September 14, 2021


This Thursday: VMS Hosts First COVID-19 Clinical Conversation

Please join us this Thursday, September 16th from 12-30-1:00 pm for the first of our new "COVID-19 Clinical Conversations." We will be joined by Meredith Plimpton and Margaret Robinson to discuss COVID-19 vaccine boosters, EUA approval for COVID-19 vaccines for 2-11 yrs old and Dr. Rebecca Bell will highlight the current strategies in bringing students back to school safely. 

Please check our Thursday schedule, where we alternate between a VMS hosted conversation with Commissioner Levine and our new COVID-19 Clinical Conversations; where we will host local experts to answer your clinical questions regarding relevant COVID-19 issues facing Vermont health care clinicians on the other listed Thursdays from 12:30 – 1:00pm. These conversations will be designed to cover the most pressing COVID-related issues during the time period surrounding each discussion. Please reach out to Stephanie Winters at to share topics you think we should cover. 


    HHS Announces $25.5 Billion in COVID-19 Provider Funding

    The Biden administration announced last Friday that the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is making $25.5 billion in new funding available for health care providers affected by the COVID-19 pandemic. More details can be found HERE.

    Important to note:

    • Eligibility is based on documented lost revenues and changes in operating expenses from July 1, 2020 to March 31, 2021
    • HRSA will reimburse a higher percentage of lost revenues and expenses for smaller providers as compared to larger providers.
    • HRSA will provide "bonus" payments based on the amount of services they provide to Medicaid, CHIP, and Medicare patients
    • HHS is also announcing today a final 60-day grace period to help providers come into compliance with their PRF Reporting requirements if they fail to meet the deadline on September 30, 2021, for the first PRF Reporting Time Period. While the deadlines to use funds and the Reporting Time Period will not change, HHS will not initiate collection activities or similar enforcement actions for noncompliant providers during this grace period.
    For more information visit:


    Meeting Notice: Vermont All-Payer Accountable Care Organization (ACO) Model Agreement

    The Vermont Agency of Human Services (AHS) will hold a virtual town hall meeting to discuss plans for seeking a one-year extension of the All-Payer ACO Model Agreement which is effective January 1, 2017 through December 31, 2022. The State is not seeking to add any additional services such as Medicaid home- and community-based services, mental health services, and substance use disorder services to the All-Payer Financial Target Services which are subject to growth targets. Additional forums about improving alignment between the delivery and financing of these services with services provided through the ACO will be discussed.

    Meeting Date and Time:

    Thursday, September 23rd from 11 AM – 12:30 PM

    Click here to join the meeting

    Or call in (audio only)

    +1 802-828-7667,,47532049#   United States, Montpelier

    Phone Conference ID: 475 320 49#


    White House Releases Vaccine Mandate for Health Care Facilities, Updated COVID-19 Action Plan

    The Biden-Harris Administration announced last Thursday that it will require COVID-19 vaccination of staff within all Medicare and Medicaid-certified facilities to protect both them and patients from the virus and its more contagious Delta variant.  Facilities across the country should make efforts now to get health care staff vaccinated to make sure they are in compliance when the rule takes effect. The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), announced that emergency regulations requiring vaccinations for nursing home workers will be expanded to include hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among others, as a condition for participating in the Medicare and Medicaid programs. The decision was based on the continued and growing spread of the virus in health care settings, especially in parts of the U.S. with higher incidence of COVID-19. CMS is developing an Interim Final Rule with Comment Period that will be issued in October.  Facilities are urged to use all available resources to support employee vaccinations, including employee education and clinics, as they work to meet new federal requirements.

    Other elements of the COVID-19 Action Plan include:

    • Requiring All Employers with 100+ Employees to Ensure their Workers are Vaccinated or Tested Weekly
    • Requiring Employers to Provide Paid Time Off to Get Vaccinated
    • Calling on All States to Adopt Vaccine Requirements for All School Employees
    • Calling on Large Entertainment Venues to Require Proof of Vaccination or Testing for Entry
    • Getting Students and School Staff Tested Regularly
    • Providing Every Resource to the FDA to Support Timely Review of Vaccines for Individuals Under the Age of 12
    • Making At-Home Tests More Affordable
    • Expanding Free, Pharmacy Testing


    CDC Releases HAN Warning of Adverse Reactions to Delta-8 THC Products

    The Centers for Disease Control (CDC) published a health advisory Tuesday, September 14th, warning clinicians of an increase in adverse reactions to cannabis products that contain delta-8 THC. According to the HAN, delta-8 THC products are increasingly appearing in both marijuana and hemp marketplaces and are also available online. Delta-8 THC products are sometimes marketed as “weed light” or “diet weed," although the health impacts of these products are largely unknown. Delta-8 THC products may also have the potential to be confused with hemp or CBD products that are not intoxicating, therefore consumers who use these products may therefore experience unexpected or increased THC intoxication. In Vermont, the Cannabis Control Board (CCB) has been holding a series of Advisory sub-committee meetings, in order to advance the rule-making outlined in Act 164. The public health subcommittee, which is made up of Commissioner Mark Levine, Tim Wessel (filmmaker) and Ingrid Jonas (retired State Police Officer), has met twice in one week and is currently focused on how best to design warning labels for cannabis products in Vermont. For the overview of the public health sub-committee's work click here. These meetings are open to the public and currently held in-person. To provide public comment on the work of the sub-committee or the CCB in general click here.


    Governor's Press Conference: Both Good and Bad News

    The Governor’s press conference today contained both good and cautionary news for Vermonters.  In the good news, Vermont has seen for the first time since June “negative case growth,” or a decrease in cases week-over-week. On the cautionary side, cases among children who are too young to be vaccinated remain high compared to the case rate among older Vermonters and the hospitalization rate continues to increase. On average, 71% of recent hospitalizations have been among the unvaccinated. Other updates include:

    • The Department of Education will be releasing more detailed contact tracing guidance for schools soon (to help address positive cases in cafeterias, recess, busses and more). It will be posted to the DOE website.
    • The State continues to add more contact tracing staff/capacity.
    • The Agency of Human Services is committed to increasing testing capacity in a community if there is an outbreak, however Vermonters are strongly encouraged to schedule a testing appointment vs walking-in to help manage testing capacity and wait times. (VMS has heard that testing capacity has been an issue and will continue to be in touch with AHS on this topic).
    • The State is ready to administer boosters, but is waiting for approval and guidance from the federal level.
    • The State and UVM are partnering on a study of outcomes for those who have contracted COVID 19 – 2500 Vermonters have been randomly selected and might hear from researchers. 

    Transcripts of the Governor’s comments each week can now be found here and modeling reports can be found on the DFR website.


    National Physician Suicide Awareness Day – Sept. 17

    On behalf of the Physicians Foundation, Dr. Lorna Breen Heroes’ Foundation and #FirstRespondersFirst, we invite you to help prevent physician suicide by learning the signs, starting the conversations, understanding the underlying barriers and sharing the resources that can help those in distress seek mental health care.

    Remember, the VMS Practitioner Health Program Medical Director, Joe Lasak, MD is available to direct any physician or PA in Vermont to resources.  The VPHP Confidential phone number is:  802-223-0400.  More resources are also listed at:


      Screening for Food Insecurity - Brief Survey

      Bi-State Primary Care is asking clinicians to help them better understand how food insecurity screening is being used at health care practices across Vermont. Please fill out their very brief survey. They are seeking responses by the end of September in order to analyze the results starting October 1st. Here's the link.

      You may also be interested in an October 12th, 12:00 - 1:15 pm, webinar for health care practices on legal considerations around food programs, which will include information about how food insecurity screening relates to inducements rules (among other topics). And if you're very curious about Food Insecurity Screening, there's also a short history of the screening tools available here. 


      Albany Medical College Primary Care Survey

      The following is a link to a brief (approximately 2 minute) survey created by two third year medical students at Albany Medical College. The goal of their study is to determine trends in referral patterns among primary care physicians for conditions/procedures in which responsibilities may overlap across subspecialties.

      Link to Survey:


      Medicaid Finalizes Changes to Home Health Ordering Clinicians, PA Authority

      Medicaid has finalized several recent policy changes. Physician assistants, nurse practitioners, and clinical nurse specialists may now order home health services along with physicians. In addition, physician assistants who enroll with Vermont Medicaid may:

      • Act as a treating provider and receive direct reimbursement for services delivered.
      • Choose to be listed as a primary care provider.

      For more information see: GCR 20-063: Home Health Services - Ordering Providers and GCR 20-105: Physician Assistant Licensure Changes—Medicaid Impact

      Vermont Medicaid is also proposing to fully transition continuous glucose monitor coverage to the pharmacy benefit only rather than covering under the durable medical equipment benefit.  For more information or to comment on this proposal see: GCR 21-041: Continuous Glucose Monitors Available Through Pharmacy Benefit.


      Action Required: Feedback on Vermont's Proposed DNR/COLST Order

      A subgroup of the Palliative Care Task Force has been working on revisions to Vermont’s DNR/COLST order over the spring and summer of 2021. The Task Force is seeking final stakeholder input for consideration before the Department of Health moves forward and adopts a new Vermont DNR/COLST form which will be effective January 1, 2022. Please review the current draft Vermont DNR/COLST order form and contact Cindy Bruzzese at with any additional comments or suggestions by NO LATER THAN SEPTEMBER 30, 2021. All comments will be compiled and shared directly with the Department of Health for review and consideration. 


      Relocation Funds Available for Newly Hired Health Care Workers

      The Vermont legislature has funded a New Relocating Worker Grant, with a maximum award of $7,500, to encourage workers to move to Vermont to work for Vermont employers.  Eligible applicants include someone who, on or after July 1, 2021:

      • Relocated to Vermont, became a full-time resident; and
      • Became a full-time employee of a Vermont employer; and
      • Is employed in an occupation identified by the Vermont Department of Labor in its Short Term Occupational Projections with the Most Openings (including many health care positions).

       For more information, visit:

        The 208th Collaborative Meeting: What This Means For You! 

        Have you registered for the 208th Annual and Collaborative Meeting yet? We are going to provide virtual participation options or you can join the VMS, AAPVT, VPA and the VAFP at the Topnotch Resort in Stowe Friday, November 5th and Saturday, November 6th. This year's meeting is brimming full of meaningful opportunities for you to communicate and collaborate with your colleagues and to have some fun as well! Crossing our fingers we can gather in person this fall, Friday evening includes specialty society receptions and our celebratory VMS Awards Dinner. Saturday morning we start the day with our fun run/walk on the beautiful, Stowe bike path and we know we will all unwind at Saturday's networking lunch. There is also plenty of opportunities to take advantage of the relaxing amenities of Topnotch in the gorgeous town of Stowe. Register today

        The VMS Council (governing board) will meet this Wednesday, September 15th to consider member feedback on four proposed policy resolutions. The resolutions are:

        VMS members wishing to attend the Council meeting, which will be held over Zoom from 6:30-8:30 pm, can contact Birdie Powell at for the log-in information. VMS also has an upcoming at-large Council seat opening and is open for nominations for the Vice President role. All members are encouraged to express interest and the Council seeks to establish inclusive and diverse representation of members in areas such as medical specialty, practice type, geography, group membership and individual demographics. The resolutions and leadership positions will be voted on at the VMS Member Business Meeting, Saturday, November 6th from 9am – 12pm. Contact Jessa Barnard at for more information. 

        Primary Care Sports Medicine Conference - Virtual

        Thursday, September 16, 2021

        Dr. Kimberly Sikule invites you to attend this virtual conference, designed to update knowledge and skills in the diagnosis and management of common sports medicine problems. Held in conjunction with the Wilderness Medicine Conference, with discounted registration fees for attending both. Registration here, with complete program and accreditation information.

        The 3rd Annual Wilderness Medicine Conference

        Friday, September 17, 2021

        Sugarbush Resort in Warren, VT

        Please join Dr. Kimberly Sikule and other faculty and local experts at the Sugarbush Resort in Warren, VT for in-person, hands-on learning!  Registration here with complete program and accreditation information.  

        See all the Primary Care conferences offered through UVM CMIE this Fall: Questions: Contact Michele Morin at or 802-656-2292.

        Webinar: Technology Creates Calming Environment for Pediatric Mental Health Emergencies

        Thursday, September 23rd, 2021, 1:00 PM - 2:00 PM EST 

        Pediatric emergency department visits for mental health conditions increased significantly during the pandemic — further exacerbating the urgent need for creative solutions for struggling youth. Join Children’s Health in Dallas and Philips and Recornect to learn how environment changes can help de-escalate stressful medical emergencies and how to co-create an innovative solution with technology companies. Register here.

        24th Annual Women’s Health and Cancer Conference: Friday, October 1, 2021

        This free, VIRTUAL educational event is aimed at empowering and supporting individuals and communities with knowledge about cancer prevention, detection, treatment and survivorship. It is for anyone interested in learning more about women’s health and cancer – patients, survivors, health care professionals, caregivers, and the general public. Continuing Education credit can be earned for a small fee.Registration here with complete program and accreditation information Questions: Contact Michele Morin at or 802-656-2292

        Sponsored jointly bythe Mayo Clinic,
        Stanford University and the American Medical Association

        American Conference
        on Physician Health
        October 7- 9, 2021

        Achieving the quadruple aim: Resilient systems in times of crisis.” Joint scientific conference that promotes scientific research and discourse on health system infrastructure, and the actionable steps organizations like yours can take to improve physician well-being.

        • Registration rates: Available through Thursday, Sept. 23.
        • To register for conference and view agenda, visit the ACPH 2021 homepage.


        Vermont Medical Society

        134 Main Street

        Montpelier, VT 05602

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