August 6, 2024

NEED TO KNOW

Did You Know Vermont’s Primary Election Day is August 13^th – But You Can Vote Today?

On Tuesday, August 13^th Vermont voters will choose their statewide and legislative candidates for the general election held on Tuesday, November 5^th, 2024. Despite Vermont’s primary being in mid-August, which is typically vacation time for many, early voting for the primary election has already started in Vermont. You can participate in early mail-in voting by requesting to have your ballot sent to you or you can also vote on-demand right now by going to your Town or City Clerk’s office before August 13^th. Click here for the Secretary of State’s guide on voting early in the Vermont’s primary, which is an opportunity many other states don’t offer. Not sure who the candidates are? Check out this very thorough Primary Election Guide from VTDigger. Click through to read about why primary candidates are running for office and their positions on issues like overdose prevention centers, a sales ban on flavored tobacco, how they would address homelessness, increase access to healthcare services in the State and more. Vermont has made voting in the primary very easy – so get out there and VOTE!

Senator Welch Leads Colleagues in Introducing Bipartisan Bill to Reform Medicare’s Physician Fee Schedule

Senator Peter Welch joined by a bipartisan group of Senate colleagues last week announced the introduction of a bill to protect access to Medicare services by reforming the program’s physician fee schedule, the Physician Fee Stabilization Act. The bill would address one major factor that has led to yearly reductions in the fee schedule - the budget neutrality threshold.  The bill would immediately increase the threshold to $53 million with an increase every five years to keep pace with the Medicare Economic Index.  The budget neutrality threshold was last updated in 1992. The Physician Fee Stabilization Act is a critical step forward to ensure greater flexibility in determining pricing adjustments for services without triggering harmful annual payment cuts to Medicare-serving physicians.  In a press release announcing the bill, Jessa Barnard, Executive Director, Vermont Medical Society, stated  “The Vermont Medical Society, representing 2900 physicians, physician assistants, and medical students across Vermont, extends our thanks and strong support to Senator Welch for working to raise the Medicare Physician Fee Schedule budget neutrality cap. Vermont medical practices, from small independent offices to hospital-based clinics, cannot continue to bear year over year fee schedule cuts. This bill is particularly important to keeping medical practices open and able to serve patients in a rural state like Vermont with high Medicare coverage and a Medicaid fee schedule that mirrors the Medicare formula.”  View a digital version of the full press release here.  Read the full text of the bill. 

Cancelled: VMS Addison County Reception for August 6^th

Today’s VMS Legislative Candidate Meet & Greet scheduled from 6-8pm at the Middlebury Inn in Middlebury, Vermont has been cancelled due to low turnout. We are optimistic for robust turnout for our fall receptions coming up in September and October!  Please register for a VMS Candidate Meet & Greet in your district today! Get to know the Vermont State House and Senate legislative candidates from Bennington, Chittenden, Essex-Orleans, Rutland and Washington counties who have been invited to these member-led receptions. All physicians and PAs who work or practice in the county are invited. The receptions run from 6-8 pm at the following dates/locations: Bennington (September 10^th), Burlington (September 17^th); Rutland (October 1^st); Essex/Orleans County (October 3^rd); and Montpelier (October 16^th). Register here for all events. For questions, please email Birdie at bpauley@vtmd.org. 

GMCB Wraps Up Act 167 Meetings; Begins Hospital Budget Review

The Green Mountain Care Board this week is wrapping up community meetings to receive input on recommendations for hospital and health system transformation.  The meetings are being led by Dr. Bruce Hamory and his team at Oliver Wyman, retained by the Green Mountain Care Board (GMCB).  The final meeting of the series will be held tonight in St. Johnsbury.  Materials and recordings for past meetings are available on the GMCB website, as well as an opportunity to send written feedback through GMCB’s public comment form.  The next step is for the Oliver Wyman consultants to finalize their report for the GMCB, and then for the Agency of Human Services to work with communities to start to prioritize options for implementation.   The GMCB is also beginning hospital budget review this month.  The Board heard presentations from staff and a number of outside speakers on hospital finances today, will receive comments from the Hospital Association and hold the first three hearings tomorrow.  Find the materials and schedule here.

2022 Vermont Physician Census Now Available – Primary Care FTE Decline Continues

The 2022 Vermont Department of Health Physician report is now posted to healthvermont.gov/health-care-workforce-reports. Data for the report was gathered by survey at the time of 2022 license renewal.  Highlights from the report include:

• At the time of 2022 license renewal (August to November 2022), 3112 physicians report providing patient care in VT – 569 in primary care and 2543 in specialty care.
• Overall, primary care full-time equivalents (FTEs) continue to decrease, now at 406 (426 in 2020), while specialty care FTEs have increased to 987 (974 in 2020). Compared to 2020, a higher percentage of primary care physicians (8% vs. 6%) plan to retire or leave within the next 12 months.
• There continues to be a large increase in the number of providers reporting some form of telemedicine, with close to 1000 individuals reporting general telemedicine not tied to a specific Vermont location. 92% of primary care physicians and 78% of specialty care physicians reported an increase in telemedicine due to the Covid-19 pandemic and over half of them expected that increase to continue beyond the pandemic.
• Franklin and Washington Counties had large decreases in their primary care FTE to 100,000 population ratio with Franklin County losing 9 FTEs from 2020 to 2022. Addison and Bennington Counties had the biggest increases in FTE to population ratio from 2020 to 2022, with Addison County adding 3 FTEs and Bennington County adding 2 FTEs.
• Compared to 2020, percentages of primary care physicians in office settings accepting new patients, accepting new Medicaid patients, and accepting new Medicare patients have all decreased slightly.

Questions or comments on the reports can be submitted to AHS.VDHPhysicianCensus@vermont.gov.

Register Now: Reproductive and Gender Affirming Health Data Webinar Aug. 21

In the last year, there have been important changes to how reproductive and gender affirming care data can be used and shared in order to ensure the privacy of patients and ability of providers to deliver care. These changes include the passing of Shield Laws by the Vermont Legislature last year, and updates to the HIPAA Privacy Laws by the Department of Health and Human Services. These changes require those organizations and individuals maintaining patient records to consider their practices for sharing this sensitive data.   

To help organizations navigate the changes, VITL is offering a webinar on Wednesday, August 21^st from 12-1pm on the new federal and state Reproductive Health Data regulations featuring health care attorney John Wallace of Primmer Piper Eggleston & Cramer, in partnership with Vermont Medical Society, Vermont Association of Hospitals and Health Systems (VAHHS), and Bi-State Primary Care Association.  

The webinar will specifically address the changing legal landscape in preparation for implementation deadlines later in 2024 and early 2025. Please join us to learn more about: 

• The legal context for protecting reproductive records
• Recent actions to protect reproductive data: Vermont Shield Law and the new HIPAA Privacy Rule
• Required changes to Notice of Privacy Practices (NPP)
• Evaluating and responding to request for records and testimony involving reproductive data
• Implications for Information Blocking

If you would like to learn more but the webinar time does not work with your schedule, please register and VITL will make the slides, recording, and reproductive health data resources available to you. If you have questions, please call the VITL team at 802-861-1800. 

MISC.

August Vermont Vaccine Program Update Now Available

The August Vermont Vaccine Program Update is now available and can be viewed here.  The newsletter covers topics including the Upper Valley measles outbreak, planning for COVID-19 vaccines and the upcoming respiratory virus season. 

VDH Health Advisory: Appropriate Use of Rabies Postexposure Prophylaxis (rPEP) in Vermont

Reports of indoor bat encounters, animal bites, and use of rabies postexposure prophylaxis (rPEP) have increased significantly over the past several weeks. Many recent reports of rPEP that the Health Department receives indicate that vaccination was unnecessary. Rabies vaccines are complex, expensive, and limited. Each person who may have been exposed to rabies must be assessed quickly to determine if they need the vaccine. People who need the vaccine and don't get it before symptoms start (typically 1–3 months after exposure) will most likely die, so this assessment is critical. This process also helps control costs, avoids unnecessary visits to emergency departments, and ensures an adequate supply of vaccine by only giving it to people who need it.

Requested Actions

1. Consult with the Vermont Department of Health if you are unsure rPEP is indicated.
2. Administer rPEP when appropriate following a thorough risk assessment.
3. Consider delaying rPEP when further diagnostic information will soon be
4. Report animal bites and any administration of rPEP.
5. Properly administer rPEP based on current ACIP recommendations.

Full advisory with more resources and explanation can be found  here.

Nominate Healthcare Leaders for VMS Awards

Nominations are now open for VMS’ Leadership Awards!  We are asking members to nominate Vermont leaders who have provided outstanding contributions to the medical profession, to health organizations and to the welfare of the public. Please submit a nomination here.  Nominations are open through August 23, 2024.

Awards include:

The awards ceremony will be held on the evening on November 1st at the 211th VMS Annual and Collaborative Meeting. Stay up to date on event details here.

Next Commissioner Call Thursday, September 5, 2024

The Commissioner of Health, Mark Levine, MD, will hold his next Public Health Update with VMS Members this Thursday, September 5th at 12:30 pm. You can join the zoom meetings here.

He held his most recent VMS member call on August 1st. Notes from the call are here.

EVENTS

Vermont Opioid Response Network Xylazine Webinar Series

August 14, August 28, September 10 at 6:30 pm

Please join Vermont Department of Health in collaboration with the Opioid Response Network for a webinar series on xylazine and wound care.  The curriculum will include an overview of the risks associated with xylazine use, best practices for identifying and treating wounds, conversational strategies for enhancing engagement in wound care among PWUDs, as well as harm reduction focused resources and recommendations for improving the health of this population. 

Vermont: Xylazine & Overdose Prevention Webinar Series – Registration Link for all Sessions

1. August 14 - Wound Care Outreach: Brief Negotiated Interview Guided by Motivational Interviewing by Stephanie Rozen
2. August 28- Additional Resources and Strategies by Michael Chaple
3. September 10 Compassion Fatigue Conversation by Paul Warren 

Birth Certificate Quality Improvement Initiative Learning Series

September 9, October 7, 2024

Virtual

In collaboration with the Vermont Department of Health Division of Family and Child Health and the Division of Health Statistics and Informatics, the Perinatal Quality Collaborative - Vermont (PQC-VT) is embarking on a vital statistics birth certificate quality improvement initiative (BCQII).

The project aim is to improve the accuracy of key birth certificate variables to support public health and quality improvement efforts. The objective is to increase birth certificate data quality in Vermont by providing education opportunities, technical assistance, and shared learning to Vermont hospital teams involved in birth certificate data collection.

Register here for the learning series.

Save the date: 2024 Vermont Suicide Prevention Symposium

September 13, 2024

Join the Vermont Collaborative for Practice Improvement & Innovation in-person on September 13, 2024 at the Vermont State University Randolph campus for a day-long conference that will include presentations, workshops, and networking opportunities featuring leading voices in the field from Vermont, New England, and beyond. Our focus is on equitable, sustainable, and comprehensive suicide prevention with sessions designed for mental health clinicians, peer support workers, advocates & families, individuals with lived experience, healthcare providers, educators, and community members.  This event is presented by the nonprofit Vermont Collaborative for Practice Improvement & Innovation in partnership with the Vermont Department of Mental Health and United Way of Northwest Vermont.

Saving Time: Practice Innovation Boot Camp

September 23 - 24 AMA Plaza, Chicago

This two-day, interactive boot camp from the AMA STEPS Forward® Innovation Academy equips attendees with the time-saving tools and strategies needed to reform their organizations and enhance professional satisfaction. CME eligible.

Learn more here.

2024 Clinical Quality Symposium - Comprehensive Care Nourishing Minds, Bodies, and Communities

October 16th Lake Morey Resort, Fairlee, VT

Registration coming soon!

Vermont ACP Chapter Annual Scientific Meeting

October 18, 2024

Trapp Family Lodge, Stowe, VT

The Vermont ACP Chapter's Annual Scientific Meeting will occur on

Friday, October 18, 2024.

This will be an in person meeting. We will

again host a poster competition for resident and student members.

Update your medical knowledge, engage with colleagues.

Meeting details and agenda forthcoming.

Learning Collaboratives on In-Basket Reduction and Reducing Regulatory Burden

October 2024 – March 2025

AMA STEPS Forward^® Innovation Academy is launching two new, six-month learning collaboratives on optimizing the in-basket to reduce work burden and rethinking how organizations apply regulatory rules to clinical practice. Each collaborative will convene dyads or triads of leadership representatives from multiple organizations to engage in a longitudinal shared learning experience. Limited space available. Learn more.

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

Vermont Medical Society

134 Main Street

Montpelier, VT 05602

-- Unsubscribe --