VPHP Medical Director Joe Lasek, M.D.: VPHP is Here to Assist You
I’m reaching out today to express gratitude for the lifesaving and often thankless work you all do a daily basis to support the health and well-being of Vermonters and doing so during a year that has been among most difficult most of us can remember. Through it all, you and so many of our fellow citizens have persisted in helping us get through this extraordinary time. But the stressful effects of the past year have taken a serious toll on many helpers and first responders.
While we have shown up to be there for others, many of us are struggling with a number of issues including anxiety, insomnia, post-traumatic symptoms and substance use. A recent study has showed that these difficulties are startlingly prevalent among health care providers (Source: here ). Though we would all tell our patients that getting appropriate support is both effective and necessary, health care professionals often shoulder their burdens on their own.
Vermont Practitioner Health Program is available as a confidential resource for referral recommendations or for more structured support if needed. Please contact us with any concerns you might have or if you have a concern about a colleague. We’re here to assist you. Here is the Confidential Phone Number: 802-223-0400. For more information click here or email Colleen Magne at cmagne@vtmd.org.
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VMS Member Survey Launching May 6th - What are your priorities? How is VMS Doing?
After taking last year off due to the pandemic, VMS is back with our annual member survey. 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? Our advocacy is only as strong as the information we get from our members. Please take 5 minutes to fill out a new streamlined survey that will help shape our 2021-2022 priorities. A survey link will be emailed to you individually from SurveyMonkey beginning this Thursday, May 6th. You will have until May 27th to complete the anonymous survey and will receive two reminders. If you do not receive a link to the survey by the end of the day on May 6th please email Elizabeth Alessi at ealessi@vtmd.org for assistance. Thank you for helping VMS serve you!
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Vermont Legislature Advances Towards Adjournment
The Vermont legislature continues to work diligently to complete their work on all remaining bills eligible to pass during the 2021 session. The Senate passed their version of the FY22 Budget, which is the only bill that actually has to pass this session, by a vote of 30-0 last week. This week, the FY22 Budget advances to the House floor, where they are likely to request a Conference Committee made up of three House members and three Senate members to hash out a compromise on areas where the chambers disagree. The VMS will work to ensure the primary care physician scholarships remain funded in the budget and will continue to advocate to add an increase in Medicaid payments to 105% of Medicare for primary care. The Senate also advanced several VMS priority bills last week: H.104, a study of telehealth licensure, H.171, a childcare financing bill, H.210, a bill to create an office of health equity and H.430, a bill to expand Medicaid coverage for migrant families. The House Health Care Committee has scheduled to review Senate changes on these bills before they go to the full House floor for final approval. S.3,the forensic mental health system bill, passed the House Judiciary Committee by a vote of 11-0 and now advances to the House Appropriations Committee. Last week, the House Health Care Committee also voted to support 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, and it will move to the House Floor. This week, the House Government Operations Committee will focus on S.25, a bill making modifications to Vermont’s tax and regulate commercial sales of recreational marijuana, including additional advertising restrictions.
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Biden Administration Loosens Federal X Waiver Requirement to Administer MOUD
Last week, the Department of Health and Human Services (HHS) released federal guidelines changing a longstanding requirement that in order for clinicians to prescribe buprenorphine they need to get an "X-waiver." The X-waiver includes an eight-hour training to prescribe the drug and many substance use disorder experts have argued it creates an unnecessary hurdle to treating opioid addiction. Under the new guidelines, qualified physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and certified nurse midwives are exempt from undergoing training to treat up to 30 patients with buprenorphine. Although health care clinicians won't need to get the waiver, they are still required to send a notice of intent to prescribe buprenorphine from HHS’s Substance Abuse and Mental Health Services Administration (SAMHSA). Health care clinicians who intend to treat more than 30 patients will need additional training and federal waivers. Currently, the Vermont Department of Health is proposing changes to Vermont's MAT rule. It is unclear how these federal changes will impact the State's proposed changes.
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Gov. Scott Says Your Mom Wants You to Get Vaccinated for Mother's Day
The Scott Administration reported that Vermont is now ranked number 1 in the nation in terms of residents who have started their COVID-19 vaccination schedule. Currently, 57.4% of Vermonters have received at least their first dose of the vaccine, but there is a sharp disparity in the number of those over 40 who have received their vaccine, 70 percent, vs. those under 40, which is 41 percent. In an attempt to attract younger Vermonters, between the ages of 18-29, who still have not scheduled their vaccine appointment, the State is going to provide clinics across the states with walk-in and drive-in opportunities. With ample supply anticipated, the State reportedly wants to make getting a COVID-19 vaccine as easy as possible for every Vermonter, in order for us to meet the benchmarks that will allow Vermont to fully reopen by July 4th. Here are the comprehensive VMS Governor's Press Conference Notes - 5.4.21
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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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House Health Care Committee Seeks Action on the Youth Waiting in Emergency Rooms
This morning, the Commissioners of the Department of Mental Health, Department of Vermont Health Access and Department of Children and Families presented to the House Health Care Committee immediate, mid-term and long-term solutions to the crisis of children waiting in emergency departments for mental health care. They noted that this systemic issue is symptomatic of inadequate “flow” in the system due to many contributing factors, including increased mental health needs due to COVID 19 and the reduced capacity of school and support services. This includes severely limited in-patient beds due to COVID 19 restrictions - currently 13 beds out of a total of 48 in the State are closed due to restrictions.
Some of the solutions presented included:
- Reducing COVID-19 restrictions on in-person services allowed by hospital, residential and crisis facilities, which would allow for more capacity
- Improving access to CVPH for Vermont children and youth
- Improve emergency department triage with ED Directors and Care Managers
- Distribute federal funding to support additional community mental health services and workforce needs
- Implement mobile response and emergency department diversion options
- Work with VAHHS to support EDs
- Support the Agency of Education on recovery planning to address social, emotional, mental health needs of students and educators
- Addressing workforce issues
- Look at possible changes in payment options and structures
- Enforce mental health parity with private insurers
The Committee will continue to hear from witnesses and VMS will keep you informed with any updates and/or outcomes. The full presentation can be viewed here.
