2023 Substance Use and Mental Health Services Administration Training

The M. Foscue Brock Institute for Community and Global Health at EVMS, the Virginia Department of Behavioral Health and Developmental Services, and the Substance Abuse and Mental Health Services Administration invite you to attend the 2023 Substance Abuse and Mental Health Services Administration Training: Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants.

Register now for the event on Tuesday, July 11, 2023 at 8:30 A.M. in Richmond, Virginia.

ADA’s Effective Communication Requirements in Healthcare Settings – Informational Meeting

To help frontline staff in healthcare settings understand ADA requirements, the DOJ is hosting an online informational meeting for the public, including healthcare personnel:

ADA’s Effective Communication Requirements in Healthcare Settings
Tuesday, June 6, 2023 | 1 PM – 4PM ET
Register Now

On Friday, April 14, 2023, The United States Attorney’s Office for the Eastern District of Virginia sent a Dear Colleagues Letter to remind healthcare providers of the rules surrounding the Americans with Disabilities Act (ADA), and encouraging Virginia agencies, healthcare providers, and partners to familiarize themselves with the legal requirements. Pursuant to the ADA, healthcare providers are required to ensure that communication with people with disabilities is as effective as communication with people without disabilities.

Register for this meeting to learn steps healthcare providers can take to comply with the ADA’s effective communication requirements.

Act F.A.S.T. If You Suspect a Stroke

BY Kerstin Bettermann, MD
Our blog this month is written for you to share with your patients. For details about MSV’s free Stroke Smart educational materials for your practice, read the last section of the blog.

Every 40 seconds in the U.S. someone has a stroke — and every 3.5 minutes someone dies of stroke. It’s the 5th leading cause of death in the U.S., and a leading cause of serious long-term disability. But do you know how to identify whether you or someone you know may be having a stroke? Recognizing a stroke is critical to treatment – that’s where F.A.S.T comes in. Every minute counts!

The sooner emergency treatment begins, the better the chances for recovery and survival. In fact, the therapeutics that work best can be given only if the stroke is diagnosed and treatment begins within 4.5 hours of the first symptoms. And getting the earliest treatment possible can make a big difference in reducing the risk of disability. That’s why the Centers for Disease Control and Prevention (CDC) created F.A.S.T. to help people easily remember what’s most important about recognizing a stroke, so you can act quickly and call 9-1-1 as soon as possible.

F.A.S.T.

F: FACE

Ask the person to smile. Does one side of the face droop?

A: ARMS

Ask the person to raise both arms. Does one arm drift downward?

S: SPEECH

Ask the person to repeat a simple phrase. Is their speech slurred or can they not express themselves or understand?

T: TIME

If any of these signs are present, call 9-1-1 right away.

Stroke Risks and Symptoms

Certain things can increase stroke risk, including age, gender, race or ethnicity, medical conditions, and family history. As we age, the risk for stroke goes up. Though strokes can happen at any age, the risk doubles every 10 years after age 55. Strokes are more common in women than men, and women are more likely than men to die from stroke no matter their age. People who are Black, Hispanic, American Indian, and Native Alaskan are more likely to have a stroke than non-Hispanic Whites or Asians, and Blacks are more likely to die from stroke than Whites. Finally, high blood pressure is a major risk factor for stroke. Other medical conditions that increase stroke risk include high cholesterol, heart disease, diabetes, obesity, sickle cell disease, and using tobacco products. This list does not include everything, so if you have questions about these and other risk factors like medications or lifestyle choices and behaviors, see a doctor to get detailed information.

Though the CDC’s F.A.S.T. is a memorable and helpful tool to remember how to recognize stroke, it doesn’t tell the full story. Let’s take a closer look at stroke symptoms which include the sudden onset of:

  1. Numbness or weakness in the face, arm, or leg, especially on one side of the body
  2. Confusion, including trouble speaking or understanding speech
  3. Trouble seeing from one or both eyes
  4. Dizziness, problems with balance or coordination, and trouble walking
  5. Headache, especially a severe one that comes on suddenly

A stroke is a medical emergency. Even if the symptoms go away, it’s important to call 9-1-1 to get help and get that person to the hospital — fast.

Physicians: Get Free Stroke Materials from MSV

Great news! MSV has free stroke materials available for Virginia medical professionals to share with patients to help them “Be Stroke Smart.” Stroke Smart posters, magnets, and wallet cards are all available for your practice. View the materials on MSV’s Stroke Smart page, then click the link to request your materials — in English or Spanish — at no charge.

To offer Stroke Smart, the MSV Foundation partnered with the Virginia Department of Health and the Virginia Stroke Systems Task Force, with funding through the CDC Paul Coverdell National Acute Stroke Program.


The information contained in this blog is for educational purposes only and does not constitute health care advice.

SafeHaven™ Releases Film in Support of Healthcare Providers Facing Stress and Burnout

SafeHaven released a film today in support of physicians and clinicians who need a safe space to seek help for burnout without fear of repercussions. The Medical Society of Virginia’s SafeHaven program launched in 2020 as an innovative solution to support healthcare providers’ well-being.

“No one was supporting our clinicians for burnout. We believed by eliminating fear, their number one reason for not asking for help, we could save lives,” said Medical Society of Virginia’s CEO and EVP Melina Davis.

“Through our conversations with our members and stakeholders, we learned quickly how much physicians, PAs, and the entire healthcare team needed SafeHaven,” said Davis. “This film is a public service announcement for us to raise awareness with other clinicians, healthcare systems, our legislators and the public about the importance of healthcare workers caring for their mental health. SafeHaven is here to make it easier for them to get the access they need to behavioral health resources.”

SafeHaven offers assistance through VITAL WorkLife’s Clinician Well-Being Resources, a comprehensive solution that includes peer coaching, behavioral health resources and work-life balance resources to support well-being for physicians, PAs, nurses, and pharmacists; as well as medical, nursing, PA, and pharmacy students. Over 6,500 clinicians have participated in the SafeHaven program and multiple states are now introducing legislation similar to what has passed in Virginia and Michigan. Additionally, national associations such as the American Society of Clinical Oncology (ASCO), are fully supportive of SafeHaven and are offering it to their members.

Since its inception, SafeHaven has seen a 47% utilization rate, far exceeding the traditional Employee Assistance Programs proving the demand for a protected assistance program.

SafeHaven is the first program of its kind in the nation. It is continuing to grow across Virginia and the United States. View the full film on the SafeHaven website. For more information email us at [email protected] and visit www.SafeHavenHealth.org.

HRSA’s National Maternal Mental Health Hotline

HRSA recently celebrated the first anniversary of the National Maternal Mental Health Hotline. Since its launch on Mother’s Day 2022, the Hotline’s professional counselors have provided emotional support, resources, and referrals to almost 12,000 pregnant and postpartum individuals who struggled with mental health concerns, and their loved ones.

HRSA is introducing an updated toll-free number for the Hotline: 1-833-TLC-MAMA (1-833-852-6262). The former number (1-833-9-HELP-4-MOMS or 1-833-943-5746) will continue to work for another year.

The National Maternal Mental Health Hotline is for pregnant and postpartum individuals and their loved ones to get the help and resources they need when they need it:

  • Provides 24/7, free, confidential emotional support, resources, and referrals before, during, and after pregnancy
  • Accessible by phone or text

Available in English and Spanish and offers interpreter services in more than 60 languages.

Read the full press release.

Learn more about the National Maternal Mental Health Hotline at the upcoming Maternal Mental Health Month webinar:

Thursday, May 18 from 12-1 pm ET
Register Here

Dawn Levinson (HRSA) will highlight the National Maternal Mental Health Hotline and two Maternal, Infant, and Early Childhood Home Visiting (MIECHV) grantees in Illinois and Minnesota share how they are addressing maternal mental health in their communities.

This webinar is part of a series hosted by HRSA’s Office of Intergovernmental and External Affairs to highlight HRSA programs and resources to improve maternal health and well-being across the lifespan.

Disability Insurance Claims: 6 steps to make filing easier

When you got your disability insurance policy, you were preparing yourself for the unexpected. You likely never expect to need to make a claim, but if you do, understanding the process can make the experience less stressful.

This process of filing a disability insurance claim is similar across all types of disability insurance: long-term, short-term, group, and business overhead insurance. In this post, we’ll break down the process of filing a disability claim, important considerations to keep in mind, and what to expect during this challenging time.

  1. Eligibility: Your disability insurance policy’s definition of disability will help you understand your eligibility. “True own-occupation” is the recommended definition for physicians, meaning you would be considered disabled if you cannot work in your specialty, even if you’re making money at another job. Reviewing the terms of your policy will help you move on to the next steps in making a claim.
  2. Initial Steps: The next step is notifying your insurance company. This can be done by phone, email or online, depending on your insurance provider. You will need to complete and submit an initial claim form, which will typically include your statement, details about your disability, and your medical history.
  3. Evidence: A disability insurance claim requires medical evidence to substantiate your claim. Your claim will need to be backed up by medical records and a doctor’s statement of your condition. Substantial documentation of your condition and treatment will help the disability insurance process move forward more quickly. Your employer will also need to make a statement, detailing how your condition is affecting you at work and the wages you have lost. If you’ve stopped working, they will also need to provide your last date at work.
  4. Waiting Period: All disability insurance policies have what is called a waiting (or elimination) period, which is a specific period of time before benefits begin to be paid out. You are able, and encouraged, to start the claim process before your elimination period has ended in order to receive your benefits in a timely manner. If your claim is accepted before the elimination period has ended, you may need to wait a few more weeks to begin collecting your benefits.
  5. Claim Review: Your insurance company will review your claim after it has been submitted to determine if it is covered under your policy. This review will include an assessment of your statements and records. This process can take between a few weeks to a month or more. They may ask for follow up documentation, and any forms should be filled out promptly to reduce delay.
  6. Decision: If your disability claim is approved, then benefit payments will begin once the waiting period has ended. These payments will continue for as long as you are disabled, or as stated in your policy. If your claim is denied, the insurance company will send you a letter detailing why. Some common reasons claims are denied include:
    • Not meeting the definition of disability defined in your policy
    • Insufficient documentation from your physician
    • Your condition being excluded in your coverage (pre-existing conditions defined during the application process)

You have the right to appeal a denied claim. Your denial letter will include instructions on how, and the insurance company will likely request additional documentation to reconsider your claim.

Disability Insurance Awareness Month

May is Disability Insurance Awareness Month, and there is no better time to review your disability insurance coverage so you can be prepared in the event you need to file a claim. Physicians should have true own-occupation coverage that protects your specialty, high monthly benefits, and portable coverage that goes with you if you change jobs. Contact the MSVIA today for a no-cost quote or review of your coverage from a reputable, physician-dedicated insurance agent.

COVID-19 Updates for Virginia

via VDH

Dear Colleague:

This letter provides an update on COVID-19 vaccines.

FDA authorizes and CDC Recommends Simplified COVID-19 Vaccine Schedule

After the U.S. Food and Drug Administration (FDA) revised its emergency use authorizations for the Pfizer and Moderna mRNA COVID-19 vaccines, the Centers for Disease Control and Prevention (CDC) announced simplifying COVID-19 vaccine recommendations on April 19. CDC updated its Interim Clinical Considerations for Use of COVID-19 Vaccines in the United States to provide detailed guidance for providers. We describe the key changes below and advise COVID-19 vaccinators in Virginia to implement these immediately.

  • All mRNA COVID-19 vaccinations will now use the bivalent vaccine formulations; monovalent mRNA vaccines are no longer authorized.
  • CDC recommends that everyone aged 6 years or older who is unvaccinated or has only received monovalent vaccines receive 1 bivalent mRNA COVID-19 vaccine.
  • Children aged 6 months through 5 years are eligible to receive at least one dose of a bivalent vaccine. The number of bivalent doses and timing will depend on the vaccine and their vaccination history.
  • Adults aged 65 years and older are eligible to receive an optional additional bivalent mRNA vaccine dose.
  • Individuals aged 6 years or older who have already received a bivalent mRNA vaccine are not eligible for an additional dose unless they are aged 65 years or older or immunocompromised.
  • Updated vaccine schedules for immunocompromised individuals will be available soon.
  • The updated guidelines do not apply to Novavax and Janssen (J&J) COVID-19 vaccines because they are not bivalent mRNA vaccines.
  • Healthcare providers can check the Virginia Immunization Information System (VIIS) to confirm patient’s vaccine history.
  • CDC and the Virginia Department of Health (VDH) are updating resources for patients and providers and plan to offer webinar training for providers. Training will be announced on CDC’s Clinician Outreach and Communication Activity (COCA) website or VDH’s COVID-19 Vaccine Healthcare Professionals website.

Table. Updated recommendations for bivalent mRNA COVID-19 vaccines for individuals who are not immunocompromised*

COVID-19 Vaccination Status Children aged 6 months to 5 years People aged 6 years or older
Has not yet received any dose Recommended to get at least 1 bivalent vaccine dose. The number of doses depends on age and vaccine type.* Recommended to get 1 dose of a bivalent vaccine.
Has received at least 1 vaccine dose Recommended to get at least 1 bivalent vaccine dose. The number of doses depends on age, vaccine type, and vaccine history.* Recommended to get 1 dose of a bivalent vaccine at least 8 weeks after last monovalent dose. If already received a bivalent vaccine dose, then an additional bivalent vaccine dose is not recommended.†
Individuals aged 65 and older may receive an additional bivalent vaccine at least 4 months after first bivalent dose.

*For more detailed recommendations, refer to CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines in the United States. An updated vaccine schedule for individuals who are immunocompromised will be available soon.

Thank you again for your continued partnership. Please visit the Virginia Department of Health website for current clinical and public health guidance on COVID-19 and other information.     

Sincerely,

Parham Jaberi, MD, MPH
Acting State Health Commissioner

What practices need to know: DOJ message regarding ADA compliance

On Friday, April 14, 2023, The United States Attorney’s Office for the Eastern District of Virginia sent a Dear Colleagues Letter to remind healthcare providers of the rules surrounding the Americans with Disabilities Act (ADA).

Pursuant to the ADA, healthcare providers must ensure that communication with individuals with disabilities meets their required communication needs. Healthcare providers may not decline to provide treatment to an individual due to their communication disabilities and are required to take affirmative steps in providing reasonable accommodations including auxiliary aids and services (e.g., sign language interpreters, means of making visually delivered materials available to those with vision impairment, and speech-to-speech transliterators).

This client advisory from MSV counsel, Hancock, Daniel & Johnson, P.C., goes into greater detail of what practices need to know. Please read the advisory and share with your practice managers and legal representation.

Given the timing of The United States Attorney’s Office for the Eastern District of Virginia’s action—the MSV would strongly encourage its members to familiarize themselves with all aspects of the ADA and review their compliance with the statute.

Please contact us with any questions at [email protected].

HHS Announces New Divisions within the OCR

Big news: The U.S. Department of Health and Human Services, through the Office for Civil Rights (OCR), announced the formation of a new Enforcement Division, Policy Division, and Strategic Planning Division.

The OCR will now reflect the structure set by the U.S. Department of Education’s Office for Civil Rights

Why did the HHS form three new divisions? “OCR’s caseload has multiplied in recent years, increasing to over 51,000 complaints in 2022– an increase of 69 percent between 2017 and 2022,” said OCR Director Melanie Fontes Rainer. “…reorganization improves OCR’s ability to effectively respond to complaints, puts OCR in line with its peers’ structure, and moves OCR into the future.”

The Strategic Planning Division will coordinate public outreach to protect civil rights and health information privacy. They will also expand data analytics and coordinate data collection across HHS leadership. With the OCR being proactive and educating the public on their rights, now would be the time to make sure you are being proactive with HIPAA compliance.

The Importance of HIPAA Compliance

HIPAA violations can result in severe consequences, including fines, legal action, and damage to a healthcare organization’s reputation. Plus, it keeps our patients’ sensitive health information safe and private. Therefore, it is critical for healthcare providers and organizations to prioritize HIPAA compliance and regularly review and update their policies and procedures to ensure they are in line with the latest regulations.

Getting (and Staying) Compliant

Your Security Risk Analysis is the first thing the OCR asks for when they come knockin’. So why not beat them to the punch? With a Security Risk Analysis, you can:

  • identify and assess potential threats and vulnerabilities to protected health information (PHI)
  • evaluate the effectiveness of your organization’s security measures and policies

A HIPAA Security Risk Analysis is an ongoing process that must be regularly reviewed and updated to ensure that the organization remains in compliance. And the MSV’s partners at Abyde automate the entire process for you.

Abyde is the leader in HIPAA & OSHA compliance education and solutions for independent Medical practices. MSV members gain access to complimentary educational consultations, HIPAA/OSHA resources and special pricing for the Abyde software solution.

If you’re ready to make compliance stress-free, reach out to Abyde today.

COVID-19 Update For Virginia

via VDH

Dear Colleague:

This letter includes brief updates on COVID-19 reporting regulations, bivalent boosters, and the ending of the federal COVID-19 public health emergency.

Updates to Virginia’s COVID-19 Reporting Regulations

The State Board of Health’s emergency regulations for COVID-19 reporting expired on January 18, 2023. The Board updated the Virginia Regulations for Disease Reporting and Control (12VAC5-90-80 and 12VAC5-90-90), and the changes went into effect on January 18, 2023.  Below, we highlight important updates specifically related to COVID-19 reporting. The updated regulations and the Virginia Reportable Disease List can be referenced on the Virginia Department of Health (VDH) website.

  • Coronavirus disease 2019 (COVID-19 or SARS-CoV-2) was added to the Virginia Reportable Disease List.
  • Physicians and directors of medical care facilities are required to report to the health department not only when a person who is infected with or who is suspected of having COVID-19 is treated or examined, but also if the person is hospitalized or admitted into an intensive care unit.
  • Directors of laboratories and other entities that hold a Clinical Laboratory Improvement Amendments Certificates of Waiver (e.g., pharmacists) are required to report positive SARS-CoV-2 tests to VDH.
    • The report must be submitted electronically within three days of identification using either VDH’s available portal for laboratory reporting (VDH’s COVID-19 Point of Care (POC) Test Reporting Portal) or electronic laboratory reporting.
    • Negative SARS-CoV-2 test results are no longer required to be reported.
    • The required data elements for reporting were updated to add the patient’s ethnicity, phone number, and email address, in addition to the already reportable items, including race.
  • Severe coronavirus (e.g., infection caused by SARS-associated coronavirus [SARS-CoV] or middle eastern coronavirus [MERS-CoV]) continues to be an immediately reportable condition for physicians, directors of medical facilities and directors of laboratories.
    • With the updated regulations, persons in charge of hospitals, nursing facilities or nursing homes, assisted living facilities, and correctional facilities are now required to notify persons practicing funeral services if the deceased person was known to have had a severe coronavirus infection.

CDC Recommends Updated Bivalent COVID-19 Booster for Certain Children Aged 6 Months through 4 Years

On March 16, the Centers for Disease Control and Prevention (CDC) updated its Interim Clinical Considerations to allow children aged 6 months through 4 years who completed a 3-dose monovalent Pfizer-BioNTech primary series to receive a single bivalent Pfizer-BioNTech booster dose at least 2 months after completion of the primary series. For more information, please visit the CDC website.

COVID-19 Public Health Emergency to End on May 11, 2023

On January 30, the White House announced that both the COVID-19 national emergency and public health emergency (PHE) will end on May 11, 2023.  The end of the PHE could impact costs or insurance coverage of COVID-19 related tests, treatments, and vaccines.  Certain Medicare and Medicaid flexibilities or waivers will also end, but the timing of the end might be on or after May 11.

Emergency use authorizations for COVID-19 vaccines or treatments will not be impacted. Additionally, the distribution and allocation of federally purchased vaccines and therapeutics are not directly tied to the PHE. They will continue to be available, at no cost, to providers until they become commercially available. Virginia’s COVID-19 testing programs will continue to offer at-home test kits to vulnerable settings or populations as resources allow.

Despite the pending end of the federal PHE, COVID-19 remains an important public health issue. Together with our federal partners, VDH remains committed to monitoring trends and preventing severe illness and death from COVID-19. Please continue to encourage your patients to take measures to protect themselves and their families.

Thank you for your continued partnership. Please visit the VDH website for current clinical and public health guidance on COVID-19 and other conditions.

Sincerely,

Parham Jaberi, MD, MPH
Acting State Health Commissioner