January 19, 2021


Scott Administration Releases More Details for “Phase 2” Vaccination – Registration to Open Jan 25th

During the press conference last Friday, January 15th, Agency of Human Services Secretary Smith provided more details on what Vermonters can expect in the next stages of COVID-19 vaccination as the state approaches completion of Phase 1A. As previously announced, the State will be transitioning to the next phase of vaccination and will start with individuals age 75 or older. A statewide registration system will open on January 25th, with the first clinics being scheduled for January 27th. 

Registration will be available via an online system and phone call-in centers – Secretary Smith urged families to assist the process by using the online system to avoid the phone system being overwhelmed. Secretary Smith also urged Vermonters not to call their local hospital, physician or the Department of Health, as registration is not available through those avenues and will not open until the 25th. More details will be released closer to the 25th. Secretary Smith stated that approximately 49,000 Vermonters are 75 or over and it could take about 6 weeks to vaccinate this population since the state is only receiving 8-9,000 doses a week. Approximately 7,200 doses per week can be administered by state run clinics, which are in development now, with 12 locations currently being planned across the state. 

Details are also being developed to make vaccines available at other sites, such as hospitals and pharmacies. After those 75 and older are vaccinated, the same system will be opened up for those 70+, then 65+, modifying the pacing of the age bands based on vaccine dose availability. The state expects to complete those age 65 and older by the end of winter (March/early April). After age 65+, the state will expand to those age 18-65 with medical conditions that put them at risk of severe illness as recognized by the CDC (meaning risk of hospitalization, admission to ICU, ventilation or death). Department of Health Commissioner Mark Levine stated that Vermont is prioritizing the following conditions:

  • Current cancer
  • Chronic kidney disease
  • COPD Heart conditions such as heart failure
  • Immunocompromised state such as related to organ transplant
  • Severe obesity
  • Type 2 diabetes
  • Pregnancy
  • Down syndrome
  • Sickle cell disease

Click here for full notes from the press conference.


Primary Care Role in COVID 19 Vaccine Administration

Vermont Medical Society staff continues to meet with Vermont Department of Health Staff to clarify the role of primary care practices in administering the COVID-19 vaccine. At this point, while the dose supply received in Vermont remains extremely limited, the plan is to administer the vaccine through community vaccination sites operated by the state or state contractors. An RFP is currently open for partners able to help provide regional or statewide vaccination logistics, with the deadline to respond to the RFP being today, January 19th. Frequently Asked Questions responding to the RFP clarify that practices do not need to submit a proposal if they intend only to vaccinate their own patients, in which case they should enroll in the vaccination program. This RFP seeks proposals supporting state-wide vaccination efforts; public or community vaccination sites that involve offering vaccine administration to more than a provider’s patient panel; and requires use of the State’s registration system (or a functionally similar system).

Additional updates include:
    • The Vermont Department of Health is planning to provide a communication for primary care practices to give to patients who have questions about how to register for vaccines, how to answer screening questions asked when registering; and with more information about the high risk conditions that may allow patients to qualify.
    • The Vermont COVID 19 Vaccine Implementation Advisory Committee met on Friday, January 15th and focused on refining the list of high risk chronic conditions – the Committee will meet again on January 29th.  


    Recent COVID-19 Guidance and Resources:

    VMS Weekly Zoom with Commissioner of Health, Thursdays at 12:30 pm


    Policy for Practices to Obtain COVID-19 Test Results

    VDH has created a policy for clinicians to obtain COVID-19 test results on a patient tested through the on-demand (CIC) or pop up (VDH) testing sites. Providers should first check VITL for any testing completed through Dr. Levine’s orders – this will be the most expedient and immediate way to access results. If they do not have access to VITL, and cannot gain access to VITL, then the provider may contact: ahs.vdhhoccovidresultsletters@vermont.gov and provide the name and date of birth of their patient and the request for their results in order to help treat that patient.” This was brought to the attention of VMS Friday and we will work with VDH to understand this process more.  We realize that this will present more administrative burden to practices, but currently there is no mechanism for alerting a primary care provider when a test has occurred except for patient self-attesting.


    Competency to Stand Trial Bill Has First Hearing in Senate

    Last Thursday, January 14th, the Senate Judiciary Committee held an introductory hearing on S.3 (this year’s forensic mental health bill). This year’s bill appears to have broad support in the Committee and from the Department of Mental Health (DMH), among other stakeholders. Last year’s forensic mental health bill passed the full Senate, but stalled during the COVID-19 public health emergency and was not taken up in the House. VMS and the VPA specifically support the inclusion of the creation of a forensic mental health system in Vermont. S.3 proposes the creation of a forensic mental health workgroup, which would be charged with analyzing solutions applied in other states in order to identify an effective methodology to create a forensic mental health system for Vermont. Other mental health bills introduced this session are:

    • H.1, an act relating to mental health insurance benefits.
    • H.2, an act relating to an integrated mental health budget.
    • H.7, an act relating to a forensic mental health working group.
    • H.19, an act relating to competency to stand trial.


    HHS’ New Guidance Eliminates Need For Federal Waiver to Prescribe Buprenorphine

    According to NPR, the Trump Administration introduced new addiction treatment guidelines last Thursday, designed to improve access to medication-assisted treatment(MAT) for opioid use disorder (OUD). The guidance gives clinicians more flexibility and eliminates a long-standing requirement that physicians obtain a special federal waiver in order to prescribe buprenorphine. Under these new guidelines, doctors who possess a Drug Enforcement Administration registration will still be limited to treating no more than 30 in-state patients with buprenorphine for addiction treatment at any one time. Nurse practitioners or physician assistants will still need to apply for separate waivers to prescribe buprenorphine. To read the NPR article, click here.


    New Paycheck Protection Program Resources 

    The Paycheck Protection Program (PPP) reopened for new and existing borrowers the week of January 11th, 2021 and will accept applications through March 31, 2021 from participating Community Development Financial Institutions (CDFIs), Minority Depository Institutions (MDIs), Certified Development Companies (CDCs), and Microloan Intermediaries. This application period of the PPP is first come, first serve and will accept First Draw PPP loan applications from small businesses with 500 or fewer employees and Second Draw PPP loan applications from small businesses with no more than 300 employees who have already received a first draw loan. For the latest information, please go to the Vermont Agency of Commerce and Community Development. The following resources are available to assist with the application process:

    Commissioner Call Update VMS weekly calls with Vermont Department of Health Commissioner, Mark Levine, M.D. are held each Thursday from 12:30-1:00 p.m. on ZOOM - click below for the virtual meeting address that will remain constant each week. 

    Once a month, VMS will feature a guest speaker during this call time, as the Commissioner has a conflict. The speaker will discuss clinical protocols and best practices during the State of Emergency.

    Join Zoom Meeting -https://us02web.zoom.us/j/86726253105?pwd=VkVuNTJ1ZFQ2R3diSVdqdlJ2ZG4yQT09

    Meeting ID: 867 2625 3105 / Password: 540684

    Dial In: 1 646 876 9923 / Meeting ID: 867 2625 3105 / Password: 540684


    DVHA Seeks Comments on Proposed Medicaid Next Generation ACO Program Rule

    The Department of Vermont Health Access (DVHA) recently released a call for comments on proposed Vermont Medicaid Next Generation (VMNG) ACO updates, including the PMPM rates for CY 2021. DVHA is entering the fifth year of the Next Generation ACO and the proposed rule includes these updates: 

    1. The value-based component of the program will be modified to include both a Value-Based Incentive Fund (as in previous years) and an additional Year-End Quality Adjustment to link ACO quality performance to financial accountability.
    2. The risk corridors will decrease for both the Traditional Attribution Cohort (from+4% to+2%) and the Expanded Attribution Cohort (from an asymmetrical risk corridor with 2% upside and 1% downside risk to a symmetrical risk corridor of+1%).
    3. Additional COVID-19 provisions will be made to the payment provisions of the contract to align with Medicare’s approaches for their 2021 ACO programs.

    These rates and changes are effective January 1, 2021, but the comment period is open until February 1, 2021. Please send your comments to Jill Sudhoff-Guerin at jsudhoffguerin@vtmd.org by January 28, 2021.

        Spotlight on VMS Member Benefits: Are You Seeking a Reliable PPE Supplier?  Check the VMS PPE Purchasing Options

        As the COVID-19 pandemic continues, we know reliable sourcing of PPE is a critical tool in continuing to maintain a safe treatment environment for your patients and a safe working environment for your staff. Understanding Vermont medical practices may be struggling to procure various items of PPE and that both availability and cost continue to be an issue, VMS pleased to offer discount group purchasing options now available to our members. Please click here for our VMS PPE Purchasing Options


        This Thursday! VMS January 2021 Webinar: Emerging Information on COVID-19

        Please join us on Thursday, January 21, 2020 from 12:00 pm to 1:00 pm for our VMS January webinar, "Emerging Information on COVID-19." Patsy Tassler Kelso, PhD, the State Epidemiologist for Infectious Disease at the Vermont Department of Health (VDH), will discuss how COVID-19 has developed, spread, and led to necessary public health changes in Vermont. The discussion will be drawing on Vermont's public health expertise and cover emerging issues related to COVID-19 epidemiology and vaccine distribution. To register click here. To see the entire VMS Thursday Webinar series for 2020/2021 click here. This webinar will take place at the same time VMS is hosting our scheduled Commissioner Call. We will provide both events as opportunities for VMS members to obtain up-to-date information regarding the COVID-19 pandemic.


        Do You Want to Be In the Room Where It Happens? 

        Are you passionate about a current health policy issue? Don't forget you are in the "Room where it happens:" the exam room! Your medical expertise makes you uniquely qualified to become a health advocate and to help lead evidence-based health care policy change. This February, VMS will host four weeks of virtual advocacy actions on each Thursday of the month as part of VMS Advocacy Month. Join us, as your voice is critical to improving care for Vermonters, Vermont’s health care system and the practice environment. Advocacy actions include:

        • Feb. 4th- Join the Vermont House and Senate in recognizing the dedication of Vermont’s health care workers during the COVID-19 pandemic.
        • Feb.11th- Participate in an Advocacy training with legislative leaders and physician advocacy experts. Register here
        • Feb. 18th- Register for our Race and Health Equity webinar for screening tools that promote anti-racism.
        • Feb. 25th-  Engage in our Town Hall discussion with our invited Congressional delegation. 

         For more information and resources for VMS Advocacy Month click here.

        Making the Case for Health Equity in VT: From Evidence to Action

        January 28th, 1:00 - 3:00 PM

        Join Northern Vermont AHEC for the second session of a 5-part virtual series, Quality Care is Equitable Care: The Case for Culturally and Linguistically Responsive Health Care, targeting Vermont health care practitioners and partners. To register for Session 2 and/or learn more about each monthly activity click here. 


        Vermont Medical Society

        134 Main Street

        Montpelier, VT 05602

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