May 10, 2022

NEED TO KNOW

Vermont Legislature Coming to the Final Days of the 2022 Session

The legislature is quickly moving towards adjournment, with speculations that the gavel could fall as early as this Thursday. At this point, the only thing the legislature needs to finish is the FY23 Budget, which reportedly the House and Senate has come to an agreement on and it will be taken up on the Senate floor tomorrow morning. The budget includes the appropriations for S.11, a compromise of the workforce development bill.  The package now includes a $2.5 million appropriation using American Rescue Plan Act (ARPA) funds to create a Vermont Health Care Professional Loan Repayment program. This new Loan Repayment program will be administered by the Department of Health in collaboration with AHEC and will provide $2 million of loan repayment for nurses and physician assistants in 2023 and $500,000 for medical technicians, child psychiatrists, or primary care providers who live and practice in Vermont. An agreement on H.353, a pharmacy benefit manager regulation bill, has passed the Senate with language prohibiting insurers from requiring white-bagging and brown-bagging (when insurers mail medications to patients or health care facilities for administration). The bill will now go back to the House for concurrence. Thank you for all of your advocacy on H.548, the miscellaneous cannabis bill, which has now died. The pieces the legislature wants has now been placed on S.188 and the existing THC potency caps in statute stay in place.  VMS will be providing full details of 2022 health care policy in our Final VMS Legislative Bulletin after adjournment.

COVID-19 Updates: VDH Sunsetting Daily Case Dashboard

At today’s Administration press conference Commissioner of Health Mark Levine, MD, stated that while COVID is still circulating in Vermont communities, the 7-day case counts remained relatively stable this week, up 4% or 12 cases per day.  The 7-day hospitalization rate increased slightly from 58 to 64.  Starting tomorrow, the Department of Health will be moving to a weekly COVID-19 surveillance report, more like flu surveillance - tracking trends in symptoms, variants and hospitalization -and will be sunsetting the dashboard that contains daily case numbers and positivity rates. Reporters questioned how Vermonters will continue to make personal decisions about masking and other mitigation measures without case counts, but Commissioner Levine stated that there will still be access to CDC Community Level information and that mitigation measures should also be based on overall trends and not one isolated day of data or cases.  Vermont is receiving another 2000 doses of Paxlovid this week so access to treatment should be available for anyone who is older or high risk.  Commissioner Levine also highlighted that today is National Fentanyl Awareness Day and Vermonters can visit www.knowodvt.com for more information about test strips, Narcan and downloadable materials. For full notes, click here. To view notes from the call with Commissioner of Health, Dr. Mark Levine on May 5th, click here.

Other COVID-19 updates from the week:

• Long COVID: A new study from Open Forum Infectious Diseases suggests that COVID-19 vaccine is protective against post-acute sequelae of SARS-CoV-2 (PASC) symptoms (“Long COVID”), new onset of health conditions, and mortality.
• Limits on J&J Vaccine: The U.S. Food and Drug Administration last week limited the authorized use of the Janssen COVID-19 Vaccine to individuals 18 years of age and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate, and to individuals 18 years of age and older who elect to receive the Janssen COVID-19 Vaccine because they would otherwise not receive a COVID-19 vaccine.
• Prescriber Patient Eligibility Screening Checklist: FDA has released more tools to help health care providers in decision making regarding Paxlovid, the preferred therapy for the management of non-hospitalized adults with COVID-19. FDA recently updated the Fact Sheet for Health Care Providers, which provide more specific recommendations for some drugs. FDA also developed a Prescriber Patient Eligibility Screening Checklist and released Updates on Paxlovid for Health Care Providers here.
• Mask & Travel Recommendation: CDC published a media statement recommending that everyone aged two and older – including passengers and workers – properly wear a well-fitting mask or respirator over the nose and mouth in indoor areas of public transportation (such as airplanes, trains, etc.) and transportation hubs (such as airports, stations, etc.).

GMCB Meeting Discusses Appointment Wait Times, Global Budgets

The Green Mountain Care Board held a regularly scheduled meeting last Wednesday.  Materials and meeting agendas can be found here.  The GMCB Executive Director provided an update on several topics, including notifying the public that as of May 2, Northwestern Medical Center transferred its two primary care practices to the NOTCH Federally Qualified Health Center.  This follows the transfer on January 1 of its pediatric practices to independent practices affiliated with Primary Care Health Partners.  The ED also provided the recommendations of a workgroup focused on how hospitals will measure hospital-owned practice wait times for primary care and specialty care appointments, as well as the top five most frequent imaging procedures.  Hospitals will be asked to report this information by August, as well as in their hospital budget hearings.  These updates were followed by a panel of advocates sharing feedback on the concepts of global budgets for hospital and other health care services.

Green Mountain Care Board Chair and Member Vacancies – Applications Due 5/27

The State of Vermont has posted the description and application for the upcoming Green Mountain Care Board Chair vacancy and a member seat. The State is seeking candidates for the Chair (full time) and Board Member (32 hours per week) who serve a term of 6 years on the Board.  Applications are due by May 27th.  For more information see https://humanresources.vermont.gov/GMCB-Search-2022.

MISC.

Coming Soon: Vermont’s Premium Pay for Workforce Recruitment and Retention Grant Program

The Vermont Agency of Human Services is informing community service and health providers about a new program that may benefit your organization - Premium Pay for Workforce Recruitment and Retention Grant Program.

KEY DATES (subject to change)

Tu May 10 - Program materials will be posted online at https://humanservices.vermont.gov

Th May 12 at 12 noon - First Town Hall webinar to assist with application

We May 18 - Application opens

Th May 19 at 12 noon - Second Town Hall webinar

Tu May 24 - Application closes

ELIGIBLE EMPLOYERS

An Eligible Employer is an entity that employs one or more individuals in Vermont in relation to its operation of one of the following:

• An assisted living residence as defined in 33 V.S.A. §7102,
• A nursing home as defined in 33 V.S.A. §7102,
• A residential care home as defined in 33 V.S.A. §7102,
• A home health agency as defined in 33 V.S.A. §6302,
• An agency designated to provide mental health or developmental services, or both, pursuant to 18 V.S.A. chapter 207 or an agency with which the Commissioner of Mental Health or of Disabilities, Aging, and Independent Living, or both, has contracted to provide specialized services pursuant to 18 V.S.A. §8912,
• A substance use treatment provider in the Department of Health’s preferred provider network,
• A recovery center,
• An adult day service provider,
• An area agency on aging,
• A program licensed by the Department for Children and Families as a residential treatment program

More information including a program manual will be available soon at https://humanservices.vermont.gov.

Vermonters Turn in Nearly 3.5 Tons of Unneeded Medication on Prescription Drug Take Back Day

Vermonters turned in almost 3.5 tons of unused, unwanted and expired medication on the 22^nd nationwide Prescription Drug Take Back Day this past Saturday. The total of 6,950.1 pounds collected eclipsed every previous Prescription Drug Take Back Day except for the event held in spring 2021.  Beyond Take Back Day, the Health Department coordinates a system of permanent prescription drug disposal sites, such as at pharmacies and police stations where disposal boxes or kiosks are open to the community year-round. People can order a free Medication Mail-Back Envelope  or find a permanent drug disposal site at healthvermont.gov/drugtakeback.

Parks Prescription Passes Summer 2022

The Vermont Governor’s Council on Physical Fitness and Sports along with the Vermont Department of Forests, Parks and Recreation is once again offering a Vermont State Parks Prescription Program for free day passes at Vermont State Parks.  The prescriptions are distributed to medical practices to give physicians and other providers a meaningful way to discuss with their patients the importance of outdoor exercise and the connection between exercise and good health.  If you are interested in participating this year, please us at  know at dbutsch@gmail.com how many prescription pads of 50 each you think you will be able to use. 

Complete Provider Relief Fund Late Reporting for Period 2 By May 13, 2022

Physicians who received more than $10,000 in provider relief funds and did not submit their Period 2 report must act immediately by submitting a late Reporting Period 2 report request by Friday, May 13, 2022 at 11:59 pm ET. Provider Relief Fund (PRF) Period 2 spanned from July 1, 2020 thru December 31, 2020, and included physicians who see patients with Medicaid and CHIP coverage. Attached is an overview of the information needed to request to report late. If a provider did not submit a Period 2 report and does not hear from HRSA, click hereto learn more about the late reporting request form or call (866) 569-3522.

Let Your Patients Know: Help Paying for Internet Service Available

The Affordable Connectivity Program is a new Federal Communications Commission program that helps connect families and households struggling to afford internet service.  This new benefit  provides a discount of up to $30 per month toward broadband service for eligible households and up to $75 per month for households on qualifying Tribal lands. Eligible households can also receive a one-time discount of up to $100 to purchase a laptop, desktop computer, or tablet from participating providers.  Eligible households can enroll through a participating broadband provider or directly with the Universal Service Administrative Company (USAC) using an online or mail in application.  You can learn more about the benefit, including eligibility and enrollment information, by visiting www.fcc.gov/ACP and find materials for patients like handouts and social media posts here.

Free Online Pain Management and Opioids Program  

NEJM Knowledge+ Pain Management and Opioids CME program enhances your knowledge about opioids, so you can feel more confident managing pain appropriately. This activity offers up to 10 CME credits at no cost and covers the entire FDA blueprint including:

• The latest practices for assessing and managing acute and chronic pain
• Current guidelines in the appropriate use of opioids for pain management
• Evidence-based strategies for recognizing and treating opioid use disorder

Register and learn more here: https://knowledgeplusoffers.nejm.org/vtms-pmom/.  Meets Vermont licensing pain management and prescribing controlled substances CME requirements- although Vermont licensees should be sure to also cover Vermont opioid prescribing and VPMS rules.

Hypertension Management Project & Resources

Did you know that you can refer your patients to www.MyHealthyVT.com to register for self-management workshops, including a new controlling high blood pressure program? This FREE community resource is available to anyone with HTN who is over age 45. The evidence-based workshop, led by trained coaches, is part of a state wide effort to enable Vermonters to better manage high blood pressure at home. Virtual and in-person training options are available, and local “lending libraries” of blood pressure monitors are available to program participants, free of charge, for use during the program.

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. 

Virtual Film Screening of Someone You Love: The HPV Epidemic

May 11, 2022, 7:30am to 9:30am OR May 26 2022, 2pm to 4pm

Virtual

Join the Bi-State Primary Care Association for a free virtual film screening of Someone You Love: The HPV Epidemic followed by discussions with experts in the fields of pediatrics and public health. Someone You Love is a powerful documentary showing the impact that preventable HPV-related cancers can have. 

Register here.

Clinician Information Sessions: New 2022 DNR/COLST Form

May 11, May 26, 2022, 12pm to 1:15pm

Virtual

On June 1, 2022, the Vermont Department of Health will be launching a new and improved DNR/COLST form for use across the state. Join the Vermont Ethics Network's Executive Director & Clinical Ethicist, Cindy Bruzzese, MPA, MSB, HEC-C, to learn about the new Vermont DNR/COLST form and review best practices for completing medical orders.

Register here.

How Can We Make Vermont More Welcoming and Inclusive for Our Diverse Community?

May 18, 2022, 6pm to 7:30pm

Vermont is one of the least diverse states in the nation. With that as our starting point, how can Vermont attract more people with diverse backgrounds and help them find community so they decide to stay? Join a panel of professionals working to promote diversity and equity in area businesses and institutions.

This event is part of The Marna and Stephen Wise Tulin Spring Community Education Series presented by the Howard Center. Read more about the series here.

Register here.

Caring for Adolescents and Young Adults with Disordered Eating: A Multidisciplinary Training

May 23, 2022, 9am to 4:00pm

Virtual

Learn how to apply a multi-disciplinary approach to caring for adolescents and young adults with disordered eating, identify best practices for case conceptualization, assessment, and intervention to apply, and more with presenters from the UVMMC Eating Disorder Consultation Clinic, The Adams Center, UVM, and panelists from the field. View the full flyer with the learning objectives and agenda here.

Register here.

The 48th Annual Family Medicine Review Course

June 7-10, 2022

In-Person and Virtual

Course Director Dr. Anya Koutras invites you to this intensive four-day program for family physicians and other primary care professionals. The program will focus on current issues in the practice of Family Medicine, with special attention to new contributions. Attendees will have a choice between in-person at the DoubleTree by Hilton Hotel, Burlington, VT and virtual participation. TOPICS include: genomics testing, Parkinson’s disease, hypothyroidism, headache management, valvular heart disease, type-2 diabetes, HPV disease, bipolar disease, endometrial cancer, LARC, skin biopsies, end of life care, knee exam, substance use disorder, gender-affirming care, geriatric psychiatry, urgent care cases

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

Vermont Medical Society Annual and Collaborative Meeting

November 4th and 5th, 2022

The 209th VMS Annual Meeting will be held on November 4th and 5th in person at Topnotch Resort, Stowe, VT, with virtual options. The weekend will be filled with educational content, time to spend with colleagues, policy-setting meetings, and the opportunity to honor physicians and other health care leaders across the state. VMS’ Annual Meeting, hosted in collaboration with the American Academy of Pediatrics Vermont Chapter, the Vermont Academy of Family Physicians and the Vermont Psychiatric Association, is a celebration of the unwavering commitment Vermont clinicians have to their practice and to the deep connection VMS members have with each other.

To view more information or submit nominees for 2022 leadership awards, please click here. Registration information will be shared in the future.

UVM will have more primary care conferences in Fall 2022. Sign-up to get updates via email for topics that are of interest here.

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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