October 26th, 2021

NEED TO KNOW

Expressing Gratitude to Our Members

As we enter fall and are over 18 months into the COVID-19 pandemic with Vermont seeing rising case counts and hospitalizations, we want you to know that VMS is here for you. We know you are working harder than ever, with resources stretched thinner than ever, are seeing more patients and have more stress in your personal lives. We also want you to know that we are grateful for your service to your patients and the State. If we have learned anything in the past 18 months, it is that we all rely on a robust healthcare and public health system, and those systems are made up of you and your colleagues. So thank you from all of us here at VMS.

We also know that “thank yous” are not enough, and we are working hard to improve Vermont’s COVID-19 response and to improve the health care environment on your behalf with the administration, policy makers and other health care associations. This week, the Agency of Human Services released a Health Care Workforce Development Strategic Plan, which includes recommendations for action and designates an accountable entity for growing and retaining health care workers through methods including financial incentives like scholarship and loan repayment, education and training programs, and streamlining licensure. The report opens “with gratitude and appreciation for all members of the health care workforce who have provided care and comfort to Vermonters and have demonstrated resilience throughout the COVID-19 global health pandemic.”

VMS, along with other health care associations, released a statement supporting the Strategic Plan. Last week, Mike Smith, Secretary of the Agency of Human Services, also stated that “The main point I really want to make here is that across the board our health care workforce is under stress. With that said, day in and day out we see them going above and beyond to care for their fellow Vermonters. So I want to take a moment to thank them, to sincerely thank them for all that they do.”

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VMS 208th Annual and Collaborative Meeting - Register Now!

We hope you will be able to join us on both Friday, November 5th and Saturday, November 6th for this year's 2021 VMS Annual & Collaborative meeting, a virtual event, held in collaboration with the American Academy of Pediatrics Vermont Chapter, Vermont Academy of Family Physicians, and the Vermont Psychiatric Association.

Although we will not be meeting in person, these virtual sessions will provide unique opportunities for you to align with VMS colleagues on how to tackle tough clinical issues in your practice.

All 2021 Annual Meeting activities will be held virtually. To view the full schedule of events, the speakers, and awardees, click here.

Register for the membership meeting here.

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AAPVT Chapter - Now Accepting Grant Applications for Flu & COVID Vaccine Clinics

The American Academy of Pediatrics Vermont Chapter, in collaboration with the Department of Health’s Immunization Program, is providing funding to support expanded influenza and/or COVID vaccination by healthcare practitioners or organizations. In an effort to decrease the incidence of disease throughout the state of Vermont, healthcare practitioners are encouraged to offer expanded services to increase influenza and/or COVID vaccine coverage, including, but not limited to, longer or designated hours, off-site clinics, or additional staffing.

Scope of Grant - Providing Support for Influenza Vaccination Clinics

It is the intent of this grant to provide support for health care practices/organizations to:

assess barriers to pediatric COVID-19 and/or seasonal influenza vaccinations in the communities served by the recipient and in collaboration with community organizations.
implement COVID-19 and/or seasonal influenza vaccination clinics in communities to address identified barriers. Emphasis should be placed on offering vaccination clinics specifically to high-risk populations or those with limited access (e.g. assisting living communities, senior housing, schools, children under the age of 18 and their care givers).
expand access to COVID-19 and/or seasonal influenza vaccination at primary care practices through patient outreach, vaccine promotion, and expansion of vaccination services.
offer off-site, weekend, and after-hours COVID-19 and/or seasonal influenza vaccination clinics at selected locations to meet the need(s) of the community served (e.g. schools, shelters, meal sites, etc.)

Health Care Practices/Organizations may receive $1000 per clinic held (up to a maximum of $5000 total). Applications may include clinics held retrospectively starting September 1^st. Applications will be reviewed on receipt and funds will be distributed upon receipt of final project report. Applications must be received by November 19^th, 2021. Immunization clinics that are part of this grant must be held and reported on by March 31, 2022.

If would like to apply for the grant, please complete the below application (either in word or pdf form) and email back to swinters@vtmd.org.

Word - Flu Clinic Grant Application 21-22.docx

PDF - Flu Clinic Grant Application 21-22.pdf

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Vermont Sees Slight Downtick in COVID Cases; Updates School Guidance

The Scott Administration held its weekly press conference today and Commissioner of Department of Financial Regulation presented his modeling report showing that COVID 19 cases in Vermont have decreased 15% over 7 days and 7% over 14 days. Cases continue to be highest in the Northeast Kingdom, including Orleans and Essex Counties, and among younger age groups. Commissioner Pieciak cautioned that while decreasing cases is a good sign, Vermont has seen cases decline and then go back up in the past. Nationally and regionally, cases, hospitalizations and deaths continue to decline. When pushed on a statewide indoor mask mandate, Governor Scott reiterated that he is not declaring a state of emergency and does not believe a mask mandate will change the course of the pandemic in Vermont.

Vermont Agency of Education (DOE) Secretary Dan French reported that universal masking guidance for schools will now remain in effect through January 18, 2022, to give time to get through the holiday season and for 5-11 year olds to be vaccinated. The Department of Education has also recently updated its close contact definition for contact tracing and only students who have been within 3 feet of an infected person for a total of 15 minutes or more over a 24-hour period are now considered a close contact. DOE is also working to support schools in standing up “test to stay” programs and 19 supervisory unions have now been sent antigen kits. Winter school sports guidance will be issued later today and will include requirements for masking or weekly testing if the sport does not allow masking. For notes from the press conference, click here.

On October 21, 2021 and October 22, 2021 Commissioner of Health, Mark Levine shared updates on cases, hospitalizations, vaccines/boosters, and more. To view the notes in details, click here.

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COVID Vaccine Booster & Pediatric Updates

Breaking News Today - FDA panel votes to recommend the Pfizer-BioNTech vaccine for those 5-11 - read more here.

Last week, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) recommended the use of booster shots for recipients of Moderna and J&J’s COVID-19 vaccines (CDC Expands Eligibility for COVID-19 Booster Shots | CDC Online Newsroom | CDC). This is in addition to the existing approval for Pfizer boosters. To read the full description from the Vermont Immunization Department, click here.

Update on pediatric Pfizer vaccine ordering: 15,900 does have been ordered for Vermont. The first doses will be distributed to mass vaccination locations such as EMS, school-based and hospital-based clinics, as soon as November 4^th. The Vermont Immunization program has received confirmation in writing that Pedi Pfizer ordering and distribution by community practices for minimum order doses will begin the week of November 8^th. That means Vermont providers will have to enter their orders into our ordering system (VIMS) by Wednesday, November 10^th. Orders could land in Vermont as early as Friday, Nov 12, likely not later than the following Tuesday 11/16. Medicare and Medicaid are preparing to activate codes for administering pediatric Pfizer doses and they will be reimbursed at $40 per vaccine, as with adult COVID vaccines and booster. See the CMS chart here.

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Physician Executive Leadership Institute - Now Accepting Applications!

The Vermont Medical Society Education & Research Foundation (VMSERF) is proud to announce its third statewide Physician Executive Leadership Institute Foundational Course to begin in winter 2022! This course is offered in partnership with the Daniel Hanley Center for Health Leadership and Lumunos.

Physicians and PAs have been asked to step up and skillfully lead rapid change throughout the COVID-19 pandemic. Every clinician brought their leadership, management styles, and skills to the forefront to ensure the best outcomes for Vermont patients. VMSERF is pleased to continue an experiential learning opportunity that will enhance and fine-tune the most important leadership skills and concepts for a statewide cohort of Vermont physicians and PAs.

To learn more details about the 2022 course, the curriculum, and how to apply, click here or contact swinters@vtmd.org. Applications are due November 19^th.

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MISC.

Congressman Welch Voices Opposition to Pending Cuts to Medicare Physician Payments

In what amounts to a “perfect storm” of payment reductions going into effect in 2022, several scheduled Medicare spending cuts would result in a combined 9.75% payment cut for physician practices on January 1st. Vermont’s Congressman Peter Welch has joined a “Dear Colleague” letter urging House leaders to act before the end of the year to avert the imminent cuts, including extending a 3.75% increase to the Medicare conversion factor that Congress included in the Consolidated Appropriations Act of 2021, to provide continued stability to the physician and provider community as it works toward broader Medicare payment reform. VMS thanks Congressman Welch for his efforts to support Vermont’s physicians and health care practices.

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Vermont's CCB Moving Quickly to Set Rules for Retail Sales of Cannabis

Vermont's newly established Cannabis Control Board (CCB) is moving fast and furious to draft recommendations and regulations required to establish Vermont's legal cannabis marketplace and meet the aggressive timeline set by legislators in Act 164 (2020) and Act 62 (2021). Last week, the CCB released a legislative report outlining their recommendations for setting a broad range of fees. The report estimated that by 2025 spending on recreational marijuana in Vermont could reach $225 million annually, netting roughly $46 million in state revenue. 30 percent of the tax revenue is slated to go towards prevention, but the legislation does not make clear where this funding will go and who will be charged with developing and implementing a comprehensive youth prevention strategy. In a meeting of the Substance Misuse Prevention Council this week, members of the Scott Administration said they will recommend the prevention funding be directed to the Vermont Department of Health. The Vermont Medical Society, along with the American Academy of Pediatrics Vermont Chapter and the Vermont Psychiatric Association provided specific recommendations late last week regarding warning label rules; advertising & marketing rules; THC potency limits for solid concentrates, Delta-8 THC hemp products, the Medical Cannabis Oversight Committee and other recommendations regarding the marijuana for symptom relief program. According to a VT Digger article released Monday, October 25th, the CCB also adopted proposed rules requiring cannabis retail stores to be 500 ft from schools, despite state prevention specialists recommendation of a 1,000 ft "buffer zone" as best practice to both limit youth exposure and limit the number of retail stores.

All of the CCB's recommendations and proposed rules are currently open for public comment. This process would benefit from your clinical expertise and we urge you to weigh in. Please send your comments to Jill at jsudhoffguerin@vtmd.org or Click here to provide public comment.

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Board of Medical Practice Rules Undergoing Updates – Open for Comments

The Board of Medical Practice has begun the rulemaking process to update the Rules for PA and physician licensure. The proposed changes (available here) update the Board rules largely to be consistent with changes that the legislature has made to state statute over the past several years. The rules would update: 1) the qualifications for physician licensure; 2) the Board’s complaint, investigation, and hearing processes; 3) the requirements for Physician Assistant licensure; and, 4) the provision for reciprocity of licensure from any other state when in good standing. It also makes operational a new option in law for the Board to offer non-disciplinary penalties for administrative infractions in lieu of possible discipline. VMS has been reviewing the proposed changes and has had an opportunity to share feedback before the rulemaking process with the Board. The proposal is now open for official comment until December 16, 2021.

Please send questions or comments to Jessa Barnard at VMS at jbarnard@vtmd.org.

NEWS ROUND UP

EVENTS

Vermont Department of Health: "Vax Visits with Less Stress: Training for Providers in Pediatric & Family Care Practices"

October 28th 12-1:15pm, ET

Vermont is launching an initiative to increase sensory supports for children with disabilities and special health needs to help ease their anxiety when they are getting their COVID-19 vaccine at pediatric and family care practices in Vermont. Join us for a one hour training led by UVM’s Children’s Hospital Empower Team. Participants will learn strategies and tips for creating a sensory-friendly environment and each participating practice will receive a sensory tool kit, shipped right to your office.

Vermont Ethics Network: "Let's Talk Refusals"

November 2nd 12-1:15pm, ET

We are obligated to provide our very best care to the patients we see. Yet sometimes, patient’s disagree with our recommendations and refuse what is being offered. This session will discuss the ethical obligations and legal framework for addressing patient refusals in a variety of clinical situations.

UVM CORA Community Rounds: "Cannabis Use and Cannabis Addiction in Rural Populations: Phenomenology, Intervention, & Policy"

November 3rd 12-1pm, ET

Join Dr. Alan Budney, PhD, from Geisel School of Medicine at Dartmouth.

The Michael Herschorn Symposium: Parkinson’s Disease and Movement Disorders in Primary Care - Virtual

November 19th, 9am - 2:15pm

The Binter Center for Parkinson’s Disease and Movement Disorders invites you to attend this virtual symposium which will provide you with the tools you need to diagnose and treat patients with various movement disorders, and to know when referrals may be needed.

Topics include: Diagnosing PD, Treatment Options for Early and Advanced PD, Cognitive and Psychiatric Manifestations of PD, Diagnosing other common movement and gait disorders such as Essential Tremor, NPH, RLS, Drug-Induced Movement Disorders, and more.

To register, view the complete program and accreditation information, click here.

VTMD.ORG

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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