January 4th, 2022

NEED TO KNOW

VMS President's Message: Time for Selfish Pursuit of Well-Being and Connection

As I sit to write this New Year's message, I am painfully aware of how many of us in health care have been pushed to our physical and emotional breaking points by the sustained pressures of the COVID-19 pandemic. The words "Happy New Year" ring somewhat hollow, while our hospitals and facilities are filled with the most recent surge in COVID-19 cases, systemwide staffing shortages continue to force us to reduce hours and close beds and patient pandemic fatigue is causing unnecessary hostility and distrust towards our health care community. Yet, does the collective catharsis of the rapidly evolving global health care crisis provide clinicians with a larger opportunity? An opportunity to prioritize well-being as a path to better health overall?

U.S. Surgeon General, Vivek Murthy says, "the truth is that if we can’t fully optimize our well-being, we can’t understand how to build a foundation for good health. If we don’t understand the interplay between our mental health, our physical health and our spiritual health." Many of us treat specific physical and mental conditions more narrowly, but increasing evidence shows that focusing on emotional well-being can have an overall impact on one's length and quality of life. For example, according to the National Institutes of Health (NIH), having a sense of purpose in life is shown to reduce the risk of heart attack and stroke. For the full message click here. 

COVID-19 Cases in Vermont Hit New Highs, Expected to Climb

The Scott Administration did not hold its typical Tuesday COVID-19 response press conference this week as the Governor will be giving his State of the State address tomorrow to the legislature. The address will air at 2 pm tomorrow and can be live-streamed here. Health Commissioner Mark Levine, MD, was the guest on VPR’s Vermont Edition today discussing the State’s response to the Omicron variant. The show will re-air tonight at 7 pm and a recording will be available here. Dr. Levine confirmed that Vermont is experiencing record-breaking case counts although compared to other locations still maintains adequate hospital capacity. He encouraged Vermonters to consider switching to more effective masks and stated that the administration is committed to helping childcare centers have access along with K-12 schools to rapid testing, with more information to come from the administration soon. The Department of Financial Regulation also released its weekly modeling report today showing that Vermont’s 7-day case average has increased 128% and the 7-day test positivity has increased 117%. Cases are rising among the fully vaccinated and not fully vaccinated, all ages and counties. COVID-19 cases are expected to sharply increase over next 4 weeks fueled by a post-holiday surge combined with more-transmissible Omicron variant. There has been a 17% increase in hospitalization average and 13% increase in the ICU average over the past week; 64 hospital beds and 20 ICU beds were available statewide as of today. 

In other COVID-19 Updates:

• VMS will host its biweekly call with Commissioner of Health Mark Levine, MD, this Thursday, Jan. 6th at 12:30 pm. Zoom link here.
• Vermont Department of Health adopted updated guidelines on isolation following a positive COVID-19 test – largely adopting the new CDC guidelines that reduce the isolation period to 5 days but also calling for two negative antigen tests performed at least 24 hours apart.  
• A Vermont Department of Health December 30 Health Update includes a change in policy regarding monoclonal antibody use, as well as information on oral treatment for COVID-19 and how to access and prescribe new COVID-19 therapeutics. VDH will be hosting an open office hours are for providers in Vermont to speak with VDH and the clinical advisor team regarding the changing COVID-19 therapeutics landscape on Thursday, Jan. 6tth from 12-1:00 PM. Click here to join the meeting or call in (audio only) +1 802-828-7667,,205693217#  
• The U.S. Food and Drug Administration yesterday amended the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 Vaccine to allow: booster shots for adolescents aged 12-15; shorten the booster interval to five months for people 12 years of age and older; and add a third primary series dose for certain immunocompromised children ages 5 through 11. CDC sign off is expected mid-week. 

Vermont Legislature Returns Remotely Tuesday, Jan. 4th

The Vermont Legislature began the 2022 legislative session today, Tuesday, January 4th. Similar to the first half of the biennium, lawmakers will be meeting remotely in order to avoid the spread of COVID-19. Legislative leaders had originally signaled lawmakers would return to Montpelier in-person, but the highly contagious Omicron variant has caused them to delay bringing the 180 House and Senate members back together under the Golden Dome. If COVID-19cases decrease significantly over the next two weeks lawmakers could be back in the Statehouse as early as January 18th, but the crush of cases predicted after the holidays puts that in question. Whether remote or in person, it being the second year of the biennium means legislation will advance at breakneck speed in 2022. Healthcare issues that are scheduled to move quickly this session are a potential statewide mask mandate, COVID-19 flexibility extensions, the constitutional amendment to protect reproductive liberty and a fiscal year '22 budget adjustment that includes increases in Medicaid reimbursement. The VMS policy team will be taking an active role in these discussions, testifying Wednesday on COVID-19 regulatory flexibilities, and urging lawmakers to invest in primary care, health care workforce, pediatric mental health and cannabis prevention. Click here to learn more on how you can get involved in advocacy in 2022!

VMSERF Announces 2022 Leadership Cohort

The VMS Education and Research Foundation is pleased to announce the participants in its 2022 Executive Leadership Institute.  This year’s class consists of 19 participants – both physicians and physician assistants.  You can find their biographies on the PELI website. The VMSERF Board was impressed by the interest of all applicants and the diversity of candidate backgrounds, including participation from across the state and in varying specialties.  The first session of the course will take place January 20^th & 21^st and continues through November. 

Please join VMSERF in congratulating the 2022 Leadership Institute Cohort.

MISC.

CMS Health Care Staff Vaccination Requirement Moving Forward in Vermont – Vaccination Required by Feb. 28

Last week, the Centers for Medicare & Medicaid Services (CMS) released guidance on the Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule that was published on November 5, 2021. The emergency regulation requires vaccinations for eligible staff at health care facilities participating in the Medicare and Medicaid programs, including Ambulatory Surgery Centers, Community Mental Health Centers, Home Health Agencies, Hospitals, Rural Health Clinics/Medicare Federally Qualified Health Centers, and Long Term Care facilities.  While implementation and enforcement of this regulation is enjoined in 25 states, the rule currently applies to facilities in the remaining 25 states, including Vermont.  Facilities covered by this regulation (but not in the enjoined states) must establish a policy ensuring all eligible staff have received the first dose of a two-dose COVID-19 vaccine or a one-dose COVID-19 vaccine prior to providing any care, treatment, or other services by January 27, 2022, 30 days following the publication of the guidance.  All eligible staff must have received the necessary shots to be fully vaccinated – either two doses of Pfizer or Moderna or one dose of Johnson & Johnson – by February 28, 2022, 60 days following the publication of the guidance.

For additional information: CMS Guidance, Cover Memo and FAQs

“No Surprises Act” Requirements Effective January 1

VMS reminds members that the Consolidated Appropriations Act of 2021 (“No Surprises Act”) established several new requirements for providers, facilities, and providers of air ambulance services to protect consumers from surprise medical bills. Many of these provisions went into effect on January 1. The most common new requirements that Vermont medical practices should be aware of include:

• Posting Notice of Balanced Billing Prohibitions (if providers furnish items or services at a health care facility, or in connection with visits at health care facilities)
• Providing “Good Faith Estimates” to Self-Pay Patients

For a summary of the requirements and links to more resources, see the VMS summary here.  Members can also contact Jessa Barnard at jbarnard@vtmd.org with questions.

EVENTS

Join us every 1^st and 3^rd Thursday of the month from 12:30pm to 1pm as Commissioner of Health, Mark Levine provides us with the most pressing COVID-19 information affecting the state and nation. You will have the opportunity to submit questions to Dr. Levine who will answer them, time-permitting.

You can join the zoom meetings beginning in January here or add to your calendar by following this link and clicking download (you will then need to open the downloaded file and click save to add to your calendar).

University of Vermont Project ECHO 

Perinatal Mental Health

January 11th - June 14th, ET

This program will highlight best practices and evidence-based care for screening and treating patients with perinatal mood and anxiety disorders. The series will identify strategies and emerging topics in perinatal mental health and highlight resources for patient care. The target audiences are individuals or teams of health professionals in family medicine, obstetrics/gynecology, psychiatry, internal medicine adult primary care, and pediatrics; including prescribers, nurses, mental health professionals, and social workers/case managers throughout Vermont.

This program is offered at no cost to participants through a grant from the Vermont Department of Health.

Participants can receive CME credits for each learning session attended. 

For more information, visit here.

University of Vermont Project ECHO 

Adult Complex Mental Health

January 19th - June 22nd, ET

This program will highlight best practices and evidence-based care for treating patients with complex mental health issues and disorders. The program will identify strategies, best practices, and emerging topics in this field – and highlight resources for patient care. The intended audience is a cohort of individuals or practice teams throughout Vermont, including Family Medicine and Internal Medicine Adult Primary Care.

This program is offered at no cost to participants through a grant from the Vermont Department of Health.

Participants can receive CME credits for each learning session attended. 

For more information, visit here.

Hospital Medicine 2022 and Optional POCUS Workshop

January 30th - February 1st, 2022, ET

The course will provide practical approaches to common problems in hospital medicine, informed by experts and the latest evidence. All provider types practicing Hospital Medicine are welcome, including administrators, resident physicians and medical students.

An optional Point-of-Care Ultrasound (POCUS) workshop will take place at the UVM SIM Lab in Burlington on Sunday morning, January 30.

For registration information (in-person and virtual option), full agenda & accreditation details, click here. 

Questions: Contact Michele Morin at: Michele.Morin@med.uvm.edu or 802-922-3594

The 33^rd Annual Eastern Winter Dermatology Conference

February 5th - 7th, 2022, ET

Dr.. Glenn Goldman invites you to attend this year’s dermatology conference which is returning to Stowe for its 33^rd year. The conference is divided into morning and late afternoon sessions, with a large mid-day break to allow for recreation. Although the course is designed for dermatologists, medical professionals with an interest in dermatology are welcome to attend.

Topics: Locoregional and in-transit metastatic melanoma, skin reactions to immunotherapy, testing and imaging for SCC, MCC, and MM, cosmetic dermatology, challenging cases, medical pearls, Dermatology Jeopardy, and more!

For registration information, full agenda & accreditation details, click here.

Questions: Contact Michele Morin at: Michele.Morin@med.uvm.edu or 802-922-3594

The Third Annual Teaching Cannabis Awareness and Prevention Conference, will be held remotely on April 27^th & 28^th, 2022 from 8:00am-12:30pm PT.

This conference is for educators, TUPE Coordinators, community-based organizations, school administrators, healthcare providers, school resource officers, parents, and anyone else working with youth to learn about the latest research on youth and cannabis, including products being used, reasons for use, health effects, and the latest available lessons for teaching cannabis education and prevention to middle- and high school-aged youth. 

This year there will be a Call for Workshops, where individuals are invited to submit abstracts and ideas if interested in presenting your own workshop. Submit Call for Workshop proposals by January 17th by visiting here.

The registration fee is a $125 per person, which will include unlimited access to view all Keynotes, workshops and resources for one year after the conference. To register visit here.

If you have any questions, email canprevtoolkit@stanford.edu.

With the influx of Afghan families resettling to U.S. States under Operation Allies Welcome we know that many clinicians and health care systems will be seeing  these individuals. 

We put together this free four-hour course, composed of recorded lectures and interactive lessons to help prepare providers to serve newly arrived Afghans. It covers topics ranging from Operation: Allies Welcome to Afghan cultural background, general and skin medical exams, and mental health care, to clinical observations from practitioners at welcome centers and in receiving states. 

We hope you will find this resource helpful. Please share this message and link with anyone you think would find it useful. We have additional free resources available here.

Register here! This course is free but does require registration. Once registered you will receive an email receipt with a link to the course.

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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