January 28, 2025

NEED TO KNOW

Governor Scott Delivers FY26 Budget Address - Includes One-Time Blueprint for Health Support

In the midst of disruptions to federal funding across every sector, Governor Scott delivered his FY26 Budget Address on Tuesday afternoon, in which he referenced major changes to education funding, investment in housing for middle-income earners and increasing the earned income tax credit. The proposed budget also includes approximately $10.8 million for Blueprint for Health Community and Health Teams and Patient Centered Medical Homes to cover 2026 funding needs prior to the implementation of the AHEAD Model. The VMS Policy team will share more details of this proposal as we learn them.

Last week, the House Health Care Committee began to move beyond introductions and 101s to pass its first bill of the session, H.35, a consensus bill that maintains a separation of the individual and small group health insurance markets in order to take advantage of ACA premium subsidies for individuals. Also in the House Health Care Committee, Jessa Barnard, Executive Director of the Vermont Medical Society, testified on H.31, another consensus bill that advocates and insurers both support that would remove claim edit standard requirements when the health care service is delivered out-of-state and would clarify the definition of primary care provider to determine exemptions from prior authorization requirements. This week, the House Health Care Committee is scheduled to vote out the prior authorization bill and to take testimony on health reform from the Green Mountain Care Board, on the AHEAD model and on Act 167. The Senate Health and Welfare Committee will focus on newly introduced bills regarding changes to CON and expanding Medicaid coverage.   

Trump Expands Immigration Enforcement in Health Care Settings – Fact Sheets

Last week, the Trump Administration rescinded a Biden-era policy that protected certain areas - including churches, schools, and hospitals and health care settings - from immigration enforcement.  The National Immigration Law Center has released updated factsheets that describe what the protected areas policy was, what laws apply to those areas now, and additional details on protecting the rights of health care facilities, staff, and patients.   FAQs for individuals about receiving health care or applying for health insurance can be found here.   More information about the intersection of HIPAA and immigration status can be found from the Network for Public Health Law here (note that the section of this guidance regarding immigration enforcement has not been updated since Trump’s change in policy) and examples of sample policies and the types of warrants that might be presented at health care facilities are available from the California Attorney General’s guidance for health care facilities here (note that some of this guidance is specific to California law).  The University of Vermont Health Network has also shared the guidance they are providing to staff.    

 

Executive Orders Target DEI Programs – What Health Care Sector Should Know

Last week, the Trump administration released two executive orders aimed at addressing “diversity, equity, and inclusion” (DEI) or “diversity, equity, inclusion, and accessibility” (DEIA) policies: Ending Illegal Discrimination and Restoring Merit-Based Opportunity and Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.

The ”Ending Illegal Discrimination” Executive Order directs  “all executive departments and agencies (agencies) to terminate all discriminatory and illegal preferences, mandates, policies, programs, activities, guidance, regulations, enforcement actions, consent orders, and requirements…and to combat illegal private-sector DEI preferences, mandates, policies, programs, and activities.”   Related to the private sector, Section 4(b)(3) calls for the Attorney General to create “a plan of specific steps or measures to deter DEI programs or principles” and

...As a part of this plan, each agency shall identify up to nine potential civil compliance investigations of publicly traded corporations, large non-profit corporations or associations, foundations with assets of 500 million dollars or more, State and local bar and medical associations, and institutions of higher education with endowments over 1 billion dollars.

Some initial guidance for entities that may run DEI programs and initiatives viewed as discriminatory by this Executive Order can be found from several law firms here, here and here.

The “Gender Ideology” Executive Order, among other things states that: “It is the policy of the United States to recognize two sexes, male and female.”  Within 30 days, the Secretary of Health and Human Services is directed to provide to the U.S. Government, external partners, and the public clear guidance expanding on the sex-based definitions set forth in the order.  It further directs federal agencies to remove any statement, policy, regulation, form, communication or other message that promotes “gender ideology;” any agency form that requires an individual’s sex to list male or female, and not request gender identity; any agency to assess grant conditions and grantee preferences and ensure grant funds do not promote gender ideology; directs the Bureau of Prisons to ensure that no Federal funds are expended for any medical procedure, treatment, or drug for the purpose of conforming an inmate’s appearance to that of the opposite sex; and directs agencies to ensure that intimate spaces designated for women, girls, or females (or for men, boys, or males) are designated by sex and not identity. 

Continued tracking of Executive Orders that impact nonprofits can be found from the Council of Nonprofits here.

Robert F. Kennedy Nomination Hearings Jan. 29th & Jan 30th

Last week, U.S. Senate Finance Committee Chairman Mike Crapo (R-Idaho) announced that the Finance Committee will hold a nomination hearing on Wednesday, January 29, at 10:00 am to consider Robert F. Kennedy Jr. to be Secretary of the U.S. Department of Health and Human Services.  Witness testimony, opening statements and a live video of the hearing will be available on www.finance.senate.gov.   The U.S. Senate Health, Education, Labor and Pensions Committee (HELP) is holding a nomination hearing on Thursday, January 30th at 10:00 am.  A live video will be available here.

Vermonters wanting to weigh in on appointments, should contact Senator Sanders at: https://www.sanders.senate.gov/contact/contact-form/ and Welch at: https://www.welch.senate.gov/email-peter/#email-peter.  Both Vermont Senators are members of the Finance Committee and Senator Sanders is the ranking member of the HELP Committee. 

Update on CVMC Closure of Psychiatric Inpatient Unit

After the UVM Health Network announced the closure in November, on January 17th the Inpatient Psychiatry unit at Central Vermont Medical Center in Berlin stopped taking admissions into the unit and by January 21st all patients had been discharged. CVMC is currently working to decommission the space.  Going forward, after screening in the CVMC ED, patients who require an inpatient psychiatric admission will be transferred to the appropriate location in Vermont to receive those.  Recent media coverage of the closure can be found here.

ACLU Abortion Criminal Defense Initiative

Who we are

The ACLU Abortion Criminal Defense Initiative (ACDI) was created in the wake of Dobbs to address criminal defense needs of abortion providers, patients, and those helping people seek abortion care. We work to ensure that those facing abortion-related investigation or prosecution have zealous, values aligned criminal-defense counsel to fight for them. The ACDI operates a network of over 140 experienced criminal defense attorneys, barred in 36 states and counting, who are ready to defend those in need of representation. We connect people who have any abortion-related criminal defense need to an attorney in our network and provide the local defense team with support and resources necessary to mount a fulsome defense.

Examples for when to reach out

  • An abortion provider, helper, or seeker has been approached by law enforcement
  • Someone has been served with a subpoena or search warrant related to abortion care
  • An abortion provider or organization needs criminal risk advising
  • A state is seeking to use evidence that someone considered or obtained an abortion as evidence of guilt
  • An abortion provider, helper, or seeker is relying on a shield law or other state-level protection to push back against an abortion-related investigation or prosecution

Ways we support providers, helpers, and abortion seekers in your state

  • Connecting people with pro bono, local defense attorneys
  • Criminal risk advising for providers and helper organizations
  • Know your rights trainings for abortion providers and helpers
  • Helping systems-involved people access care
  • Facilitating access to funding for bail or legal services
  • Filing amicus briefs and/or serving as co-counsel in civil or criminal litigation where an issue at stake could impact prosecutions related to abortion care

How to reach us

Lauren Johnson, ACDI Director, ljohnson@aclu.org, (202) 731-5567

Liz Jarit, ACDI Senior Staff Attorney, ljarit@aclu.org, (862) 395-5826

https://www.aclu.org/campaigns-initiatives/abortion-criminal-defense-initiative

MISC.

Webinar:  Removing Invasive and Stigmatizing Language on Mental Health from Credentialing Applications

Next Wednesday, Feb. 5, 2025, from 11 a.m. – 12 p.m. CST, please join the AMA in conversation with the Dr. Lorna Breen Heroes’ Foundation (LBHF) to learn how organizations are removing barriers for physicians seeking mental health care. The webinar will focus on the organizational-wide process of removing stigmatizing and overly invasive mental health questions in credentialing applications. Panelists will describe how health systems can approach this work, common barriers, and solutions based on real examples. 

Northwell Health, a health system recognized by the Joy in Medicine Program with verification by ALL IN: Wellbeing First for Healthcare (a coalition led by the LBHF), will also share their firsthand experience for how they successfully updated their credentialing applications and describe key strategies that were important for their success. 

The panel discussion will be followed by a Q&A with the audience.

Panelists

  • Kevin Hopkins, MD, Physician Director, Health System Engagement, AMA
  • Corey Feist, CEO, Dr. Lorna Breen Heroes’ Foundation
  • Daniel Blaney-Koen, JD, AMA
  • Annabella Salvador-Kelly, MD, FACEP, Deputy Chief Medical Officer and Senior Vice President, Medical Affairs, Northwell Health

Register now.

For questions about the AMA Joy in Medicine program, please email Practice.Transformation@ama-assn.org  

Salary Data and Contract Review Tips: March 18th, 12-1pm

VMS has partnered with Resolve to help connect members to contract review services and access to compensation data. On March 18th from 12-1pm join Resolve CEO Kyle Claussen for a webinar to learn tips about physician employment contracts. Register here. How do you know what you are worth? What's in a normal contract? How do you know if you have leverage? Kyle will address key contract provisions including:

  1. Compensation
  2. Call Coverage
  3. Maternity Leave
  4. Non-competes
  5. Side Gigs
  6. Intellectual Property
  7. Private Equity Buy-outs

Bring your questions! Whether you are considering your first job after residency, thinking about a position change or just want to understand what is in your current contract, this webinar is for you.

Kyle Claussen is the CEO of Resolve, an attorney and physician compensation and contract expert. He has spent the last decade advocating for physicians in their employment contracts. Kyle is married to an ophthalmologist, has 3 kids, and a dog.

Register for the webinar here.

Back for 2025, Quarterly Financial Webinars Hosted by Pinnacle Wealth (FKA Pastore Financial Group)

Pinnacle Wealth has been a supporter of VMS for decades.  Our independent, fiduciary advisors will share insights to help you on your financial journey.  Can’t make the webinar but have quesitons? Please email info@pinnaclevt.com for an individual meeting.

Early Career: Questioning your student loan strategy?  Do you have the right amount of life and disability insurance?  Are you maximizing opportunities to accumulate wealth and minimize taxes? Join us for an exclusive seminar for VMS members. We will discuss updates to SAVE and PSLF, important insurance concepts, and strategies to maximize accumulation during your early years as a physician.

Register for Tuesday evening, February 11th from 7-8pm 

Approaching Retirement: Are you confident in your retirement plan? Concerned about market volatility? Do you have a strategy to protect your investments while maximizing returns? Join us for an exclusive retirement planning seminar for VMS members.  We will discuss key strategies to secure your financial future and enhance your investment growth in today’s unpredictable market.

Register for Wednesday evening, February 12th from 7-8pm 

Next Commissioner Call, February 6, 2025

The Commissioner of Health, Mark Levine, MD, will hold his next Public Health Update with VMS Members this Thursday, February 6th at 12:30 pm. You can join the zoom meetings here.

He held his most recent VMS member call on January 2nd. Notes from the call are here. 

EVENTS


AMA Advocacy Priorities with a New Administration and Congress Webinar

January 29th, 12pm

With a new administration and new Congress taking the reins at the start of this new year, how is AMA advocacy positioned to effect change on the key issues facing patients and physicians? What opportunities and challenges lie ahead, and how can physicians get involved?

Join this AMA Advocacy Insights webinar on Jan. 29 at Noon Eastern/11 a.m. Central to hear the latest, and get a sneak preview of the upcoming AMA National Advocacy Conference in February.

Register here.


Contemporary Issues in Health Care Ethics: A 4 Part Series

January 2025, 12pm - 1:15pm


Incapacitated Refusals & Vermont's Ulysses Clause

January 30th - Register here


42nd PAAV Annual Winter CME Conference

January 30th - February 2nd, 2025

The annual winter PA Academy of Vermont Conference is at Stoweflake in Stowe, VT 1/30/25 -2/2/25

Please come join the fun and get CME too!

VMS President, Dr. Katie Marvin speaking on Saturday!

The early bird rate is extended through 12/13/24. (save $100)

Learn more and register here.

Learning Collaboratives on In-Basket Reduction and Reducing Regulatory Burden

October 2024 – March 2025

AMA STEPS Forward® Innovation Academy is launching two new, six-month learning collaboratives on optimizing the in-basket to reduce work burden and rethinking how organizations apply regulatory rules to clinical practice. Each collaborative will convene dyads or triads of leadership representatives from multiple organizations to engage in a longitudinal shared learning experience. Limited space available. Learn more.

For more information about offerings from UVM CMIE, visit here.

VTMD.ORG

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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