March 9, 2021

NEED TO KNOW

Next Week: VMS Thursday Webinar for March: "Practicing in a Pandemic: A Panel Discussion 

Please join us to hear from four Vermont physicians, on how they've adapted their practice during the COVID-19 pandemic on Thursday March 18th from 12pm-1pm. Join speakers Trey Dobson MD, Matthew Prohaska MD, FAAOS, Wendy Davis MD, Katie Marvin MD to discuss their work during this past year and how they've gained new insight and perspective along the way. This panel will allow for in-depth discussion and cover these topics:

  • Lessons in Leadership & Communication Garnered During the Pandemic: Dr. Dobson discusses how to motivate and inspire staff which results in better outcomes. 
  • Adapting Orthopaedic Care to The COVID World with Dr. Prohaska: Although the medical environment changed due to COVID-19, hips and knees continued to cause pain and dysfunction requiring adaptations at every level, including same day joint replacements.
  • VCHIP & Pediatric Community Perspective: Dr. Davis will discuss the VCHIP collaborative work on disseminating timely information during a pandemic.
  • Primary Care & Telehealth: Dr. Marvin will present a firsthand account of the effect of the pandemic on primary care and the way in which telehealth was utilized during the pandemic.

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. 

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Vermont Legislature Returns to Crossover Week Prepared to Pass Priority Bills

After a brief respite for their respective Town Meetings, Vermont lawmakers are preparing for a hectic week, in which they will be focused on getting priority bills across the "crossover" finish line. The crossover deadline this year is March 12th and requires legislation to have passed out of the first chamber's policy committees in order to continue to advance this legislative session. Appropriations and tax committees have until March 19th to move their bills and crossover deadlines are often subject to other exemptions. The added anticipation of the passage of President Biden's stimulus package this week has lawmakers speculating the 2021 session will either run longer than usual or they will need to return to work this Fall in order to determine how best to allocate a potential $1.25 billion coming to Vermont for additional COVID-19 recovery. The VMS is starting this week with relief, as the Senate Health and Welfare Committee voted 5-0 to pass legislation extending most of the COVID-19 emergency flexibilities to March 2022. This bill includes a compromise on extending insurance coverage for audio-only telehealth services, which will allow the Department of Financial Regulation (DFR) to adopt rules regarding reimbursement for these services for insurance plan years 2022, 2023 and 2024. Although reimbursement parity for audio-only telehealth services is not required in the Senate version of the bill, the bill urges DFR to provide adequate reimbursement to allow practitioners to be able to continue to provide medically necessary care through this medium. This bill now goes to the full Senate for a vote and then needs to get through the House before March 31st. 

Other VMS Policy Priorities likely to advance this week include: 

  • S.3, a bill to create a forensic mental health system, is scheduled for a hearing and will potentially be voted out this week; 
  • S.22, a bill regarding health care practitioners administering stem cell products not approved by the U.S. Food and Drug Administration, is scheduled for a full-Senate vote tomorrow; 
  • S.25, a bill making changes to the cannabis commercialization bill, is being heard in the Senate Judiciary and Government Operations Committees this week and scheduled to be voted out by the end of this week;
  • S.24, the bill to prohibit the sales of flavored tobacco, is scheduled for a vote in the Senate Health and Welfare Committee, but reportedly has tepid support. Please email the Committee to let them know flavored tobacco products, including menthol, are NOT cessation products, rather they are used to initiate young Vermonters, who become addicted to these deadly products. Committee emails: VLyons@leg.state.vt.usrhardy@leg.state.vt.us
  • acummings@leg.state.vt.uschooker@leg.state.vt.usJTerenzini@leg.state.vt.us
  • S.30, a bill to prohibit the possession of firearms in hospitals is being considered in the Senate Judiciary Committee. Please let this Committee know firearms do not belong in health care settings! Committee emails: rsears@leg.state.vt.us; pbaruth@leg.state.vt.us; jwhite@leg.state.vt.us; anitka@leg.state.vt.us; jbenning@leg.state.vt.us 
  • S.53, a bill to provide a tax exemption for feminine hygiene products, passed the full Senate today and moves to the House for consideration;
  • H.104, a bill to provide for permanent interstate telehealth licensing flexibilities, is likely to be expanded to include all health care professions and become a study run by the Office of Professional Regulation; 
  • H.210, a bill to create a Vermont State Office of Health Equity and to require Continuing Medical Education that addresses cultural competency, is likely to pass the House Health Care Committee this week and advance to the House Appropriations Committee. 
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This Thursday AHS Expanding COVID-19 Vaccination to Vermonters Aged 16-64 with High Risk Health Conditions

At the Governor's press conference today, Secretary Mike Smith said after a sluggish number of COVID-19 vaccination registrations by Vermonters 55 and older with certain high-risk health conditions (HRHC), the State will open registration to Vermonters aged 16-64 with HRHC starting this Thursday, March 11, 2021. The State has estimated that there are approximately 75,000 people with HRHC in the full age band, but when only 10,000 people signed up yesterday, they made the decision based on vaccine supply and staffing to open vaccine registration to the full population of Vermonters between the ages of 16-64 with HRHC. Late last Friday, the Vermont Department of Health released a memo for practitioners outlining the registration process for patients with indicated HRHC (listed on page three of the document). They also included a list of ICD-10 codes that may be helpful in identifying and verifying those eligible for COVID-19 vaccination. Practices may be contacted beginning this week to verify a sample of patients as having HRHC. As of yesterday, teachers, school staff and childcare staff are also eligible to receive their COVID-19 vaccine at on-site school vaccine clinics or through the Walgreens pharmacy program. They can make an appointment only AFTER being contacted by school leadership or by the Department for Children and Families, who will provide a code. Appointments are required and the clinics cannot accept walk-ins. Secretary Smith anticipates these clinics will begin to ramp up pretty quickly. Last week, the Governor announced a loosening of restrictions on multihousehold gatherings for those who are vaccinated. Today, he said on Friday he will be announcing further loosening of restrictions on small gatherings that will have indications for restaurant capacities, as long as individuals maintain masks and 6 foot social distancing. 

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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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Behavioral Health Integration Study: Seeking Primary Care Participation

The Behavioral Health Integration (BHI) Collaborative, a partnership between the American Medical Association and seven other leading physician organizations, is launching a research study in 2021 to gather feedback and experiences from primary care and physician practices that are interested in integrating behavioral health care for their patients. The study will run through early April, and participation includes a 45-minute interview and completion of a series of online activities. Learn more and respond to a series of screening questions to see if your practice qualifies.

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

Mental Health and Wellness Supports Free for Vermonters in Need

We have all been stretched thin by the COVID-19 pandemic and many Vermonters are in need of mental and wellness support. COVID-19 is a FEMA grant funded program through Vermont Care Partners and the Vermont Department of Health that can offer your Vermont patients free services and resources to help people cope with the pandemic through education, emotional support and connections to community services that promote resilience, empowerment and recovery. Click here to learn more

MISC.

VDH Proposes Changes to MAT Rule: Hearing on April 2nd

The Vermont Department of Health proposed Rule 21P004 on March 3, 2021, which would amend the Medication-Assisted-Treatment (MAT) Rule to:

  1. Remove all patient load limits that are determined at the federal level and change periodically;
  2. Require providers with 100 clients to submit to the Department for review a continuity of care checklist to ensure they have an adequate plan for the continued care of their patients should there be an issue with a practitioner's ability to provide services; and
  3. Update terms, references, and formatting. 

For the proposed rule amendments click here. There will be a virtual hearing at 10:00 am on Friday, April 2nd. Please send any questions or suggestions on this rule change to Jill at jsudhoffguerin@vtmd.org

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DVHA Proposes Changes to Rules Regarding Non-Physicians Ordering Home Health, Etc.

The Department of Vermont Health Access (DVHA) has proposed changes to update Medicaid coverage requirements for home health services, durable medical equipment and medical supplies. These rules are being amended to allow non-physician providers working within their scope of practice to order and conduct the face-to-face visit as required by Medicare. There will be a virtual hearing on the rules listed below on April 7th at 12:00 pm. Please send any questions or suggestions on this rule change to Jill at jsudhoffguerin@vtmd.org

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VPQHC Launches Health Equity Training Starting in March

The Vermont Program for Quality Health Care (VPQHC) is offering free health equity training for health care clinicians that will qualify for 3 CME credits, entitled, "Structural Competence and Cultural Humility to Address Disparities and Inequities." This training is being provided by Dr. Maria Mercedes Avila, PhD, MSW, MED and will focus on increased awareness of biases, increased knowledge of cultural and linguistic competencies and increased knowledge of the link between racial inequities and health outcomes. This training is being offered on three different dates throughout Spring 2021. Click here to learn more. 

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Applications Open for Medical Justice in Advocacy Fellowship

The AMA and the Satcher Health Leadership Institute at Morehouse School of Medicine announced the inaugural Medical Justice in Advocacy fellowship aiming to advance equity and remove barriers to optimal health for marginalized people and communities. This collaborative educational initiative is open to eligible physicians and residents with a demonstrated interest in health equity and advocacy. Selected participants will receive a stipend of $15,000 and will be eligible for up to 28 CME credit hours. The deadline to submit applications is March 31, 2021. Learn more.

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New Information Blocking Rules Take Effect April 5 – Resources Available

New federal “information blocking” rules go into effect on April 5. To help organizations prepare, eight prominent industry groups have pooled their efforts to launch the Information Blocking Resource Center, a free online resource packed with helpful guidelines and documents.  Physician practices might want to start by reviewing American Medical Association resources such as What Is Information Blocking? and How Do I Comply with Info Blocking and Where do I Start? Physicians can experience info blocking when trying to access patient records from other providers, connecting their electronic health record (EHR) systems to local health information exchanges (HIEs), migrating from one EHR to another, and linking their EHRs with a clinical data registry. Patients can also experience info blocking when trying to access their medical records or when sending their records to another provider. Under the new rule, for nearly all electronic health information requests, physicians must respond and release patients’ medical records unless an appropriate exception can be identified and used. Vermont Information Technology Leaders (VITL) staff are available to talk with providers and health care organizations about both the ONC and CMS rule requirements that take effect this spring. Reach out to Maurine Gilbert at mgilbert@vitl.net

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DVHA Seeking Three Members for Medicaid Clinical Review Board

The Department of Vermont Health Access (DVHA) is seeking three new members to participate in the Governor-appointed Clinical Utilization Review Board (CURB). CURB members take part in examining existing medical services, emerging technologies, and relevant evidence-based clinical practice guidelines and make recommendations to the Department regarding coverage and appropriate medical necessity of services in the State's Medicaid programs. Additional information about the CURB such as meeting dates, agenda, and minutes can be found at https://dvha.vermont.gov/advisory-boards. Dr. Scott Strenio, Chief Medical Officer for DVHA and the State’s liaison to the Clinical Utilization Review Board can be contacted with additional questions via email at scott.strenio@vermont.gov


        EVENTS

        The Role of Telehealth in Expanding Access to Healthcare During the COVID-19 Pandemic: Considerations for Vaccine Uptake and Monitoring for Adverse Events

        Thursday, March 11, 2021

        2:00 pm - 3:00 pm 

        Please click on the Zoom link below to join: https://www.zoomgov.com/j/1600341756?pwd=N2JKc3pOcW1lSGdtWUJQVkRjREt0dz09

        For more information click here. 

        Bi-State Offers Virtual Diabetes Care Trainings on Thursdays from 2-3pm. Please contact Kaylana Blindow kblindow@bistatepca.org

        March 25, 2021

        "How to Maximize Diet Interventions for your Patients with Diabetes and Hypertension," Kate Bean, RD, CHWC, CDCES and Morgan Gosselin, MS dietetic intern

        April 8, 2021

        "Making Sense out of Sensors: A Review of Considerations for Use of Continuous Glucose Sensors," Donna Hunt, RRMC Diabetes Program

        "Perspectives on Connection, Compassion and Belonging"

        Howard Center 4th Annual Conference

        March 30, 2021

        9am-1pm

        Howard Center’s annual conference is designed for a broad audience, including mental health and healthcare providers, educators, clients and families, representatives of state and local government, law enforcement, the judiciary, and the general public. Click here for more information and to register. 


        Reducing Implicit Bias in Health Care: Moving Toward Equal Treatment

        April 8th, 1:00 - 3:00 PM

        Join Northern Vermont AHEC for the third session of a 5-part virtual series, Quality Care is Equitable Care: The Case for Culturally and Linguistically Responsive Health Caretargeting Vermont health care practitioners and partners. To register for Session 3 and/or learn more about each monthly activity click here. 

        2021 Rx Drug Abuse and Heroin Summit Goes Virtual

        April 5th-8th 2021

        The Rx Drug Abuse and Heroin Summit, the largest and most influential annual conference addressing the opioid and addiction crisis, is taking place online April 5-8. With overdoses increasing at alarming rates, this is a critical year for stakeholders to convene and discuss what is working in prevention and treatment. The virtual conference will feature four days of live education led by multi-disciplinary experts from across the nation. On-Demand access for 60 days will be available for the 75+ Sessions with live Q&A. Register now.

        Special Enrollment Period from Feb. 16-May 14th, 2021

        Due to the COVID-19 emergency, Vermont Health Connect has opened a Special Enrollment Period from February 16 through May 14 2021. During this time, any uninsured Vermonter can sign up for a qualified health plan through Vermont Health Connect. Qualified families can also get financial help paying for coverage. Please call us 1-855-899-9600 to learn more.

        VTMD.ORG

        Vermont Medical Society

        134 Main Street

        Montpelier, VT 05602

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