February 15th, 2022

NEED TO KNOW

Take Action – Contact Senators TODAY on S.158 to Protect Eye Safety

The Senate Government Operations will once again take testimony on Friday on S.158, a bill that will allow optometrists to perform eye surgery using scalpels, injections and lasers without adequate training.  While the bill may be modified by the committee this week, the list of procedures will likely still include lasers, injections and scalpels. 

Now is the time to contact Senators to express your concern with the bill and how it will affect patient safety.  They need to hear from you AND your patients! Please direct patients wanting to get involved to the Safe Surgery Coalition website, which will provide them with talking points and a direct message to their local Senator(s).

As a reminder, this issue has been discussed for multiple legislative sessions and in 2019 the legislature asked Office of Professional Regulation (OPR) to conduct a study of optometric advanced procedures.  The conclusions of OPR’s report were clear:

• The report concluded that optometrists are not properly trained in and cannot safely perform the proposed advanced procedures.
• OPR found that there is little need for, and minimal cost savings associated with, expanding the optometric scope of practice to include advanced procedures.

Given the risk to public safety the Vermont Ophthalmological Society, joined by the Vermont Medical Society, are strongly opposed to S.158. We urge you to contact the Vermont Senate TODAY and to urge your patients to as well:

bbalint@leg.state.vt.us; pbaruth@leg.state.vt.us; pbaruth@uvm.edu; jbenning@leg.state.vt.us; cbray@leg.state.vt.us; rbrock@leg.state.vt.us; bcampion@leg.state.vt.us; tchittenden@leg.state.vt.us; AClarkson@leg.state.vt.us; bcollamore@leg.state.vt.us; acummings@leg.state.vt.us; RHardy@leg.state.vt.us; chooker@leg.state.vt.us; ringalls@leg.state.vt.us; jkitchel@leg.state.vt.us; vlyons@leg.state.vt.us; mmacdonald@leg.state.vt.us; rmccormack@leg.state.vt.us; anitka@leg.state.vt.us; CParent@leg.state.vt.us; CPearson@leg.state.vt.us; APerchlik@leg.state.vt.us; apollina@leg.state.vt.us; kram@leg.state.vt.us; rsears@leg.state.vt.us; msirotkin@leg.state.vt.us; rstarr@leg.state.vt.us; jterenzini@leg.state.vt.us; rawestman@gmail.com; jwhite@leg.state.vt.us

Please attend VMS Congressional Town Hall March 3^rd and Thank You for Attending the Health Care Policy Town Hall!

Legislative Update – Contact Governor Scott Regarding Firearm Safety

The legislature is in the thick of considering and voting on bills this week.  Bills impacting VMS members include:

• S.30: Prohibits Firearms in Hospitals: passed the House last week and advances to the Governor and it is unclear whether he will sign it. The bill as amended would close the “Charleston loophole,” which currently allows firearm sales to be approved if background checks take longer than 3 days to complete. Please contact Governor Scott’s office this week to urge him to support this bill.
• FY22 Budget Adjustment: The House is expected to give final approval to the FY22 Budget Adjustment which increases state spending by $367 million and
• Maintains an increase to Medicaid’s RBRVS reimbursement rates through its alignment with the Medicare fee schedule - thank you especially to Representatives Lori Houghton and Alyssa Black from the House Health Care Committee for their work ensuring the full Medicare rate is matched;  
• Includes the legislature’s support to pursue federal approval of Medicaid coverage for 12-months of post-partum care. The application process begins in April of 2022; 
• Provides $60 million in healthcare workforce recruitment and retention funding that includes $30 million for another round of Agency of Human Services health care stabilization grants for eligible health care employers which include hospitals, independent medical practices, hospital-owned medical practices, designated and specialized services agencies, FQHCs and other health care providers
• Prop 5: the Reproductive Liberty Amendment: the House floor debated for several hours last Tuesday before approving the proposed constitutional amendment by a vote of 107-41. It will now go before all Vermont voters as a ballot initiative on the 2022 General Election ballot. 
  
• H.548, the misc. cannabis bill, that seeks to remove the THC potency limits in solid concentrates is now in the House Gov. Ops Committee and VMS testified against this provision today.
• Mental Health legislation aimed at preventing emergency department wait times: S.194, S.195, and S.197 is scheduled for mark-up and potential vote this Friday in the Senate Health and Welfare Committee.
• S.158, a bill that would expand the scope of procedures optometrist may perform to include injections, lasers and surgeries to the eye and adjacent structures is scheduled for mark-up and possible vote in the Senate Government Operations Committee this Friday afternoon. 
• H.654, COVID-19 Flexibilities: The bill that aims to extend regulatory COVID-19 flexibilities until March 31, 2023, is scheduled for a possible vote this Weds. in the Senate Health and Welfare Committee
• H. 655, a bill to establish a telehealth licensure and registration system is scheduled for a hearing in the House Committee on Ways and Means to discuss fees.  
• S.244, a bill aimed at strengthening primary care by raising reimbursement, increasing the overall spend on primary care and providing parity reimbursement for audio-only telehealth services received a second hearing in the Senate Health and Welfare Committee today. The Committee is also continuing their discussion on S.285, which proposes to expand the Blueprint for Health program.  

COVID-19 Updates, Change to School Masking Recommendations

At the Administration press conference today, Commissioner of Department Financial Regulation Michael Pieciak provided the latest case updates and modeling report, showing that COVID-19 cases in Vermont have continued to drop.  Vermont cases are down 23% in the past week, 84% since the Omicron peak – to the lowest weekly total of cases since November 1^st.  The modeling report forecasts cases to continue to fall across February and March. Hospital admissions are down 30% and modeling shows fatalities should begin to drop by mid-February.   Weighing all of the factors, the Administration is reviving guidance issued in August for schools and beginning February 28^th schools that have reached an 80% vaccination rate may drop a mask mandate.  This is guidance and local schools can make their own masking policies.  The Department of Education is still gathering data to report the number of schools that have reached this threshold but it appears to be well under half.  In order to continue a return to normalcy, schools will also be encouraged to drop any mitigation measures not recommended at the state level, for example masking at recess, no talking during meals or closing libraries. The DFR modeling report can be found here and full notes from the press conference can be found here. To view the VAHHS call notes from February 11th, click here.

Other COVID-19 Updates from the week:

• The FDA said Friday it would delay a decision on authorizing the use of the Pfizer vaccine for children under age 5 until data on the effects of three doses is available.
• Last week, the FDA issued an emergency use authorization (EUA) for bebtelovimab, a new monoclonal antibody for the treatment of COVID-19 that retains activity against the omicron variant. The EUA for bebtelovimab is for the treatment of mild to moderate COVID-19 in adults and pediatric patients (12 years of age and older) with a positive COVID-19 test, and who are at high risk for progression to severe COVID-19, and for whom alternative COVID-19 treatment options approved or authorized by the FDA are not accessible or clinically appropriate. 
• The Centers for Disease Control and Prevention updated its booster guidance to allow people with weakened immune systems to get additional vaccine doses after three months instead of five.
• A CDC study finds that vaccine effectiveness against COVID-19–associated emergency department/urgent care visits and hospitalizations was higher after the third dose than after the second dose but waned with time since vaccination.

MISC.

Dementia Screening Pilot Open to Primary Care Practices

The UVM Health Network is seeking 10 primary care practices to participate in an exciting proposal called SPREAD, (System Preparedness and Response for Early Alzheimer’s Disease and Related Disorders) Detection Project beginning Fall 2022.  The project will test a new model to increase screening and diagnosis of dementia (mild cognitive impairment and Alzheimer’s and related dementias). For participating PCPs the nursing students overseen by UVM Nurse faculty will conduct the Medicare Annual Wellness Visits, including a cognitive assessment, with results documented and communicated to the provider. No provider time or exam room is needed. Dementia training is available, which covers how to make screening sustainable using the clinic’s nursing staff. The Davos Alzheimer’s Collaborative Foundation is funding this effort to cultivate systems change to increase earlier detection of cognitive decline.  Please contact Mary Val Palumbo DNP, APRN by Feb 21: (802) 371-7743 or mary.palumbo@med.uvm.edu

The Physicians Foundation Announces Fellowship Program

The Physicians Foundation has opened a Call for Applicants for its Fellowship Program, which advances physicians’ leadership skills to strengthen the physician-patient relationship, support medical practices’ sustainability and navigate the changing health care system. The Fellowship Program is open to physicians who are new or mid-career in their practice. Specifically, the fellow will develop and implement a project that builds broad-based understanding of the social drivers of health and their implications for patients and physicians with counsel from a fellowship mentor, a member of the Foundation’s Board of Directors and The Physicians Foundation’s collaborating organizations. 

The Fellowship Program will last for 12-months beginning July 1, 2022 through June 30, 2023, and participating fellows will receive a stipend of $24,000 as well as reimbursement for program related travel and lodging expenses. This fellowship requires approximately 10 to 15 hours monthly for project development and implementation, along with external thought leadership activities. For more information about The Physicians Foundation’s Fellowship Program and to apply by Friday, March 25, 2022, visit here.

Medical Justice in Advocacy Fellowship Open for Applications

The Medical Justice in Advocacy Fellowship is a collaboration between American Medical Association’s Center for Health Equity and Morehouse School of Medicine’s Satcher Health Leadership Institute.  Using an anti-racist, equity-centered learning framework, the fellowship provides a mentoring and training platform that equips participants with the foundational skills, tools and knowledge to engage in institutional and political health advocacy.  The fellowship empowers and mobilizes physicians to be part of the next generation of advocacy leaders, driving meaningful policy and structural changes that produce equity and justice in the communities they serve.  Apply now and join the second cohort of health equity-rooted physicians committed to closing the detrimental health gap impacting so many lives. Deadline is March 14, 2022 at 11:59 p.m. Eastern.

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).

AMA STEPS Forward^TM Webinar: No One Should Care Alone: Creating Processes for Intentional Professional Connection

February 24th, 11am CST

Dr. Mark Greenawald launched the nationally acclaimed PeerRxMed program (www.PeerRxMed.org) last year to help healthcare professionals support each other as they move away from distress and toward thriving. The tag line for the PeerRxMed program is "No One Cares Alone," which captures Dr. Greenawald’s mission in his work toward advancing professional well-being. Join the AMA at 11 a.m. CST on Feb. 24 to revisit Dr. Greenawald's webinar, “No One Should Care Alone: Creating Processes for Intentional Professional Connection.” A live Q&A session with Dr. Greenawald will follow the presentation.

Project ECHO: Aging, Community, and Equity (PEACE)

2nd Wednesday of Every Month from February to September

12pm to 1:30pm, EST

Project ECHO® (Extension for Community Healthcare Outcomes) is an evidence-based method developed by researchers at the University of New Mexico. During teleECHO™ sessions, expert mentors share their expertise across a virtual network via case-based learning.

In this Older Adult ECHO program, we will explore:       

• Pandemic-related social isolation
• Methods to support formal & informal caregivers
• Impacts of the pandemic on cognitive decline
• Effects of isolation on physical & mental health
• Solutions for rural communities

Intended audience: Medical, mental health, and community social service individuals working to support older adults in rural settings of Maine, New Hampshire, Vermont, and Northern New York

The 27th Annual Vermont Perspectives in Anesthesia Conference

March 2nd - March 4th, ET

Drs. Matt Fisher and Bob Williams invite you to join them for this year’s Live VIRTUAL Conference, with practical reviews and timely informative clinical updates on a variety of topics of current interest in Anesthesia. Registered participants will have access to On-Demand Recordings to view and claim credit for any sessions that are missed during the live conference - for up to 12 months following the conference.

Topics: The Difficult Airway, Obstructive Breathing Patterns in the PACU, Perioperative EEG, Patients with Opioid Use Disorder, NORA emergencies, Non-Cardiac Surgery: Myocardial Injury and Preoperative Assessment, The Value of Women on Teams, The Anesthesia Department on the Other Side of COVID, 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

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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