March 15th, 2022

NEED TO KNOW

Crossover Week Narrows Issues for Legislative Session; FY23 Budget Deadline Looms for the House

The Vermont legislature has essentially crossed the mid-way point of the 2022 legislative session as last Friday was the crossover deadline, in which legislation needed to pass out of the first chamber's policy committees or it would be deemed dead this session. Appropriations and tax committees have until March 18th to advance their bills and reportedly the FY23 Budget bill is down to some remaining determinations in the House Appropriations Committee. The FY22 Budget Adjustment bill was sent to the Governor's desk last Thursday and he has until tomorrow to take action on the spending package which includes health workforce recruitment and retention funding. We have heard the Governor will sign the bill. These bills being followed by VMS also received action:

• S.30: Prohibits Firearms in Hospitals: the Senate overrode the Governor's veto by a vote of 21-9, but it was largely ceremonial as the House does not intend to take up the veto. The Senate then voted out S.4, which includes the Governor's compromise on the “Charleston loophole,” allowing firearm sales to be approved if background checks take longer than 7 days to complete, rather than the 30-day requirement passed in the bill. The bill is now being heard in the House Judiciary Committee.
• H.548, the Misc. Cannabis bill: in a surprise move the House Government Operations Committee reversed course on removing the THC potency limits in solid concentrates in the bill saying they wanted to slow it down. The bill advanced to the full House with THC limits still in place. Thank you to our member who reached out to lawmakers on this bill and please express your thanks to the Committee members for their support.
• H.654, COVID-19 Flexibilities: The bill that aims to extend regulatory COVID-19 flexibilities until March 31, 2023, still has not been sent to the Governor's desk.
• H. 655, a bill to establish a telehealth licensure and registration system has passed the House on second reading and awaits final passage in the House. The Senate Health and Welfare Committee begins looking at the bill this week.
• S.285, a bill that includes a study regarding increased investment in the Blueprint for Health program was voted out of the Senate Health and Welfare Committee and heads to the Senate floor this week. The bill also directs $5 million to the Green Mountain Care Board to hire consultants, including a primary care clinician, to facilitate a patient-focused, community-inclusive redesign of Vermont’s health care system and to develop a process for implementing hospital global budgets. Click here to read a VPR story on primary care crisis.
• H.711, a bill to create an opiate settlement fund, passed the House Human Services Committee and advances to the House Appropriations Committee. A separate House Human Services Committee bill that increases opioid treatment and recovery services and prohibits prior authorization for MAT for the first 60 days also passed the Committee last week and advances to the floor.
• H.703, a workforce development bill, passed the House Commerce Committee and advances to the House Ways and Means Committee. This bill currently includes language that requires the Department of Financial Regulation to analyze opportunities to align and streamline prior authorization request processes and provide recommendations by January of 2023 to the legislature.

S.158 Will Not Move Forward in the Vermont Legislature this Year  

The Senate Government Operations Committee met last Tuesday afternoon - after citing "hitting a brick wall" without a clear path forward through Senate Health and Welfare or enough votes on the Senate floor – they decided to send the issue back to OPR to go through a new statutory assessment for scope expansion that was put in to place following the original report.

The new process requires the profession to provide the information (burden of proof) prior to the office undertaking the study.  This will take place next summer/fall and will include stakeholder engagement and public hearings.  The final report will be due back to the legislature in November of 2023 for review/possible action in the 2024 session (starting in January).  We will of course be engaged in the process and keep you updated.

Thank you to all of you for the outreach and communications! It made a difference.

COVID-19 Cases Continue to Trend Down, Updated State Guidance Released

According to the Department of Financial Regulation’s Modeling Report posted today, Vermont cases are down 94% from the peak of the Omicron wave, leading to the continued decline in new hospital admissions, which are down 80% from the peak. Today, Vermont is reporting 12 individuals in the hospital for the virus, with four requiring ICU care. Per capita, Vermont is tied with New Hampshire and Massachusetts in reporting the lowest COVID-19 hospitalization rates in the nation. Vermont COVID-19 cases are expected to continue to decline in the coming weeks. Declines in COVID-19 fatalities are also expected over the next 4 weeks and no deaths have been reported in the last 10 days. Commissioner of Health Mark Levine, MD, reminded the public that the Department of Health has posted updated guidance this week:

• If you test positive: isolate for 5 days: https://www.healthvermont.gov/covid-19/symptoms-sickness/what-do-if-you-test-positive-covid-19
• If you are a close contact, you do not need to quarantine but should test if you are “not up to date” with vaccines: https://www.healthvermont.gov/covid-19/symptoms-sickness/what-do-if-you-are-close-contact
• Consider your own risk factors and circumstances in determining other actions you take: https://www.healthvermont.gov/covid-19/protect-yourself-others

State testing sites will also be offering options for individuals to request rapid testing (antigen and/or take-home LAMP tests) beginning this week through the state scheduling system. The Department of Education has updated testing guidance in schools to be consistent with statewide guidance.

For full notes from today’s press conference, click here.

COVID-19 Vaccine Ordering Update Guidance

On March 3, the Vermont Immunization Program communicated that COVID-19 Vaccine Ordering would change starting the week of March 14. Below, find a guidance document outlining the expectations around these changes. Additionally, an calendar tool has been developed to help practices stay on schedule with regular vaccine ordering. If you know your ordering schedule, visit the Vaccine Ordering webpage to find a printable resource. COVID-19 Ordering Update Guidance | VDH

A recorded provider call will be held on March 22, from 12:15 om – 1:00 pm, to review the new ordering process and expectations. See meeting information below and look for an official meeting invitation in the coming days.

The Agency of Human Services Seeks Input on Community-based Mobile Crisis Intervention Services

Join The Agency of Human Services (AHS) on March 22, 2022 from 1pm – 2:30pm for a virtual Mobile Crisis Services Town Hall to ensure a broad input and inclusive process on the expansion of community-based mobile crisis intervention services.

The AHS intends to provide an overview of a CMS grant to Vermont and community mobile crisis guidance, discuss key requirements for implementing Medicaid mobile crisis intervention services, highlight Vermont’s planning grant priorities, and secure participant input and discuss ways interested parties can remain involved throughout the planning process.  

Please register here.

MISC.

Final Call for Applicants: The Physicians Foundation Fellowship Program

Career Fair Hosted by The Associated General Contractors of Vermont

The Associated General Contractors of Vermont is hosting “The Super Bowl of Career Fairs” a multi sector career/job fair with the potential to host 150 recruiters and 1500 job-seekers from Vermont on April 26^th from 10:00 a.m. to 6:00 p.m. This multi sector Career Fair will be held at the Champlain Valley Expo in Essex Junction with 150 booths for employers to recruit prospective employees.  Click here for the registration page to reserve a booth at the event for $300. For more information contact 802-223-2374 or email shawn@agcvt.org.

Navigating the Current Healthcare Landscape: COVID-19, Staffing Crisis, and Administrative Burden Webinar Recording

Physician practices across the country continue to operate in an atmosphere of uncertainty, now compounded by a staffing crisis due to the ongoing effects of the COVID-19 pandemic.

The latest AMA STEPS ForwardTM webinar, “Navigating the Current Healthcare Landscape: COVID-19, Staffing Crisis, and Administrative Burden,” addresses the current health care workforce landscape, how to plan for workplace shortages, and best practices in workplace safety and efficiencies for staff.

The webinar will also feature practical, actionable resources to transform and improve your practice, including:

• Caring for Our Caregivers During COVID-19
• AMA STEPS ForwardTM De-implementation Checklist
• AMA Debunking Regulatory Myths series

To accompany the webinar, the AMA has released an updated version of “A Physician Guide to Keeping Your Practice Open During COVID-19” to address concerns about workforce protection and retention during the pandemic. The guide serves as a one-stop-shop outlining how best to keep a practice open with checklists, supplemental information and helpful links to COVID-19 resources from the AMA, Centers for Disease Control and Prevention (CDC) and other federal agencies.

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).

No Cost Well-Being Workshops

VMS is continuing our partnership with Doug Wysockey-Johnson of LumunosWellBeing to offer no-cost clinician wellbeing workshops at up to 10 Vermont medical staffs/practices over 2022. There are 3 remaining slots available this spring.  New topics for 2022 include A Clinician’s Guide to Recovering from the COVID Marathon and A Realistic Look at ‘Work-Home Balance’ for Clinicians. See the full list and additional details here.  Members can contact jbarnard@vtmd.org or doug@lumunos.org for more information or to schedule a workshop. 

AMA STEPS Forward^TM Webinar: Racial and Health Equity: Concrete STEPS for Health Systems

March 24, 2022, 12pm CST

The new AMA STEPS Forward™ toolkit “Racial and Health Equity: Concrete STEPS for Health Systems,” developed in collaboration with HealthBegins, offers five steps to advancing health equity for clinicians, patients, and the communities served. The toolkit helps motivated leaders develop a shared understanding and commitment, set data-driven goals, and embark on a journey of continuous learning and improvement for racial justice and health equity. Join co-authors Denard Cummings, AMA Director of Equitable Health Systems Integration, and Rishi Manchanda, MD, MPH, President and CEO of HealthBegins as they provide actionable steps for advancing racial and health equity in your health care system.

Register for the webinar.

The UVM Medical Center Cardiovascular/Vascular Forum

May 2, 2022

Course Director Dr. Matt Alef invites Primary Care, internal medicine, and urgent care providers to attend virtually or in-person to learn more about cardiovascular and vascular disease, including additional POCUS skills for evaluation. The objective is to improve accuracy of appropriate and timely cardiovascular disease treatment and efficiently use expert consultation in a value-based environment.

TOPICS: SAVR vs TAVR, vascular nurse wounds, aortic dissections, POCUS hands-on workshop, echocardiography and more.

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

The 48th Annual Family Medicine Review Course

June 7-10, 2022

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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