June 13, 2023


Vermont Enacts Forensic Facility and Competency Restoration Legislation

After previous attempts to pass comprehensive forensic mental health laws in Vermont, and numerous cases in which those found incompetent to stand trial churned back and forth between the criminal justice and mental health systems in Vermont, Governor Scott recently signed into law two separate bills to address the care of those charged with a violent crime, yet found incompetent to stand trial. Act 27/S.89, which was signed into law on May 30th and became effective immediately, authorizes the State to build a nine-bed forensic mental health care wing at the Vermont State Psychiatric Care Hospital. Act 28/S.91, which was signed into law on May 30th and becomes effective July 1, 2023, establishes comprehensive competency restoration practices for Vermont, including analyzing whether a competency restoration program is right for our State. 

According to Act 27, the initial forensic wing at the Vermont Psychiatric Hospital will require rulemaking to allow the use of emergency involuntary procedures and the administration of involuntary medication. The new law creates a new Working Group on Policies Pertaining to Individuals with Intellectual Disabilities who are Criminal Justice-Involved. The working group will be made up of 15 members and will consult with psychiatrists or psychologists with experience conducting competency evaluations. The working group will propose legislation to establish the process and criteria for committing individuals to the forensic facility and will review any programmatic options for enhanced community supports for at-risk individuals committed to the custody of DAIL.

A key component to Act 28 is the separation of the processes for competency and sanity evaluations. VMS supports this separation as best practice. The new law will also allow competency and sanity examinations to be conducted by a doctoral-level psychologist trained in forensic psychology. Currently, only psychiatrists are allowed to perform these evaluations. Stakeholders from the court advocated for this expansion, citing the 6 to 9-month backlog in evaluations and stating that Vermont and Rhode Island are currently the only two states in the nation that do not allow forensic psychologists to perform these evaluations. This scope expansion will sunset on July 1, 2024, giving the State one year to evaluate the adequacy of the treatment. 

The bill also requires the Joint Legislative Justice Oversight Committee to study whether competency and sanity examinations could be conducted by other doctoral level mental health providers, including psychiatric nurse practitioners, or any other professionals. On or before November 15, 2023, the Committee will report back to the legislature on whether these evaluations can be provided by these other health care professionals and recommend any necessary changes to permitting competency and sanity examinations by doctoral-level psychologists trained in forensic psychology.

DMH and DAIL are also required to report back to the Governor and the legislature on November 15, 2023 regarding whether Vermont should adopt a competency restoration program and if so, the report shall include recommendations for best practices, any changes to law necessary to establish the program, estimated costs, and a proposal for implementing the program.

Please look for our Final Final 2023 VMS Legislative Bulletin, which will include write-ups on all relevant health related legislation, after the legislative veto session, which will be held next week from June 20th-June 22nd.

Vermont Represented at American Medical Association Annual Meeting

From left, Vermont is being represented at the American Medical Association 2023 Annual Meeting being held in Chicago this week by Alternate AMA-Delegate, Catherine Schneider, MD (General Surgery, Mt. Ascutney); AMA Delegate Norman Ward, MD (Family Medicine, UVMMC); VMS President, Ryan Sexton, MD (Emergency Medicine, NVRH); VMS Staff, Jessa Barnard; and VMS Board Member, Delegate for the American College of Radiology, Naiim Ali, MD (Radiology, UVMMC).  The AMA House of Delegates sets AMA policy and so far at the meeting have discussed public health issues such as tobacco control and disparate criminal sentencing and payment issues including telehealth and sufficient Medicare payment.  One adopted report directs the AMA to provide more education to payers and physicians regarding the use of Modifier -25 when providing two services on one day, which will help bolster current VMS advocacy efforts with payers on this topic. Follow the highlights of the AMA meeting here

Help Us Help You! Important Survey to Document Changes in Physician Practice Expenses

We are writing to ask for your support of a national study about physician practices, currently being sponsored by the American Medical Association (AMA) and supported by more than 173 health care organizations, including the Vermont Medical Society. The objective of this study is to help document changes in the U.S. health care delivery system that impact your practice every day. One of the recurring comments that we hear from physicians is that decision-makers and payers are not fully informed about the broad clinical, operational, and financial challenges that their practices face. This study represents your opportunity to communicate accurate financial and operational information to policymakers, including members of Congress and the Centers for Medicare & Medicaid Services. Data from this survey will be used to help determine physician payment levels.

The AMA has contracted with Mathematica, an independent research company with extensive experience in survey methods as well as care delivery and finance reform, to conduct the survey. Physician practices will be selected randomly to collect their confidential responses. The AMA and Mathematica will make data collection as convenient for you and your practice as possible and assure you that your individual data will be kept private. Financial information is critical to this survey and we, therefore, anticipate that financial experts will be needed to complete this portion of the data collection effort. Please afford your staff the necessary time so that your voice may be included in the final study results. Additionally, it is critical that we understand the direct patient care hours provided in your practice. Thus, we anticipate that many physicians will need to respond to a few questions to collect this information accurately.

Thank you in advance for your consideration. We hope that if you are selected, you will take the opportunity to participate in this critical study. Your involvement will make certain that the information collected will accurately represent your practice, patients, and profession.

Mildred Reardon Medical Student Scholarship Open for Applications

Do you dream of becoming a Vermont doctor?  See below to apply for a $10,000 scholarship for a rising 3rd year student committed to practicing medicine in Vermont.

The Vermont Medical Society’s Education and Research Foundation (VMSERF) is now accepting applications for the Mildred Reardon scholarship, which awards $10,000 to a University of Vermont Larner College of Medicine third year student committed to practicing medicine in Vermont. The scholarship is made to a student interested in any specialty, with a preference for specialties in high need in Vermont.  The scholarship is tuition-linked and is paid directly to the College of Medicine towards tuition. This year the award will be made at the VMS Annual Meeting, being held at Topnotch in Stowe and virtually on November 3, 2023.  Click here for more information and details on applying for the scholarship.


Commissioner of Health Public Health Update on Thursday, July 6th

The next Public Health Update call with Commissioner of Health Mark Levine, MD will be Thursday, July 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 June 1, 2023 call here.

You can join the zoom meetings here.

BCBSVT Offers Lifestyle Medicine Training and Board Certification Scholarships

Blue Cross and Blue Shield of Vermont, in partnership with the American College of Lifestyle Medicine (ACLM) and the American Board of Lifestyle Medicine (ABLM), is offering Lifestyle Medicine training and board certification to our clinical provider network through a unique scholarship program. ACLM/ABLM Certification typically costs over $2500 per provider, but BCBSVT is funding fifty (50) awards free of charge to eligible healthcare clinicians who are interested in pursuing a high level of professional training in lifestyle medicine and who are committed to the expansion of lifestyle medicine education, programs and initiatives to better serve their patients.

Learn more here. With questions or to apply for one of the scholarship awards, email Keri LeCompte at lecomptek@bcbsvt.com, BCBTVT Program Director for Lifestyle Medicine.



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

June 27th, 2023

The Northern Border Region Technical Assistance Center (NBR-TAC) is pleased to present a four-part webinar series on the journey to Value-Based Care (VBC) for rural hospitals and primary care providers/facilities (FQHC’s/RHC’s) interested in learning more about operating in a value-based care environment. This webinar is open to organizations or individuals interested in this topic who are welcome to attend.

View the topics of the webinar series here.

Save the Date: Vermont ACP Chapter Annual Scientific Meeting

September 29, 2023 at Trapp Family Lodge, Stowe, VT

The Vermont ACP Chapter's Annual Scientific Meeting will occur on Friday, September 29, 2023. We are planning for an in person meeting. We will again host a poster competition for resident and student members.

Update your medical knowledge, engage with colleagues, and receive 5 AMA PRA Category 1 CME credits and 5 MOC points.

Meeting details, agenda and registration information will be forthcoming.

Save the Date: 210th Annual and Collaborative Meeting Taking Place from November 3-4, 2023

The 210th VMS Annual Meeting will be held on November 3rd and 4th in person at Topnotch Resort, Stowe, VT, with virtual options. The weekend will be filled with educational content, time spent with colleagues, policy-setting meetings, and the opportunity to honor physicians and other health care leaders across the state.

Stay up to date on details here and nominate Vermont leaders who have provided outstanding contributions to the medical profession, to health organizations and to the welfare of the public for a VMS Leadership Award here.

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


Vermont Medical Society

134 Main Street

Montpelier, VT 05602

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