April 4, 2023

NEED TO KNOW

Vermont Medical Society 2023 Mid-Session Legislative Bulletin

The Vermont Legislature has passed the mid-way point of the 2023 session and, despite one third of the lawmakers being brand new and many committees being led by new chairs, they have made significant progress on some incredibly complex issues.

Many people in the Statehouse are saying this is the year to tackle hard topics, like child-care financing, paid family leave, and universal school meals, because there is still some residual ARPA funding, and next year the State will likely have less revenue on the horizon. The VMS policy team has also been working hard to advance some important legislation and are incredibly grateful for the amazing VMS members who have shown up to testify on workplace violence, the "shield laws," suicide and firearm prevention, opioid overdose prevention, tobacco prevention and forensic mental health. Your expertise and advocacy grounds the Committees on what actually happens in the field and will improve health and health care in the State. We welcome your voice and as always thank you for your incredible commitment and dedication to your patients and the practice of medicine in Vermont.

VMS is pleased to release this mid-session Legislative Bulletin, which will provide summaries and the status of legislation that VMS actively tracked this session. Vermont Medical Society 2023 Mid-Session Legislative Bulletin

Stay tuned as the VMS Policy team has a busy week as the House Health Care Committee is taking up S.37, the shield law, House Judiciary continues to work on S.36, the workplace violence bill, the Senate Health and Welfare Committee is taking up H.222, the opioid prevention bill, and we will be weighing on H.270, the miscellaneous cannabis bill, and the OPR bill in the Senate as well. 

Take Action: Please Send Us Your Prior Authorization Stories

When asked what impacts your ability to practice VMS members have resoundingly answered that prior authorization creates one of the highest administrative burdens across practice areas. The VMS has been working on legislation that would provide opportunities to reduce and streamline prior authorization and move the needle on solutions like expanded gold card programs. 

Prior authorization legislation is likely to come up within the next two weeks and lawmakers need to hear how prior authorization impacts your practice and your patients' needs. We know that these administrative burdens delay necessary care while negatively and directly contributing to physician burnout and unsustainable workloads. We will collect your feedback to share with the Committees.

Please share your prior authorization stories with Jill Sudhoff-Guerin, VMS Policy and Communications Consultant, at jsudhoffguerin@vtmd.org or let her know if you would like to testify when the legislation is scheduled for a hearing.

Climate and Health Legislative Advocacy Day – April 7^th – Please RSVP

As you know too well, the climate crisis is a huge public health issue. There are solutions to combat it – and we need your help to make them happen.

Please join a few fellow Vermont Climate and Health Alliance and Vermont Medical Society members for a day at the Vermont State House to elevate the public health consequences and benefits of climate action: Friday, April 7th from 8am-12 pm in Montpelier. 

Can you join us – if even for an hour or two – to call on legislators to take bold action to reduce health-harming, planet-warming pollution?  Opportunities include a press event, meetings with legislative leadership, 1-on-1 connections with lawmakers and more. In advance of the day, with support from Vermont Natural Resources Council, we will share information on the big climate policies under consideration and provide talking points, informational materials, and a policy briefing to support you in knowing what bills are on the table for climate and health this session. 

Please let us know by Friday, March 31st if you’re available and interested in joining by completing this Google form

In the meantime, check out the Vermont Conservation Voters 2023 Environmental Common Agenda, supported by 19 groups, which outlines key climate and environmental priorities for the session or register here for a background webinar to update you on priority climate bills currently under consideration by the Legislature being held on Wednesday, April 5, from 12-1:00pm.

DEA Issues Guidance on New 8-hour Training Requirement for All DEA-Registrants – Effective June 2023

The US Drug Enforcement Administration (DEA) last week issued a letter outlining the new one-time, eight-hour training requirement for all DEA-registered practitioners on the treatment and management of patients with opioid or other substance use disorders. This training was passed as part of the Consolidated Appropriations Act of 2023 and will go into effect June 27, 2023.  Find the full letter here: https://deadiversion.usdoj.gov/pubs/docs/MATE_Training_Letter_Final.pdf

The letter states that, effective June 27, 2023, physicians will be able to simply check a box on their DEA registration application or renewal form indicating that they have satisfied this training requirement.

A few key points related to this training:

1. The training does not have to occur in one session. It can be cumulative across multiple sessions that equal eight hours of training.
2. Past trainings on the treatment and management of patients with opioid or other substance use disorders can count towards a practitioner meeting this requirement. In other words, if you received a CME accredited training from one of the groups outlined in the letter — prior to the enactment of this new training obligation on December 29, 2022—that training counts towards the eight-hour requirement.
3. Past DATA-Waived trainings count towards a DEA registrant’s 8-hour training requirement.
4. Trainings can occur in a variety of formats, including classroom settings, seminars at professional society meetings, or virtual offerings.

MISC.

Updates from Vermont Vaccine Program & Other Public Health News

The Vermont Vaccine Program released its March/April 2023 newsletter this week.  The issue can be viewed on their website, here.  Among many other vaccine-related updates, the issue addresses vaccine distribution after the end of the public health emergency:

• We have had many questions about what the end of the public health emergency on May 11, 2023 means for COVID-19 vaccine distribution.
• The end of the public health emergency will not stop the current national vaccine distribution program. 
• There are still many questions regarding commercializing COVID-19 vaccines. This transition is expected in fall of 2023.

More information will be shared as soon as it is available. 

See FDA FAQs: What happens to EUAs when a public health emergency ends?

In other public health news from the week:

Judge strikes down free HIV drugs, other preventive services under ACA

FDA approves over-the-counter Narcan. Here's what it means

GMCB Releases FY24 Hospital Budget Guidance, Reviews 2022 Hospital Year End Actuals

Last week, the Green Mountain Care Board (GMCB) voted unanimously to approve hospital budget guidance to inform budgets that Vermont hospitals will have to submit for approval this summer for the 2024 Fiscal Year (FY). The approved hospital budget guidance maintains a two-year revenue growth cap of 8.6% for Vermont hospitals and benchmarks for evaluating hospital budget requests.  The GMCB will consider factors driving hospital expense growth, hospitals’ ability to manage those expenses, and how Vermont hospitals perform relative to peers based on national benchmarks. The GMCB also reviewed FY22 year-end actuals for Vermont’s 14 community hospitals. Vermont hospitals continued to face significant financial challenges. In FY22, 9 out of 14 Vermont hospitals had negative operating margins. Increasing expenses associated with labor and staffing as well as medical supplies continued to stress hospital finances. Increasing labor expenses is a national trend.  Due to the financial results and outlook for the hospital sector in Vermont and nationally, the GMCB declined to pursue any enforcement action based on FY22 performance. For GMCB meeting materials click here, for the press release on budget guidance, click here.

Baystate Financials' Plan Well Financial Education for Physicians

Vermont Medical Society has partnered with Baystate Financial for The PlanWell™ Series. This is a financial education curriculum geared explicitly towards VMS members. The objective is to help you realize your financial goals, whether it's saving for a house, paying off student debt, or planning for retirement.

There will be multiple webinar offerings in May for early to mid-career physicians and PAs (click here for details) and for late-career to retired physicians and PAs (click here for details).

Learn more and register here.

VMS Policy Resolutions Open for Member Feedback

The VMS Board is seeking member feedback on two policy resolutions related to:

• The Medicare Advantage Program;
• Eliminating Medicare’s Direct Contracting Entity (DCE)/ACO-Reach Programs

All VMS members should have received an email with a link to submit survey feedback on these proposed resolutions between March 14th and April 12, 2023. If you had issues opening up the full resolutions, please try again because the links have since been updated. To read the full resolutions, click here. If you did not receive your survey links or have any questions or concerns with completing the survey please contact bpauley@vtmd.org. The resolutions will then be discussed together with the feedback received from members by the VMS Board at its April 19th Board Meeting.

Resolutions are now considered by the VMS Board on a year-round basis and members can submit resolution topics for consideration at any time. For more information on the resolution adoption process see: https://vtmd.org/vms-resolutions/. Members wishing to listen to the VMS Board discussion or share feedback at the Board meeting can contact bpauley@vtmd.org for zoom log-in information.

Commissioner of Health Public Health Update on April 6th

The next Public Health Update call with Commissioner of Health Mark Levine, MD will be on Thursday, April 6th at 12:30 pm. Hear about the the most pressing public health information affecting the state and nation and have the opportunity to submit questions to Dr. Levine who will answer them, time-permitting. You can view the notes from the March 2, 2023 call here.

You can join the zoom meetings here.

Commissioner of Health Mark Levine, MD, gave a public health update on March 10, 2023 to the Vermont Association of Hospitals and Health Systems. Notes from the call can be found here.

EVENTS

Save the Dates - Preparing for and Delivering Value-Based Care in Rural Communities

May 2nd, June 6th, and June 27th, 2023

View the topics of the webinar series here.

Division Of Substance Use Programs

April 5, 2023, 11:30am-1:00pm and

April 6, 2023, 1:30-3:00pm

Virtual

In honor of Alcohol Awareness Month, the Division Of Substance Use Programs is hosting 2 webinars to discuss treatment access for alcohol use disorder (AUD). Each webinar will focus on a specific audience, one for emergency department providers and one for community-based practitioners. All are welcome to register for one or both webinars.

Please see the flyers in registration link here for more information.

Emergency Department Providers

April 5, 2023, 11:30am-1:00pm

Community-Based Practitioners

April 6, 2023, 1:30-3:00pm

Vermont Ethics Network Presents: Spring 2023 Palliative Care Virtual Series

April 18th, 25th, May 4th, 9th, 17th from 12pm to 1:15pm

Virtual

Join the Vermont Ethics Network for their first session in their Spring 2023 Palliative Care Virtual Series!

They Just Don't Get It: Serious illness communication strategies, skills, opportunities and pitfalls will be presented by Diana Barnard, MD - Associate Professor of Family Medicine & Lead Palliative Care Physician - UVM Health Network - Porter Medical Center on April 18th. Register here.

Other sessions include:

• April 25th - Mining the Language Gap: The words we use may not always convey the meaning we intend
• May 4th - Uncertain End of Life Trajectory: Care implications for patients with severe psychiatric illness
• May 9th - Clear as Mud: The nuances of hospice eligibility & financial issues at end of life
• May 17th - Use of Opioids in Serious Illness: Inpatient and outpatient considerations

Learn more about all sessions here.

Howard Center Annual Conference: Breaking Barriers: Finding Purpose & Possibilities Together

April 19, 2023

In-person and Virtual

The 6th Annual Howard Center Spring Conference is taking place on April 19th from 8:30am to 4:30pm with featured speakers including Dr. Nadine Burke Harris, Dr. Dacher Keltner, Dr. BJ Miller, Dr. Jeffrey Swanson, and Dr. Anna Malaika Tubbs.

For more information about the speakers, sponsors, and to register, visit here. 

Vermont Geriatrics Conference

April 20, 2023

In-person

The 17th Annual Vermont Geriatrics Conference is designed to equip physicians, advance practice providers, nurses, pharmacists, social workers and other healthcare professionals with practical and innovative approaches to the medical care of older adults.

For more information about our speakers, sessions, accreditation and to register, visit here. 

Integrative Pain Management Conference

May 5, 2023

In-person

This conference will meet the needs of an interdisciplinary healthcare community in the following ways:

1. Learn about integrative therapies and share best practices, research, and innovations in integrative approaches for chronic pain management.
2. Understand national initiatives and innovative policies that increase access to high-quality, evidence-based, comprehensive pain treatments in the context of an opioid epidemic and a mental health crisis.
3. Explore ways to provide integrative treatment of chronic pain to medically underserved populations.
4. Provide attendees with information and techniques which can be effectively integrated into day-to-day clinical practice to enhance patient engagement.
5. Demonstrate ways healthcare systems can support clinicians to prevent provider burnout and promote resiliency when working with the chronic pain population.

Learn more and register here.

Diabetes 2023: Updates on Management and Treatment

May 12, 2023

In-person

This conference is designed to equip primary care clinicians and other professionals, including dietitians, with updated knowledge on issues related to outpatient management of patients with diabetes.

For more information about our speakers, sessions, accreditation and to register, visit here.

49th Annual Family Medicine Course

June 6-9, 2023

In-person and Virtual

This intensive four-day program (with optional pre-conference full-day workshop taking place June 5, 2023) for family physicians, advance practice providers, nurses, and other primary care professionals will focus on current issues in the practice of Family Medicine, with special attention to new contributions. Emphasis is on practical, clinically-applicable diagnostic and management issues in primary care.

The conference dates will overlap with the Burlington Discover Jazz Festival, and all ages, live-music event on four stages in downtown Burlington that brings the community to life! 

The pre-conference workshop titled Mastering Early Goals of Care Conversations will take place on June 5, 2023

Empathic, honest conversations are cornerstones of patient- and family-centered care. Research shows that patients who speak with their clinicians about their goals and values are more likely to receive the care they want, have fewer non-beneficial medical treatments, spend fewer days in hospitals and intensive care units, and report a better quality of life. Take part in this safe, small group pre-conference workshop.

For more information about our speakers, sessions, accreditation and to register, visit here.

For more information about offerings from UVM CMIE, visit here.

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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