Maine Medicine Weekly Update - July 16, 2021
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Promoting COVID-19 Vaccination in Clinical Settings: The Critical Role of Maine’s Physicians

By Lisa M. Letourneau, M.D., M.P.H., Senior Advisor for Delivery System Change

    Through the collective efforts of the state and health care providers, Maine has done well in its efforts to promote COVID-19 vaccination. That said, as of mid-July, over a third of Mainers were still unvaccinated, and the threat posed by COVID-19 remains serious.  Seasonal trends and the continued emergence of viral variants indicate that infections will likely rise in the coming months unless we vaccinate more of the unvaccinated.  Maine DHHS continues to employ a multi-pronged vaccination strategy that includes both clinical and community vaccination sites, as well as an active communication campaign targeted to vaccine-hesitant individuals. But we need your help.

    Through the collective efforts of the state and health care providers, Maine has done well in its efforts to promote COVID-19 vaccination. That said, as of mid-July, over a third of Mainers were still unvaccinated, and the threat posed by COVID-19 remains serious.  Seasonal trends and the continued emergence of viral variants indicate that infections will likely rise in the coming months unless we vaccinate more of the unvaccinated.  Maine DHHS continues to employ a multi-pronged vaccination strategy that includes both clinical and community vaccination sites, as well as an active communication campaign targeted to vaccine-hesitant individuals. But we need your help.

    Physicians are consistently identified as highly trusted advisors and are among the most influential voices in driving their patients toward vaccination. The US CDC cites studies showing that a doctor’s strong recommendation is closely correlated with vaccination.  Additionally, a national survey of vaccine hesitant adults showed that 30% said they would be more likely to get vaccinated if the vaccine were offered to them during a routine medical visit.  As such, offering COVID vaccination in medical practices and health care settings is a key component of our state’s ongoing vaccination strategy.

    Given this unique role, we urge physicians to take the following steps to support continued vaccination efforts: 

    • Always ask: As trusted advisors, physicians have a key opportunity to reinforce the importance of vaccination by asking patients about their COVID-19 vaccination status in every clinical encounter. Asking sends the clear message that you support COVID vaccination and opens the door to conversation. It also provides an opportunity to reinforce the decision of those who are vaccinated by encouraging them to talk with their family and friends about getting vaccinated.
    • Share your story: Sharing your personal story about getting the COVID vaccine can provide a helpful influence in your patients’ decision to get vaccinated. Strong statements can help, such as “I got vaccinated as soon as I could,” and “I encouraged my family and children to get vaccinated as well.”
    • Prepare to discuss concerns, and lead with empathy:  Reluctance to get vaccinated is often due to patient questions and concerns.  As a trusted advisor, you hold a key role in answering your patients’ questions and making a strong recommendation to get the vaccine can be pivotal to whether they choose to get vaccinated. National groups have studied effective messages that can address concerns about side effects, the rapid development of the vaccines, misinformation, and how to start the conversation with patients.
    • Offer COVID-19 vaccination in your practice or health care setting: Once a patient has agreed to get vaccinated, having the vaccine immediately available can make the difference in whether they follow through.  Maine CDC has made several changes to make it easier for practices to order and administer vaccine, including decreasing order sizes, updating storage requirements, and adjusting the “Efficient Use” policy. Research has shown that sending patients targeted communications such as “Your vaccine has been reserved for you” can also make a meaningful difference in vaccine uptake.  
    • Know where to refer your patients: If your practice cannot offer the COVID vaccine, identify 2-3 reliable options where you can refer your patients locally. Many sites offer drop-in hours including early morning and evening hours to accommodate busy schedules. Visit Maine’s list of COVID vaccination sites or encourage your patients to call the Maine Community Vaccination Line (1-888-445-4111) to find a vaccination location.

    For more information on Maine DHHS’ efforts to promote the COVID-19 vaccine, visit Governor Mills’ COVID vaccine webpage. With your help, we can get these life-saving vaccines into the arms of remaining unvaccinated Mainers and bring this pandemic to an end as quickly as possible.

    A Call to Action- Protecting the Children of Maine

    By Adrienne W. Carmack, MD, Medical Director of Office of Child and Family Services

    The recent deaths of young children in Maine during the month of June has caused us all to take pause and consider how we can work to better serve Maine families and children.

    The recent deaths of young children in Maine during the month of June has caused us all to take pause and consider how we can work to better serve Maine families and children.

    As Jeanne Lambrew, Commissioner of the Maine Department of Health and Human Services stated, “These deaths, like all involving children, are heartbreaking and deeply concerning. Every child in Maine deserves to have the opportunity to grow up healthy, to get a good education, and to live a productive, happy, and meaningful life. When children die, they are robbed of these opportunities and we lose the light, love, and potential of these children. This is a call to action. In addition to our own review and ongoing work, we requested Casey Family Programs bring to bear its wealth of experience and national perspective to help us, and we’re bolstering StrengthenME to ensure Maine families have access to the support they need to cope with the significant stresses of the pandemic.”

    As medical providers for families and children, it is crucial to heed this call to action. Do not wait for families to call to reschedule missed medical care. Use these upcoming months to reach out to families and bring them back into the office. When families are in the office, take the time to screen both adults and children for mental health needs, and offer to connect families to supports available in the community. Evidence from across the country continues to suggest that adults and children are experiencing heightened mental health and substance use issues. DHHS will extend and broaden the StrengthenME campaign, which offers free stress management and resiliency resources to anyone in Maine experiencing stress reactions to the pandemic.

    Contact StrengthenME at  207-221-8198 or at https://strengthenme.com/

    For those families affected by substance use disorder, there are resources available through https://eyesopenforme.org/ and the new OPTIONS website, https://knowyouroptions.me/resources/.

    Public Health Nurses and Maine Families Home Visitors are available for pregnant women and families with newborns and young children. Contact CradleME at 1-888-644-1130 or at https://www.maine.gov/dhhs/mecdc/public-health-nursing/documents/CradleME-request-form-instructions.pdf

    Over the past year, many children have missed their important regularly scheduled well child check-ups. Especially vulnerable are the children with complex needs and developmental disabilities, who may have missed their therapeutic services as well. Contact families to catch up on needed immunizations, but also be sure they schedule an office visit as well, to check on growth and development, and administer recommended screenings.

    Especially important, the well child check is a time to review safety tips for families with children, including discussion about gun safety, water safety to prevent drowning, and the safe storage of medication and hazardous materials.

    Many resources are available with strategies for education and messaging, through websites such as:

    https://www.cdc.gov/safechild/

    https://www.healthychildren.org/english/safety-prevention/Pages/default.aspx.

    https://eyesopenforme.org/safe-storage/

    Physicians, and members of the entire medical team, are vital to the health, safety and well-being of Maine’s children and families. Thank you for your care and dedication. Please share any additional thoughts by contacting me directly at adrienne.w.carmack@maine.gov. 

    For concerns related to child abuse or neglect call the Child Protection Hotline at 1-800-452-1999.

    COVID News: Surgeon Gener Surgeon General Issues Vaccine Misinformation Warning; JAMA Peds Retracts Masks Study

    •  Surgeon General Issues Vaccine Misinformation Warning
    • JAMA Peds Retracts Masks Study
    • US CDC Director Warns of 'Pandemic of the Unvaccinated' as Cases Rise
    • CDC Advisory Panel to Make Recommendations for COVID-19 Vaccine & Immunocompromised
    • Report Shows Rise in Pediatric COVID-19 Cases
    • Symptoms That Indicate a COVID-19 Delta Variant Infection
    • What the Delta Variant Means for Vaccinated and Unvaccinated People
    • Maine Cases are Low, but Contagious Variant Poses Risks for Unvaccinated
    • Everything You Need to Know About the COVID-19 Vaccine Booster Debate
    • US CDC Maintains Mask Requirement for Travel

    • Surgeon General Issues Vaccine Misinformation Warning
    • JAMA Peds Retracts Masks Study
    • US CDC Director Warns of 'Pandemic of the Unvaccinated' as Cases Rise
    • CDC Advisory Panel to Make Recommendations for COVID-19 Vaccine & Immunocompromised
    • Report Shows Rise in Pediatric COVID-19 Cases
    • Symptoms That Indicate a COVID-19 Delta Variant Infection
    • What the Delta Variant Means for Vaccinated and Unvaccinated People
    • Maine Cases are Low, but Contagious Variant Poses Risks for Unvaccinated
    • Everything You Need to Know About the COVID-19 Vaccine Booster Debate
    • US CDC Maintains Mask Requirement for Travel

    Surgeon General Issues Vaccine Misinformation Warning

    U.S. Surgeon General Vivek Murthy issued an advisory this week calling health misinformation an “urgent threat” amid the COVID-19 vaccination push.

    “Health misinformation is an urgent threat to public health,” Murthy said in a statement. “It can cause confusion, sow distrust, and undermine public health efforts, including our ongoing work to end the COVID-19 pandemic.”

    In summary, the 22-page document from the White House askes journalists to “avoid amplifying misinformation,” expand credible sources beyond national scientists and public health experts to include trusted local medical authorities, and “consider headlines and images that inform rather than shock or provoke.”

    JAMA Peds Retracts Masks Study

    A controversial study from Germany suggesting that masks may harm children by exposing them to high carbon dioxide levels has been retracted. (MedPage Today)

    JAMA Network Retraction Notice

    Retracted Research Letter (JAMA Network)

    From JAMA Retraction:

    “Following publication, numerous scientific issues were raised regarding the study methodology, including concerns about the applicability of the device used for assessment of carbon dioxide levels in this study setting, and whether the measurements obtained accurately represented carbon dioxide content in inhaled air, as well as issues related to the validity of the study conclusions. In their invited responses to these and other concerns, the authors did not provide sufficiently convincing evidence to resolve these issues, as determined by editorial evaluation and additional scientific review.”

    US CDC Director Warns of 'Pandemic of the Unvaccinated' as Cases Rise

    Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky warned of rising cases during a White House Press briefing on Friday, July 16, stating that COVID-19 is "becoming a pandemic of the unvaccinated" and that vaccinated people are protected against severe disease. (The Hill)

    CDC Advisory Panel to Make Recommendations for COVID-19 Vaccine & Immunocompromised

    “The Advisory Committee on Immunization Practices, which makes vaccine recommendations to the Centers for Disease Control and Prevention, is scheduled at a July 22 meeting to discuss” whether health care “workers should be allowed to give additional coronavirus shots to patients with fragile immune systems.” (Washington Post; subscription site)

    Report Shows Rise in Pediatric COVID-19 Cases

    A report from the American Academy of Pediatrics and the Children's Hospital Association documented nearly 19,000 new pediatric COVID-19 cases for the week ending July 8, up from the previous week's 12,000. The report also showed that children accounted for 22.3% of all new cases during the week, compared with 16.8% the previous week, and that there have been 344 COVID-19-related deaths among children in the 46 jurisdictions, which include 43 states, New York City, Guam and Puerto Rico, that are reporting the data by age. (Medscape; free registration)

    Symptoms That Indicate a COVID-19 Delta Variant Infection

    The Los Angeles Times spoke with two infectious disease experts — Dr. Robert Bollinger of Johns Hopkins University and Dr. Otto Yang of UCLA — about what we know so far. (LA Times via Bangor Daily News)

    What the Delta Variant Means for Vaccinated and Unvaccinated People

    Q & A article from Johns Hopkins Bloomberg School of Public Health podcast in early July with epidemiologist Jennifer Nuzzo, DrPH, SM, from the Center for Health Security. She answered questions about delta’s transmissibility and whether it causes more severe disease, what the variant means for both vaccinated and unvaccinated people, and what everyone should take away from recent headlines. (Article also includes audio link to Q&A)

    Maine Cases are Low, but Contagious Variant Poses Risks for Unvaccinated

    Coronavirus cases are up 94 percent over the past two weeks nationwide, according to the New York Times. The Bangor Daily News highlights the opposite trend in Maine, with coronavirus infections declining steadily for the past three months.

    The Maine CDC “expects to see a greater impact of the delta variant in the state in the coming weeks,” according to Dr. Nirav Shah.

    Everything You Need to Know About the COVID-19 Vaccine Booster Debate

    Last week, Pfizer announced that in August, they plan to seek Food and Drug Administration authorization of a third dose because it could boost levels of virus-fighting antibodies, possibly helping ward off worrisome mutants. U.S. and international health authorities say that for now, the fully vaccinated seem well protected. Experts are watching closely to determine if, and when, people might need another shot. At the same time, many suggest the priority for the time being should be more work to make sure all countries have more access to vaccines. (Bangor Daily News via the Associated Press)

    US CDC Maintains Mask Requirement for Travel

    The Centers for Disease Control and Prevention said wearing a mask over your nose and mouth is required on planes, buses, trains, and other forms of public transportation and while indoors at U.S. transportation hubs such as airports and stations.

    Additional reading:

    Delta variant accounts for 58% of US infections; Missouri requests field hospital: COVID-19 updates. (USA Today)

    Johnson & Johnson Recalls Sunscreens After Carcinogen Found

    Johnson and Johnson announced a recall of 5 NEUTROGENA® and AVEENO® aerosol sunscreen products this week testing identified low levels of benzene in some samples of the products. More information on Benzene can be found by visiting this link on the U.S. CDC website.

    Johnson and Johnson announced a recall of 5 NEUTROGENA® and AVEENO® aerosol sunscreen products this week testing identified low levels of benzene in some samples of the products. More information on Benzene can be found by visiting this link on the U.S. CDC website.

    J&J recall includes the following:

    • NEUTROGENA® Beach Defense® aerosol sunscreen,
    • NEUTROGENA® Cool Dry Sport aerosol sunscreen,
    • NEUTROGENA® Invisible Daily™ defense aerosol sunscreen,
    • NEUTROGENA® Ultra Sheer® aerosol sunscreen, and
    • AVEENO® Protect + Refresh aerosol sunscreen.

    According to J&J, adverse reactions or quality problems experienced with the use of this product may be reported to the FDA's MedWatch Adverse Event Reporting program either online, by regular mail or by fax.

    Opioid & Substance Use Disorder News

    • US Overdose Deaths Hit Record 93,000 in 2020
    • Overdose Deaths In State Prisons Have Jumped Dramatically Since 2001
    • Opioid Use Disorder Treatment Rises in Medicaid Recipients
    • ED-administered Buprenorphine May Enhance Opioid Use Disorder Treatment Outcomes
    • Maine Attorney General, Aaron Frey Urges Continued Action at Governor's Opioid Summit

    • US Overdose Deaths Hit Record 93,000 in 2020
    • Overdose Deaths In State Prisons Have Jumped Dramatically Since 2001
    • Opioid Use Disorder Treatment Rises in Medicaid Recipients
    • ED-administered Buprenorphine May Enhance Opioid Use Disorder Treatment Outcomes
    • Maine Attorney General, Aaron Frey Urges Continued Action at Governor's Opioid Summit

    US Overdose Deaths Hit Record 93,000 in 2020

    Overdose deaths soared to a record 93,000 last year in the midst of the COVID-19 pandemic, the U.S. government reported this week. That estimate far eclipses the high of about 72,000 drug overdose deaths reached the previous year and amounts to a 29% increase. Fentanyl was involved in more than 60% of the overdose deaths last year, CDC data suggests. Vermont was one of 10 states predicted to have at least a 40% rise in drug overdose deaths from the previous 12-month span. (Associated Press)

    Overdose Deaths In State Prisons Have Jumped Dramatically Since 2001

    Prisons and jails in the United States have been increasingly deadly places in recent years, according to new federal data. But one cause of death has climbed most dramatically: overdoses. From 2001 to 2018, the number of people who have died of drug or alcohol intoxication in state prisons rose more than 600%, according to an analysis of newly-released data from the Bureau of Justice Statistics. In county jails, overdose deaths increased by more than 200%. (NPR)

    Opioid Use Disorder Treatment Rises in Medicaid Recipients

    Opioid use disorder (OUD) treatment increased in Medicaid recipients from 2014 to 2018, data from 11 different state programs, including Maine. Individual states varied widely in use of these medications, but the lower end of the range increased from 35.3% to 45.7% from 2014 to 2018 while the upper end stayed fairly steady at around 74%, as reported in JAMA (subscription required). (MedPage Today)

    ED-administered Buprenorphine May Enhance Opioid Use Disorder Treatment Outcomes

    High-dose buprenorphine therapy, provided under emergency department care, is safe and well tolerated in people with opioid use disorder experiencing opioid withdrawal symptoms, according to a study supported by the National Institutes of Health’s National Institute on Drug Abuse (NIDA) through the Helping to End Addiction Long-term Initiative, or the NIH HEAL Initiative.

    Maine Attorney General, Aaron Frey Urges Continued Action at Governor's Opioid Summit

    Attorney General Aaron M. Frey participated in Governor Janet Mills's third Opioid Summit this week. His remarks focused on efforts to prevent overdose deaths, to disrupt the flow of fentanyl into Maine, and to expand access to treatment.

    Frye was quoted in a department media release, "As attorney general, I see the impact of the continued impact of the opioid epidemic on families, communities, and our state," said Frey. "I am grateful that the administration has continued to make this crisis a top priority and marshalled the resources of every corner of our state government in working to save lives and abate the crisis. I am particularly encouraged by the recent creation of the Accidental Overdose Death Review Panel, which will examine systems and practices with the goal of saving lives."

    Medicare Updates

    • Medicare Proposes 2022 Payment and Quality Reporting Changes
    • Medicare to Weigh Nationwide Coverage Rules for Biogen Alzheimer's Drug

    • Medicare Proposes 2022 Payment and Quality Reporting Changes
    • Medicare to Weigh Nationwide Coverage Rules for Biogen Alzheimer's Drug

    Medicare Proposes 2022 Payment and Quality Reporting Changes

    The Centers for Medicare & Medicaid Services (CMS) released the proposed 2022 Medicare physician fee schedule (PFS) rule this week, which includes proposed changes to the Merit-based Incentive Payment System (MIPS) and alternative payment model (APM) participation options and requirements for 2022.

    The changes include a decrease in the "conversion factor" -- the multiplier that Medicare applies to relative value units (RVUs) to calculate reimbursement for a particular service or procedure under Medicare's fee-for-service system.

    ·      CMS Fact Sheet – Physician Fee Schedule (webpage)

    ·      CMS Fact Sheet – Quality Payment Program (PDF download)

    ·      CMS Fact Sheet – Medicare Diabetes Prevention Program (webpage)

    ·      Complete CY 2022 Physician Fee Schedule and Quality Payment Program proposed rule.

    CMS is accepting comments on the proposed rule until September 13.

    Medicare to Weigh Nationwide Coverage Rules for Biogen Alzheimer's Drug

    CMS will formally consider whether to adopt nationwide rules for coverage of Biogen's new Alzheimer's drug Aduhelm, announcing Monday the opening of a determination process that could shape how millions of Americans are able to access the controversial treatment. (Healthcare Dive)

    Federal Advocacy Update

    Discussions in Washington D.C. continue surrounding a $3 to $4 trillion federal spending bill. The legislation being discussed includes an approximate $300 billion expansion of Medicare to cover dental, vision, and hearing care. Under the plan, these new benefits would be free for seniors in the program and could start as soon as next year. Also included in the current proposal being crafted is new spending for elder care, home care, childcare, prekindergarten, paid family and medical leave, housing programs, and other education and safety net programs. There may also be  plan climate-related sections in a future bill.

    Discussions in Washington D.C. continue surrounding a $3 to $4 trillion federal spending bill. The legislation being discussed includes an approximate $300 billion expansion of Medicare to cover dental, vision, and hearing care. Under the plan, these new benefits would be free for seniors in the program and could start as soon as next year. Also included in the current proposal being crafted is new spending for elder care, home care, childcare, prekindergarten, paid family and medical leave, housing programs, and other education and safety net programs. There may also be  plan climate-related sections in a future bill.

    Suggested way to pay for the infrastructure bill included tax hikes on upper income Americans and corporations, as well as IRS changes to ‘tax gaps.’ Other major new sources of revenue include raising the top marginal tax rate, increasing the corporate tax rate, and changes to the international tax system.

    Registration Open for MMA’s 168th Annual Membership Meeting (Sep 10-12)

    When the COVID-19 pandemic stalled travel and eliminated in person meetings, MMA leaders quickly adjusted and took the 2020 meeting online. The 2020 MMA Virtual General Membership Meeting took place in mid-October.

     

    When the COVID-19 pandemic stalled travel and eliminated in person meetings, MMA leaders quickly adjusted and took the 2020 meeting online. The 2020 MMA Virtual General Membership Meeting took place in mid-October.

    The 2021 Annual Membership Meeting will be hybrid model at the Jordan Hotel and Conference Center in Newry, Maine (Sunday River) on Friday, September 10, through September 12.

    Register here.

    We know many members are ready to gather in person for timely and useful information from experts and participate in discussions that allow for detailed questions, informal learning from colleagues and peers in a social setting, and generally catching up with friends or making new ones.

    MMA leadership and staff continue to work with resort staff to ensure a safe experience in accordance with current pandemic guidelines. For those who are not comfortable gathering for meetings, we will make key portions of the meeting available remotely.

    The theme of the Annual Session is, “Equality, Equity, and Our Evolving Health Care System” and the CME Program will focus on this theme with a keynote presentation by “Bowtie” Todd Jenkins, Ph.D. entitled, Moving from Diversity to Inclusion. You can learn more about “Bowtie” Todd’s life and work at www.bowtieleadership.com.

    Register here.

    What we’re looking forward to:

    ·       The meeting will open on Friday evening with a casual reception and BBQ dinner followed by ‘smores around the fire pits.

    ·       The General Membership meeting and CME Program will take place through early afternoon on Saturday.

    ·       Saturday afternoon activities also will include an optional MICIS opioid prescribing presentation and a meeting of the Maine Society of Anesthesiologists.

    ·       MMA Past Presidents will have a reception in their honor on Saturday afternoon and all attendees will gather for a reception and Awards Dinner on Saturday evening.

    ·       The Awards Dinner will feature presentation of the President’s Award for Distinguished Service and the Mary Floyd Cushman, M.D. Award for Distinguished Humanitarian Service, and the inauguration of the 169th President of the Maine Medical Association. President Karen Saylor, M.D. will pass the gavel and present the Presidential Medal to Jeffrey Barkin, M.D., President-Elect.

    ·       Following a family breakfast on Sunday morning, the closing CME session will be an open forum for discussion of the issues and ideas raised during the presentations on Saturday.

    ·       Recreational opportunities include yoga on both Saturday and Sunday mornings, a group hike and wine tasting on Saturday afternoon, and spa treatments available throughout the weekend.

    Register here.

     

    Notice of Rulemaking: Immunization requirements for Maine school children

    BRIEF SUMMARY: The Department of Health and Human Services - Maine Center for Disease Control and Prevention (DHHS) and the Maine Department of Education (DOE) are jointly proposing these routine technical rule changes to implement P. L. 2019, Ch. 154: An Act to Protect Maine Children and Students from Preventable Disease by Repealing Certain Exemptions from the Laws Governing Immunization Requirements (the “Act”). The Act prohibits the rule from including any provision governing medical exemptions and repeals the exemption from required immunization for school students who object, based solely on a sincere religious belief or philosophical reason, effective September 1, 2021, with exemptions for certain students. 

    AGENCY: Department of Health and Human Services Maine Center for Disease Control and Prevention; Department of Education

    CHAPTER NUMBER AND TITLE: 10-144 CMR, Chapter 261: Immunization Requirements For School Children (DHHS) / 05-071 CMR, Chapter 126: Immunization Requirements For School Children (DOE)

    TYPE OF RULE:   Routine Technical  

    PROPOSED RULE NUMBER (leave blank; to be assigned by Secretary of State): 2021-P116, P117

    BRIEF SUMMARY: The Department of Health and Human Services - Maine Center for Disease Control and Prevention (DHHS) and the Maine Department of Education (DOE) are jointly proposing these routine technical rule changes to implement P. L. 2019, Ch. 154: An Act to Protect Maine Children and Students from Preventable Disease by Repealing Certain Exemptions from the Laws Governing Immunization Requirements (the “Act”). The Act prohibits the rule from including any provision governing medical exemptions and repeals the exemption from required immunization for school students who object, based solely on a sincere religious belief or philosophical reason, effective September 1, 2021, with exemptions for certain students.

    Those students who may have declined immunizations based on religious or philosophical objection and are otherwise not eligible for exemptions permitted under Maine’s immunization laws, including those attending elementary or secondary schools for pre-kindergarten instruction, will be subject to current immunization requirements for the certain specified diseases.

    This rule proposes to require schools to include in their annual report any stricter immunization requirements that may be adopted by ordinance or policy, in addition to the immunization status of all students, including immune students, exempt and non-immunized excluded students.

    Additionally, these proposed rule changes include new and revised definitions; add a vaccine schedule for pre-kindergarten students; clarify existing authority and responsibility to dismiss or exclude a child from school when there is a public health threat (20-A MRS § 6301; 22 MRS ch. 250); and clarify superintendent and school authority and responsibility related to recordkeeping and attendance tracking for those students exempt from immunization requirements.

    Finally, changes are proposed to the format of the rule for conformity with Maine CDC rulemaking standards.

    Date, time and location of PUBLIC HEARING (if any): Virtual Public Hearing on July 26, 2021 at 9:00 am

    https://mainestate.zoom.us/j/86404327981?pwd=TXdOalFzT1YyakJVdlZTTXdRNEVKZz09

    Meeting ID: 864 0432 7981 Passcode: XeNRq!D2 Hearings may be conducted virtually until July 30, 2021, in accordance with  1 MRS §403-A (C)(PL 2020 c. 617).

    COMMENT DEADLINE: August 5, 2021 at 5:00 pm

    CONTACT PERSON FOR THIS FILING (include name, mailing address, telephone, fax, TTY, email):

    DHHS-Maine CDC: Bridget Bagley; 286 Water Street, 11 State House Station, Augusta, ME, 04333-0011; Tel: 207-287-4490 or 711; Fax: 287-2887; bridget.bagley@maine.gov

    CONTACT PERSON FOR SMALL BUSINESS IMPACT STATEMENT (if different):

    FINANCIAL IMPACT ON MUNICIPALITIES OR COUNTIES (if any): None anticipated.

    STATUTORY AUTHORITY FOR THIS RULE: 20-A M.R.S. §6358(1); 22 M.R.S. §806

    SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different): PL 2019, c. 154

    AGENCY WEBSITE:  http://www.maine.gov/dhhs/mecdc/rules/

    Maine Secretary of State Seeking Physician Volunteers

    Secretary of State, Shenna Bellows is asking the Maine Medical Association to provide recommendations to fill vacancies on the Medical Advisory Board for licensing drivers in the State of Maine.

     

    Secretary of State, Shenna Bellows is asking the Maine Medical Association to provide recommendations to fill vacancies on the Medical Advisory Board for licensing drivers in the State of Maine.

    The Medical Advisory Board is comprised of physicians and motor vehicle staff and consists of 8-10 physicians from various specialties. State law requires the board include the specialties of cardiology, gerontology, internal medicine, neurology or neurosurgery, ophthalmology. Psychiatry, family medicine, and rehabilitative medicine.

    The board advises the Secretary of State on matters relating to medical conditions, vision standards, and driving. The board, or individuals may also be asked to evaluate reports submitted by clinicians on whether a person is medically competent to operate a motor vehicle on public roads.

    By law, the board must meet at least every 2 years, but traditionally has met twice a year, usually on the first Friday of April and November from noon to 3:00 p.m. Expense reimbursement is provided.

    Please reach out directly to MMA Director of Communications and Government Affairs, Dan Morin at dmorin@mainemed.com or by phone at (207) 480-4199 if you, or a colleague may be interested.

    SUPPORT for ME: Strengthening Substance Use Disorder Treatment and Recovery Services for MaineCare Members

    SUPPORT for ME is a statewide effort to improve SUD treatment and recovery services for all Mainers.

     

    SUPPORT for ME is a statewide effort to improve SUD treatment and recovery services for all Mainers, with a particular focus on the following: 

    • Adolescents and youth (12-21) 

    • Individuals transitioning from care settings (e.g., leaving incarceration) 

    • American Indian / Alaska Native Nations 

    • Rural populations 

    PROJECT GOAL: 

    This planning grant aims to increase MaineCare providers’ capacity to deliver Substance Use Disorder (SUD) treatment and recovery services. 

    WHY? 

    Maine has one of the top 10 highest drug overdose rates in the country. In 2019, there were 380 drug overdose deaths, with over 80% due to opioids, nearly always in combination with other drugs or alcohol. 

    For more information, visit: https://www.maine.gov/dhhs/oms/about-us/projects-initiatives/support-for-me 

    or contact Joanie Klayman (joan.klayman@maine.gov

     

     

     

    Are You a Professional Who Works with Individuals in Maine Who Have a Substance Use Disorder? We Want to Hear From You!

    The Maine Department of Health and Human Services’ SUPPORT for ME initiative, in collaboration with the University of Southern Maine, is hosting virtual group discussions for Maine providers who deliver services to people with substance use disorder (SUD).

     

    The Maine Department of Health and Human Services’ SUPPORT for ME initiative, in collaboration with the University of Southern Maine, is hosting virtual group discussions for Maine providers who deliver services to people with substance use disorder (SUD). 

    You are invited to share your feedback about the resources available in Maine to address SUD by taking part in this important group discussion online or by phone. The session will last no longer than 60 minutes. Any identifying information of focus group participants will be closely protected and kept confidential. Your feedback about your experiences as a provider will help identify how to improve treatment and recovery services in Maine. We’d like to hear from you! 

    Virtual Focus Group Dates and Times (Each focus group will be limited to 10 participants) 

    Recovery support and social service providers:

    Wednesday, June 30, 2021, 12:00PM

    Tuesday, July 13, 2021, 8:00AM

    Medical providers:

    Thursday, July 15, 2021, 7:30AM

    Tuesday, July 20, 2021, 12:00PM

    Behavioral health providers, currently providing SUD services:

    Tuesday, July 13, 2021, 7:30AM

    Behavioral health providers working with individuals with SUD, but not providing SUD-specific services:

    Wednesday, July 21, 2021, 12:00PM

    Youth-oriented SUD services:

    Tuesday, July 20, 2021, 11:30AM

    Harm reduction service providers:

    Thursday, July 15, 2021, 9:00AM

    To register, go to: http://bit.ly/maineproviderfocusgroup

     

     

    Maine Community Action Partnership: Did You Know?

    Did you know that almost half of parents surveyed say they are more concerned about the COVID-19 vaccine than they are of the vaccine itself?  That’s an alarming statistic, but a full 71% of all parents said they would be more likely to get their child vaccinated if in-person school could be “normal”.

     


    Did you know that almost half of parents surveyed say they are more concerned about the COVID-19 vaccine than they are of the vaccine itself?  That’s an alarming statistic, but a full 71% of all parents said they would be more likely to get their child vaccinated if in-person school could be “normal”.

    This information offers us opportunities to educate parents and their kids about the benefits of the vaccine. A study by the de Beaumont Foundation has found the most effective messaging when addressing these concerns:

    Vaccinating children can help the country reach herd immunity and can protect children from the mental and physical effects of lockdowns and other restrictions.

    Parents can protect their children from needing hospitalization or have lasting COVID-19 symptoms. There are documented deaths in children due to COVID-19, and the long-term impact of the virus remains unknown.

    Medical science has proven that other vaccines keep dangerous diseases and viruses away from our children. The COVID-19 vaccine is no different.

    Vaccinated children can go back to school – in person and without masks – to get the education they want, need, and deserve.

    We hope you find this information helpful when speaking to your patients.

    For more information visit https://debeaumont.org/changing-the-covid-conversation/poll-vaccine-perceptions-among-parents-of-teenagers/   

    Or contact me at mleary@mecap.org

     

    MMA Mary Cushman, MD Award for Humanitarian Service

    The Mary Cushman, MD 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.  Nominations for the 2021 award are due by July 23, 2021.

     

    Nominations for the 2021 Mary Cushman Award for Humanitarian Service are due by July 23, 2021.

    The Maine Medical Association presents the Mary F. Cushman, MD Award for Exceptional Humanitarian Service as a Medical Volunteer each year to recognize the service of medical volunteers who serve in Maine, the US or abroad.  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 2021 Mary Cushman Award are due by Friday, July 23, 2021.  The award is announced at the MMA Annual Session in September and includes a $1,000 donation to the institution or organization of the recipient's choice.

    2021 Mary Cushman, MD Award Nomination Form

    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

    September 11, 2021
    Maine Society of Anesthesiologists Fall Business Meeting

    (Held in conjunction with the Maine Medical Association’s Annual Meeting)

    The Jordon Hotel, Sunday River Resort, Newry, ME from 2:00pm – 5:00pm
    Contact: Lisa Montagna 207-620-4015 or mesahq@gmail.com

    September 24, 2021
    Maine Society of Eye Physicians and Surgeons Fall Business Meeting
    (Held in conjunction with the 20th Annual Downeast Ophthalmology Symposium)
    Harborside Hotel & Marina – Bar Harbor, ME from 10:30am – 11:45am
    Contact:  Shirley Goggin 207-445-2260 or sgoggin@mainemed.com

    September 24-26, 2021
    20th Annual Downeast Ophthalmology Symposium
    (Presented by the Maine Society of Eye Physicians and Surgeons)
    Harborside Hotel & Marina – Bar Harbor, ME
    Contact:  Shirley Goggin 207-445-2260 or sgoggin@mainemed.com

    October 21-22, 2021
    Sleep, Health, and Cognition - A Lifecycle Perspective

    (Presented by the Maine Association of Psychiatric Physicians)
     Hilton Garden Inn – Freeport, Maine
    Contact: Dianna Poulin 207-622-7743 or dpoulin@mainemed.com

    March 18-20, 2022
    Northern New England Urological Symposium

    (Presented by the Maine Urological Association)
    Grand Summit Resort Hotel & Conference Center – Newry, Maine
    Contact: Dianna Poulin 207-480-4194 or dpoulin@mainemed.com

     

     

     

     

     

     

      


     

    AAP EQIPP Course: Immunizations - Strategies for Success (for RURAL Health Providers)

    The recently revised EQIPP immunization course is designed to identify immunization rates in your practice, uncover barriers to immunization delivery systems, and provide techniques to overcome those barriers using clear aims that reflect expert principles and proven quality improvement methods and tools.

     

    The recently revised EQIPP immunization course is designed to identify immunization rates in your practice, uncover barriers to immunization delivery systems, and provide techniques to overcome those barriers using clear aims that reflect expert principles and proven quality improvement methods and tools. 

    The online course features two tracks; the 19–23-month-old track and the adolescent track with data collection activities specific to each population. The course is eligible for PI CME, NAPNAP, MOC Part 2, and MOC Part 4 credits. 

    The course is free to AAP members - and for a limited time, is being offered free to ALL rural health clinicians in Maine (Pediatricians AND Family Practice) through an AAP initiative.  Additional course information is available here

    For rural health care providers that are non-AAP members and interested in taking this immunization course, contact Melissa Ponce at mponce@aap.org for additional information and to have your course fee waived through the Supporting Pediatricians to Improve HPV and Pediatric Influenza Vaccination Rates Initiative - again, the EQIPP immunization course is open to all Maine physicians serving youth, and the course fee is being waived for ruralhealth clinicians!

    SUPPORT for ME Training and Technical Assistance Initiative

    The Maine Medical Association- Center for Quality Improvement, in partnership with the Maine Department of Health and Human Services, launched the SUPPORT for ME Training and Technical Assistance initiative.

     


    The Maine Medical Association- Center for Quality Improvement, in partnership with the Maine Department of Health and Human Services, launched the SUPPORT for ME Training and Technical Assistance initiative. 

    This initiative is funded by the Centers for Medicare and Medicaid Services (CMS) and is designed to support the Department’s goals to enhance Maine’s response to the opioid epidemic through increased access to vital treatment and services for substance use disorder (SUD), including opioid use disorder (OUD). 

    Navigate to this link for more details: SUPPORT for ME TA 

    or email either skring@mainemed.com,kcole@mainemed.com 

     

     

    Working with Children & Adolescents? Maine Pediatric & Behavioral Health Partnership (MPBHP) Webinar Series (July thru December 2nd Wednesday of month)

    The Maine Pediatric & Behavioral Health Partnership (MPBHP) is a partnership between Maine Centers for Disease Control (CDC), Northern Light Acadia Hospital, and MaineHealth. MPBHP is offering a webinar series for medical providers who work with children and adolescents and you will earn Continuing Medical Education (CME) credit.

     

    The Maine Pediatric & Behavioral Health Partnership (MPBHP) is a partnership between Maine Centers for Disease Control (CDC), Northern Light Acadia Hospital, and MaineHealth. MPBHP is offering a webinar series for medical providers who work with children and adolescents and you will earn Continuing Medical Education (CME) credit. 

    The 2021 Learning Series schedule will include webinars on the 2nd  Wednesday of each month from 7:30 – 8:30 AM. For more information, please see the topics offered in the list below and how to register for the sessions. 

    Therapeutic Interviewing - July 14, 2021 

    Register in advance for this webinar: 

    https://mainestate.zoom.us/webinar/register/WN_n3O026CLQN6R8-F8ilwYug 

    ADHD – August 11, 2021 

    Register in advance for this webinar: 

    https://mainestate.zoom.us/webinar/register/WN_1IgwbEdSS8mrceGhLyTCxw 

    Depression – September 8, 2021 Register in advance for this webinar: 

    https://mainestate.zoom.us/webinar/register/WN_I7m60qy4Q4O-budFnkVEdw 

    Eating Disorders – October 14, 2021 

    Register in advance for this webinar: 

    https://mainestate.zoom.us/webinar/register/WN_J7oOGRT1QVS1wPv3gxwtxA 

    Psychosis – November 10, 2021 

    Register in advance for this webinar: 

    https://mainestate.zoom.us/webinar/register/WN_Ip8s_YGpS2iJkVHJ6vVn4w 

    Trauma – December 8, 2021 

    Register in advance for this webinar: 

    https://mainestate.zoom.us/webinar/register/WN_9DAt1INbTy2n5s5uscTnXw  

    See the flyer below for details about the Autism webinar on June 2nd: 

    Training Invite Flyer Autism Spectrum Disorder June 2 2021docx.pdf 

    Maine Pediatric & Behavioral Health Partnership (MPBHP) Training Videos MPBHP is also offering on-demand trainings for CME credit. You simply click on the training link, watch the training video, and complete the evaluation. See the below for details about training topics offered, links to the training videos, and details about how to earn CME credit. 

    Approaching Psychiatric Issues in Primary Care  

    On Demand Link: 

    https://mainestate.zoom.us/rec/share/JDVV3FdbQC5NcNsKomvmmX-hQvNJQSEzE7kmvdO26-ow_UK0a_-IbEDRVGcy208.aCtp2L7gTx9V7NeO?startTime=1615379178000 

    Post Training Evaluation: To log your attendance in CloudCME, please TEXT attendance code 75868 to 207-808-7704. Go to MaineHealth Continuing Education (cloud-cme.com). Sign in and complete the evaluation and receive your CME credit. 

    Suicide Risk Management 

    On Demand Link: 

    https://mainestate.zoom.us/rec/share/DaFX8Z4sWnXxWDLpIOpO6hoHbzlKlfeB5rwtJFl_8r7YKmand5jGBkjYJ9icLpJt.YdpURvDhySVyllE2?startTime=1618399283000 

    Post Training Evaluation: To log your attendance in CloudCME, please TEXT attendance code 75099 to 207-808-7704. Go to MaineHealth Continuing Education (cloud-cme.com). Sign in and complete the evaluation and receive your CME credit. 

    Anxiety  

    On Demand Link: 

    https://mainestate.zoom.us/rec/share/xmkThwBZsn-piWjLe5HF1X6QY-Kf8TQ_dcJnczG5q156VnIW6BeWMP0wtITOuw07.atoGuge84OT5_BKb?startTime=1620818853000

    Post Training Evaluation: To log your attendance in CloudCME, please text the attendance code 75919 to 207-808-7704. Go to MaineHealth Continuing Education (cloud-cme.com). Sign in and complete the evaluation and receive your CME credit. 

    Additional Training Opportunities: 

    MaineHealth is hosting a lunch and learn series. For session dates, topics, and to register, see Pediatric Psychiatry and Behavioral Health in Primary Care Learning Series webpage.

     

     

    Physician (BC/BE in Family Medicine) - Strong Area Health Center

    Strong Area Health Center seeks a Physician (BC/BE in Family Medicine) with outstanding clinical and interpersonal skills. In addition, an X waver is desirable.

    Strong Area Health Center seeks a Physician (BC/BE in Family Medicine) with outstanding clinical and interpersonal skills. In addition, an X waver is desirable. The selected candidate will provide outpatient medical care to individuals and families of all ages in our NCQA certified Patient-Centered Medical Home with integrated behavioral health services and general dentistry. The health center, which was established in 2003, offers care of chronic and acute illnesses, physicals, laboratory services, substance use and mental health counseling, and community resource referrals.

    Each year, 1800 patients from Strong, Phillips, New Vineyard, Farmington, and surrounding towns access services. The selected candidate will receive a $10,000 SIGN-ON BONUS, competitive salary and benefits, malpractice coverage, pension plan with employer match, relocation, and loan repayment opportunities. EOE.

    Strong Area Health Center is part of HealthReach Community Health Centers, a system of 11 Federally Qualified Health Centers in Central and Western Maine established in 1975 offering accessible, high quality healthcare with integrated behavioral health, psychiatric medication management, and referrals. HealthReach accepts Medicare, MaineCare and major insurances and a sliding fee program is available to uninsured and underinsured residents as well as assistance with applications for programs that help with the cost of health care and medications including the Health Insurance Marketplace.

    Contact: Recruiter, HRCHC, 10 Water Street, Suite 305, Waterville, ME  04901 ~ 207.660.9908 ~ Fax 207.660.9901 ~ Communications@HealthReach.org ~ www.StrongCHC.org

    7/23/21

    Physician (BC/BE in Family Medicine) - Richmond Area Health Center

    Richmond Area Health Center seeks a Physician (BC/BE in Family Medicine) with outstanding clinical and interpersonal skills. In addition, an X waver is desirable.

    Richmond Area Health Center seeks a Physician (BC/BE in Family Medicine) with outstanding clinical and interpersonal skills. In addition, an X waver is desirable. The selected candidate will provide outpatient medical care to individuals and families of all ages in our NCQA certified Patient-Centered Medical Home with integrated behavioral health services. The health center, which was established in 1977, offers care of chronic and acute illnesses, physicals, laboratory services, substance use and mental health counseling, and community resource referrals.

    Each year, over 2,000 patients of all ages access health center services. They come from Richmond, Gardiner, Litchfield, Dresden, Bowdoinham, as well as Augusta and surrounding communities. The selected candidate will receive a SIGN-ON BONUS, competitive salary and benefits, malpractice coverage, pension plan with employer match, relocation, and loan repayment opportunities. EOE.

    Richmond Area Health Center is part of HealthReach Community Health Centers, a system of 11 Federally Qualified Health Centers in Central and Western Maine established in 1975 offering accessible, high quality healthcare with integrated behavioral health, psychiatric medication management, and referrals. HealthReach accepts Medicare, MaineCare and major insurances and a sliding fee program is available to uninsured and underinsured residents as well as assistance with applications for programs that help with the cost of health care and medications including the Health Insurance Marketplace.

    Contact: Recruiter, HRCHC, 10 Water Street, Suite 305, Waterville, ME  04901 ~ 207.660.9908 ~ Fax 207.660.9901 ~ Communications@HealthReach.org ~ www.RichmondCHC.org

    7/23/21

    Help educate new physicians – join our accredited Family Medicine Residency Program as faculty

    Northern Light Eastern Maine Medical Center's Family Medicine Residency program is seeking a BC, full-spectrum Family Medicine provider to join our dynamic faculty in Bangor, Maine. 

    Northern Light Eastern Maine Medical Center's Family Medicine Residency program is seeking a BC, full-spectrum Family Medicine provider to join our dynamic faculty in Bangor, Maine. Our residency program offers a "best of both worlds" place to teach and learn Family Medicine: a tertiary care, quality hospital with an unopposed, rural medicine training focus, and leadership rooted in Family Medicine and heavily invested in the success of the program. We also have Osteopathic recognition and offer a full-spectrum curriculum.

    Why Northern Light Health?

    • Competitive compensation, benefits, and PTO packages
    • Sign-on and relocation bonuses
    • Student loan reimbursement programs - up to 20K per year with no maximum benefit!
    • Leadership opportunities, if desired

    More about our Residency Program: https://northernlighthealth.org/familymedicineresidency

    If you are interested in learning more about our Family Medicine Residency Faculty opportunities, please email ProviderJobs@northernlight.org.

    8/27/21

    Join our region-leading Neuroscience/Stroke Center

    Northern Light Eastern Maine Medical Center’s Neuroscience Center in the vibrant small city of Bangor, Maine seeks to expand its Neurology Department. 

    Northern Light Eastern Maine Medical Center’s Neuroscience Center in the vibrant small city of Bangor, Maine seeks to expand its Neurology Department. A BC/BE neurologist with or without subspecialty interests (incl. strokologist/neurohospitalist) will be considered.

    Why Northern Light Eastern Maine Medical Center?

    • Competitive compensation/benefits package
    • Student loan reimbursement programs – up to $20k per year with no maximum benefit
    • Sign-on and relocation bonuses
    • CME allowance
    • Leadership and teaching opportunities, if desired

    NL Eastern Maine Medical Center is a 411-bed regional tertiary care center, Joint Commission-accredited Stroke Center, and ACS-verified Level II Trauma Center that offers a full spectrum of inpatient and outpatient services. Bangor serves as the regional hub for medicine, the arts, and commerce, and offers easy access to Maine’s spectacular coast, lakes, and mountains, including Acadia National Park.

    If you are interested in learning more about our neurology opportunities, please email ProviderJobs@northernlight.org.

    8/27/21

    Contract Clinical Advisor - Healthcare Coalition of Maine

    We are searching for a detail oriented, highly skilled and motivated Contract - Clinical Advisor (clinically active physician, advanced practice provider, or registered nurse) to provide clinical leadership to the Healthcare Coalition of Maine and serve as a liaison between the Coalition and medical directors/medical leadership at health care facilities, supporting entities, and EMS agencies!


    We are searching for a detail oriented, highly skilled and motivated Contract Clinical Advisor to serve the Healthcare Coalition of Maine (HCCME), a membership group composed of hospitals, EMS, emergency management, public health, and other stakeholders. HCCME is responsible for providing statewide coordination of healthcare emergency preparedness and response services in accordance with ASPR Hospital Preparedness Program.

    Required Experience:

    • 5+ years’ experience as a clinically active physician, advanced practice provider, or registered nurse residing in Maine
    • Knowledge of medical surge issues, basic familiarity with chemical, biological, radiological, nuclear, and explosives (CBRNE), trauma, burn, and pediatric emergency response principles
    • Excellent communication, Microsoft Office skills
    • Awareness of Coalitions

    This position will require:

    • Flexible working style, ability to adapt to changing priorities
    • Self-directed work, limited oversight, teamwork
    • Domestic travel which may include weekends; Majority of travel within Maine.
    • Valid, unexpired drivers’ license
    • Clean driving record

    For more information and to apply - https://www.mainehccs.com/s/Clinical_Advisor_Job_Posting_HCCME.pdf

    8/13/21

    Medical Director

    Sacopee Valley Health Center, a Federally Qualified Health Center, is seeking an experienced, Board Certified Physician to become our next Medical Director.

    Sacopee Valley Health Center, a Federally Qualified Health Center, is seeking an experienced, Board Certified Physician to become our next Medical Director.

    The qualified candidate will oversee all clinical programs. You will lead an interdisciplinary team of physicians, NPs, PAs, mental health providers, dentists, and specialty providers, along with social workers, to assist in integrating services for patients. You will be expected to model a culture of inclusion and accountability.

    Full time, flexible work week, part time considered.

    Join our multidisciplinary team including behavioral health and dental care in Western Maine. We are located just 45 minutes from Portland and enjoy four seasons of recreation.

    You will earn a competitive salary with benefits including relocation assistance, health and dental insurance, generous time off, holidays and vacations, participation in a retirement plan, and more. You are eligible to apply for federal loan repayment and will receive dedicated CME days and funds.

    Contact us today to learn more:
    Send resume to lwatson@svhc.org or mail to:
    Chief Operating Officer, Sacopee Valley Health Center, 70 Main Street, Porter, ME 04068

    7/30/21