name, address, and office of the official to whom the person is related; and the nature of the relationship:
                 N/A

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                 N/A

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                  N/A

If the recipient entity has a contract with any elected or appointed state official or an immediate family member of such an official or with the state or any political subdivision of the state:
(a) If the contract is with an elected or appointed state official, provide the name and address of the official and the office held by such person: 
               N/A

(b) If the contract is with an immediate family member of an elected or appointed state official:
          Provide the name and address of such person:
               N/A

          Provide the name, address, and office of the official to whom the person is related:
                N/A

          What is the nature of the relationship?  N/A

(c) If the contract is with the state or a political subdivision of the state, provide the name and address of the state entity or political subdivision of the state:
                

(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               As outlined in the project summary, this contract supports the delivery of Hazel Health’s school-based mental health pilot in St. Tammany Parish School District. Hazel will provide virtual mental health services through its HEART™ (Hazel Early Assessment and Response Treatment) Program, an evidence-based model designed for K–12 students.

Services provided under this contract include behavioral health assessments, short-term one-on-one virtual therapy sessions, crisis consultations for school personnel, family engagement and communication, and care coordination with community providers. All services are delivered by licensed mental health professionals through a secure, HIPAA- and FERPA-compliant telehealth platform and are available at no cost to families.


Contact Information
name:  Erin Davis 
                                       address:  8300 Esters Blvd, Ste 900 Irving TX, 75063
                                       phone:  913-271-1095
                                       fax: 
                                       e-mail:  erindavis@hazel.co
                                       relationship to entity:  VP Strategic Growth