November 23rd, 2021


VMS Publishes Green Mountain Physician for Fall 2021/Winter 2022

The VMS has published our Fall 2021/Winter 2022 Green Mountain Physician magazine, which features VMS member engagement and participation in our 208th Annual & Collaborative Meeting that was held virtually November 5th and 6th, 2021. You will find 2021 policy resolutions, the Vermont Medical Society Education & Research Foundation Medical Scholarship winner, VMS' new officers for 2022 and the 2021 VMS Award winners. This edition also highlights VMS' 2022 policy priorities for the 2022 legislative session and provides information on how you can become a VMS Health Advocate. The Green Mountain Physician is VMS’ quarterly membership magazine that features news, updates from VMS leaders and profiles on members of Vermont's health care community. Please click here to read the Green Mountain Physician for Fall 2021/Winter 2022

Special Session Yields Municipal Masking Compromise

In a one-day special legislative session held Monday, Vermont lawmakers passed a bill that gives Vermont municipal governments the authority to adopt temporary indoor masking mandates for their towns and cities. The special session was called after Governor Phil Scott responded to repeated calls from Democratic leadership for the Administration to implement a statewide masking mandate with a narrowly prescribed compromise. In a letter to House Speaker Jill Krowinski, D-Burlington, and Senate President Becca Balint, D-Windham, the governor stated he remains opposed to using his executive authority to institute a statewide masking policy and encouraged legislators to instead vote on the town-by-town approach. S.1, as passed, provides the legislative body of municipalities the authority to vote on indoor masking on a month-by-month basis, requiring them to vote on such an ordinance every 30 days. This authority expires April 30, 2022. Democratic leadership in both the House and Senate did not feel the narrowly prescribed authority went far enough to protect all Vermonters from the delta COVID-19 surge ravaging our State. A House member stated, "People are struggling with the fact that things are not normal. But they keep receiving the message that everything is fine, when it is not fine." 

To stress this point, the Senate also adopted a resolution urging the governor “to use all possible public health measures to reduce the number of COVID-19 cases and associated deaths and maximize vaccination rates among all eligible population groups.” These measures include declaring a state of emergency and enacting a statewide indoor mask mandate. The special session ended yesterday with concern that S.1 would exacerbate the polarizing debate on masking and put town governments at the center of this debate, yet many supported this action over no action.

Booster Shots Authorized for All; COVID-19 Updates

While the Scott Administration has been encouraging broad uptake of COVID-19 vaccine boosters for weeks, last Wednesday Governor Scott officially directed the Agency of Human Services to implement a Universal Booster Program for COVID-19 vaccinations and is strongly encouraging every Vermonter over the age of 18 to get a booster. Anyone who has received the Johnson & Johnson vaccine is eligible two months after their first dose. Individuals who received a Pfizer or Moderna vaccine are eligible six months after completing their initial vaccination.  Learn more at the Department of Health COVID-19 Vaccine webpage and FAQs.  

The FDA and CDC also took official action approving Pfizer and Moderna booster doses for all individuals over 18 last week.  The CDC states that anyone who initially received Moderna or Pfizer should get a booster if you are ages 50 years and older or ages 18 years and older and live in a long-term care setting.  Anyone else 18 and older may get a booster.  Everyone 18 and over who received J&J should receive a booster after 2 months.

The Administration also held its weekly press conference on Tuesday.  COVID-19 cases have remained steady over past week, with only a 4% increase, although they remain at an elevated level.  The modeling report does not forecast a decrease in cases over the next 4 weeks and Thanksgiving adds additional uncertainty. Hospitalization rates are up 17% - 69% of hospitalized patients were unvaccinated – and ICU rates were up 12%.  Cases remain highest among 5-11 year olds, and state officials urged parents to have eligible children vaccinated.  Vermont currently leads the nation with a 30% rate of 5-11 year olds having received one dose and 10% more registered.  Commissioner of AHS Mike Smith added that it is not too late to be tested before Thanksgiving gatherings and the state has added testing capacity as well as piloting faster LAMP testing kits and “self-service” tests that individuals mail in for results. For notes of the press conference click here.

VMS Board Adopts Updated Policy on Cannabis Sales, Warnings

The VMS Board met last Wednesday evening for the first time under new bylaws that authorize the Board (formerly the Council) to adopt Resolutions/Policies after posting for member feedback. The Board adopted an updated policy on commercialized sales of marijuana stating that that VMS strongly opposes the advertising, marketing and promotion of cannabis in the state of Vermont (including through the use of packaging, flavorings and placement/density of retail locations) in order to disincentivize establishments from pushing sales through fostering high use and addiction. The resolution also calls for inclusion of evidence-based warnings on all cannabis products and adequate funding for statewide prevention and education efforts. To see the full text of the adopted resolution, click here.

OSHA Suspends Enforcement of Large Employer Vaccine Mandate

On November 12, 2021, the U.S. Court of Appeals for the Fifth Circuit granted a motion to stay OSHA's COVID-19 Vaccination and Testing Emergency Temporary Standard, published on November 5, 2021, which required employers with over 100 employees to adopt a policy requiring employees to choose to either be vaccinated or undergo regular COVID-19 testing and wear a face covering at work.  The court ordered that OSHA "take no steps to implement or enforce" the ETS "until further court order." While OSHA remains confident in its authority to protect workers in emergencies, OSHA has suspended activities related to the implementation and enforcement of the ETS pending future developments in the litigation.  This suspension of enforcement does not apply to the separate rule issued by the Centers for Medicare & Medicaid Services (CMS), which mandates that all healthcare workers whose organizations receive funding from Medicare or Medicaid be fully vaccinated against COVID-19 by Jan. 4, 2022.

U.S. House Passes Budget Bill with Health Care Provisions

Friday, the U.S. House of Representatives passed a “Build Back Better” package of social safety net spending. Among the health care provisions included:

  • Extending more generous subsidies for ACA plans purchased on the health exchange;
  • Adding hearing coverage to Medicare, limiting Medicare cost sharing for insulin and vaccines, capping Part D out of pocket spending;
  • Funding medical student and residency training for those serving in rural or underserved communities;
  • Allowing the Federal government to negotiate certain Part D prescription drug prices. 

The bill passed the House 220-213 and must now be considered by the Senate. Vermont’s Representative Peter Welch provides a summary on what the package would mean for Vermonters here.  For a summary of the Medicare components see the AARP summary and for a comprehensive overview of what the bill contains and how it would be paid for, see the New York Times coverage here.


AHS Seeking Feedback on EHR Technology

The Vermont Agency of Human Services (AHS) requests your participation in a survey on the usage of electronic health record (EHR) technology. AHS intends to continue a state-run incentive program to support Medicaid providers in adopting data collection tools (EHRs, care coordination platforms, referral tools, etc) and connecting to the VHIE. The survey will help AHS better understand the current landscape, the impact of rolling out the federal EHR incentive program, and inform next steps. We welcome responses from a clinician, practice manager, or any individual that is familiar with your organization’s use of the EHR system. Please use this link to complete the survey. Note, the survey must be completed in one sitting – it will not save. If you have questions about the survey or encounter any problems completing the survey, please direct them to

Comments Submitted on Psychologist Prescribing Proposal

The Vermont Medical Society, Vermont Psychiatric Association, Vermont Academy of Family Physicians and American Academy of Pediatrics Vermont Chapter submitted collaborative comments on the Office of Professional Regulation (OPR) Sunrise Review process to allow psychologists to prescribe “medications for the treatment and management of mental disorders,” including controlled substances contained in Schedules I-V of the Controlled Substances Act. Comments highlighted that while psychologists are experts in important behavioral interventions and are highly valued members of the health care community, the proposal before OPR would not provide adequate clinical training to expand their scope to include prescriptive authority while adequately protecting the public. The comments expanded on the following areas:

  1. There is no evidence that authorizing psychologists to prescribing medications will increase access to needed mental health services in Vermont. 
  2. Expanding prescriptive authority to insufficiently trained clinicians poses risk to the public.
  3. The training proposed lacks consistent, rigorous in-person training requirements and does not include supervised clinical rotations.
  4. There are evidence-based solutions to increase access to care while maintaining physician or advanced practice professional prescribing.

VMS will keep you updated on the process and any decisions made by OPR. Thank you to all members that have been involved in this process and that have provided testimony.

Highlights from the November 2021 AMA Special Meeting

The AMA's bi-annual meeting of the House of Delegates took place Nov. 12-16. Important issues included rural health inequities, strengthening public health systems, closing the gap of the uninsured, tackling health misinformation and more. Vermont was represented by Delegate Norm Ward, MD, and Alternate Delegate Catherine Schneider, MD. Read more here.

OneCare Vermont Announces New Managers; Dr. John Brumsted Stepping Down as Chair

Last Thursday, OneCare Vermont announced new membership on its board of managers and also noted that after six years serving on the OneCare board of managers and three years as the chair, Dr. John Brumsted will step down from the board in January of 2022. Read more here.

Grant Funding Available for Practices Caring for Patients Ineligible for Medicaid due to Immigration Status

The State has released Phase I and Phase II of a grant opportunity for practices to receive funding for deliv­ering health care services to pregnant individuals and children who would be eligible for Vermont Medicaid EXCEPT for their immigration status in accordance with Act 48 (H.430) of 2021. Currently, grant agreements are being executed by Blueprint for Health Administrative Entities. Additionally, the grant opportunity for practices not covered under the Blueprint for Health Administrative Entity agreements are now posted so these locations can review and apply to execute grant agreements directly with the Department of Vermont Health Access. Please visit here to learn more.

Vermont Medicaid is also reminding practices that up to 125 Afghan evacuees, spouses and children may be arriving in Vermont. In September Congress passed legislation that allows these individuals to receive benefits including Medicaid, resettlement assistance and Refugee Medical Assistance.  Most evacu­ees will receive Medicaid.  Verbal and written translation of the health care process, services and medical terms may be critical for evacuees to access health care and DVHA is reminding practices of their obligation to provide language access services to people with limited English proficiency. For more information and resources, see here.


Please share this widely and join Dr. Peter Hogenkamp on Wednesday, December 1st from 7pm to 8pm for information and a discussion on the COVID-19 vaccine for adults.

Click to join the meeting here!

Please join us for a conversation about COVID-19 vaccines for children. Find the forum dates here. To view recordings from previous forums, click here.

Financial Planning Highlights for Residents, Fellows, and New Attending Physicians

December 7th 7-8pm, ET

Pastore Financial Group, LLC are bringing back their Complimentary Financial Educational Webinar Series for Physicians that will cover:

  • Model and project cash flow needs for retirement income
  • Align investment allocation with retirement goals
  • Mitigate estate transfer taxes and costs
  • Effectively manage income taxes in retirement
  • Maximize Social Security benefits
  • Organize your finances using technology so you can make informed financial decisions
Register here.

Financial Planning Highlights for Residents, Fellows, and New Attending Physicians

December 9th 7-8pm, ET

Pastore Financial Group, LLC are bringing back their Complimentary Financial Educational Webinar Series for Physicians that will cover:

  • Understand the pro’s and cons of loan forgiveness and loan repayment
  • Consider protecting your income for yourself as well as your family
  • Understand the ins and outs of individual disability insurance
  • Set financial goals and priorities for your finances the early years of your career
  • Organize your finances using technology so you can make informed financial decisions
Register here.


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