June 14, 2022

NEED TO KNOW

Supreme Court Ruling on Roe v. Wade Could Come as Early as Tomorrow

The Supreme Court is expected to release their final opinion on Roe v. Wade as early as tomorrow. Based on the leaked draft opinion, it is likely that Roe v. Wade and Planned Parenthood v. Casey will be overturned. Last month, the Vermont Medical Society and other Vermont health care organizations denounced the draft Supreme Court opinion. The statement expresses support for every person to have the right to control their own health care decisions, including the right to abortion care. In 2019, Vermont put protection for abortion access into law, but we know there is still work to be done, including passing the proposed "Reproductive Liberty Amendment," a constitutional amendment ensuring every Vermonter’s right to personal reproductive liberty is protected into the future. If you are concerned about the overturning of Roe v. Wade there will be rallies across Vermont on what Planned Parenthood is calling "Decision Day." Click here to learn more. 

Highlights from the 2022 AMA Annual Meeting 

The American Medical Association House of Delegates’ meeting is taking place this week, from June 10-15, in Chicago.  Vermont is represented at the House of Delegates by delegate Norm Ward, MD (pictured above), and VMS President Simha Ravven, MD. Read the latest highlights or explore major moments below: 

• AMA Announces a Recovery Plan for America’s Physicians
• Low-wage work exacerbates health inequities 
• Doctors demand action on public health crisis of climate change

Congress Sees Framework on Firearm Safety Legislation

Billed as "commonsense," a bipartisan group of U.S. Senators put forward on Sunday the first firearm legislation proposal in three decades. 

The legislation would:

Administration Press Conference Focuses on COVID-19 Recovery

At today’s Administration press conference, Commissioner of Health Mark Levine, MD, highlighted the latest updates on COVID-19 cases, testing and vaccination.  Currently, statewide COVID-19 levels are “low” and the trajectory continues in this direction.  The Commissioner and Governor Scott expressed optimism that Vermonters will be able to socialize safely this summer.   Commissioner Levine reminded Vermonters to find the latest information on the availability of vaccines to children under age 5 at https://www.healthvermont.gov/covid-19/vaccine/vaccines-children and that testing sites are closing as of June 25^th.  He indicated that the changes in COVID-19 response are not a “step backwards” but are a step forward as the science evolves and that this means an increased focus on responding to the impacts on Vermonters living through two years of a pandemic on substance use disorder, mental health, food insecurity, eating disorders, academic success, health behaviors and more.   Jenney Samuelson, Secretary of the Agency of Human Services also highlighted AHS’s focus on three priority areas of increased substance use and acute mental health challenges; stabilizing the health care system and workforce; and supporting families and children, including addressing housing instability.  Secretary of Education Dan French outlined efforts to address learning loss and the social-emotional needs of children, including how to distribute the $280 million remaining in federal recovery dollars.  Find notes from the press conference here.

• COVID-19 vaccine for children under the age of 5 has been available for preorder and is anticipated to arrive to Vermont practices the week of June 20. Read more here and here.  FDA advisory panels have given preliminary review finding both Pfizer and Moderna’s vaccines effective in this age group. 
• State testing sites are ending by June 25. Patients can still pick up take-home tests from state testing sites until then and households can order a 3^rd round of free tests from the federal government at https://www.covid.gov/tests.
• The State surveillance report is available here.

Out-of-Pharmacy Dispensing and Compounding Survey – Check your Email

All Board of Medical Practice and Office of Professional Regulation prescribing licensees should have recently received a survey from the Vermont Office of Professional Regulation regarding in-office dispensing and compounding. If you dispense or compound medications in your practice, it is particularly important that you take a moment to respond to this survey. 

In April of 2019, the Vermont Board of Pharmacy requested that the Office of Professional Regulation and Executive Officer for Pharmacy establish an Interdisciplinary Task Force including stakeholders from all prescribing fields, to discuss in-office compounding and clinic, facility, and office dispensing of legend drugs. The objective of the Task Force is to recommend consistent and enforceable patient-safety standards across diverse practice settings.  The Task Force met four times between October 2019 and January 2022. Task Force members were drawn from a diverse range of credentials and specialties, including  advanced practice and registered nurses, dentists, naturopaths, pharmacists, physicians, physician assistants, optometrists, and veterinarians. The Task Force discussed specific needs for out-of-pharmacy compounding and dispensing arising in dermatology, oncology, ophthalmology, and more.  Before forming recommendations, the Task Force wants to better understand prevailing practices, including the nature and scope of outside-of-pharmacy compounding and dispensing, particularly of sterile products. We hope you will help us by taking a few minutes to describe your clinical practice relative to drug compounding and dispensing, so that we may make more informed recommendations.

VMS Board Retreat June 29th

Thank you to all members who have completed the member survey we have been circulating since May 26^th. The survey will stop accepting responses on Thursday, June 16^th and will be used to inform VMS Board discussions at a retreat on June 29^th regarding how to best support our members and future directions for the organization.  Action steps will be shared with members via future issues of the Rounds. VMS members can locate your Board members here or reach out with any further questions or feedback to VMS President Simha Ravven, MD, at president@vtmd.org.

MISC.

Updated DNR/COLST Order Now Available 

On June 1, 2022, the new and improved VT DNR/COLST order went into effect. Download the form. This form was developed in collaboration with the Palliative Care Task Force, the Vermont Department of Health and with extensive input from clinicians across the state. As of June 1st, all new orders should be completed on this form if possible, although orders on previously approved VT DNR/COLST forms remain legal and valid. To learn more about the updated form and best practices for clinicians completing these orders watch the Vermont Ethics Network Information Session video and reviewing the accompanying slide deck. 

Private Practice Learning Collaborative: E/M Documentation Burden Reduction

The American Medical Association (AMA) has launched a new learning collaborative opportunity for private practice physicians designed to help implement actionable changes that can quickly increase their practice’s efficiency. Each eight-week session in the Private Practice Simple Solutions series will focus on a single topic. Physicians will be able to access a pre-recorded didactic presentation and a discussion board (NOTE: the discussion board requires individual registration to access this closed community). The discussion board runs throughout the entirety of the eight weeks, offering opportunities to interact with fellow cohort members and ask questions of subject matter experts who oversee the sessions. A second pre-recorded presentation will follow the first, focusing on the common obstacles or questions identified on the discussion board. The first session, which provides insights on using the AMA STEPS Forward® E/M Documentation Burden Reduction Toolkit as a guide, will be released on July 7. The second recording will be released on Aug. 16. Learn more here: https://www.ama-assn.org/practice-management/private-practices/ama-private-practice-simple-solutions

Patient Educational Materials Available To Promote Colorectal Cancer Screening

The Vermont Medical Society is partnering with the American Society for Gastrointestinal Endoscopy (ASGE) to  encourage every physician in the state to visit the ASGE Colorectal Cancer Screening Appropriate Use web page to download patient education resources, including a printable office/practice poster, patient letter templates (for positive and negative test results), and an article for local newspapers.  Materials explain the colorectal cancer screening options based on patient age and risk including colonoscopy, fecal immunochemical test (FIT) and MT-sDNA (Cologuard). 

ASGE President Douglas Rex, MD, MASGE, explains, “More than 30 percent of U.S. adults aren’t getting screened for colon cancer and it’s a disease that has a 90 percent survival rate when detected early. Further, most cancers can be prevented through polyp removal at colonoscopy.  This campaign will save many lives.”  Physicians can also refer their patients to ASGE.org/Screening for an easy-to-understand infographic on the appropriate screening test.

Vermont Beginning Immigrant Health Insurance Plan July 1

Act 48 of 2021 created a new, state-funded health care program for pregnant individuals and children who have an immigration status for which Medicaid coverage is not available. This program will begin July 1, 2022.  Program information, including the application, will be posted to the Immigrant Health Insurance Plan page on the DVHA website as it becomes available.  The new final rule applicable to the program can be found here: Immigrant Health Insurance Plan.

OCR Releases Guidance on How the HIPAA Rules Permit Audio-Only Telehealth

Yesterday, the U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), issued guidance on how covered health care providers and health plans can use remote communication technologies to provide audio-only telehealth services when OCR’s Notification of Enforcement Discretion for Telehealth - PDF is no longer in effect (after the end of the federal public health emergency).  For example, the guidance clarifies that the HIPAA Security Rule does not apply to audio-only telehealth services provided by a covered entity that is using a standard telephone line, often described as a traditional landline, because the information transmitted is not electronic. However, traditional landlines are rapidly being replaced with electronic communication technologies such as Voice over Internet Protocol (VoIP) and mobile technologies that use electronic media, such as the Internet, intra- and extranets, cellular, and Wi-Fi. The HIPAA Security Rule applies when a covered entity uses such electronic communication technologies.

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. 

Providing Health Care to Afghan Refugees: Cultural Considerations

June 30, 2022. 12:15pm to 1pm EST

This webinar will discuss Afghan resettlement in Vermont and both general Afghan culture as well as cultural considerations applicable to providing health care.

This webinar will be a first in a series of webinars on Health Care for Afghan Refugees hosted by the Vermont Medical Society. Anyone interested is encouraged to attend. Registration is required here.

To learn more about what other topics will be included in this series, click here.

July 13, 2022, 12pm to 1pm EST

Join the UVM CORA Community Rounds Workshop series session on, “Strategies for Distributing Naloxone to Rural Communities.” Our speakers are Geoff Capraro, MD, and Brooke Lawrence, co-founders of NaloxBox, an organization whose mission is to reduce harm from opioid use disorder by improving access to naloxone. This presentation will explore the need for naloxone distribution in rural areas and discuss innovative methods and technologies for increasing access.

REGISTER HERE

Can't make it? Watch the webinar recording to claim Continuing Education credits (within one month of the live event). Register for the webinar before July 13th so that you'll receive the recording later!

Vermont ACP Chapter Annual Scientific Meeting

October 14, 2022

Trapp Family Lodge, Stowe, VT

The Vermont ACP Chapter's Annual Scientific Meeting will occur on Friday, October 14, 2022. The ACP is optimistically planning for an in-person meeting. The ACP will host a virtual poster competition for resident and student members.

Update your medical knowledge, engage with colleagues, and receive CME credits and MOC points.

Meeting details and agenda forthcoming.

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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