August 23, 2022

NEED TO KNOW

Save the Date! VMS to Host Fall Candidate Member Forums this October

Please join the Vermont Medical Society this Fall for VMS’ 2022 Candidate Forums in three districts across the State. These will be in person social events in which we will be inviting Vermont State House and Senate legislative candidates from Washington, Chittenden and Rutland counties to member-led receptions in their respective districts. VMS members who work or practice in these districts are invited to these informal meet & greets to get to know the candidates who could be representing them after the General Election in November. After the election, the VMS will also host virtual statewide forums for all members to engage with their new Representatives and Senators on our policy priorities. For questions please email Birdie at bpauley@vtmd.org. Look for the confirmed Washington County date and venue coming soon.

Register for each event below:

Providing Healthcare to Refugees: Medical Considerations in Providing Care to Adult Refugees

Join us on August 25th from 12:15pm to 1pm EST, for a webinar that will discuss medical considerations in providing care to adult refugees.

This webinar is a part of a series of webinars on Health Care for 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.

Register and Secure Your Discounted Room for the Vermont Medical Society Annual and Collaborative Meeting

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 on the event, please click here.

Register here.

To secure the discounted rate for a limited number of rooms for Friday, November 4th of the meeting, you can:

1. Call (800)451-8686 and reserve under the VMS Annual and Collaborative Meeting
2. Visit here and have the discount code (VMED22) automatically applied to your reservation

Vermont Invests in Substance Use Disorder Treatment, Prevention and Recovery

Late last week, the Governor held a press conference at the Central Vermont Medical Center (CVMC) to highlight Vermont’s recent investments into opioid and other substance use treatment, prevention and recovery programs. This past session the Vermont Legislature appropriated approximately $66.2 million to address substance use disorder (SUD), which includes:

• $4 million to local and regional substance misuse prevention coalitions

• $2 million for substance use disorder treatment and recovery beds 
• $1.2 million in rate increase for preferred providers to support treatment and recovery
• $1.54 million for recovery centers, employment services and regional recovery partners

Vermont Department of Health Commissioner Mark Levine said the tragic spike in overdose deaths Vermont has seen during the COVID-19 pandemic has driven the increased investment in SUD treatment, prevention and recovery. Melanie Sheehan, the Vice-Chair of Vermont’s Substance Misuse Prevention Oversight and Advisory Council, thanked the Governor for the $4 million in prevention funding for regional prevention coalitions. Also in attendance, Anna Noonan, President of CVMC, and Dr. Javad Mashkuri, VMS award winner, thanked the Governor for his commitment to support innovative approaches to substance use treatment and recovery. Dr. Mashkuri highlighted the Rapid Approach to Medication (RAM), the life-saving immediate medication-assisted-treatment program that was piloted at CVMC. For the full transcript of the press conference click here.

Vaccination Updates

In July 2022, CDC was notified of a case of polio in an unvaccinated individual from Rockland County, New York. Since then, there has been a renewed interest in ensuring complete polio vaccination coverage. 

Polio vaccination in children

1. Any Vermont Children’s Vaccine Program (VCVP) enrolled provider receives the polio vaccine (IPV) for use in children at no cost through a CDC contract.
2. CDC recommends that children get four doses of polio vaccine. They should get one dose at each of the following ages: 2 months old, 4 months old, 6 through 18 months old, and 4 through 6 years old. Up-to-date polio vaccination is required for child care and school attendance.
3. For pediatric catch-up scheduling see the IPV Catch-up Guidance for Children 4 months through 17 years of age.

We encourage all providers who see children to assess their patient coverage and make efforts to keep pediatric patients up to date. Practices that see patients under 18 years old will see polio rates highlighted in the upcoming quarterly report, sent from the IMR by mail.

For assistance in using the Immunization Registry (IMR) for patient recall, see the Not-Up-To-Date Guidance.

Polio vaccination in adults

Most adults were vaccinated for polio as children, and IPV is not a routine adult vaccine. The CDC vaccine purchase contract does not include IPV for adults, and state-supplied IPV may not be used for adults.

However, adults SHOULD receive a polio vaccine if they are:

1. unvaccinated
2. incompletely vaccinated
3. completely vaccinated but at higher risk for contact with poliovirus

Unvaccinated adults should be given three doses of IPV at recommended intervals. Titers should not be drawn to assess immunity.  

You may receive requests from adults searching for the polio vaccination for any of the above reasons. Currently, the only option is to purchase the vaccine privately or refer these patients to an administering pharmacy, or travel clinic if appropriate. If and when the CDC contract changes to allow for IPV administration in adults, the Immunization Program will update the Vaccine Availability Sheet and communicate by e-mail.  

Resources:

Polio Vaccination: What Everyone Should Know | CDC

Pinkbook: Poliomyelitis | CDC

Polio Vaccination: For Healthcare Providers | CDC

Catch-up Guidance for Children 4 months through 17 years of age-Inactivated Polio Vaccine (IPV) | CDC

Vermont Vaccine Availability August 2022 | VDH

Not Up To Date Report | VDH

Other vaccines updates from the week:

• Reuters: The United States said on Thursday it will boost its supply of monkeypox vaccine by making available an extra 1.8 million doses of Bavarian Nordic's Jynneos shot, as the number of reported cases in the country rose above 13,500. The additional doses would be available for states and local health departments that administer the vaccine intradermally, and have used 90% of their current supply, White House monkeypox response coordinator Bob Fenton said.
• NBCNews: White House Covid coordinator Dr. Ashish Jha said on Wednesday that the newly updated Covid boosters will be available to teens and adults "in a few short weeks." "I believe it’s going to be available and every American over the age of 12 will be eligible for it," Jha told NBC News' Lester Holt.

2022/2023 Flu Season Vaccine Update

The Immunization Program 2022/2023 Flu Season FAQ document is now available. This document will be updated periodically as additional information is made available.

• Practices will be able to place initial flu vaccine orders in VIMS starting August 29, 2022
• Initial orders will require a reconciliation of the full vaccine inventory in VIMS.
• Subsequent orders may be placed as needed using the flu-only reconciliation.
• Practices should base orders on immediate need and storage, not the whole season. Plan to order 3-4 weeks as storage allows.
• It is a priority of the state to have flu vaccine available wherever COVID-19 vaccine is available, including all walk-in clinics. With this increased access, patients may get their flu vaccine at a walk-in clinic rather than their primary care office. We suggest ordering vaccines thoughtfully with that in mind.
• State-supplied flu may be given to any patient under the age of 65.
• The CDC has made a preferential recommendation for high-dose flu vaccines for people aged 65 and older.
• The Immunization Program encourages practices to purchase these vaccines privately or refer older patients to the pharmacy.
• State-run walk-in clinics will not have high-dose flu vaccine available. Please ensure you can serve this population with the appropriate vaccine through private purchase or referral to a pharmacy.
• Grant money will be available to assist with clinics again this year.
• These funds may be available for a broader usage than in the past.
• The application process will remain essentially the same, with more information to be communicated soon.
• Check the AAPVT website for future details: Welcome to the American Academy of Pediatrics Vermont Chapter | AAPVT

MISC.

Preparing the Health Care System for Operation After the Public Health Emergency – Fact Sheets and Blog

At the beginning of the COVID-19 Public Health Emergency (PHE), the Centers for Medicare & Medicaid Services (CMS) used emergency waiver authorities and various regulatory authorities to enable flexibilities so providers could rapidly respond to people impacted by COVID-19. CMS has developed a cross-cutting initiative to use a comprehensive, streamlined approach to reestablish certain health and safety standards and other financial and program requirements at the eventual end of the COVID-19 PHE. Most waivers and flexibilities will terminate at the conclusion of the PHE – and several have already been terminated. CMS encourages health care providers to prepare for the eventual end of these flexibilities as soon as possible and to begin moving forward to reestablishing previous health and safety standards for and billing practices. Similar to the guidance CMS has made available to states, CMS is releasing fact sheets that will help the health care sector transition to operations once the PHE ends, whenever that may occur. The fact sheets released last week summarize the current status of Medicare blanket waivers and flexibilities by provider type as well as flexibilities applicable to the Medicaid community.

The physician and other clinician fact sheet is available here: https://www.cms.gov/files/document/physicians-and-other-clinicians-cms-flexibilities-fight-covid-19.pdf

Other fact sheets are available here: https://www.cms.gov/coronavirus-waivers

A Creating a Roadmap for the End of the COVID-19 Public Health Emergency blog is available at: https://www.cms.gov/blog/creating-roadmap-end-covid-19-public-health-emergency

Request for Reports of Pharmacy Denials of Care for Substance Use Disorders

Preliminary results of a new American Society of Addiction Medicine (ASAM) survey found more than 100 reports of pharmacies denying or delaying access to medications for patients with a substance use disorder, including buprenorphine. ASAM began conducting the survey in 2020 and has received results from 19 states. To provide better detail and coordinate with the AMA and other medical societies, ASAM is asking for survey feedback from prescribers in all states. The survey can be found here: https://www.surveymonkey.com/r/ASAMpharmacy

Please contact ASAM’s Corey Barton at cbarton@asam.org with any questions.

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 4th, 2022.

Click here for more information and details on applying for the scholarship by August 26, 2022.

EVENTS

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 summer.  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. 

Practitioner and Stakeholder Perspectives on Opioid Use and Treatment Across Rural Northern New England

August 31, 2022, 12:00 pm ET

This presentation will explore data from UVM CORA's Baseline Needs Assessments in Vermont, New Hampshire, and Maine, sharing insights gathered from practitioners and stakeholders about their concerns about opioid use and their perceived barriers to and beliefs about opioid use disorder treatment. Learn what others in the field are saying! 

The speakers will be Valerie Harder, PhD, MHS, Associate Professor in the Departments of Pediatrics and Psychiatry and Co-Director of CORA’s Surveillance and Evaluation Core at the University of Vermont, and Julia Shaw, MPH, Manager of the Surveillance and Evaluation Core at UVM CORA. 

Register here.

Frontiers in Psychiatric Treatment: Pregnancy and Postpartum

August 31, 2022, 12:00 pm ET

Frontiers in Psychiatric Treatment is a webinar series designed to equip clinicians with the latest knowledge about advances in patient care through digestible, clinically relevant updates across an array of subspecialties. On Wednesday, August 31, Veerle Bergink, MD, PhD, will cover recent developments in mental health treatment during pregnancy and the postpartum period.

Join here.

Addressing Adult Suicidal Ideation in Primary Care Setting

September 1, 2022, 12:00 pm CT

September is Suicide Prevention Awareness Month. Building off the Practical Strategies for Managing Suicidal Ideation & Reducing Risk, this pre-recorded webinar focuses on how primary care practices can address suicidal ideation within their adult patient population.

Register here.

Dismantling Stigma for All: Addressing Physician and Patient Mental Health and Suicide Risk

September 8, 2022, 12:00 pm CT

As part of National Suicide Prevention Week, this live, interactive forum will connect attendees with industry experts on suicidal ideation and physicians with lived experience to discuss solutions for dismantling the stigma around seeking mental health treatment.

Register here.

Private Practice Simple Solutions: Team Documentation

September 8, 2022, 10:00 am CDT

The AMA’s newly launched Private Practice Simple Solutions series is designed to help implement actionable changes that can improve efficiencies within a physician’s practice.

Each FREE multi-week session focuses on a single topic. This Team Documentation session will focus on: implementing multiple contributor documentation process, designing efficient documentation workflow, and appropriately delegating tasks to staff. 

Register here.

Regenerative Medicine: Highlighting and Correcting Misinformation

September 9, 2022, 8:00 am CT

Panelists, Zubin Master and Emily Vraga, will discuss the clinical and promotional landscape of stem cell-based interventions, ways of correcting misinformation, and resources and multi-sectoral policy approaches to help lead patients to more informed decision-making.

Learn more about the event here.

Register here.

VMS COVID Conversation with the Commissioner of Health, Mark Levine, M.D.

September 15, 2022, 12:30pm EST

Our August 18th call with the Commissioner of Health has been cancelled. The September 1st call will be replaced by the Providing Catch Up Immunizations/On-going Pediatric Care as part of our Providing Healthcare to Refugees webinar series. You can register for that webinar here.

The next time we will speak with the Commissioner of Health will be September 15th where he will provide us with the most pressing 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 here which take place on the 1st and 3rd Thursday of the month from 12:30pm to 1pm EST 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).

25th Annual Women's Health and Cancer Conference

September 30, 2022, 8am to 3pm EST

In-person and Virtual

Join us for a special 25th anniversary celebration and a keynote address by Kim Dittus, MD, PhD, Moving from treating cancer to treating the whole person. 

This free, educational event is geared towards a broad range of clinical providers as well as patients, friends and family members, researchers, and caregivers. Together, you'll learn about cancer screening, treatment, survivorship, reducing the cancer burden, and how the science has changed over 25 years (and where it’s going next). This conference is accredited at no charge to participants courtesy of the UVM Cancer Center.

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

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.

Private Practice Simple Solutions: Team Documentation

October 18, 2022, 10:00 am CDT

The AMA’s newly launched Private Practice Simple Solutions series is designed to help implement actionable changes that can improve efficiencies within a physician’s practice.

Each FREE multi-week session focuses on a single topic. This Team Documentation session will be a panel with subject matter expert on common obstacles  in a clinical vignette.

Register 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.

Register here.

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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