January 24, 2023

NEED TO KNOW

Thank You for a Compelling 2023 VMS Advocacy Day!

The 2023 VMS Advocacy Day was a huge success thanks to all of you who came to share your insights with lawmakers on Vermont's current health care landscape and your highest priority policy needs. The day started with VMS Executive Director Jessa Barnard introducing the new House Health Care Committee to VMS' policy priorities and the stresses facing health care professionals. VT Digger covered Jessa's testimony, along with testimony from the Vermont Association of Hospitals and Health Systems, and called the article, "Vermont’s health care system is a ‘village on fire’."  Our intrepid health care advocates then gathered for a brief advocacy training before filing into the Vermont House chamber where Rep. Alyssa Black, D-Essex, recognized the entire VMS Membership for their dedication to serving patients, and all 150 Representatives gave VMS members a round of applause. Later that afternoon, a legislative reception provided opportunity for meaningful discussion and tough conversations with lawmakers about the critical policy solutions to meet the needs of your patients. VMS President Ryan Sexton, M.D., highlighted the extreme emergency department capacity gap and urged lawmakers to invest in primary care and mental health to prevent the ED bottleneck. VT Academy of Family Physicians President Anne Morris, M.D., told lawmakers that Vermont needs to continue investment in competitive scholarships and loan repayment to recruit and retain our valuable primary care clinicians, and VMS President-Elect Becca Bell, M.D., urged lawmakers to support public health intiatives, and invest in housing, child care and other social determinants of health. If you missed it - there will be many other opportunities and if you made it - you made a huge impact.  VMS advocacy continues this week with testimony to the House Judiciary Committee on Thursday supporting a “shield law” to protect clinicians who provide reproductive or gender affirming health care services.

Governor Scott Provides FY 2024 Recommended Budget: Includes Investment in Mental Health in Primary Care

Last Friday, Governor Scott provided his FY24 Recommended Budget Address and outlined his spending priorities for the upcoming fiscal year. At $8.4 billion, this is Vermont's largest budget in history and is still bolstered by one-time federal funding. His funding recommendations include investments in housing, workforce training, childcare, health care and mental health. The release of the draft budget signals the legislature to begin their work of accepting or pushing back on the Governor's initiatives, as they advance in passing the FY24 Budget. The VMS Policy team will work to better understand these proposals over the next few weeks, but here are some of the Governor's initial spending recommendations that will impact health care:

• Increased Blueprint Investment: $20.9 million over 2 years for Blueprint for Health Expansion to integrate mental health into primary care
• Provider Stabilization Funds: $10 million to replenish the Provider Stabilization Fund
• Violence Prevention: $10 million for a violence prevention grant program
• Childcare: $48 million to expand the childcare subsidy, covering families at 400% of the “federal poverty level”
• Afterschool: $7 million to expand access to afterschool programs by making more programs eligible for subsidy
• Dental Care: $13.2 million to increase access to dental care for Vermonters enrolled in Medicaid

VMS understands the proposal includes approximately level funding for the Medicaid physician fee schedule to begin June 2023. We will provide more information as we learn more and as these proposals advance.

Feedback Sought: Naturopathic Physician Statute Change Requests

The Vermont Association of Naturopathic Physicians is seeking several changes to Vermont Statute this year to incorporate NDs into statute that don’t clearly include their profession – some of these would be new authority while others would be codifying into statute existing practice. The chart of statute change requests and rationale can be found here. In summary, the requests are to include NDs in the statutes that:

1. Allow patients to get drug coverage for purchases of drugs from Canada, allow payers to bypass the out of pocket limits and/ or benefit limit for drugs, allow patients to pay > $100/ month for insulin (current practice but NDs not included in statute)
2. Apply the Patient Privilege from disclosing health information (current practice but NDs not included in statute)
3. Allow the prescribing of epinephrine in a school’s name for the school to stock
4. Allow for the prescription of controlled substances (already allowed by rule, statute is unclear)
5. Allow for the signing of death certificates (VDH does not currently allow for NDs)
6. Allow for authorizing patient to participate in Vermont’s Medical Aid in Dying law (not currently allowed by statute; PAs and APRNs also not currently included)
7. Allow for the signing of COLST and DNR orders (not currently allowed by statute)
8. Allow professionals to delegate tasks to LPNs (statute unclear, this is current practice)

Please share feedback on these proposals with Stephanie Winters or Jessa Barnard at swinters@vtmd.org or jbarnard@vtmd.org.

VMS Board Meeting Feb 1, Medicare Advantage Up for Discussion

The Vermont Medical Society Board will be meeting remotely on Wednesday, February 1^st from 6:30-8:30 pm.  The Board will focus significant attention on policy issues, including reviewing two resolutions related to Medicare (addressing Medicare Advantage Plans and Direct Contracting Entities – they will then be sent out for member feedback); discussing whether to take a position on safe injection sites; and supporting the Vermont Association of Hospitals and Health Systems campaign related to violence against health care workers.  VMS members wishing to attend the meeting can contact Birdie Pauley for the zoom link at  bpauley@vtmd.org. 

Commissioner of Health Public Health Update on February 2nd 

The next Public Health Update call with Commissioner of Health Mark Levine, MD will be on Thursday, February 2nd at 12:30 pm. Hear about the the most pressing public health information affecting the state and nation and have the opportunity to submit questions to Dr. Levine who will answer them, time-permitting.

You can join the zoom meetings here.

MISC.

AHRQ Safety Program for Telemedicine: Improving the Diagnostic Process

Is your practice interested in improving the cancer diagnostic process for your patients who receive some or all of their care via telemedicine? The Agency for Healthcare Research and Quality (AHRQ)  is recruiting ambulatory and primary care facilities, including OB/GYN practices for a free 18-month program to improve diagnostic verification, timeliness, and communication with patients diagnosed with breast, colorectal, and lung cancer.  Practices will receive training and one-on-one expert coaching to implement sustainable improvements to effectively close the loop at critical points in the cancer diagnostic process. Learn more and sign up for an informational webinar on the program website: safetyprogram4telemedicine.org.

Grand Rounds with Dr. Libby Stuyt - January 31, 2023, 9am to 10:30am ET

Dr. Libby Stuyt is a board-certified Addiction Psychiatrist and has worked in the addiction/behavioral health field since 1990. Her current mission is to educate as many people as possible on the un-intended consequences of the commercialization of marijuana in Colorado, focusing primarily on the deleterious effects of high potency THC on the developing brain.

This webinar will discuss the negative impacts of high potency THC on community and patient safety.

Learn more here and register here.

Vermont Medicaid Reinstating Copays

Effective February 1, 2023, Vermont Medicaid will reinstate copays from Medicaid members for hospital outpatient services and certain medications. Medications include the following prescription and over-the-counter medications: analgesics (e.g., acetaminophen and ibuprofen), antihistamines, cough suppressants, cough & cold combination products, inhalers, and leukotriene receptor antagonists. These copays were put on hold at the beginning of the COVID-19 Public Health Emergency (March 2020).  All other copays - including for dental services and most prescription drugs - remained in place during the COVID-19 Public Health Emergency. Information about copays for Medicaid members can be found at https://dvha.vermont.gov/members/medicaid.

Medicaid Renewals to Restart in April 2023

Starting spring 2023, Vermont will be required to redetermine Medicaid and Dr. Dynasaur eligibility. For the last three years, states have been required to keep people on Medicaid with a few exceptions. Vermont is preparing for the end of this requirement. Vermont Medicaid (DVHA, the Department of Vermont Health Access) has made an "unwind" plan to explain the process and health care options that patients will have. The webpage https://dvha.vermont.gov/unwinding has more information for patients and community partners about what to know about the redetermination process. This effort will be spread out over 12 months. It will take more than a year to complete the process for all Medicaid enrollees. Check back for regular updates.

EVENTS

The UVM CORA Clinician Office Hours

Weekly on Thursdays from 12pm to 1pm ET

This program offers free and confidential consultation from addiction medicine-certified physicians focusing on substance use evaluation and management. Information shared will be general in nature and should not be considered as case-specific medical care.

The UVM CORA Clinician Office Hours program is intended only for healthcare providers or others directly serving people with substance use disorders in HRSA-designated rural areas.

Please complete the form here to register for the Clinician Office Hours sessions held weekly on Thursdays, 12:00 -1:00 pm ET.

Registration will close weekly on Wednesdays at noon.

Hospital Medicine 2023

January 29 - 31, 2023

In-Person - Lodge at Spruce Peak, Stowe, VT

This course will provide practical approaches to common problems in hospital medicine informed by experts and the latest evidence. Target audience: physicians, physician assistants, nurse practitioners, and nurses practicing Hospital Medicine. Also open to program administrators, resident physicians, and medical students with an interest in careers in Hospital Medicine. Topics will include: Curbing the Opioid Crisis, Pharmacy Pearls, Long COVID, Biliary Disease, End of Life Care in the Hospital. Optional workshop: POCUS

2023 Rural Hospital and Clinic: Performance Improvement Webinar NOSORH Region A Providers

January 30, 2023

There is still time to register for this FREE webinar covering a range of improvement issues facing rural hospitals and clinics. You can view the agenda with all the topics here.

Presenters are national specialists with long histories in rural health.

Registration is required here.

Eastern Winter Dermatology Conference

February 2 - 5, 2023

In-person - Stoweflake Mountain Resort & Spa, Stowe, VT

The 34^th Annual Eastern Winter Dermatology conference is designed to provide high-level continuing education for dermatologists and medical professionals specializing in dermatology, keeping them abreast of new and exciting findings in basic science, clinical dermatology and dermatologic therapy. Primary care physicians and medical professionals with a special interest in dermatology are also welcome to attend. Topics will include: Acne & rosacea update, innovations in connective tissue disease management, diagnosis of early CTCL, hidradenitis suppurativa, pediatric psoriasis issues, professional development - “how to say no,” erythema migrans pearls, management of high risk skin cancer, medical pearls from the literature and more!

2023 Epilepsy & EEG in Clinical Practice

February 10, 2023

In-person - Main Street Landing, Burlington, VT

Held in Burlington for the first time, the 2023 Epilepsy & EEG course will focus on providing a review of current medical and surgical clinical practices related to seizures and conjunction with adjunctive EEG testing and will address errors that may lead to incorrect diagnosis and treatment. An interactive and didactic format that includes multimedia presentations and allows for audience participation. Target audience: internists, family practice and general practice physicians, pediatricians, neurologists, physician assistants, nurses, allied health professionals and residents involved in the care of patients with seizures and epilepsy are encouraged to attend.

Note: This is being held in conjunction with the EAEEG Annual Meeting. There is a discount for attending both events.

Indigenous Historical and Intergenerational Trauma Training

for Health/Mental Health Care Providers

February 15 and 22, 2023

Virtual

This training will provide a general overview of indigenous historical and intergenerational trauma and

how this trauma directly impacts the indigenous community’s overall health and wellness.

The presenters for this training will be Kheya Ganguly, the Director of Trauma Prevention and Resilience

Development for the Agency of Human Services and Dr. Frederick Wiseman, a citizen of the Abenaki

Nation of Missisquoi and Coordinator of the Vermont Indigenous Heritage Center.

This training is for all community health and mental health related providers and first responders

View the flyer here.

Click here to join the February 15, 2023 meeting from 1pm to 4pm.

Click here to join the February 22, 2023 meeting from 1pm to 4pm.

Future Health Best: Practices for Advancing Care

March 31, 2023

Virtual and In-person at Waltham, MA

Join physician leaders and health care experts from the Northeast for a signature event to share knowledge and research that advances equitable, sustainable, patient-centered, and best-in-class health care.

For more information about the speakers, program, CME accreditation and to register please visit here.

Note: You can use the discount code of FHB23NE when registering for this event 

Save the Dates - Preparing for and Delivering Value-Based Care in Rural Communities

April 4th, May 2nd, June 6th, and June 27th, 2023

View the topics of the webinar series here.

Look for more information and registration details in February 2023 

More conferences from UVM CMIE are expected this Spring to include these topics: Anesthesia, Cardiovascular/Vascular Disease, Geriatrics and Family Medicine. Sign-up to get updates via email for topics that are of interest here

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

-- Unsubscribe --