Many licensees have contacted the Board with a variety of questions regarding COVID-19 as it relates to medical licensure, rules and regulations. Please submit other topics of interest as related to medical licensure pertaining to COVID-19 to AHS.VDHMedicalBoard@vermont.gov
Please note that this applies to only the professions licensed by the Board of Medical Practice (MD, PA, DPM, AA, and RA). Members of professions regulated by the Office of Professional Regulation (e.g., DOs, APRNs, and Naturopaths) should contact OPR.
Deemed Licensure for Health Care Professionals Licensed in Other States
By virtue of Act 85 of 2022, through June 30, 2023, health care professionals who are licensed in another U.S. jurisdiction and in good standing in all states where licensed, and who are not currently subject to disciplinary proceedings in another state or barred from practice in Vermont, are able to practice in Vermont for up to six months without obtaining a license, in the following circumstances:
- Practice as part of the staff of a licensed facility
- Practice at a Federally Qualified Health Center
- Practice as a volunteer with the Medical Reserve Corps (MRC)
Those who are practicing with the MRC or as staff of a licensed facility or FQHC must have the organization submit to the Board their name, contact information, and locations at which they will be practicing. This authority applies until June 30, 2023, so long as the individual remains in good standing in all jurisdictions where licensed to practice, however, for all but those practicing with the MRC, it may be used for only six months after the date of enactment, March 22, 2022.
After relying on this provision for a period of six months that begins on or after March 22, 2023, the health care professional must obtain a license to continue practice in Vermont. This means that someone who was practicing as of March 22, 2022 and who continues to practice may rely upon this provision until September 22, 2022. Someone who begins practice in Vermont on January 1, 2023, may practice until June 30, 2023. Someone who begins practice after January 1, 2023 may practice under this authority only through June 30, 2023, not for the full six months. The only exception to the six-month limitation is for those who limit practice to the MRC. The provisions of Act 85 of 2022 that allow practice without a license as described above are at pages 7 through 9 of the law.
Deemed Licensure for Vermont Physicians Whose License Became Inactive within the Past Three Years
Health care professionals whose Vermont licenses became inactive within the past three years and who were in good standing also have been, and continue to be, eligible to be “deemed” licensed to practice until June 30, 2023 in the same circumstances as listed above: with the MRC or as staff of a licensed facility or FQHC. If you began practicing in Vermont under this authority within three years of the date on which you no longer held an active license and have continued to practice, you will remain eligible to practice through June 30, 2023, so long as all other conditions are still satisfied. That is to say that you have not been subjected to discipline or barred from practice in Vermont. The extension of the provision that allows those whose licenses became inactive within the past three years to be deemed to be licensed to practice are found at pages 10-11 of Act 85 of 2022.
Emergency Licensure for Health Care Professionals Whose Vermont Licenses Became Inactive Between Three and Ten Years Ago
Health care professionals whose Vermont license became inactive more than three years ago are not able to be “deemed” licensed as described just above. However, those whose Vermont licenses became inactive between three and ten years ago may apply for a temporary emergency license to practice with the MRC or as staff of a licensed facility or FQHC. They must fill out an abbreviated application, which will be reviewed by the Board. Limitations may be placed on such licenses. Licenses obtained under this provision may also be extended through June 30, 2023, as provided by Act 85 of 2022 at page 11.
On November 3, 2021, the Vermont Board of Medical Practice issued a Position Statement on Unprofessional Conduct Related to COVID-19. The Board makes this statement to inform Vermont licensees and the public of its expectations for professional conduct in circumstances that may arise in the prevention and treatment of COVID-19, and in discourse about prevention and treatment of COVID-19.
The Board has received questions and expressions of concern about practicing medicine during the public health emergency brought about by COVID-19. Healthcare professionals have been forced to adapt to rapidly changing circumstances and this is only the beginning. The demand for services, constrained resources, the need to modify patient encounters to reduce risk of infection, and peers being unable to practice because of illness have impacted, or will impact, the way you treat patients.
What does all this mean for you in terms of your personal liability, either regarding discipline for unprofessional conduct, or with regard to malpractice liability?
With respect to the Board of Medical Practice and the potential for discipline based on a failure to meet the standard of care, you can be assured that your actions will always be judged based on the circumstances. That does not mean that anything goes in a crisis, but that due consideration will always be given to the circumstances in which you practice.
The law that defines the different forms of unprofessional conduct requires the Board to consider the circumstances whenever deciding if the standard of care was met, as seen in 26 V.S.A. § 1354(a):
22) in the course of practice, gross failure to use and exercise on a particular occasion or the failure to use and exercise on repeated occasions, that degree of care, skill, and proficiency that is commonly exercised by the ordinary skillful, careful, and prudent physician engaged in similar practice under the same or similar conditions, whether or not actual injury to a patient has occurred.
The Board does not play a role in malpractice lawsuits, and cannot give licensees legal advice, but we note that the statutory standard for malpractice liability includes comparable phrasing in the law that establishes what must be proved in a medical malpractice claim in Vermont, as seen in 12 V.S.A. § 1908:
In a malpractice action [ . . . ] the plaintiff shall have the burden of proving:
(1) the degree of knowledge or skill possessed or the degree of care ordinarily exercised by a reasonably skillful, careful, and prudent health care professional engaged in a similar practice under the same or similar circumstances whether or not within the State of Vermont;
(2) that the defendant either lacked this degree of knowledge or skill or failed to exercise this degree of care; and
(3) that as a proximate result of this lack of knowledge or skill or the failure to exercise this degree of care the plaintiff suffered injuries that would not otherwise have been incurred.
Healthcare professionals may also want to consult the State of Vermont guidance on medical services in times of crisis. The Vermont Department of Health has set forth a framework for operating in a public health emergency in a document known as the Crisis Standards of Care Plan. A summary of the plan and the plan itself are available on the Health Department website.
Questions about prescribing requirements during the COVID-19 public health emergency?
The US Drug Enforcement Agency has an informative webpage that is updated regularly. It addresses topics including whether requirements for in-person contact with patients for controlled substance prescribing are in effect.