November 30th, 2021

NEED TO KNOW

Commissioner of Health Mark Levine, MD, will be joining VMS this Thursday, December 2nd.

To join us at 12:30pm on Thursday, December 2nd, click here.

Statement from Health Commissioner Mark Levine, MD, on Omicron Variant; COVID-19 Updates

Health Commissioner Mark Levine, MD, released a statement on the Omicron COVID-19 variant on Monday. According to the statement, there have been no identified cases associated with the Omicron variant in Vermont to date. The Health Department continues to obtain genomic sequencing information on SARS-CoV-2 specimens and will report any detection of the Omicron variant in Vermont. The statement adds that there is a lot that is unknown about this new variant, but it appears to be more infectious, already showing up in various countries, including Canada. Research over the next few weeks will determine whether Omicron will affect the severity of illnesses, and how effective the current vaccines are against Omicron.

Commissioner Levine reiterated many of these points in Tuesday’s Administration press conference. Other updates at the press conference included Secretary of Human Services Mike Smith addressing hospital capacity, stating that 47 more subacute beds around the state have been identified as being available to open and 13 are expected to be available this week. AHS is also working to open more ICU capacity, supporting staffing 1 more at SVMC, 5 more at UVMMC, and working to open beds at CVMC and Northwestern. The Administration is also emphasizing preventing hospitalization through vaccinating children, everyone over 18 obtaining a booster, and those who test positive asking about monoclonal antibodies. 71% of hospitalizations for COVID-19 are among the unvaccinated and data shows even lower hospitalization among those who have received a booster. Vermont is currently leading the nation in children 5-11 vaccinated (41% have received or scheduled an initial dose) and boosters administered to those over 65.  While Vermont has seen a decrease is cases over 7 days, that is likely due to reduced testing over Thanksgiving. Find the DFR Modeling Report here and notes from the press conference here.

In federal updates, CDC Director Rochelle Walensky, MD, announced on Monday updated vaccine guidance in the wake of Omicron, stating that all adults "should" get a COVID-19 booster shot. This is now consistent with Vermont Department of Health recommendations, which for weeks have been encouraging all adults to receive boosters. Pfizer and BioNTech are also expected to ask the FDA to authorize boosters for 16- and 17-year-olds. The FDA's Antimicrobial Drugs Advisory Committee (AMDAC) is meeting today to vote on whether Merck’s oral antiviral molnupiravir’s benefits outweigh its risks.

Click to join the meeting here!

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.

All Practices Seeing Kids 5-11 Encouraged to Have Available COVID-19 Vaccine

The Vermont Immunization Program is encouraging all practices who see patients in the 5-11 year old age group to keep a small amount of pediatric COVID-19 vaccine on hand.  Making this vaccine available in the medical home is particularly important for those patients for whom community clinics may not be appropriate.  

• The pediatric Pfizer vaccine is:
• Available to any COVID-19 enrolled provider. If you are unsure of your enrollment status, reach out to AHS.VDHImmunizationProgram@vermont.gov
• Delivered in quantities as small as a single vial through the Vermont Vaccine Depot or as a Direct ship minimum order of 10 vials/100 doses through the manufacturer.
• Presented as 10 dose vials. The vaccine is good at refrigerator temperatures for up to 10 weeks and must be used within 12 hrs of puncture/dilution.
• Concerns about waste should not prevent you from ordering and receiving the COVID-19 vaccine. The priority of the CDC and Vermont is to have the COVID-19 vaccines in as many medical homes as possible. Be thoughtful with planning, but do not turn anyone away.
• While COVID-19 vaccine for the 5-11 population is still limited a practice’s total order request may not be available.  VDH recommends that practices prioritize your high-risk patients, children and youth with special healthcare needs, and those who may not be suitable for a community clinic for whatever reason.
• On November 5, the Immunization Program held a training on the management of this vaccine. To view the video, click here. In the slide deck you will find many resources for the administration and management of this vaccine. To view the slides, click here.

MISC.

VMS Issues Press Release Calling on State Leaders to Limit Cannabis Potency 

On Tuesday, the VMS distributed a press release announcing VMS' recent adoption of a policy resolution regarding commercial sales of cannabis. The new policy urges the Vermont Cannabis Control Board (CCB) and the Vermont legislature to require that all cannabis grown, produced or sold in the state contain less than 15% THC. The VMS policy also opposes all cannabis advertising and advocates for all cannabis products and advertising to list evidence-based health risks associated with cannabis use including psychosis and suicide attempts in persons with no prior mental health history, uncontrollable vomiting, dangerous driving, addiction, and harm to fetuses and nursing babies. Last week, the CCB released proposed rules, which include draft warning label language that leaves out all mention of serious mental health effects associated with cannabis use including the increased risk of addiction, anxiety, psychosis, suicide attempt or self-injurious behavior. Click here to read the press release. 

Feedback Sought – Charges for Electronic Funds Transfer Payments

VMS has heard that nationally and in Vermont, physician practices can face challenges when attempting to access fee-free reimbursement for claims paid via Electronic Funds Transfer.  Practices may be forced to incur mandatory, percentage-based fees for the receipt of electronic payments from health plans for payments made via the EFT transaction standard.  Sometimes these fees are described as being for “value-added” services, such as customer service hotlines, and vendors do not offer physician practices the choice of electing basic EFT payments without charge.  VMS is seeking feedback on how widespread these concerns are in Vermont.  Please respond to Jessa Barnard at jbarnard@vtmd.org if your practice has experienced charges for EFT payments. 

EVENTS

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.

In Conversation with the Surgeon General: The Latest on COVID-19 Children's Vaccines, Boosters and Combating Misinformation 

November 30th, 3:30 - 4:30pm, ET

Please join us for a conversation with Surgeon General Murthy and CDC Foundation President and CEO, Judy Monroe, MD. They will include ample time for Q&A so that local trusted messengers are well-equipped with clear, consistent, equity-centered communication to counter misinformation and encourage vaccination among those still on the fence.

Register 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

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

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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