Maine Medicine Weekly Update - May 20, 2020
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Maine CDC Eliminates COVID Testing Prioritization Upon Agreement With IDEXX

The Maine CDC announced on Monday they have broadened the criteria for who can be tested as they ramp up their test-processing capacity. They now urge physicians not to be hesitant in sending samples due to previous state resource limitations

 

The Maine CDC announced on Monday they have broadened the criteria for who can be tested as they ramp up their test-processing capacity. They now urge physicians not to be hesitant in sending samples due to previous state resource limitations.

An important note is that officials are still asking congregate, and group settings to still reach out to one of the senior epidemiologists at CDC (i.e., Medical: Drs. Sirii Bennett and Stephen Sears & for Infectious Disease Epidemiology: Ann Farmer and Sara Robinson) if a large batch of samples will be sent. The prioritization tiers mostly affect individual cases.

The welcomed change is due to the new availability of an independent supply of reagents from IDEXX. According to Maine CDC, it places Maine in a much better position relative to other states regarding the overall supply chain and availability of testing.

Maine health care providers should use their clinical judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. For added help, a Maine Health Alert Network message was sent earlier this week which included Infectious Diseases Society of America (IDSA) Guidelines on the Diagnosis of COVID-19. IDS A guidelines. They arguably represent the best evidence-based diagnostic guideline to assists clinicians, clinical laboratorians, patients, and policymakers in decisions related to the optimal use of SARS-CoV-2 nucleic acid amplification tests. They are summarized but extensive.

The process for submitting and receiving results will not change and will continue to be compatible with your existing workflow. Testing forms and information on acceptable swabs and transport media can be found here.

While the large health systems will play a critical role in large scale testing, we are in the process of finding out how private practitioners will have access to needed testing supplies. There are many primary care physicians who are not part of a hospital system. It is critical that widespread access to critical diagnostic testing services, including practice level viral transport media is available to meet both current needs and future needs for any potential surge in cases coinciding with the next influenza season.

Please do not hesitate to reach out to Director of Communications and Government Affairs, Dan Morin at dmorin@mainemed.com or (207) 838-8613 for more information or to pass along any difficulties in acquiring supplies for samples at the ground level.

If you would like to receive future important Maine Health Alert Network (MaineHAN) messages by email. Please sign up here. MaineHAN is a secure, web-based communication system used by the Maine CDC to exchange vital information with physicians, nurses, hospital staff, clinicians, public health workers, emergency preparedness and management personnel, first responders, and many others.

 

MMA Seeking Physicians to Provide Peer Reviews

MMA has provided external Peer Review services for over 30 years to hospitals and practices in Maine

 

Maine Medical Association is seeking physicians in the following specialties to perform Peer Reviews: cardiology, neurology, endocrinology and orthopedics. You will be compensated for your time reviewing records and writing a report.

If you are interested, please send a copy of your CV to Dianna Poulin at dpoulin@mainemed.com.  

MMA has provided external peer review services for over 30 years to hospitals and practices in Maine.   

Click HERE to learn more about MMA’s External Peer Review Program.   

 

JAMA Study Shows No Benefit from Hydroxychloroquine for Covid-19

The study was conducted by researchers at New York-Presbyterian Hospital—Columbia University Irving Medical Center, and published last week in the New England Journal of Medicine (JAMA)

 

The study was conducted by researchers at New York-Presbyterian Hospital—Columbia University Irving Medical Center, and published last week in the New England Journal of Medicine (JAMA). It showed that  among patients hospitalized with COVID-19, treatment with hydroxychloroquine, azithromycin, or both was not associated with significantly lower in-hospital mortality. The observational study included 1,376 patients. There continue to be, however, numerous randomized, controlled trials of hydroxychloroquine underway. 

The Federal & Drug Administration has granted Emergency Use Authorization (EUA) for Chloroquine Phosphate and Hydroxychloroquine Sulfate for Certain Hospitalized COVID-19 Patients but cautioned against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems. The agency stresses that use under the EUA are for a certain population of hospitalized patients with COVID-19.  Given the uncertainty regarding the potential benefits and risks for COVID-19, it is critical to first have evidence from clinical trials.

Paycheck Protection Program Forgiveness Application Released

The Treasury Department and Small Business Administration recently released the loan forgiveness application for the Paycheck Protection Program (PPP)

 

The Treasury Department and Small Business Administration recently released the loan forgiveness application for the Paycheck Protection Program (PPP). This application must be completed to apply for forgiveness of a PPP loan and submitted to the lender who approved the loan. Borrowers are eligible for loan forgiveness for the following costs: payroll costs paid and payroll costs incurred during the eight-week Covered Period and certain nonpayroll costs including mortgage obligations, rent obligations and utility payments; the nonpayroll costs cannot exceed 25 percent of the total forgiveness amount.

 

Attestation Deadline for Receipt of Federal Provider Relief Fund Payments & Opportunity for Relief

The US Department of Health and Human Services has extended the deadline for healthcare providers to attest to receipt of payments from the Provider Relief Fund and accept the Terms and Conditions. Providers now have now have 45 days, increased from 30 days, from the date they receive a payment to attest and accept the Terms and Conditions or return the funds

 

The US Department of Health and Human Services has extended the deadline for healthcare providers to attest to receipt of payments from the Provider Relief Fund and accept the Terms and Conditions. Providers now have now have 45 days, increased from 30 days, from the date they receive a payment to attest and accept the Terms and Conditions or return the funds. 

The initial 30-day deadline for providers who may have received payment on April 10, 2020, is extended to May 24 from May 9, 2020. With the extension, not returning the payment within 45 days of receipt of payment will be viewed as acceptance of the Terms and Conditions. In addition, DHHS is reminding eligible providers that they have until June 3, 2020, to accept the Terms and Conditions and submit their revenue information to support receiving an additional payment from the Provider Relief Fund $50 billion General Distribution. All providers who automatically received an additional General Distribution payment prior to 5:00 pm, Friday, April 24th, must provide HHS with an accounting of their annual revenues by submitting tax forms or financial statements. These providers must also agree to the program Terms and Conditions if they wish to keep the funds. Providers who have cases pending before the department for adjudication with regard to eligibility for general distribution funding will not be impacted by this closure. All cases needing individual adjudication will need to be received by HHS no later than June 3, 2020. 

The submission of tax forms or financial statements to the portal will also serve as an application for additional funding for those providers that have not already received an additional General Distribution payment. If these providers do not submit their revenue information by June 3, they will no longer be eligible to receive potential additional funding from the $50 billion General Distribution. Please visit the CARES Act Provider Relief Fund website for more information.

 

AMA Cautions Physicians, Public About Limitations of Antibody Testing for SARS‑CoV‑2

With a growing number of tests claiming to identify people who have been exposed to SARS-CoV-2 and potentially immune to COVID-19, the AMA announced guidance to help ensure physicians and the general public are aware of the limitations and potential uses of serological testing, also known as antibody testing

 

[From AMA Advocacy Update 05/16/20]

With a growing number of tests claiming to identify people who have been exposed to SARS-CoV-2 and potentially immune to COVID-19, the AMA announced guidance to help ensure physicians and the general public are aware of the limitations and potential uses of serological testing, also known as antibody testing. Through the new guidance, the AMA cautions physicians and the general public about using these tests to determine individual immunity and warns that the discontinuation of physical distancing should not be made on the basis of antibody test results.

"Given that we do not yet have scientific evidence showing if, when and for how long individuals might become immune to COVID-19, physicians and the general public should not use antibody testing to consider anyone immune to the disease—doing so may lead individuals to falsely assume they can stop physical distancing and further the spread of illness," said AMA President Patrice A. Harris, MD, MA. "Although many are using these tests to determine whether an individual had COVID-19, we encourage physicians to only use antibody tests authorized by the Food and Drug Administration (FDA) and only for the purposes of population-level studies, evaluating recovered individuals for convalescent plasma donations, or along with other clinical information as part of a well-defined testing plan for groups or individuals."

The AMA's new guidance provides physicians and the general public with an overview of the current state of antibody testing for SARS-CoV-2, including their limitations, potential uses, and how they are and are not regulated. This guidance can be found online as part of the AMA's COVID-19 Resource Center.

While antibody tests may play an important role in determining the overall prevalence of COVID-19 in the U.S. population, including asymptomatic infection, inherent limitations exist in using them to identify prior infection in individuals. Many of the antibody tests currently on the market may return a significant number of false positive results, as well as show cross-reactivity—meaning the tests also identify antibodies for other coronaviruses, such as those causing the common cold. Given these limitations, the AMA recommends that currently available antibody tests not be used as the sole basis of diagnosing COVID-19, and not be offered to individuals as a method of determining immune status, and not be used to inform decisions such as returning to work, discontinuing physical distancing, or as the basis for "immunity certificates."

Additionally, concerns continue to mount about the performance and fraudulent labeling of many of the SARS-CoV-2 antibody tests currently available. The vast majority of more than 120 tests on the market have not been authorized by the FDA, despite marketing claims to the contrary. The AMA urges physicians to pay close attention to the regulatory status of all available SARS-CoV-2 antibody tests. A list of all antibody tests authorized by FDA for SARS-CoV-2 can be found on FDA's website.

The AMA continues to recommend physical distancing to reduce the spread of COVID-19. However, there are marginalized and minoritized patient-communities disproportionately impacted by COVID-19 and their housing or employment status may make it difficult to adhere to physical distancing recommendations. The new guidance calls for providing messaging to medically underserved communities that explicitly takes into consideration the cultural and social features affecting their ability to make long-term choices on physical distancing and other COVID-19 precautions.

The AMA will continue to provide resources to physicians and physicians-in-training to help prepare them to care for patients as the pandemic evolves and protect themselves and their patients from illness. These resources are available on the AMA COVID-19 Resource Center.  

 

Cleaning and Disinfection of Environmental Surfaces in the Context of COVID-19

The purpose of this document is to provide guidance on the cleaning and disinfection of environmental surfaces in the context of COVID-19

 

[From WHO 05/16/20] 

https://www.who.int/publications-detail/cleaning-and-disinfection-of-environmental-surfaces-inthe-context-of-covid-19

Overview: 

The purpose of this document is to provide guidance on the cleaning and disinfection of environmental surfaces in the context of COVID-19. This guidance is intended for health care professionals, public health professionals and health authorities that are developing and implementing policies and standard operating procedures (SOP) on the cleaning and disinfection of environmental surfaces in the context of COVID-19.

Excerpt:

"Coronavirus disease 2019 (COVID-19) is a respiratory infection caused by SARS-CoV-2 (COVID-19 virus). The COVID-19 virus is transmitted mainly through close physical contact and respiratory droplets, while airborne transmission is possible during aerosol generating medical procedures.1 At time of publication, transmission of the COVID-19 virus had not been conclusively linked to contaminated environmental surfaces in available studies. However, this interim guidance document has been informed by evidence of surface contamination in health-care settings2 and past experiences with surface contamination that was linked to subsequent infection transmission in other coronaviruses. Therefore, this guidance aims to reduce any role that fomites might play in the transmission of COVID-19 in health-care3 and non-health care settings." 

 


 

MMA Mary Cushman Award for Humanitarian Service

Nominations for the 2020 award are due by July 31.  The award is presented each year by the Maine Medical Association to recognize the humanitarian service of medical volunteers who serve in Maine, the US or abroad.

 

The Maine Medical Association presents the Mary F. Cushman, MD Award for Exceptional Humanitarian Service as a Medical Volunteer each year. The award was established in 2003 in recognition of the MMA's 150th anniversary.

Priority consideration is given to:

  • the nomination of a Maine physician who is a member of the Maine Medical Association
  • nominations submitted by members of the Maine Medical Association
  • nominations that, for international volunteering, include training people in other countries to provide care in their own communities.

Nominations for the 2020 Mary Cushman Award are due by July 31, 2020. The award is announced at the MMA's Annual Session in September and includes a $1,000 donation to the institution or organization of the recipient's choice.

2020 Mary Cushman Award Nomination Form

Maine CDC Public Health Advisory: 2020 Lyme and Other Tickborne Disease Information

Lyme disease is the most common vectorborne disease in Maine. Ticks are already active, and we expect the number of Lyme disease cases to increase as the weather continues to get warmer. May is Lyme Disease Awareness Month in Maine and we want to encourage Mainers to use the “Tick Tock” strategies to stay tick free.

 

[From Maine CDC 05/13/2020]
 
Lyme disease is the most common vectorborne disease in Maine. Ticks are already active, and we expect the number of Lyme disease cases to increase as the weather continues to get warmer. May is Lyme Disease Awareness Month in Maine and we want to encourage Mainers to use the “Tick Tock” strategies to stay tick free.
 
Background:
Lyme disease is a bacterial infection that is carried by the deer tick (Ixodes scapularis). Cases increased over the last decade in Maine and occur in all 16 counties. For the first time, providers reported over 2,000 cases of Lyme disease statewide in 2019. Lyme disease is most common among school age children and mature adults over the age of 65. Most infections occur during the summer months, and as the weather continues to warm up, more ticks will be out in the open increasing the risk for tickborne diseases. Providers are already reporting cases in 2020, and the number will rise as we enter the summer months. Many individuals and families are spending more time outdoors during the COVID-19 pandemic. This may put them at increased risk of exposure to tickborne pathogens.
Deer ticks can also carry the bacterium that causes anaplasmosis and the parasites that cause babesiosis. Both anaplasmosis and babesiosis are also increasing in Maine, and individuals bitten by the deer tick can acquire more than one infection.
 
Symptoms:
The most common early symptom of Lyme disease is an expanding red rash (erythema migrans) that occurs 3-30 days after being bitten. Fever, joint and muscle pains may also occur. Untreated infections can lead to clinical findings in skeletal, cardiac, and nervous systems. Disseminated manifestations of disease include: arthritis characterized by recurrent, brief attacks of joint swelling; lymphocytic meningitis; cranial neuritis (such as Bell’s palsy); encephalitis; and second- or third-degree atrioventricular block. Lyme disease is treatable, and most patients recover after receiving appropriate therapy.
 
What to do after a tick bite:
• Remove the tick properly, ideally using tweezers or a tick spoon.
• Clean the area around the bite.
• Instruct the patient to watch for signs and symptoms for 30 days.
• Identify the tick and the engorgement level, or the amount of time the tick was attached.
• Testing of the tick is not routinely recommended for clinical purposes because even if the tick tests positive for Lyme, that does not mean it was attached long enough to transmit the disease. Even if the tick tests negative that does not mean it was a patient’s only exposure.
 
Prophylaxis:
• Prophylaxis after a tick bite is not routinely recommended, but can be considered under specific circumstances including:
o Tick is identified as an engorged deer tick that was attached for at least 24 hours.
o Exposure occurred in an area where there is a high rate of infected ticks. Areas south of Bangor have the highest rate of infected ticks in the state. There are limited data from the more northern counties on the rate of infection among ticks.
o Prophylaxis can be started within 72 hours of tick removal. Even if prophylaxis is used, Maine CDC recommends monitoring for symptoms for 30 days.
• There are no data showing if prophylaxis is effective in preventing anaplasmosis, and a single dose of doxycycline will not have an effect on babesiosis. Therefore, even if prophylaxis is used, Maine CDC recommends monitoring for symptoms for 30 days.
 
Tick identification and testing:
• Tick identification and testing is available through the Tick Lab at the University of Maine Cooperative Extension. More information can be found at ticks.umaine.edu.
• Tick identification is available for free.
• Tick testing is available for $15 with a three-day turnaround time. This service is only available to Maine residents.
o Deer ticks are tested for Lyme disease, anaplasmosis, and babesiosis.
o American dog ticks, lone star ticks, and other related tick species are tested for Rocky Mountain spotted fever, ehrlichiosis, and tularemia.
• While testing ticks for clinical purposes is not recommended, data from tick testing is very helpful for surveillance purposes and determining tick infection rates in the state.
• However, clinical decisions should not be made based off the results of this service.
 
If Providers suspect Lyme disease:
• Preferred laboratory testing is a two-tier method, with an EIA or IFA test followed by either a Western Blot for both IgG and IgM.
o Federal CDC issued updated recommendations for serologic diagnosis of Lyme Disease in August 2019 recommending that when cleared by FDA for this purpose, serologic assays that utilize EIA rather than western immunoblot assay in a two-test format are acceptable alternatives for laboratory diagnosis of Lyme disease. More information is available at http://dx.doi.org/10.15585/mmwr.mm6832a4.
• IgM is only considered reliable in the first month after exposure.
• IDSA guidelines for assessment, treatment, and prevention of Lyme disease are available at http://cid.oxfordjournals.org/content/43/9/1089.full.
Maine Center for Disease Control and Prevention
2020PHADV021 – 2020 Lyme and Other Tickborne Disease Information 3
• Consider testing for other tickborne diseases as well if warranted.
 
What to report:
Lyme disease is a reportable condition in the state of Maine. Report all diagnosed erythema migrans rashes and all positive lab diagnoses. Cases can be reported by fax at 1-800-293-7534 or by phone at 1-800-821-5821.
 
Other tickborne diseases:
Other diseases that can be transmitted by deer ticks in Maine include anaplasmosis, babesiosis, Borrelia miyamotoi, and Powassan. Symptoms of anaplasmosis include: fever, headache, malaise and body aches. Symptoms of babesiosis include: extreme fatigue, aches, fever, chills, sweating, dark urine, and possibly anemia. Symptoms of B. miyamotoi include: fever, chills, headache, body and joint pain, and fatigue. Symptoms of Powassan include: fever, headache, vomiting, weakness, confusion, loss of coordination, speech difficulties, seizures, and encephalitis and meningitis. Preferred testing for anaplasmosis, babesiosis, B. miyamotoi, and Powassan is by PCR. Testing for Powassan and Deer Tick Virus can be performed at Maine’s Health and Environmental Testing Laboratory (HETL). Many reference and commercial laboratories offer testing for anaplasmosis, babesiosis, ehrlichiosis, and B. miyamotoi.
 
In 2019, providers reported 685 cases of anaplasmosis, 138 cases of babesiosis, 13 cases of B. miyamotoi, and two cases of Powassan. Current case count data can be found on the Maine Tracking Network Near Real-Time dashboard.
 
Anaplasmosis, babesiosis, ehrlichiosis, Powassan, and Rocky Mountain spotted fever are all reportable in Maine; however, ehrlichiosis and Rocky Mountain spotted fever are uncommon in the state. Borrelia miyamotoi is currently reportable under the unusual illnesses of infectious causes category.
 
A Physician’s Reference Guide is available and describes the most common tickborne diseases in Maine. This guide can be found on our website at: www.maine.gov/dhhs/vectorborne under Resources. Paper copies can be requested through disease.reporting@maine.gov.
 
Additional information:
• Lyme disease: www.maine.gov/lyme.
• Other tickborne diseases: www.maine.gov/dhhs/vectorborne.
• Frequently asked questions: www.maine.gov/dhhs/tickfaq.
• To order Lyme educational materials: www.maine.gov/dhhs/order.
• HETL requisition: www.mainepublichealth.gov/lab.
• Maine Tracking Network tickborne disease data: data.mainepublichealth.gov/tracking.
o Visit the “Data Portal” for data tables, maps, charts, and near real-time reports of Lyme disease, anaplasmosis, babesiosis, and tick exposures in Maine emergency departments.
• UMaine Cooperative Extension Tick Lab data: extension.umaine.edu/ticks/maine-tick-data.
o Includes data tables, maps, reports, and real-time updates.
• Maine CDC Disease Reporting and Consultation Line: 1-800-821-5821.

A Message from Maine Responds

We appreciate all of the offers coming in to assist in Maine CDC's COVID-19 response.  By registering with Maine Responds, you will join our listing of volunteers against which we search for any emergent volunteer workforce needs. Read on for the details of joining both Maine Responds, and our more involved volunteer opportunities through Maine Medical Reserve Corps - members of both start with the same first step: register at maineresponds.org.

 

A Message from Maine Responds:

We appreciate all of the offers coming in to assist in Maine CDC's COVID-19 response.  By registering with Maine Responds at maineresponds.org, you will join our listing of volunteers against which we search for any emergent volunteer workforce needs. Read on for the details of joining both Maine Responds, and our more involved volunteer opportunities through Maine Medical Reserve Corps - members of both start with the same first step: register at maineresponds.org.

The Maine Responds Emergency Health Volunteer System is the online registration system for public health, healthcare and emergency response volunteers for the State of Maine.

Maine Responds is a partnership that integrates local, regional, and statewide volunteer resources to assist our public health and healthcare systems. It is part of a national initiative to train, coordinate, and mobilize volunteers during an emergency. Maine Responds coordinates verified, pre-credentialed public health, healthcare and emergency response volunteers into a single database that can coordinate the need for volunteers across county, regional and state lines if needed.

Maine Medical Reserve Corps (MRC) volunteer programs reinforce our state's public health infrastructure and support low stress/no-fault exercise environments that test critical response capabilities.  Members of both Maine Responds and MRC start with the same first step: register at maineresponds.org.You will be able to select your local MRC unit in the drop-down menu under the "Organizations" section of the registration - refer to this link to determine your Public Health District(s).  Maine Responds ESAR-VHP is our volunteer communication and activation system.

Contact: Edward Molleo  edward.f.molleo@maine.gov

Public Health Emergency Preparedness
Department of Health and Human Services
Maine Center for Disease Control and Prevention

The 2020 Census Is Happening Now

Responses to the 2020 Census will inform funding for clinics, Medicare, the Children's Health Insurance Program, and other health care assistance programs.

 

The 2020 Census is happening now. Responses to the 2020 Census will inform funding for clinics, Medicare, the Children's Health Insurance Program,  and other health care assistance programs.

Health care providers have a unique opportunity to remind their patients about the importance of the census.  Children under the age of 5 are the group most commonly undercounted. 

All responses will inform where funding is distributed each year to communities nationwide for clinics, schools, roads and more.  In 2016 $4.1 billion of federal funding was allocated to Maine based on census data.  Each person not counted is a loss of $15,000-$20,000 of federal funds lost to Maine over the course of 10 years.

About the 2020 Census: The census is a count of every person who lives in the US and its territories, and it happens every 10 years. In 2020 every household in America will receive a notice to complete the census to count everyone who lives in your home as of April 1, 2020.  

Respond to the 2020 Census online, over the phone or by paper form.  Responses to the 2020 Census are safe, secure, protected by federal law, and answers can only be used to produce statistics.  For more information, visit 2020Census.gov.

Opportunities to Support Physician Candidates for the 130th Maine Legislature

State legislators have historically given great weight to physician opinions in Augusta, and certainly appreciate the work you do to keep their constituents healthy. However, the voice of physicians is being diluted in many debates. At this time, we are aware of 6 active or retired physician candidates for the 130th Maine Legislature and we wanted to make you aware of their candidacies and of opportunities to provide financial support for the campaigns if you are so inclined. 

 

Our lives have been all COVID, all the time, for many weeks. However, this still remains a critical election year. Elections have occurred during the 1918 pandemic, through economic catastrophes like the Great Depression, during both world wars and even in the midst of the Civil War.  

State legislators have historically given great weight to physician opinions in Augusta, and certainly appreciate the work you do to keep their constituents healthy. However, the voice of physicians is being diluted in many debates. Nearly every profession and well organized advocacy group now has a solid presence at the Capitol. The vocal diversity of interests can positively or negatively sway opinions, such as the immunization debate and the physician assistant scope bill respectively. Therefore, any time we can have more physicians involved in the debate and in the seats making decisions, the better.

At this time, we are aware of 6 active or retired physician candidates for the 130th Maine Legislature and we wanted to make you aware of their candidacies and of opportunities to provide financial support for the campaigns if you are so inclined. 

  • Charles Pattavina, M.D., Senate District 11, Waldo County. Dr. Pattavina is an emergency physician, Past President, and current Board member. He running as a Democrat for this seat in his first run for the legislature. He does have a primary race with other Democrats. He is running under the Maine Clean Elections Act (MCEA) and is collecting seed money contributions which is the initial step in qualifying under the MCEA. He could really use help in raising 30 contributions of $100 for this purpose. Seed money cannot exceed $100 per contribution. Please note that you DO NOT need to live in the district in order to contribute seed money. You can contribute to his campaign by going to this link: https://secure.actblue.com/donate/charles-pattavina-1. If you prefer to write a check, you can make it payable to “Pattavina for Senate” and send it to his home address: 709 N. Main St., Winterport, ME 04496.
  • Richard Evans, M.D., House District 120, Dover-Foxcroft area. Dr. Evans is a general surgeon who is a Past President and current AMA delegate. He is running as a Democrat for this seat for the third time and he is running as a traditional candidate, meaning that he can accept campaign contributions up to a limit of $400, per election. This means that you could make a contribution during the primary election period between now and the primary election on July 15th and another during the general election period between July 16th and November 3rd. You can make a contribution to the campaign by going to this link: https://secure.actblue.com/donate/drevansmaine. If you prefer to write a check, you can make it payable to “Evans for House” and send it to his home address: 14 Winter St., Dover-Foxcroft, ME 04426.
  • Sam Zager, M.D., House District 41, part of Portland. Dr. Zager is a family physician with Martin’s Point and is running as a Democrat for this seat in his first campaign for the legislature. He is on the Board of the MAFP and has been very active in statewide advocacy on matters of health policy. He has already qualified as a Maine Clean Elections Act candidate, and if you live in the district, you can make a $5 contribution to his campaign by going to this link: https://apps1.web.maine.gov/cgi-bin/online/ethics/cleanelection/home.pl

There are also three incumbents running for reelection:

  • Senator Ned Claxton (D), Senate District 20, Androscoggin County. Dr. Claxton is a retired family physician and faculty member of the CMMC family medicine residency program. He serves as the Senate Chair of the State & Local Government Committee and as a member of the Health & Human Services Committee. He is running for his second term in the Senate under the Maine Clean Elections Act (MCEA). If you live in the district, you can make a $5 contribution to his campaign by going to this link: https://apps1.web.maine.gov/cgi-bin/online/ethics/cleanelection/home.pl
  • Representative Patty Hymanson (D), House District 4, Ogunquit and parts of York, Wells, and Sanford. Dr. Hymanson is a retired neurologist who serves as House Chair of the Health & Human Services Committee in the current legislature. She is running for her fourth and final term in the House under the Maine Clean Elections Act (MCEA). If you live in the district, you can make a $5 contribution to her campaign by going to this link: https://apps1.web.maine.gov/cgi-bin/online/ethics/cleanelection/home.pl
  • Representative Heidi Brooks (D), House District 61, part of Lewiston. Heidi trained in family medicine. She serves on the Insurance & Financial Services Committee in the current legislature. She is running for her fourth and final term in the House as a traditionally funded candidate, meaning her campaign can accept contributions up to a limit of $400, per election. This means that you could make a contribution during the primary election period between now and the primary election on July 15th and another during the general election period between July 16th and November 3rd. You can make a contribution to Heidi’s campaign by writing a check, payable to “Heidi for State House” and send it her home address: 1 Pleasant St., Apt #2, Lewiston ME 04240.

 

 

 

Upcoming Specialty Society Meetings

Below you will find an on-going list of Upcoming Specialty Society Meetings. Any questions should be referred to the contact person listed for each specialty.

 

Below you will find an on-going list of Upcoming Specialty Society Meetings.  Any questions should be referred to the contact person listed for each specialty.

UPCOMING SPECIALTY SOCIETY MEETINGS

July 31 - August 2, 2020
Maine Chapter, American College of Surgeons Annual Conference
Sugarloaf Mountain Hotel, Carrabassett Valley, ME
Contact:  Cathy Stratton at 207-592-5725 or cstratton@mainemed.com

August 29 - September 1, 2020
Maine Academy of Family Physicians 28th Annual Family Medicine Update

DoubleTree by Hilton Portland, South Portland, ME
Updated schedule and online registration available at http://www.maineafp.org/cme/mafp-cme-meeting
Contact Deborah Halbach at 207-938-5005 or maineafp@tdstelme.net

September 19, 2020
Maine Society of Anesthesiologists Business Meeting
Stave Island Room in Pool House 2:00pm-5:00pm
Harborside Hotel – Bar Harbor, ME
Contact:  Lisa Montagna at 207-620-4015 or mesahq@gmail.com
 
September 26-27, 2020
American Academy of Pediatrics, Maine Chapter Annual Meeting
Hilton Garden Inn and Conference Center – Freeport, ME
Contact:  Dee Kerry 207-480-4185 or dakerry@aap.net

October 2-4, 2020
19th Annual Downeast Ophthalmology Symposium

(Presented by the Maine Society of Eye Physicians and Surgeons)

Virtual Meeting (More details to come)
Contact:  Shirley Goggin 207-445-2260 or sgoggin@mainemed.com

 October 8-9, 2020
Maine Association of Psychiatric Physicians, 14th Annual Program

Sexual Health in Psychiatric and Medical Practice

Hilton Garden Inn, Freeport, ME
Contact Dianna Poulin at 207-480-4194 or dpoulin@mainemed.com  

November 11, 2020
Maine Gastroenterology Society: Topics in Gastroenterology 2020 Update

Hilton Garden Inn, Freeport, ME
Contact Gail Begin at 207-485-1341 or gbegin@mainemed.com

 

 

 

 

  


 

May 28 Webinar: Medicare COVID-19 Related Billing, Coverage and Payment Information

In partnership with National Government Services (NGS) our Medicare Administrative Contractor (MAC), we will be hosting a webinar on Thursday, May 28 from 10:00am - 11:30am to review the temporary changes for telehealth and telemedicine services, and to review common questions

 

Medicare COVID-19 Related Billing, Coverage and Payment Information

In partnership with National Government Services (NGS) our Medicare Administrative Contractor (MAC), we will be hosting a webinar to review the temporary changes for telehealth and telemedicine services, and to review common questions we've received.  Much has been changing with the coverage and billing requirements related to Medicare services during this time of Public Health Emergency (PHE).  NGS will provide an overview of the changes brought about by the PHE and address many of your questions and concerns during this informative session.

When: Thursday, May 28, 2020
Time: 10:00 AM - 11:30 AM

This session will be conducted via a webinar.  We ask you to register anytime prior to the session but at least 15 minutes prior to the start of the webinar.  Once registered you will receive a confirmation email from National Government Services.  The email will contain the link to the webinar.

Once you are in the webinar, we recommend using the telephone call in number that appears on the webinar dashboard.  This will enable you to communicate with the presenters when the Q&A portion takes place.  You will also have the option of typing in any question you may have in the question box on the webinar dashboard.

To Register:

Click on this Registration URL: https://attendee.gotowebinar.com/register/7267033394688215565

Presentation Development and Design Live Webinar - June 19

We use presentations as one of our primary strategies to share content-knowledge, build skills, ignite calls to action and affect culture change. However most of us never receive any formal training in presentation design. In this three-hour webinar workshop, participants will learn practical skills to plan and deliver exceptional presentations using the tools and resources they already have.

 

Presentation Development and Design 

Live Webinar, Friday, June 19, 2020, 9:00 AM - 12:00 PM

Presented by Info Inspired, LLC
Jamie Comstock and Robin Carr

Hosted by AdCare Educational Institute of Maine, Inc. 

Date: Friday, June 19, 2020, Time: 9:00 AM - 12:00 PM

Cost: $15.00

For More Information and To Register

We use presentations as one of our primary strategies to share content-knowledge, build skills, ignite calls to action and affect culture change. However most of us never receive any formal training in presentation design - despite all we expect them to do for us. 

In this three-hour webinar workshop, participants will learn practical skills to plan and deliver exceptional presentations using the tools and resources they already have. We’ll also highlight ways to transfer face-to-face presentation skills to the virtual environment.

After the session, participants will be able to:

  • Apply a four-step process to create brain-friendly presentations
  • List the most common presenter mistakes and understand how to prevent them
  • Use tools and techniques that enhance learning
  • Use and display data effectively
  • Increase audience engagement and participation
  • Design compelling, polished visual aids for presentation

Target Audience

Nonprofit and public sector professionals, substance use prevention professionals, behavioral health professionals, public health professionals and others tasked with delivering presentations

 

 

 

Successful Opiate Recovery Strategies - New Date November 14

A doctor's personal story of substance use and recovery, with Dr. Stephen Loyd.  This event was scheduled for June 3 at 2pm and has been postponed until November 14, 2020 at 1:30pm

 

Successful Opiate Recovery Strategies
with Dr. Stephen Loyd
A doctor's personal story of substance use and recovery

New Date: Saturday, November 14, 2020 at 1:30pm
Augusta Civic Center
75 Community Drive, Augusta ME

Presented by NAMI Maine Register Here

Join us for an afternoon with Dr. Stephen Loyd, a medical practitioner who brings his own personal experiences with addiction to opioids and benzodiazepines to the conversation on substance use and recovery.  This event is free and open to the public and is presented in partnership with the City of Augusta.

While there is no charge to attend, please register to reserve your seat.  Register Here

Maine Suicide Prevention Program Training for Clinicians

MMA partners with the Maine Suicide Prevention Program to offer training for clinicians, including Suicide Prevention and Management Training for Healthcare Professionals.

 

Suicide Prevention and Management Training for Healthcare Professionals
Available through a collaboration with the Maine Suicide Prevention Program, NAMI Maine and the Maine Medical Association. Topics include:

  • Suicide Prevention and Management Lunch & Learn for Healthcare
  • Clinical Assessment Trainings
  • Use of Collaborative Safety Planning in Healthcare Settings
  • Ethical Considerations in Managing Suicide Risk: From Death With Dignity to Involuntary Hospitalization

For more information, contact Suicide Prevention Coordinator Gretchen Swain at mspp@namimaine.org or (800) 464-5767 x2318


The Maine Suicide Prevention Program
, administered by NAMI-Maine, offers the following suicide prevention, assessment and management trainings.  MMA works closely with NAMI-Maine to provide educational opportunities for Maine physicians and other clinical providers.

Suicide Prevention Gatekeeper Training

Suicide Prevention Training of the Trainers

Suicide Assessment for Clinicians Training

Non-Suicidal Self Injury Training

Suicide Prevention Protocol Development Training

Suicide Prevention Curriculum Training

If you have needs not identified in the above list, please contact Gretchen, NAMI Maine Suicide Prevention Coordinator, to discuss a customized training program. 

The Maine CDC and Sweetser are offering free online Suicide Prevention Training Modules!
Enrolling is easy. There are 12+ courses available at no charge. Download the flyer with enrollment info here.

Sample modules:
· Columbia Suicide Severity Rating Scale (C-SSRS)
· Depressive Disorders in Children and Adolescents
· Counseling on Access to Lethal Means (CALM)
· Collaborative Assessment & Management of Suicidality (CAMS)
· Safety Planning Intervention for Suicide Prevention
· Suicide Risk Factors, Screening and Assessment

Family Medicine Outpatient Physician

Maine Medical Partners Westbrook Primary Care is seeking a BC/BE Family Medicine physician for their well-established outpatient practice located in the greater Portland, Maine area.

Maine Medical Partners Westbrook Primary Care is seeking a BC/BE Family Medicine physician for their well-established outpatient practice located in the greater Portland, Maine area.  The selected candidate will join 3 family medicine physicians, 4 internal medicine physicians, 4 pediatricians, 4 advanced practice professionals, a pharmacist, behavioral health provider and a geriatrician.

Maine Medical Partners is a division of Maine Medical Center and is Maine's largest multi-specialty medical group serving the healthcare needs of patients locally and throughout northern New England.  This high quality team of nearly 600 physicians and 300 advanced practice professionals provides a wide range of hospital based, primary, specialty, and sub-specialty adult and pediatric care delivered throughout a network of 30 locations across the State and acts as a regional referral network.

Maine Medical Center has 637 licensed beds and is the state’s leading tertiary care hospital and Level I Trauma Center, with a full complement of residencies and fellowships and is an integral part of Tufts University Medical School. 

For more information please contact Gina Mallozzi, Physician Recruiter at (207) 661-2092 or gmallozzi@mainehealth.org.            

6/3/20

Physician - Nasson Health Care

Nasson Health Care is seeking a qualified clinical leader to work collaboratively with a team of health and administrative professionals to provide comprehensive primary care to patients while utilizing the Patient-Centered Medical Home model of care delivery. 

Nasson Health Care is seeking a qualified clinical leader to work collaboratively with a team of health and administrative professionals to provide comprehensive primary care to patients while utilizing the Patient-Centered Medical Home model of care delivery.  The Physician provides direct clinical services and works in partnership with members of the practice team to manage the care of patients, assuring a high standard of medical care.   

Applicants must have a degree from an accredited medical school in the U.S., Board certification in Family or Internal Medicine, an unrestricted Maine license to practice medicine, as well as a U.S. Drug Enforcement Agency license.  Qualifications include:

  •  A minimum of three years’ experience in a primary care medical practice; 
  • Demonstrated respect for cultural diversity in serving patients and families;
  • Working knowledge of the core concepts of evidence-based practice, social and behavioral determinants of health, population-based care, integration of medical, behavioral health and dental care, and Meaningful Use of health information technology;

Springvale is an iconic New England village located in western York County, Maine, less than an hour’s drive from Portland, Maine and Portsmouth, New Hampshire

Visitwww.nassonhealthcare.org for an application. Completed cover letter, resume, and YCCAC employment application will be accepted until May 29, 2020.

York County Community Action Corp.
6 Spruce Street, P.O. Box 72
Sanford, ME 04073      
(207)324-5762 or 1-800-965-5762
Fax (207)459-2811
apply@yccac.org

EOE

5/27/20

Nurse Practitioner - Nasson Health Care

Nasson Health Care is seeking a qualified Nurse Practitioner to work collaboratively with a team of health and administrative professionals to provide comprehensive primary care to patients while utilizing the Patient-Centered Medical Home model of care delivery. 

Nasson Health Care is seeking a qualified Nurse Practitioner to work collaboratively with a team of health and administrative professionals to provide comprehensive primary care to patients while utilizing the Patient-Centered Medical Home model of care delivery. 

  • Provides direct clinical services in accordance with the highest standards of medical and nursing practices and in full accordance with health center policies and protocols.
  • Fully embraces and carries out all applicable NCQA Patient Centered Medical Home standards and Federally Qualified Health Center requirements.

Applicants must have a Master’s degree in nursing, an unrestricted Maine license to practice as an adult, family or pediatric nurse practitioner, as well as a U.S. Drug Enforcement Agency license.  Qualifications include:

  •  A minimum of three years’ experience in a primary care medical practice required.
  •  A working knowledge of the core concepts of evidence-based practice, social and behavioral determinants of health, population-based care, integration of medical, behavioral health and dental care, and Meaningful Use of health information technology.

Visit www.yccac.org for an application. Completed cover letter, resume, and YCCAC employment application will be accepted until May 29, 2020.

York County Community Action Corp.
6 Spruce Street, P.O. Box 72
Sanford, ME 04073
(207)324-5762 or 1-800-965-5762
Fax (207)459-2811
apply@yccac.org

EOE

5/27/20

Psychiatric Nurse Practitioner - Nasson Health Care

Nasson Health Care is seeking a qualified Nurse Practitioner to work collaboratively with a team of health and administrative professionals to provide comprehensive primary care to patients while utilizing the Patient-Centered Medical Home model of care delivery. 

Nasson Health Care is seeking a qualified Nurse Practitioner to work collaboratively with a team of health and administrative professionals to provide comprehensive primary care to patients while utilizing the Patient-Centered Medical Home model of care delivery. 

  •  Provides diagnoses, conducts therapy and prescribes medication for patients with substance use disorder, psychiatric disorders and medical organic brain disorders.
  • Fully embraces and carries out all applicable NCQA Patient Centered Medical Home standards and Federally Qualified Health Center requirements.

Applicants must have a Master’s degree in nursing, an unrestricted Maine license to practice as an adult, family or pediatric nurse practitioner, as well as a U.S. Drug Enforcement Agency license.  Qualifications include:

  •  A minimum of three years’ experience in a psychiatric or primary care medical practice required.
  • A working knowledge of the core concepts of evidence-based practice, social and behavioral determinants of health, population-based care, integration of medical, behavioral health and dental care, and Meaningful Use of health information technology.

Visit www.yccac.org for an application. Completed cover letter, resume, and YCCAC employment application will be accepted until May 29, 2020.

York County Community Action Corp.
6 Spruce Street, P.O. Box 72
Sanford, ME 04073
(207)324-5762 or 1-800-965-5762
Fax (207)459-2811
apply@yccac.org

EOE

5/27/20

Orthopedic Surgeon Opportunity in Beautiful New England

Our Northern Light Inland Hospital and Northern Light Sebasticook Valley Hospital Network seeks a BC/BE General or Hand Orthopedic Surgeon to join our Orthopedic Specialist team. 

Our Northern Light Inland Hospital and Northern Light Sebasticook Valley Hospital Network seeks a BC/BE General or Hand Orthopedic Surgeon to join our Orthopedic Specialist team.  This position will be split between the two hospitals and the scope of practice will primarily focus on hand and upper extremity surgery, while also including a component of general orthopedics.  Extensive hand surgery experience is a must!  The ideal candidate will have a desire for community outreach and promoting collaborative relationships with other physicians in the community.  The preferred candidate will also have the interest to live within the hospital service area.

For confidential consideration, please contact:
Nick Huff, DASPR, CST
Provider Recruiter
Email: providerjobs@northernlight.org
Phone:207-973-5358
Or apply directly to: https://northernlighthealth.org/Careers/Position/60311/Orthopedic%20Surgeon

6/24/20

Opportunities at the VA for Volunteer Physicians

Take advantage of this opportunity with the Veterans' Administration to thank our veterans in a concrete way for their service and their sacrifices.

The Physician Ambassador Program was created by the Department of Veterans Affairs as a best practice recruitment and placement initiative seeking fully licensed physicians and clinicians to enhance health care services for Veterans.

The Physician Ambassador Program is a without compensation program that provides civilian physicians and clinicians an opportunity to give back to the Veteran community by serving in a volunteer role to deliver health care services to Veterans. 

If you are interested in participating in this program at VA Maine Healthcare System, please contact Jonathan Barczyk at (207) 621-4886.

Volunteer Opportunity with Partners for World Health - Portland, ME

Partners for World Health has a great need for advice from certain medical professionals on how to sort and package the vast amount of supplies received, for shipping and use in destination countries.

Partners for World Health (PWH) is a non-profit 501(c)3 based in Portland, Maine committed to reducing medical waste, improving the quality of healthcare in underserved countries, and educating our local community about global healthcare issues.

Our mission is to collect unused/discarded medical supplies from local medical facilities and to distribute those medical supplies to international communities in need. This work limits the negative impact we have on the environment and provides much-needed resources to the developing world. To support our work in improving health conditions around the world, we send local medical personnel on medical missions to developing countries, and we educate our local Maine community about global health issues. 

PWH has a great need for advice from certain medical professionals on how to sort and package the vast amount of supplies received, for shipping and use in destination countries, specifically, in the areas of:

  • Surgery: all aspects of OR medical supplies and equipment
  • Respiratory: any and all aspects
  • Anesthesia
  • Laparoscopic surgery: advice on the proper components of a “tower”
  • Cardiology

Please note: this request is not for ongoing time commitment but rather for a few hours of a professional’s time to help organize certain supplies appropriately.

While PWH receives tens of thousands of pounds of equipment/supplies from hospitals and clinics, there are certain critical items always in short supply.

For more information, contact volunteer Rita Zanichkowsky at rznct@maine.rr.com or 207-232-3264, or contact Partners directly at 774-5555.  Thank you! 

https://www.partnersforworldhealth.org/