October 24, 2023

NEED TO KNOW

Mental Health Urgent Care Spaces Open Across Vermont as Alternatives to Emergency Departments

This fall, mental health support programs have opened across the State to provide alternatives to Emergency Departments (EDs) for Vermonters in need of urgent care mental health services. The Vermont Department of Mental Health (DMH) has provided funding for a variety of alternative mental health models of care to treat both youth and adults. According to DMH, they have awarded seven out of eight grants for community-based care that a recent VT Digger article described as, “instead of a packed waiting room, there is a wide sofa on a cozy carpet surrounded by bright posters and cheerful plants. ...[T]he plan is for a visitor to be greeted by someone whose focus is solely on the person in front of them.”  DMH says they know that these spaces won’t keep everyone out of the emergency room, but they hope that by providing this access at the community level they can treat people when they need it and prevent it from escalating.  The Department awarded grants to VT CARES (formerly CAHOOTS) in Chittenden County, three Living Room models to Northeast Kingdom, Washington County, Addison Counties, three PUCK (Psychiatric Urgent Care for Kids) in Bennington, Windham/Windsor, and Lamoille Counties. The remaining grant that needs to be executed is PUC (Psychiatric Urgent Care for adults) in Chittenden County. Click here for an overview of current DMH activities, including addressing system capacity.

Violence Against Vermont Healthcare Workers Highlighted in NYTimes

The New York Times highlighted in an article and video published today the frequent, devastating acts of violence that health care workers are subject to on the job.  The video was created by the University of Vermont Health Network as a way to amplify staff stories and improve awareness of this challenge.  See more on the Health Network project and video here.   Thanks to testimony by many health care workers and support of organizations including VMS, the Vermont Association of Hospitals and Health Systems and the Health Network, the Vermont legislature passed Act 24 this session, which allows arrest without a warrant for violent or threatening behavior in hospitals. 

Apply by October 31st for the AAPVT Chapter - Flu and COVID19 Vaccine Grant

The AAPVT Chapter is pleased to again partner with the Vermont Department of Health to offer another round of funding for Flu and COVID19 immunization clinics. This is a grant that allows practices to apply for a maximum grant award of $10,000 (pending availability of funds).

Applications will be reviewed on receipt and funds will be distributed upon receipt of final project report. The reporting requirements will be distributed after the application deadline. Reporting will be due April 1, 2024.

The last date to return the completed application with the required budget is October 31, 2023.

Find more details and how to apply by October 31st here. 

If you have any questions, please reach out to Birdie Pauley at BPauley@vtmd.org.

Seeking Feedback on Department of Health Proposed Rule Changes: Telehealth Licenses Created, ALS Reporting, Co-Prescribed Naloxone

The Department of Health has released a number of draft rules for comment, described further below.  Please share comments or concerns regarding any of these rule proposals with Jessa Barnard at VMS at jbarnard@vtmd.org by Friday, November 17th.   

  • Board of Medical Practice Rule Adds Telehealth Licensure and Registration:   Rule changes proposed by the Board largely put into rule statutory changes passed by the legislature, including: adding a telehealth license and registration process for physicians, PAs and podiatrists, which would allow out of state practitioners to receive a telehealth-specific license or registration based on the number of Vermont patients seen; adding the ability of the Board to issue administrative penalties; and updating the language regarding supervising radiology assistants.   The draft rule can be found here.
  • ALS Registry: The Department has released a draft rule to establish a Vermont Amyotrophic Lateral Sclerosis (ALS) Registry, as directed by the Vermont legislature in 18 V.S.A. chapter 4A.  The rule will require a health care provider who screens for, diagnoses, or provides therapeutic services to patients with amyotrophic lateral sclerosis to report to the Department all individuals diagnosed as having ALS not later than six months from the date of diagnosis, unless the provider knows that a report for that patient has already been made to the Department.  Note that the Department adopted an emergency rule in August to establish the ALS Registry.   Changes included in this draft final rule include not requiring a provider to make a report if they know that a report has already been made.  The full proposed rule can be found here and the draft reporting form can be found here.   
  • Naloxone co-prescribing: The Department has proposed an update to the Rule Governing Prescribing Opioids for Pain that would allow any "opioid antagonist" rather than only “naloxone” to be co-prescribed in the section of rule that requires the co-prescribing of an opioid antagonist when prescribing 90 MME or more of an opioid or a concurrent benzodiazepine.  The draft rule can be found here. 
  • Hub and Spoke rules: The Department has been working with stakeholders, including VMS, to update the rules for Office-Based Opioid Treatment (OBOT) Providers and Opioid Treatment Programs (OTP).  Changes include updating terminology; updating descriptions of the use of telehealth; removing outdated references to needing a DATA 2000 waiver; updating language regarding informed consent, ongoing monitoring and diversion.  The draft rule can be found here. 

CDC Health Alert Network (HAN) Health Advisory: Limited Availability of Nirsevimab in the United States

The Centers for Disease Control and Prevention (CDC) has issued a Health Alert Network (HAN) Health Advisory to provide options for clinicians to protect infants from respiratory syncytial virus (RSV) in the context of a limited supply of nirsevimab, a long-acting monoclonal antibody immunization product recommended for preventing RSV-associated lower respiratory tract disease in infants.  CDC recommends prioritizing available nirsevimab 100mg doses for infants at the highest risk for severe RSV disease: young infants (age <6 months) and infants with underlying conditions that place them at highest risk for severe RSV disease.  See the full HAN here. 

Reminder: Community Meetings to Inform Hospital Transformation Run Today Oct 24th - Nov 15th

In 2022, the legislature passed Act 167 (of 2022) which called for healthcare delivery reform in the state of Vermont, focused on reviewing the services offered in each of Vermont’s hospital service areas.  A central part of the information gathering process is a listening tour to hear directly from health care clinicians and Vermonters about current experiences with the healthcare system.  It is critical that physicians, PAs and other clinicians attend and share input on the services provided in your area.

A schedule of community meetings is now live on the Green Mountain Care Board website.   On this page you can register directly for the meeting(s) you’d like to attend in your region.

Provider meetings are all scheduled from 6:30-8:30 pm on the following dates:

  • Barre / Central Vermont Medical Center - Monday, November 6, 2023
  • Bennington / Southwestern Vermont Medical Center - Thursday, November 2, 2023
  • Brattleboro / Brattleboro Memorial Hospital - Monday, October 30, 2023
  • Burlington / University of Vermont Medical Center - Thursday, October 26, 2023
  • Middlebury / Porter Medical Center - Wednesday, November 8, 2023
  • Morrisville / Copley Hospital- Wednesday, November 8, 2023
  • Newport / North Country Hospital - November 14, 2023
  • Randolph / Gifford Medical Center - Thursday, November 9, 2023
  • Rutland / Rutland Regional Medical Center -  Thursday, November 16, 2023
  • Springfield / Springfield Hospital - Wednesday, November 15, 2023
  • St. Albans / Northwestern Medical Center -  Monday, November 13, 2023
  • St. Johnsbury / Northeastern Vermont Regional Hospital - Tuesday, October 24, 2023
  • Townshend / Grace Cottage Hospital - Tuesday, November 7, 2023 
  • White River Junction / Mt. Ascutney Hospital and Health Center - Wednesday, November 1, 2023

See the full schedule and sign up here: https://bit.ly/Healthcare-Community-Meetings.  

MISC.

Register for the 210th Annual and Collaborative Meeting Today!

The 210th VMS Annual Meeting will be held on November 3rd and 4th in person at Topnotch Resort, Stowe, VT, with virtual options. The weekend will be filled with educational content, time spent with colleagues, policy-setting meetings, and the opportunity to honor physicians and other health care leaders across the state.

Learn more about the agenda and register here!

Survey Closing Today 10/24 - Proposed Resolution on Ethical Dilemmas in Pay for Performance Programs

The VMS Board is seeking member feedback on a policy resolution related to Addressing Ethical Dilemmas in Some of CMS’s Pay for Performance and Value Based Care Programs  The full text of the Resolution is available here.   The survey to provide feedback will close today.  If you did not receive your survey link or have any questions or concerns with completing the survey, please contact bpauley@vtmd.org. The resolutions will be discussed together with the feedback received from members by the VMS Board at its November 8th Board Meeting. If you would like to join this meeting via Zoom, please contact Birdie Pauley at BPauley@vtmd.org.

Apply By Nov 1: VMS ERF Clinician Leadership Course

The Vermont Medical Society Education & Research Foundation is accepting applications through November 1st for a 5th statewide Executive Leadership Course beginning in January 2024. VMSERF is pleased to continue to offer an experiential learning opportunity that will enhance and fine-tune leadership skills and concepts for a statewide cohort of Vermont physicians and PAs.  The course will run from January through November 2024.  It is aimed at individuals with 5 or more years of clinical experience but minimal formal leadership training, with a goal of enrolling 15-20 physicians and PAs from across Vermont.  To apply, submit a CV and brief description of interest to swinters@vtmd.org by November 1st. View the full 2024 brochure, schedule and application information here.

PlanWell Financial Education Series Launches Nov 13th


Baystate Financial, in partnership with VMS, is offering a holistic financial education curriculum that aims to provide thoughtful and objective information focused on the achievement of personal financial goals at any stage of career, or life. These workshops are offered virtually at no cost to any of the participating physicians.  The series includes:


SaveWell:  Monday, November 13th at 12:30 p.m. or 5 p.m.

InvestWell: Monday, November 20, 2023 at 12:30pm or 5:00pm

ProtectWell: Monday, November 27, 2023 at 12:30pm or 5:00pm


Learn more about the other workshops being offered and register here. 

Vermont Retirement Systems Seek Member for Medical Review Board

Vermont’s three public retirement systems seek a licensed physician to be a member of the State’s Medical Review Board (MRB).  The MRB is a State Board comprised of three physicians that reviews and makes recommendations on applications for disability retirement benefits.  The Board is staffed by employees of the Retirement Division, which is housed in the State Treasurer’s Office.  The position involves a limited commitment of approximately 6 hours/month.  For more information about the position, please see here. Interested candidates should send a resume and statement of interest to briana.howard@vermont.gov. 

Commissioner of Health Public Health Notes from Update and Next Call Thursday, November 2nd

The Commissioner of Health, Mark Levine, MD, joined the VMS for a public health update on October 5th. You can find the notes here.

The next Public Health Update will be Thursday, November 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.

You Are Invited to the 2024 Vermont Voices of Medicine Advocacy Breakfasts

Please join us in January to meet your lawmakers and to advocate for health care policies over coffee and a light breakfast. These breakfasts, which will be held in the cafeteria at the Vermont Statehouse in Montpelier, are an informal opportunity to educate lawmakers on ways to improve Vermont's practice environment. Each breakfast starts on specific Thursdays and runs from 7:30-9 AM. 

The Vermont Medical Society (VMS) will be hosting several of the breakfasts with others hosted by the Vermont Academy of Family Physicians, the American Academy of Pediatrics Vermont Chapter, the Vermont Ophthalmological Society, the Vermont Psychiatric Association, the OB/GYN residency program, and Larner College of Medicine medical students. Please RSVP to attend the breakfasts being hosted by the specialty society of which you are a member. The VMS advocacy breakfasts are open to all specialties to attend. Please reach out to Jill Sudhoff-Guerin at jsudhoffguerin@vtmd.org if you have any questions. 

Click here for the list of dates & to register. 

Click here for more information. 

EVENTS

Vermont Reimagining Drug Policy Conference

November 9, 2023 from 10am to 2pm

Webinar


Keynote speaker Dr. Sarah E. Wakeman is the Medical Director for the Mass General Hospital Substance Use Disorder Initiative, program director of the Mass General Addiction Medicine fellowship, and Assistant Professor of Medicine at Harvard Medical School. 

Panels on evidence-based reforms and the impacts of criminalization will feature international experts, including:

  • Corey Davis (Network for Public Health Law)
  • Niamh Eastwood (Release)
  • Jeffrey Bratberg (University of Rhode Island College of Pharmacy)
  • Daniela Gilbert (Vera Institute)
  • Kennedy Stewart (SFU School of Public Policy)
  • Jennifer Carroll (NC State)

Learn more about the conference agenda, featured speakers, and register for FREE here. 

Osteoporosis Update for Primary Care November 2, 2023

Hampton Inn Conference Center, Colchester, VT

This conference is designed to improve the skills of the primary healthcare team, as they are often the first to encounter patients who have (or are at risk of developing) osteoporosis. A wide spectrum of diagnostic, management and treatment options will be presented. Topics will include: osteoporosis treatment and fractures, physical therapy and bone health, glucocorticoid-induced osteoporosis, and risks, evaluation and treatment for postmenopausal osteoporosis.

Registration information, full agenda, and accreditation details can be found here.

#MEAction New Hampshire - The Untreated Epidemic: Understanding and Treating Long Covid and ME/CFS

November 6, 2023

Virtual and In-Person at the Dartmouth-Hitchcock Medical Center

This free AMA PRA Category 1 Credits™ (3.5 hours) features Grand Rounds speaker Dr. Lucinda Bateman, Medical Director of the Bateman Horne Center and one of the leading worldwide experts in Long COVID and ME/CFS. Also featuring Ryan Prior, former CNN reporter and author of “The Long Haul”, who will moderate our panel titled “Educating Each Other: Enhancing Patient/Provider Collaboration”, and Lisa McCorkell, co-leader of thePatient-Led Research Collaborative who will speak on the future of medicine and research. 

To register and learn more, click here.

New England Rural Health Association's Annual Fall Conference

"New Horizons in Rural Health Equity"

November 8-9, 2023

Killington Grand Resort Hotel, Killington VT

This conference is an opportunity for rural healthcare professionals, hospital administrators, educators, students and community leaders to learn from experts in rural topics, and to network with each other. Designed to involve all sectors that impact the health of people in rural New England, this multidisciplinary event gives attendees the opportunity to delve into specific areas of interest or participate in sessions spanning a variety of topic areas.

Register today for NERHA's Fall 2023 Conference and learn more here.

CPT & RBRVS 2024 Annual Symposium

November 15-17, 2023

CPT & RBRVS 2024 Annual Symposium is the world's only medical coding conference where attendees learn about the upcoming changes to the Current Procedural Terminology (CPT) code set and payment policies directly from members of the AMA-convened CPT Editorial Panel, AMA/Specialty Society Relative Value Scale Update Committee (RUC), and CPT and RUC Advisors.

Join virtually to get the first look at the 2024 CPT code set with guidance from the experts, earn continuing education credits, and join over a thousand of your peers for premier coding education at the CPT & RBRVS Symposium!

Register with early bird discounted rates through September 30th here.

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

VTMD.ORG

Vermont Medical Society

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Montpelier, VT 05602

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