February 2, 2021

NEED TO KNOW

Join VMS on February 11th for our 2021 Virtual Advocacy Training

Are you passionate about health care policy issues? Fired up about public health? Are you curious about how you craft a successful advocacy message? Please join us Thursday, February 11th from 4-6pm for our 2021 Virtual Advocacy Training. We will start by hearing from these Vermont legislative leaders, who will give us insight on what makes an effective legislative message:

Attend member-led breakouts in which you will craft and practice delivering your own message on one of these three VMS policy priorities:

  1. Access to Reproductive Health - w/Lauren MacAfee, M.D.
  2. Injury Prevention  - w/Becca Bell, M.D. 
  3. Mental Health - w/Simha Ravven, M.D. 

Click here to learn more about this event where your colleagues will share simple tools to help you craft cogent, effective communication strategies. Click here for the 2021 VMS Advocacy Toolkit for the training curriculum. 

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Action Alert: Ask the Legislature to Continue Reimbursement for Phone-Only Medical Services

During the COVID-19 state of emergency, the Department of Financial Regulation has required that Vermont insurers reimburse for nearly all medical services delivered with audio-visual telehealth and audio-only telephone. The House Health Care Committee is currently discussing whether to require insurance companies to continue to reimburse for phone-only medical services beyond the period of the emergency. A number of medical professionals and organizations testified in favor of this proposal last week. Your voice is now needed to stress the importance of insurance coverage for this lifeline to services. Please contact members of the House Health Care Committee today to share stories of how being able to provide care via telephone will continue to be needed after the pandemic. Other themes to share with Committee members include:

  • Equity (we know that older, minority and lower socio-economic status individuals are most at risk for lacking broadband or the technology to connect with video)
  • Patient preference (some patients prefer to connect without video)
  • Reimbursement continuing at the same rate with in-person services (it can take the same if not more effort, time, staffing to serve patients via telehealth)
  • Standard of care (the same standard of care applies regardless of the modality and clinicians have the skills to screen patient to see if they can address an issue via phone vs in-person)

House Health Care Committee members’ email addresses are: wlippert@leg.state.vt.us; adonahue@leg.state.vt.us; LHoughton@leg.state.vt.us; ablack@leg.state.vt.us; eburrows@leg.state.vt.us; bcina@leg.state.vt.us mcordes@leg.state.vt.us; lgoldman@leg.state.vt.us; elong@leg.state.vt.us; wpage@leg.state.vt.us; apeterson@leg.state.vt.us

Contact Jessa Barnard at jbarnard@vtmd.org with any questions or concerns.

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Governor's COVID-19 Vaccination Update Providing Cautious Optimism 

Governor Scott announced positive developments during today's press conference, as the Biden Administration is going to increase the State's COVID-19 vaccine allotment by another 5 percent, which means that the State will receive roughly 22% more vaccine over the next 3 weeks than recently received. The federal government also promised to provide Vermont with the specific syringes necessary to get the extra dose out of the Pfizer vaccine vials and retroactive 100 percent reimbursement for FEMA operations, which could mean that millions of dollars come back to Vermont. The federal government will also be directly providing approximately 10% more vaccine to Vermont pharmacies to be utilized in Vermont over the next few weeks. Vermont has currently vaccinated approximately 10 percent of our entire population, with 35,000 Vermonters receiving a first dose and 19,000 receiving their second dose. Approximately 34,000 Vermonters in the 75+ age band have registered for their vaccine, with 14% of this age band receiving their first dose. AHS Secretary Mike Smith announced that they are opening more vaccination sites across the State, with the goal of everyone having one within 30 minutes of their home. VDH Commissioner Mark Levine and Secretary Smith said 37 of the skilled nursing homes are almost entirely vaccinated, and high percentages of the residents at residential and assisted living facilities. AHS is also working with the CDC and CMS on guidance to open up shared dining and visitation opportunities for people at long-term care facilities. All Vermonters in the 75+ age band are encouraged to register for their COVID vaccine today. Patients should go to this website to register.

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COVID 19 Vaccine Registration: Screening Questions and Primary Care Concerns

Blood Thinner and Vaccination Registration – VMS heard from many members with concerns regarding the question about blood thinners on the registration form, which directed patients to discuss concerns with their primary care practitioners (PCPs). As blood thinners are not a contraindication for vaccine administration, this direction was causing undue call volume to PCPs. After discussions with VDH, VMS learned that questions regarding blood thinners will no longer be included in the registration system at all, but each patient will be asked whether they are on blood thinners at the vaccination sites using the CDC vaccination checklist.

Registering for Vaccine without Email / Care Coordinator Registration of Patients - Currently, the only way for Vermonters over 75 yrs old who do not have an email address to register for their COVID-19 vaccination is to call 855-722-7878. If a patient without an email address has a family member or friend who can add them as a dependent, they can be registered that way. VMS will continue to work with VDH to think about ways to allow care coordinators to help register people without email addresses but for now the process is to register patients through the phone line listed above.

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VMS Thursday Call to Address COVID-19 Vaccine Adverse Reactions

Please join VMS this Thursday, February 4th at 12:30 pm for a discussion on how best to advise patients with a history of an allergic reaction to vaccines, who are currently not able to register for a COVID vaccine and to learn more about the higher rates of axillary adenopathy being reported after the administration of COVID-19 vaccines. We will hear from: 

  • Dr. Elizabeth Jaffe, M.D., Allergy and Immunology Specialist at Timberlane Allergy and Asthma Clinic; and
  • Dr. Sally Herschorn, M.D., Radiologist and Co-Division Chief and Medical Director Breast Imaging at UVMMC. 

This discussion will occur during our regularly scheduled call with Commissioner Levine who is unavailable this Thursday. Please click below to attend the ZOOM meeting: 

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

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    VDH Publishes Screening Policy for Health Care Workers in Phase 1A

    Monday, February 1st, 2021 the Vermont Department of Health (VDH) published guidance, providing the latest screening criteria to determine which health care clinicians are eligible to qualify for the Phase 1A COVID-19 vaccination group. If a patient is not eligible based on the screening questions outlined in the guidance, they will need to wait for a new phase of the vaccine rollout in which they meet eligibility criteria. If you are a 1A-qualified individual please contact your hospital to schedule your vaccine now.

    Other hospitals – contact Elizabeth Alessi at the Vermont Medical Society for contact information: ealessi@vtmd.org.

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    Recent COVID-19 Guidance and Resources:

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

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    Legislature Begins Tackling a Myriad of VMS Priorities

    With almost a month of meeting remotely, the Vermont Legislature has begun to take action on 2021 legislation. Last week, three VMS members testified during two different Committee hearings. VMS Vice-President Ryan Sexton, M.D., Emergency Physician at Northeastern Vermont Regional Hospital, testified in the Senate Judiciary Committee in support of S.30, a bill that would prohibit the possession of firearms in hospitals, childcare centers and government buildings. Joe Lasek, MD, and Elizabeth Hunt, M.D., testified in the House Health Care Committee in support of equitable reimbursement for audio-only telehealth coverage (please see action alert above). This week the VMS Executive Director will testify in a joint hearing of the Senate Health and Welfare and House Health Care Committees on extending COVID-19 emergency regulatory flexibilities until March 2022. The following week we expect hearings on S.24, the flavored tobacco ban bill, and S.3, the forensic mental health bill. 

    MISC.

    Vermont Medicaid Seeking Input on How to Improve Medicaid Program

    Vermont’s Global Commitment to Health 1115 Demonstration waiver expires at the end of 2021. This is an agreement between the Centers for Medicare and Medicaid Services (CMS) and the Vermont Medicaid program giving Medicaid flexibility in how it uses federal funds. A new application must be submitted to CMS the by June 30th, 2021. In advance of drafting the renewal request, the Vermont Agency of Human Service (AHS) is holding an open meeting on February 25, 2021 from 2:00 to 3:30pm to hear from stakeholders. The meeting will focus on answering “what would improve Vermont’s Medicaid program related to your/your constituency’s goals?” Proposals should include:

    1. What is the problem you are trying to address?
    2. What is your proposed solution to the problem?
    3. How does this promote: transformation to value-based payment, improved care coordination, promoting public health/prevention or increasing access to care?

    More information can be found here and comments can also be submitted in writing to Jill at jsudhoffguerin@vtmd.org by February 23, 2021.

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    Second Round 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. 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. 

          EVENTS


          VMS February 2021 Webinar: Race and Health Equity


          Please join us on Thursday, February 18, 2020 from 12:00 pm to 1:00 pm for our VMS February webinar on "Race and Health Equity." Please join Dr. Becca Bell, President of the American Academy of Pediatrics Vermont Chapter, for a discussion on the task force created by the AAP Vermont Chapter on race and health equity. The task force has focused on developing guidance and resources for practices working towards creating a culturally safe medical home for families experiencing racism. The task force has also created screening tools for clinicians to identify bias and to promote anti-racism practices. 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. 


          VPQHC Telehealth Office Hours

          Wed., February 3rd, 12:00 - 1:00 PM

          Lisa Bard Levine from the MAVEN Project 


          VPQHC will host a special guest for the February Monthly Telehealth Office Hours. The MAVEN Project combines clinical consultations between primary care providers and specialists, mentoring / coaching for individual providers, and educational sessions designed for practices' needs. The calendar invitation is available from Mary McQuiggan at VPQHC marym@vpqhc.org. Here is the Zoom link: https://zoom.us/j/206326018

           

          AMA Invitation to Fireside Chat with Dr. Fauci - February 9th


          On February 9 from 12:00 - 1:00 pm EST, the American Medical Association and COVID Collaborative is hosting a Fireside Chat with Dr. Anthony Fauci entitled "COVID-19 Action in the Biden Era." Dr. Fauci will answer questions about how the new administration is approaching the crisis and there will be a moderated Q&A during which time you can ask Dr. Fauci questions through the chat function. To RSVP, please visit this link

          VTMD.ORG

          Vermont Medical Society

          134 Main Street

          Montpelier, VT 05602

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