The SAAHI team works to improve adolescent and young adult (AYA) health care throughout Vermont. In its earlier years, known as the Youth Health Improvement Initiative (YHII), the initiative focused on increasing the skills and confidence of providers (pediatricians, family medicine physicians, nurse practitioners, office staff) in providing comprehensive preventive health visits for AYA, including screening for risks, and assessing strengths. Currently, our efforts are focused on cultivating the VT RAYS (Youth Health Advisory Council) in order to create interest and value in high quality preventive health services among youth and elevate the voice of Vermont’s youth through increased youth engagement and youth empowerment. Additionally, the SAAHI team supports quality improvement efforts around: a) addressing youth nicotine use (vaping); b) VDH’s injury prevention priorities; and c) strengthening collaboration among schools and medical homes.