June 8, 2021


State Invites All Primary Care Practices to Administer COVID-19 Vaccine

The Vermont Department of Health Immunization Program has announced that all Vermont primary care practices are now eligible to order the COVID-19 vaccine for administration to their patient population beginning June 21st. Practices must be enrolled as COVID-19 vaccine sites, and the primary vaccine contact is required to complete a training before they can order the vaccine. The trainings are available starting the week of June 14th and practices should email ahs.vdhimmunizationprogram@vermont.gov to register. The Immunization program is developing a system for practices to be able to order smaller quantities of vaccine, but says practices should expect experience higher levels of vaccine waste. See the Minimizing Waste Policy for more guidance. For more information on the COVID-19 vaccine enrollment process, please check out the COVID-19 Vaccine Enrollment Process Guide and FAQs and the VDH Vaccine Information for Health Professional website. For hospital-based practices, vaccine administration is being coordinated between the Department of Health and your hospital and not all primary care practices may become vaccine sites – contact your hospital administration for more information. 


VMS Joins Comments on AHS 1115 Waiver Proposal

Vermont’s Agency of Human Services (AHS) released public notice last month of its intent to seek a renewal of its Medicaid Section 1115 Demonstration Waiver, Vermont Global Commitment to Health, effective January 2022. An “1115 Waiver” is negotiated with the Centers for Medicare and Medicaid Services (CMS) and imposes a global cap that limits the state to drawing down federal Medicaid matching funds in exchange for additional flexibility in how the state can use federal dollars. Vermont has had an 1115 Waiver in place since 2005.  In this draft application, the State seeks federal approval to move toward full population-based payment by transitioning DVHA into a public, state-run, risk-bearing Medicaid managed care plan (MCO). In conversation with State officials, VMS has been told that the transition to an MCO structure is the path that will afford Vermont the most flexibility and the best chance at negotiating favorable spending caps with CMS. VMS, along with a coalition of other health care associations including hospitals, home health, and others, submitted comments last Friday on the draft. The comments state that the coalition supports the goals of funding flexibility within generous enough spending caps. At the same time, we are aware that in some states, Medicaid MCOs have created substantial administrative burdens for providers and barriers to care for patients, which the coalition would not support.


Scott Administration Launches Economic Recovery Bridge Program

Monday, June 7th, Governor Phil Scott, along with the Agency of Commerce and Community Development (ACCD) and Department of Economic Development opened applications for the new “Economic Recovery Bridge Program.” The program aims to provide $30 million in financial relief to Vermont businesses who did not qualify for other state or federal relief programs and to businesses who may have received some aid, but still show a continued loss of revenues due to the COVID-19 pandemic. Grants will be issued on a first come, first served basis and priority for the first 30 days will be given to businesses that have not received any State or Federal financial assistance in 2020 or 2021 including, but not limited to PPP Loans or Healthcare Provider Grants.  After the initial 30-day window, second tier priority will be given to businesses who suffered a 2020 net tax loss and can still demonstrate an adjusted net loss after adding back the amounts of non-taxable assistance received in 2020 and 2021. For more information visit the ACCD COVID-19 Recovery Resource Center.


Clinical Consultation on Managing Alzheimer’s Disease Available for Primary Care Clinicians

Vermont’s Alzheimer's Disease Hub and Spoke Work Group, in collaboration with the Department of Disabilities, Aging and Independent Living (DAIL), Vermont Department of Health (VDH), and others has announced the availability of the “Corner Consult with Dr. Pendlebury.” Dr. William Pendlebury (Co-Director UVMMC Memory Program) will be available on the second and fourth Wednesdays of the month (June 2021 to May 2022) from 2:00-4:00 pm for ad hoc/informal consultation to discuss clinical issues concerning Alzheimer’s disease and related disorders. These consultations can take the form of discussion of interesting or problematic clinical cases, pharmacologic treatment, or review of specific clinical or research topics. There will be no fee for these consultations, and the content is directed by the primary care provider requesting the consultation.  Each session is scheduled for 45 minutes over zoom. Sign up at https://www.signupgenius.com/go/5080B4AACAE2FA6FC1-corner

Contact Mary.palumbo@med.uvm.edu for further information on these additional offerings beginning Sept 16, 2021:

  • An ECHO© series - Enhanced Diagnosis and Management of Dementia by the Primary Care Team. This series will include 9 sessions (1.5 hrs) from Sept 2021 to May 2022 @ 7:30-9 AM (co-sponsored by AHEC). Continuing Medical and Interprofessional Education credits will be available. Ten Vermont primary care teams (PCP, Nurse and Social Worker) will be sought to participate.  
  • An on demand Continuing Education session on Dementia Diagnosis, Treatment and Management for primary care providers (MD,NP, DO, PA) and their team members (SW, PT, RN, RD and others).


VMS Survey Reveals Clear Advocacy Priorities

A new abbreviated version of the VMS annual survey circulated over May asked members to give us feedback on what advocacy priorities VMS should address, whether our communication strategies are effective, whether our wellness solutions meet your needs, whether our events provide relevant and timely content and whether the VMS is working towards our mission of improving the practice environment in Vermont. Mental health, administrative burden, increasing Medicaid rates and getting a clinician on the Green Mountain Care Board are the advocacy priorities that rose to the top of issues that members stated VMS should lead. Public health, social determinants of health and workforce issues were areas members responded that VMS could work within coalitions to address. Thank you to all of you who took the time to fill out the survey, all of your answers help us to better focus our efforts on the priorities that matter to our members. These results will also inform the work of the VMS Council at our Summer Priority Planning Retreat on June 24th. 


Recent COVID-19 Guidance and Resources:

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

New Summer Schedule! Commissioner Call Update | VMS calls with Vermont Department of Health Commissioner, Mark Levine, M.D. will be held on specific Thursdays from 12:30-1:00 p.m. throughout the summer. These calls are on ZOOM - click below for the virtual meeting address that will remain constant each week.

Summer dates will be: June 10 & 24th; July 22nd; August 5& 19th; September 2 & 16th.  Click here for an online schedule. 

Click here for the summer schedule. 

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


Feedback Needed by June 10: Pharmacist Prescribing of Tobacco Cessation Products in Vermont

The Board of Pharmacy released a draft protocol (starting on page 3) and met last week to allow for comment on pharmacists prescribing tobacco cessation products. State law passed last year authorizes pharmacists in Vermont to prescribe tobacco cessation products in accordance with an adopted protocol. As stakeholders in this process, VMS, VTAFP & AAPVT provided comments outlining our support for pharmacists prescribing nicotine replacement products, but stating the organizations’ concern with prescribing of non-nicotine replacement therapy tobacco cessation medicines. The comments stated that the protocol should prohibit the prescribing of tobacco cessation medications Buproprion (Zyban) and Varenicline (Chantix) due to the risk of significant side effects, including complex psychiatric and other health complications, risk of complications with other medications even in the absence of a mental health diagnosis, and an increased rate of abuse of bupropion with horrific effects such as vascular necrosis in those who have injected it. In response, the Vermont Pharmacists Association stated that significant data collected in the last five years shows that that these concerns are not necessary and cited this 2016 study. Attached are their full comments.

VMS is seeking further feedback to inform follow-up comments.  Please send your input by Thursday, June 10 and any supporting information to Stephanie Winters at swinters@vtmd.org.


MACs Resume Medical Review on a Post-payment Basis

Beginning August 2020, Medicare Administrative Contractors (MACs) resumed post-payment reviews of Medicare items and services with dates of service before March 2020. MACs may now begin conducting post-payment medical reviews for later dates of service. The Targeted Probe and Educate program (intensive education to assess provider compliance through up to 3 rounds of review) will restart later. The MACs will continue to offer detailed review decisions and education as appropriate.


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. 


          VMS' Final Webinar on 2021 New Health Care Laws

          Our next VMS Webinar on Thursday, June 17th, 2021 will provide you with what you need to know about the 2021 New Health Care Laws and will feature VMS’ Jessa Barnard and Jill Sudhoff-Guerin. Click here to register. This webinar will cover information from our Final 2021 VMS Legislative Bulletin the VMS Policy Team published last week, which provides a comprehensive status update on 2021 health care legislation that advanced this session and a preview of what to expect next session. This is the last webinar in our 2020/2021 series, but for the recordings and presentations of all of our webinars go to: VMS Thursday Webinar series for 2020/2021Thwebinar 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.

          Gun Violence and Public Health

          Jun 10, 2021 5:30 PM 

          A discussion of the epidemic of gun violence as a public health issue, with panelists Dr. Becca Bell, Dr. Cassandra Crifasi, and Jeremy Stein. Moderated by Clai Lasher-Sommers. Register here. 

          Loneliness of Serious Illness – The Population Health Impact and What We Can Do About It.

          Friday, June 18, 2021 from 12:00pm-1:00pm. 

          This session will be presented by Dr. Robert Grambling and include a presentation on this important topic with time for questions and answers. Register here. 

          VCP 2021 Webinar Series: 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.

          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.


          Vermont Medical Society

          134 Main Street

          Montpelier, VT 05602

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