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Summer 2019 | Vol. 24, No. 4
Central Vermont Advance Care Planning Initiative Accomplishments

During the 2018-2019 fiscal year, the Vermont Ethics Network received a generous grant from Massachusetts Health Decisions to support the Taking Steps Vermont advance care planning initiative in Central Vermont.

The areas of focus for this initiative included consumer education, serious illness communication education for providers, and system documentation trainings for healthcare staff.

The work for this project was accomplished in collaboration with The University of Vermont Medical Center, Central Vermont Medical Center, Central Vermont Home Health & Hospice, BAYADA Hospice, OneCare Vermont, Central Vermont Council on Aging, BlueCross BlueShield of Vermont, Quality Improvement Organizations, Centers for Medicare and Medicaid Services, and The New England Quality Innovation Network.

Consumer Education Accomplishment Highlights:
  • Interacted with 362 people through 12 consumer education events.
  • 89% of respondents were motivated to do their AD as a result of attending a presentation.
  • 100% of respondents found the trainings to be useful.
  • Over 1,050 ACP forms and related informational pieces distributed.

System Documentation Accomplishment Highlights:
  • 3 ACP presentations for facility staff at the local hospital, a nursing home/res care facility, and local home health agency that reached a total of 43 staff members.
  • Hospice utilization rates during the grant period increased by 26% (average length of stay on hospice) and 38% (average daily census) respectively.

Provider Education Accomplishment Highlights:
  • 2 serious illness trainings held (using UVM Medical Center's TalkVermont program) for a total of 28 providers.
  • Serious illness communication focused CME held at Central Vermont Medical Center with 40 participants.
  • Evaluation results:
VEN Ethics Survey: What Are Your Ethics Needs? Let Us Know!

If you work in a health care setting, we want to know more about your ethics needs. The Vermont Ethics Network is conducting a short survey to better understand the clinical ethics questions and/or concerns that arise in health care organizations, as well as staff training and/or resource needs that would be beneficial to you. Through this survey, we hope to better understand the nature of ethical issues encountered in Vermont and New Hampshire health care settings, and use that information to assist us in developing programming and services that support and promote ethics quality and healthcare improvement throughout our region. The survey should only take 5 – 10 minutes to complete.
Your input is valuable and all responses will be de-identified and handled confidentially. Thank you in advance for assisting us in understanding the ethics needs that exist in Vermont & New Hampshire.
NHPCO Report Highlights Hospice Increase in Vermont

According to a report from the National Hospice and Palliative Care Organization (NHPCO) released this month, the proportion of Medicare decedents enrolled in hospice at the time of death has increased by 22.29% (the highest increase of any state) since their last report was released in 2014.
Organ Donation in Vermont

Did you know?
  • Anyone can become an organ donor. Age and health considerations are assessed for each case at the time of death.
  • There are few exclusions to donations. Anyone can register to be an organ donor if that is their wish.
  • Even if a person is a registered organ donor, every effort will be made to save their life. Organ and tissue donation will only be pursued after death is legally declared.

Become an Organ Donor
Donor registries are a fast and easy way to register your consent for organ and tissue donation and provide an electronic record that can be accessed 24/7 in the event of your death.

To become an organ donor in Vermont, register online at Donate Life Vermont or enroll at the Department of Motor Vehicles (DMV). By registering you give legal consent for organ and tissue donation.
Highlights from the VEN Spring Palliative Care Conference

On May 29, the Vermont Ethics Network held our Spring Palliative Care Conference entitled "Listening, Language and the Power of Truth-Telling". The conference had 130 registered participants. Here's what some of them had to about how it will impact their professional practice/performance:
Stay tuned for information about VEN's statewide ethics conference this fall!
Vermont Advance Directive Registry Benefits

Did you know?
Vermont offers a registry for residents to submit their advance directives free of charge. The Vermont Advance Directive Registry is part of the national US Living Will Registry. It is a secure online database where Vermonters can submit copies of their completed advance directive forms to be accessed by authorized health care facilities and providers.

Benefits of Registering Your Advance Directive
  • Immediate access to your document when it is most needed
  • Portable across state lines (can be accessed anywhere, not just in Vermont)
  • Annual reminders are mailed to you to ensure regular review

What happens if I move out of state and have an advance directive in the Vermont Advance Directive Registry?

  • Option 1: You may choose to transfer your account from the Vermont Advance Directive Registry to the U.S. Living Will Registry (USLWR). Your document(s) will be removed from the Vermont Advance Directive Registry and registered directly with the U.S. Living Will Registry. USLWR will send you a new wallet ID card (your Registration ID# will remain the same), you will receive annual email reminders from USLWR, and you will be able to update your account profile and your advance directive document as needed. The cost to register with USLWR is $30.00 for a five year period with the use of the promo code TransferVT123. This cost represents a 50% discount made available exclusively to former VT residents. After the initial five year period, you may renew for $25 every five years.
  • Option 2: You may choose to entirely remove your account and documents from the USLWR and no longer be part of the registry. To choose this option, email the USLWR. In the email, include only your name, date of birth and Registration ID#. Please write “REVOKE MY FILE” in the subject line.
  • Option 3: If you do not choose Option 1 or Option 2, your document will remain in the Registry at no cost to you and will essentially be “inactive”. You will still be able to login to your personal account using your username and password to view your personal information and document(s). However, your document will not be accessible using your Registration ID#. Providers and health care facilities will only be able to call the registry to request a copy of your document be faxed directly to them.
Save the Date

Please save the date for:

The 50th Meeting of the NH/VT Ethics Committees
Physician Aid in Dying: The Controversy Continues
October 7, 2019 | 11:00am - 4:45pm
Dartmouth-Hitchcock Medical Center, Auditorium G, Lebanon, NH

Physician aid in dying refers to a prescription by a physician of a lethal dose of medication to a patient, upon their request and under certain conditions. The practice enables the patient to take the medication if they choose to hasten their death. The goal is to allow the patient to control the time and manner of his or her closely approaching death so as to preserve personal dignity and prevent potentially refractory pain and distress. Although physician aid in dying is legal in several states including Vermont and Maine, the issue remains controversial. Whatever their position on the controversy, health care professionals have an ethical duty to be knowledgeable about this evolving end of life option. Join the NH/VT Ethics Committees as they discuss the ethics of this emotional and sensitive issue.

Opening soon via this link. For questions, please contact Amanda Sanchez
HEALTH DECISIONS is a publication of the Vermont Ethics Network.

The mission of the Vermont Ethics Network is to advance ethics in health care.
Board of Directors
E. Tobias Balivet, Esq.
George K. Belcher, JD
Linda Cohen, JD, MHCDS
Kier Olsen DeVries, MA
Shaden Eldakar-Hein, MD, MS
Linda Hurley, RN, MS
Alden Launer, MDiv
Peg Maffitt
Madeleine Mongan, Esq.
Hilary Ryder, MD
John Saroyan, MD, FAAP
Cindy Bruzzese, MPA, MSB
Executive Director and Clinical Ethicist

Catrina Brackett
Executive Admin/Bookkeeper

Honorary Board Members
James L. Bernat, MD
Michelle Champoux, LICSW
Jean Mallary, RN
Robert Macauley, MD