VMS Annual Meeting Goes All Virtual: Register Today
Late last week, the VMS Annual Meeting Planning Committee made the difficult decision to transition the 2021 Annual and Collaborative Meeting to an entirely virtual event. Originally, we had planned on having a hybrid meeting, with both in-person and virtual participation offered. With the safety of our membership and staff the highest priority, we will now come together virtually continue to offer valuable opportunities to connect and share with our Vermont Medical Society, American Academy of Pediatrics Vermont Chapter, Vermont Academy of Family Physicians and the Vermont Psychiatric Association colleagues.
Register for the 2021 VMS Annual & Collaborative Meeting, which starts Friday, November 5th at 1pm and ends Saturday, November 6th at 4pm.
Join us virtually on Friday for the AAPVT, VTAFP and VPA meetings, Awards Dinner and educational sessions on primary care investment, access to child psychiatry and transgender care. Our Saturday virtual schedule begins with the VMS Business Meeting at 9am, where VMS members will consider by-laws changes, four proposed policy resolutions and a new slate of officers. In the afternoon, our collaborative educational sessions include presentations on COVID-19 and bias and stigma in addiction care. For more information click here. Register for the membership meeting here. __________________________________________________________________________
VMS Participating in Health Care-Related Workgroups
Each legislative session, health care policy legislation results in summer studies and stakeholder-led work groups in order for policymakers to better understand how new laws and proposed policies will impact the current health care practice environment. The VMS Policy Team is currently engaged in a number of legislative workgroups over the summer and fall, including:
- Cannabis Control Board (CCB) Public Health Advisory Sub-Committee – this sub-committee is chaired by Health Commissioner Mark Levine and is currently working to determine regulations for warning labels and packaging for recreational cannabis products. Click here for more information.
- Forensic Mental Health Workgroup – this workgroup is made up of a diverse stakeholder group with backgrounds in criminal justice, mental health, corrections and public safety. The workgroup is charged with helping to develop a forensic mental health system for Vermont. Click here for meeting materials.
- Task Force on Affordable, Accessible Health Care – this legislative committee is charged with exploring opportunities to make health care more affordable for Vermont residents and employers and is meeting tomorrow. Click here for meeting information.
- Essential Health Benefits Plan Review – the Department of Financial Regulation is analyzing whether the State’s current essential health benefits plan provides adequate coverage for Vermonters and whether plans should include hearing aids, dentures, vision care, durable medical equipment, fertility services, or two primary care visits with no cost-share. Click here for the EHB Review Work Plan.
- Interstate Telehealth Licensure Workgroup – this workgroup, led by the Office of Professional Regulation, was created by Act 21 of 2021 to compile and evaluate methods for facilitating the practice of health care professionals throughout the United States using telehealth modalities.
- Healthcare Workforce – Act 155 of 2020 directs AHS along with an advisory group to develop and maintain a health care workforce development strategic plan that continues efforts to ensure Vermont has the health care workforce necessary to provide care to Vermonters.
- Administrative Burden – Under Act 140, Sec. 10 of 2020, the Green Mountain Care Board has been tasked with drafting a report to “evaluate opportunities for and obstacles to aligning and reducing prior authorization requirements under the All-Payer Model as an incentive to increase scale, as well as potential opportunities to waive additional Medicare administrative requirements in the future.” The GMCB has held several stakeholder meetings to inform the drafting of this report.
There is also an opportunity for VMS Members to engage in virtual, regional discussions hosted by House Speaker Jill Krowinski and Senate President Pro Tem Becca Balint called "Investing in Vermont's Future Community Conversations." These listening sessions will focus on where you think Vermont policymakers should invest American Rescue Plan Act funds. Click here for more information.
Governor Provides COVID Boosters Update; Schools Partner with Pediatricians on Test to Stay Program
Governor Phil Scott announced during his Administration press conference that the booster roll-out is going well. Last Friday, Vermont became one of the first states to launch mass vaccination states to register eligible Vermonters for a third dose of the Pfizer vaccine. All patients must have had their second dose of the Pfizer vaccine 6 months ago and do need to make an appointment for their booster shot. The state currently has 72 vaccination clinics open statewide and is moving rapidly through the age bands this week. Eligibility to register for state clinics for the third Pfizer dose began with those 80 yrs and above last Friday and starting this Friday, October 1st, will include:
- Those 65 and above;
- Those 18-64 who have certain underlying medical conditions;
- those who work in healthcare and other locations where they are at higher risk of being exposed to COVID; and
- those who live in congregate settings and long-term care facilities.
Vermonters can also check with their primary care practice or pharmacy for booster availability and may be able to register sooner at those locations than with the state sites. The Governor also announced that the State is now recommending that all schools keep universal masking in place until Nov. 1st. Secretary of Education Dan French gave an update on the State’s testing strategies in schools and announced a new “Test to Stay” program, which has the support of the American Academy of Pediatrics Vermont Chapter (AAPVT). Test to Stay (TTS) programs provide unvaccinated, asymptomatic children, who are a close contact of a COVID-19 case due to in-school exposure, an option to undergo daily rapid antigen testing for 7 days following exposure. Students may attend school each day following a negative test result, but otherwise must quarantine at home during the testing period. AAPVT will continue to work closely with state agencies, school nurses and school leaders to develop solutions that will allow students to attend school safely while minimizing transmission of COVID-19.
Vermont Awarded Federal Dollars for Pediatric Mental Health Care Access, Mobile Crisis Intervention
The Health Resources and Services Administration (HRSA) has awarded Vermont an American Rescue Plan Act-funded Pediatric Mental Health Care Access grant to support the creation of a centralized hub for integrated care, called the Center for Pediatric Integrated Care that will, among other supports, provide telemedicine, email and telephone consultation to primary care clinicians in the state for pediatric mental health questions and referral assistance. Read more here.
Vermont has also recently been awarded a planning grant from the Centers for Medicare and Medicaid Services to support expanding community-based mobile crisis intervention services for Medicaid beneficiaries. By connecting people who are experiencing a mental health or substance use disorder crisis to a behavioral health specialist or critical treatment, these services—which will be provided by funding from the American Rescue Plan —will be available 24 hours per day. Read more here.
AHS Seeks Feedback on One-Year All-Payer Model Agreement Extension
The Vermont Agency of Human Services held a Town Hall Meeting last week to update stakeholders and take comments on a proposal to negotiate a one-year extension of the State of Vermont’s All-Payer Accountable Care Organization Model Agreement (APM) between the State and the Center for Medicare and Medicaid Innovation (CMMI). The current Agreement expires at the end of 2022; it was a five-year agreement that began in 2018. The Agreement is limited to outlining Medicare’s participation in Vermont’s payment reform efforts.
AHS offered the following rationales for a one-year extension versus a longer agreement:
- Challenges understanding the impact of the model within the current timeframe due to COVID-19 anomalies;
- More time for testing care transformation;
- Providing Vermont additional time to engage with new federal partners, the Biden Administration is taking a close look at value-based payments more generally and developing “a strategy refresh;”
- Allowing more time for engagement with providers, payers, advocates and Vermonters – this ability was limited by pandemic.
AHS stated that some potential modifications that would be negotiated in a one-year extension include:
- Developing a fixed, non-reconciled Medicare alternative payment methodology;
- Seeking clarity for Critical Access Hospitals participating in Medicare on how participation impacts their cost reporting obligations;
- Incorporating technical changes into the agreement (e.g. dates and timelines, flexibility on some reporting due to public health emergency);
- 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 financial target services within the Model, however the State would like to continue to improve alignment between the delivery and financing of these services through the ACO and will be working on more stakeholder agreement in these areas.
The State must submit a proposal to CMMI by December 31, 2021 and continues to accept comments on a one-year extension. Please send feedback to Jessa Barnard at VMS at email@example.com to inform VMS Comments on the extension. Comments can also be submitted directly to AHS at Kristin.firstname.lastname@example.org with the subject line “APM Extension Comments”
OneCare Vermont Governance Change Announced
Dartmouth-Hitchcock Health (D-HH), OneCare Vermont and the University of Vermont Health Network (UVMHN) announced last week a governance change that will make the UVMHN the sole parent organization for OneCare’s work moving forward. OneCare will remain its own legal entity and will maintain a governance board that includes managers from throughout the state that represent the full continuum of care and consumers. The governance change will not impact OneCare’s statewide provider membership. As parent organization, UVMHN will support OneCare’s processes and share resources.