May 18, 2021

NEED TO KNOW

American Academy of Pediatrics Holds Town Hall Conversations with Families on the COVID-19 Vaccine in Adolescents

The American Academy of Pediatrics Vermont Chapter (AAPVT) scheduled 13 forums this week throughout the state to provide factual information on the COVID-19 vaccine in adolescents and give families the opportunity to ask questions of their local pediatric practitioner. To date 6 forums have been held in Burlington, Middlebury, Central Vermont, St. Johnsbury and Newport. The conversation has been invaluable and the families have been incredibly engaged. Anyone can attend any of the forums, which will take place tonight through Thursday with the final forum taking place Sunday the 23rd. For a list of the forums with links to join click here.

AAPVT thanks all of the practitioners who have volunteered their evenings to answer questions from families, as well as Stephanie Winters, Breena Holmes, MD, and Wendy Davis, MD, Rebecca Bell, M.D. and Ilisa Stalberg (VDH) for hosting the sessions as well as all the school liaisons for coordinating. Based on the questions asked and feedback received, the AAP is optimistic that these sessions will contribute to increasing the vaccination rate among young Vermonters. 

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Scott Administration Lifts Mask Mandate for Vaccinated and Expands Walk-In Vaccination Opportunities Across the State

Last week, Governor Phil Scott signed an executive order lifting the State’s mask mandate and physical distancing requirements for fully vaccinated individuals in Vermont. The announcement came after the release of updated guidance from the Centers for Disease Control and Prevention (CDC) and became effective as of May 15th, 2021. Masks will still be required in schools, healthcare settings, long term care facilities, correctional facilities and on all modes of public transportation. The mask mandate remains in place for unvaccinated or partially vaccinated citizens, including children who are not yet eligible for a vaccine. Vermont businesses and municipalities can continue to require people to wear masks if they choose. The Governor also announced last week that with over 60% of the Vermont population vaccinated, the State will advance into Step 3 of the Vermont Forward Plan roughly two weeks ahead of schedule, which removes testing requirements for travel and increases gathering size restrictions. The State opened eligibility for Vermont adolescents 12-15 years of age to receive a Pfizer COVID-19 vaccination last Thursday and the Vermont Department of Health (VDH) worked collaboratively with the Agency of Education to develop school and community-based vaccination clinics in every region of the State. Click here for the listing. The American Academy of Pediatrics Vermont Chapter is strongly encouraging parents to get their 12-15 yr old vaccinated and as mentioned above are holding family forums on the COVID-19 Vaccine in every region of the State between May 13th and -May 23rd.  VDH continues to create more walk-in opportunities to receive a COVID-19 vaccine, specifically targeting Vermonters in the 18-29 age group, which lags behind the majority of the population in vaccination rates. Please urge your patients to get their vaccine and click here for the current walk-in clinic offerings.

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State Expands Vaccine Access to Independent Primary Care Practices

Starting May 19th, nine independent, primary care practices will receive the Moderna COVID-19 vaccine as part of a pilot program. Of note, because adolescents are only eligible to receive the Pfizer COVID-19 vaccine, no pediatric practices are included in this initial pilot. According to VDH, the rollout of the COVID-19 vaccine program will be expanded in the near future to all independent practices that are interested in providing the COVID-19 vaccine to their patients. Practices must be enrolled in the Vermont COVID-19 Vaccine Program to be eligible. Please reach out to the Immunization Program at AHS.VDHImmunizationProgram@vermont.gov or for more information on the process, please check out the COVID-19 Vaccine Enrollment Process Guide and FAQs. One of the concerns for primary care offices was the storage requirements for the COVID-19 vaccine, but VDH guidance states that an enrolled practice can now store the vaccine for a more extended period. While the expectation is that you will assess patient need and attempt to administer the vaccine within a 2-week timeframe, Moderna and Janssen vaccines may be stored for many months in the freezer and refrigerator, respectively. Additionally, the Pfizer vaccine has submitted a request for EUA approval to expand its viability at refrigerated temperatures.

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Legislature Seeks to Finish Budget and Adjourn the 2021 Session This Saturday

The Vermont Legislature heads into what is forecasted as the final week of the 2021 legislative session with little left to complete except the FY22 Budget. The Budget Conference Committee began early Monday morning and continued to plow through small differences between the House and Senate versions of the budget, contemplating replacing allocations of federal American Rescue Plan Act (ARPA) funds, with higher-than-expected State revenues. This action is due in part to the Scott Administration's desire for a more comprehensive plan on how to spend the approximate $1 billion in federal funds and also for the legislature to gain a better understanding of recent federal guidance outlining how such funds can be used. The VMS is pleased to report the budget includes ongoing funding for the primary care physician scholarship program. After the legislature adjourns, the VMS will publish a final Legislative Bulletin with a comprehensive status of all of our priority bills and proposals. Here is an update on some of the final proposals we are watching this week:  

  • J.R.H. 6, a joint resolution declaring racism as a public health emergency passed the Senate Health and Welfare Committee Monday, after passing the House last week. The resolution now advances to the Senate floor. 
  • S.3, the forensic mental health system bill, passed the House last week and will go back to the Senate for concurrence on Wednesday. The Senate Judiciary and Health and Welfare Committees reportedly have additional amendments, which could hold up the legislation. 
  • S.22, a bill aimed at ensuring patients have accurate information regarding risks and FDA-approval status of stem cells administered outside of clinical trials, passed the House today and advances to the Senate for concurrence. 
  • Children’s mental health – the House Health Care Committee, along with the Agency of Education and the Vermont Association of Hospitals and Health Systems, sent a letter to the Agency of Human Services with immediate, short-term and long-term recommendations to better support parents and children in need of mental health care and end children being subjected to long emergency department wait times.
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Recent COVID-19 Guidance and Resources:

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

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

MISC.

VMS Member Survey: the Final Reminder This Week!

We need to hear from you! What policy issues are most impacting you and your patients right now? Surviving COVID downturns in patient volume? Patient mental health needs? After taking last year off due to the pandemic, VMS is back with our annual member survey. Our advocacy is only as strong as the information our members provide us! Please take 5 minutes to fill out a new streamlined survey that will help shape VMS 2021-2022 priorities. This week, every VMS member who did not fill out the survey will be emailed a final survey link from SurveyMonkey. You have until May 27th to complete the anonymous survey.  If you have not received a link to the survey please email Elizabeth Alessi at ealessi@vtmd.org for assistance.  Thank you for helping VMS serve you!

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Green Mountain Care Board Vacancy – Health Professionals Encouraged to Apply

With a vacancy expected in September 2021 at the expiration of Board member Maureen Usifer’s term, VMS is strongly encouraging health care professionals to apply for an open seat on the Green Mountain Care Board. The opening has not yet been posted, however a job description for prior openings can be found here. The annual salary for a board member is currently $107,000 and Board members can be part-time and have outside work. Board members may practice medicine and be a non-management employee of a hospital or other health care facility, but would be required to recuse themselves from any Board matters which involve their employer. Candidates need not resign these positions prior to accepting a position. Candidates who apply will first be reviewed by a Nominating Committee; qualified candidates are then forwarded to the Governor, who makes Board appointments with the consent of the Senate. More information on the nomination process can be found here. If you have questions or want to suggest candidates, please contact Jill at jsudhoffguerin@vtmd.org. 

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AMA Wants to Hear From You as Medicare Begins Advance Payment Recoupment

The Centers for Medicare and Medicaid Services (CMS) recently began automatic recoupment of COVID-19 Accelerated and Advance Payments, which were an advance of up to three months of Medicare payments to help physician practices keep the lights on early in the COVID-19 pandemic. The American Medical Association (AMA) and the Federation of State Medical Societies strongly advocated for improved repayment terms, which Congress and CMS adopted in 2020. Under the revised repayment terms, physicians should be aware that:

  • These funds are loans that are required to be repaid.
  • Repayment begins one year from when the Medicare advance payment is received, rather than 120 days under the original terms.
  • The per claim recoupment amount was reduced from 100% to 25% for the first 11 months, and then 50% for an additional six months.
  • If there is an outstanding balance after the 17-month recoupment time frame, the Medicare Administrative Contractor (MAC) will issue a demand letter requiring repayment subject to an interest rate of 4%, a decrease from the original interest rate of 10.25%.
  • Physicians may repay the Medicare advance payment in full at any time by contacting their MAC.

The AMA is very interested in feedback about recoupment of the Medicare advance payments. Please share your feedback with Jessa Barnard at jbarnard@vtmd.org and we will forward to the AMA. 

For more information about the programs established by the federal government to help physician practices offset the financial impact of COVID-19, access these AMA resources. 

National Government Services has also developed a Part B COVID-19 Accelerated and Advanced Payment, Repayment and Recoupment Process YouTube Video to address common questions. 

          EVENTS

          This Week: Join us for the VMS May 2021 Webinar: What You Have Missed in Compliance!

          This Thursday, May 20, 2021 from 12:00 pm to 1:00 pm VMS will host our May webinar "What You Have Missed in Compliance!" with presenters Anne Cramer and Shireen Hart. After a year of enormous disruption and change, this program will educate you on areas of critical federal and state regulatory changes for physician practices in 2021, including:

          • New informed consent requirements for audio-only telehealth
          • New information blocking rules
          • Vaccine mandates
          • Employment law changes

          Bring your questions for top health care law experts! Click here to register. 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.

          Building and Cultivating Culturally Effective Organizations

          May 26th, 1:00 - 3:00 PM

          Register today!

          Join Northern Vermont AHEC for the final session in 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 5 and/or learn more about each monthly activity click here. 

          2021 Northern New England Society of Addiction Medicine Virtual Spring Scientific Session

          Saturday, June 5th, 2021

          8:00 am-12:15pm 

          Registration now open for NNESAM's 2021 Spring Scientific Session. This virtual event will take place on Saturday, June 5th, 2021 and will be followed by 
          an hour long NNESAM Business Meeting at 12:30 p.m.           The American Society of Addiction Medicine has designated this live activity for a maximum of 4 AMA PRA Category 1 Credits. NNESAM is a VMS-managed Specialty Society as of January, 2021. Register here. 

          VCP 2021 Webinar Series: May 27: Collaborative Documentation with Kids and Families Northwestern Counseling and Support Services Children, Youth, and Family Services clinicians share practical advice and lessons learned on using Collaborative Documentation as a clinical intervention to improve engagement with children, youth, and families. Register here.

          June 25: How to Help Your Older Clients Improve their Sleep CSAC Medical Director Dr. Joe Lasek will provide information and strategies for assessing and promoting better sleep for your older clients, including pharmacological and non-pharmacological interventions for insomnia in the elderly. Register here.

          More details on these webinars are available at the VCP Events and Trainings site.

          Child Psychiatry and Family Medicine Conferences 

          14th Annual Child Psychiatry in Primary Care Conference – June 4 (virtual) 8:00-4:30pm Dr. David Rettew invites you to attend this year’s virtual conference on: Post-COVID Mental Health for children, School Violence Threat assessments, Integrated Care, The Science of Praising (and Overpraising) and more. Register here.

          Family Medicine Review Course – June 8-11 (virtual) 

          Dr. Anya Koutras invites you to attend this year’s virtual conference. Sessions cover a wide-range of topics including, among many others: anxiety disorders, liver disease, cardiac testing, neuropathy, opiates, hospice care, racism and health inequities, adolescents on the gender spectrum, Type 2 diabetes, and musculoskeletal telemedicine. See the entire program at the event webpage.

          VPQHC Expands Health Equity Training Offerings Due to High Demand!

          The Vermont Program for Quality Health Care (VPQHC) has expanded the free health equity training offerings that qualify health care professionals 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 is currently waitlisted through May. Register here.

          Special Enrollment Period Now Until August 15th, 2021

          Due to the COVID-19 emergency, Vermont Health Connect has opened a Special Enrollment Period through August 15, 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.

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          Vermont Medical Society

          134 Main Street

          Montpelier, VT 05602

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