VMS Thanks VT Lawmakers for Work on 2021 New Health Care Laws
The VMS extends our deep gratitude to all of our Vermont lawmakers for their hard work and dedication during the 2021 legislative session. Click here to send your lawmaker a thank you email. The virtual legislative session often required grueling, back-to-back Zoom calls, with little time off-screen. Vermont legislators met these challenges by doubling down on tackling legislation covering COVID flexibilities and recovery; mental health; health equity and coverage for audio-only telehealth services. Although the Vermont legislature adjourned the 2021 session in late-May, they did schedule a veto session on June 23-24, to allow the legislature an opportunity to override the governor’s action on the bills he has vetoed. This veto session seems unlikely at this point because the Governor has signed the FY22 Budget into law. The legislature also adopted a resolution to allow them to return to the Statehouse in October in the event that Congress passes an Infrastructure bill and they need to allocate these federal funds.
Please join us this Thursday, June 17th, 2021 for our last VMS Webinar in the 2020/21 series, where VMS’ Jessa Barnard and Jill Sudhoff-Guerin will provide you with what you need to know about the 2021 New Health Care Laws Click here to register. This webinar will cover information from our Final 2021 VMS Legislative Bulletin, which provides a comprehensive status update on 2021 health care legislation that advanced this session and a preview of what to expect next session. For the recordings and presentations of all of our webinars go to: VMS Thursday Webinar series for 2020/2021. The webinar content will take place from 12-1pm as Commissioner Mark Levine is not available on June 17th for our regular Thursday calls with the Commissioner of Health. See article above on summer Commissioner Call schedule.
State Has Reached 80% Vaccination Goal – Health Care Practices Still Must Follow CDC Guidance, New OSHA Rule
As has been well publicized by the media, Governor Phil Scott announced yesterday that 80.2% of Vermont’s eligible population - those age 12 and older - have received at least one dose of the COVID-19 vaccine, making it the first state to reach this major milestone. Governor Scott also announced he has rescinded all state COVID-19 restrictions. Additionally, Vermont’s State of Emergency, slated to expire at midnight tonight, June 15, will not be renewed.
At this time, Vermont will no longer require sector-specific guidance for health care settings, such as the Guidance for Inpatient and Outpatient Procedures and Hospital Visitor Guidance. Instead, health care settings may establish their own guidance and are expected to follow CDC guidance, including Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination. This document includes updated testing recommendations for health care workers, visitation guidance and guidance for communal gatherings/activities in the health care setting. Some sectors, such as hospitals and long-term care settings, may be required to follow CDC guidance by federal accreditation/inspection standards.
Practices should note that last week OSHA released a new Emergency Temporary Standard (ETS) for health care workers related to minimizing the risk of exposure to COVID-19. See article below for further details regarding these requirements and compliance dates.
With Vermont ending the State of Emergency related to COVID-19, members are reminded that there are some regulatory flexibilities pegged to the State of Emergency, although S. 117/Act 6 extended many to a date certain and are not dependent on the State of Emergency. A summary of Act 6 is available here. Note the following that are linked to the State of Emergency:
- Waiver of obtaining/documenting a patient’s informed consent for use of telemedicine (sunsets 60 days after the State of Emergency or August 14, 2021) (informed consent for audio-only telehealth currently required, see sample);
- Liability protections for health care providers engaged in emergency management services or response activities.
The following will continue to a date certain:
- Health insurance companies must continue to reimburse for audio-only telehealth services at parity with in-person services (through the remainder of 2021);
- Ability for out-of-state licensed health care professionals to provide services to patients located in Vermont by telehealth (through March 2022);
- Buprenorphine prescription renewals without an office visit (through March 2022); and
- Waiver of using HIPAA compliant telehealth platforms (through March 2022, if federal waiver continues to allow – dependent on Federal Public Health Emergency).
Waiver of licensure requirements for telehealth services provided to patients located in other states, such as New Hampshire or New York, are determined by those states’ laws, and in many cases are dependent on the status of a declared emergency in those states. See the charts from the Federation of State Medical Boards to confirm if you will need to seek licensure to provide services to patients located in other states when the state of emergencies end in those jurisdictions. New Hampshire announced last week that all COVID-19 Emergency Licenses issued prior to June 12, 2021, expired on that date with the expiration of the State of Emergency. All healthcare COVID-19 Emergency Licenses will automatically be converted to a temporary license that will be valid for a period not to exceed 120 days (October 20, 2021) from June 12, 2021. As of publication, New York State continues to waive licensure requirements for telehealth under and executive order. For questions or concerns regarding this transition, contact firstname.lastname@example.org.
New OSHA Rule Requires COVID 19 Safety Measures in Health Care Settings
Last week, the Occupational Safety and Health Administration (OSHA) released new standards for health care settings “where suspected or confirmed COVID-19 patients are treated.” According to the OSHA fact sheet, the Emergency Temporary Standard (ETS) is aimed at protecting workers facing the highest COVID-19 hazards. This includes employees in hospitals, nursing homes, and assisted living facilities; emergency responders; home healthcare workers; and employees in ambulatory care facilities where suspected or confirmed COVID-19 patients are treated. For more information see the “Is your workplace covered by the COVID-19 Healthcare ETS?” flow chart
Some of the key requirements of the ETS are:
- COVID-19 plan: Develop and implement a COVID-19 plan (in writing if more than 10 employees)
- Patient screening and management: Limit and monitor points of entry to settings where direct patient care is provided; screen and triage patients, clients, and other visitors
- Develop and implement policies and procedures to adhere to Standard and Transmission-Based precautions based on CDC guidelines
- Personal protective equipment (PPE): Provide and ensure each employee wears a facemask when indoors*
- Physical distancing: Keep people at least 6 feet apart when indoors*
- Physical barriers: Install cleanable or disposable solid barriers at each fixed work location in non-patient care areas*
- Health screening and medical management: Screen employees before each workday and shift
- Ventilation: Requirements for employer-owned or controlled existing HVAC systems
- Vaccination: Provide reasonable time and paid leave for vaccinations and vaccine side effects
- Training: Ensure all employees receive training so they comprehend COVID-19 transmission, tasks and situations
- Recordkeeping: Establish a COVID-19 log (if more than 10 employees) of all employee instances of COVID-19
* There are exceptions to masking, distancing, and barrier requirements for fully vaccinated staff when in well-defined areas with no reasonable expectation that a COVID-19 patient will be present
The ETS is effective immediately upon publication in the Federal Register (OSHA is working to have the standard published “as soon as possible”). Employers must comply with most provisions within 14 days, and with provisions involving physical barriers, ventilation, and training within 30 days. OSHA will use its enforcement discretion for employers who are making a good faith effort to comply with the ETS.
For more information, see the Fact Sheet, Full Text and FAQs regarding the ETS.
VT Pediatricians Provide Guidance to Families with Children on How to Navigate the Summer
Last week, the American Academy of Pediatrics Vermont Chapter (AAP-VT) published guidance for Vermont families with children on how to navigate the upcoming summer and to stay healthy and active. Pediatricians are thrilled that Vermont has reached the benchmark of 80% of its eligible population receiving at least one dose of the COVID-19 vaccine, but as Vermont moves forward with its reopening plan, it is important to remember that young children are not yet eligible for the vaccine. AAP-VT is recommending the following based on current COVID case rates and rates of vaccination in VT:
As restrictions are loosened, many parts of the world have seen an increase in common respiratory viruses. Currently, there is an increase in pediatric hospital admissions in Vermont for respiratory illness caused by rhinovirus, a common respiratory virus.
- Unvaccinated children over 2 years of age as well as unvaccinated adults should continue to wear masks indoors when they are around other unvaccinated people.
- Given the low risk of transmission during outdoor activities, it is reasonable for unvaccinated children to not wear masks outside.
- Adults and children who are sick should continue to stay home whether or not they are vaccinated. Employers can help in this effort by supporting a flexible sick day policy.
- When planning activities, AAP-VT encourages families to have honest and clear conversations about comfort level with other families regarding masking, vaccination, illness, and other expectations.
- AAP-VT is hopeful that children and adolescents will have a fun and rejuvenating summer. Visit the Vermont Afterschool website for summer opportunities.
- They recommend all adolescents eligible for the vaccine get it as soon as possible. Check out the AAPVT website for past recordings and announcements of future forums.
View the Press Release in PDF
Highlights from the June 2021 AMA Special Meeting
The American Medical Association House of Delegates’ virtual meeting is happening this week, from June 11–16. Vermont is represented in the AMA by Norm Ward, MD, and Barbara Frankowski, MD. Dr. Ward currently heads the New England Delegation, which includes all New England states and meets to discuss positions on proposed AMA policy and leadership candidates before and during the AMA meeting. Read more from the AMA.
Recent COVID-19 Guidance and Resources:
VMS Weekly Zoom with Commissioner of Health, Thursdays at 12:30 pm