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May 13, 2021
Nemours Children's Health System Announces Changes
Nemours Changes Name of Hospital and Brand Identity
Nemours Children's Health System announced a change in name to Nemours Children's Health to emphasize health and reflect Nemours' bold vision of creating the healthiest generations of children, as well as create a unified brand across the health care system's five-state footprint. A new brand mark, coined "The Loop of Care," represents the transformative vision for Nemours' future.

On Wednesday, Nemours unveiled its new name, the launch of a new five-year strategic plan, and the introduction of its new brand during a virtual event on its Founder's Day, which celebrates founder and benefactor Alfred I. duPont's philanthropic legacy. What is known as the Nemours/Alfred I. duPont Hospital for Children (or "A.I.") will become Nemours Children's Hospital, Delaware. To honor duPont as Nemours' benefactor and his commitment to Delaware, the estate, which includes the hospital, Nemours Mansion, formal garden, and tower, will be designated the Alfred I. duPont Campus. MSD member, Michael A. Alexander, MD, participated in the event. Dr. Alexander became chief of Rehabilitation Medicine at Nemours and now currently serves as an Emeritus faculty member.
State of Delaware Group Health Insurance Plan Change
Plan Will Transition to a New Pharmacy Benefit Manager
CVS Caremark will be the pharmacy benefit manager (PBM) for individuals enrolled in a State of Delaware non-Medicare health plan administered by Highmark Delaware or Aetna effective July 1, 2021. This means members could experience changes in their formulary options and may contact providers in order to discuss alternative options, prior authorizations, or step therapy requirements. CVS Caremark will reach out to members directly in advance of the transition to provide notification of any changes and suggested alternatives. Retail pharmacy options will not be restricted to CVS pharmacies. Additional information about the State of Delaware non-Medicare Prescription Plan is available online at dhr.delaware.gov/benefits/cvs.
Saving Primary Care in Delaware
Information You Can Provide to Your Patients
Senate Bill 120 (SB 120) is legislation that will reform the primary care system in Delaware. Thanks to all our physicians and support teams who have been making contact with their state legislators asking for support of SB 120. We need to continue the grassroots efforts by involving our patients. Patients need to understand how this situation affects them. Please take the time to explain the challenges our primary care physicians are facing and what it means to your patients. MSD has provided a handout to provide to your patients asking them to contact their state legislators to encourage support of this most important piece of legislation. Download the handout.
AMA Releases New Strategic Plan on Racial Justice, Health Equity
AMA To Use Its Influence To Fight Racism in the US Health Care System
The AMA unveiled an ambitious new three-year roadmap to embed racial justice and advance health equity with the AMA and our health care system. The 83-page report, AMA Plan to Embed Racial Justice and Advance Health Equity, lays out five important steps to help dismantle structural racism in health care, recognize past failures, and work in partnership with others to improve health outcomes for communities of color and other historically marginalized groups. The AMA acknowledged it was not the first organization to take these steps, but wanted to be part of the solution by leveraging the power of its membership, its influence, and reach to bring lasting change to medicine. Read more.

The Medical Society of Delaware is also in the planning stages of forming a group to begin addressing health disparities in our state. Watch for more information in the coming weeks.
HHS Announces Prohibition on Sex Discrimination
Restores Health Protections for Gay and Transgender Communities
Discrimination in health care impacts health outcomes. Research shows that one-quarter of LGBTQ people who faced discrimination postponed or avoided receiving needed medical care for fear of further discrimination.

Earlier this week, the Department of Health and Human Services (HHS) announced that the Office for Civil Rights will interpret and enforce Section 1557 and Title IX's prohibitions on discrimination based on sex to include: (1) discrimination on the basis of sexual orientation; and (2) discrimination on the basis of gender identity. Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in covered health programs or activities. Protections for gay and transgender communities were denied by the Trump administration. The update was made in light of the U.S. Supreme Court's decision in Bostock v. Clayton County and subsequent court decisions. The Supreme Court's ruling found that LGBTQ people are protected by the Civil Rights Act of 1964 banning discrimination on the basis of sex. The new interpretation will apply to covered health programs or activities, which include doctors, hospitals, insurance companies, and other health care organizations that receive federal funding. Read the press release.
Tell Congress to Make Expanded Telehealth Services Permanent
Telehealth Remains A Critical Tool To Provide Care
The AMA has initiated a grassroots effort to make expanded telehealth services permanent. During the pandemic, Congress acted to temporarily expand access to Medicare-covered telehealth services to all Medicare beneficiaries by authorizing Health and Human Services (HHS) to waive outdated statutory restrictions on where telehealth services may be provided. Recently, legislation was introduced in both the House and Senate that would make the expanded access to telehealth services permanent. The Telehealth Modernization Act of 2021 (H.R. 1332/S. 368) would lift the rural-only restriction. The CONNECT for Health Act (H.R. 2903/S. 1512) would provide HHS with permanent authority to waive these restrictions, similar to the authority the agency has for the duration of the COVID-19 public health emergency. Read the Grassroots Update.

Tell Congress to make expanded telehealth services permanent and ask them to support making expanded telehealth services permanent today!!
CDC Updates Mask Guidance
For Those Fully Vaccinated
The Centers for Disease Control and Prevention (CDC) announced today it was easing mask-wearing guidance and that those who are fully vaccinated can resume activities without wearing a mask or physically distancing, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including business and workplace guidance. The guidance still calls for wearing masks in crowded indoor settings like buses, planes, hospitals, prisons, and homeless shelters. Read the announcement.

Governor Carney had previously announced Delaware's updated restrictions effective 8:00 a.m. May 21 to include masking and social distancing guidance as well as capacity restrictions:
  • Masks are required indoors to prevent the spread of COVID-19.
  • Outdoors, Delawareans should follow masking guidance issued by the CDC (this refers to CDC guidance in effect prior to today's CDC announcement).
  • Social distancing requirements will move from 6 feet to 3 feet.
  • Capacity restrictions inside restaurants, retail, gyms, other business establishments, and houses of worship will be lifted. Facilities can use as much capacity as social distancing requirements will allow.
  • Customers must continue to remain seated indoors and outdoors at bars and restaurants unless a plan for dance floors and other areas is approved by DPH.
  • Events over 250 people indoors and outdoors will still require plan approval from DPH to ensure compliance with basic precautions to prevent the spread of COVID-19.

Governor Carney on Wednesday signed a new COVID-19 omnibus order, the Twenty-Eighth modification to the original state of emergency order, updating school bus distancing requirements, eliminating most business capacity restrictions effective May 21 and outlines additional changes that were announced last week. Beginning with summer programming, schools should follow the CDC guidance on school buses when transporting students. The CDC advises schools to create distance between children on school buses when possible and to following masking and other COVID-19 safety precautions.
FDA Grants Use of Pfizer-BioNTech Vaccine for 12-15-Year-Olds
CDC's Advisory Committee on Immunization Practices (ACIP) Supports
The Food and Drug Administration (FDA) on Monday approved Pfizer and BioNTech's request to allow their COVID-19 vaccine to be given to kids ages 12 to 15 on an emergency use basis. The Centers for Disease Control and Prevention's advisory committee voted on Wednesday to endorse the Pfizer-BioNtech vaccine for use in children as young as 12.

According to the Delaware Division of Public Health (DPH), based on the action of the FDA and on recommendation from the U.S. Department of Health and Human Services that individuals may be eligible for vaccination as soon as a vaccine is available to them under an Emergency Use Authorization, providers may administer the Pfizer-BioNTech vaccine for COVID-19 to those 12 and older immediately, or as soon as they are in a position to do so. DPH has created a website specifically for vaccinations for 12 to 15-year-olds at de.gov/youthvaccine
 
Read the EUA letter and fact sheets for providers and recipients/caregivers. FDA website:  Pfizer-BioNTech COVID-19 Vaccine | FDA.
CDC COCA Call About COVID-19 Vaccination of Adolescents
Find Out The Answers To Your Questions.
The Centers for Disease Control and Prevention (CDC) Clinician Outreach and Communication Activity (COCA) is presenting "What Clinicians Need to Know About Pfizer-BioNTech COVID-19 Vaccination of Adolescents" via zoom on Friday, May 14 from 2:00 - 3:00 p.m. ET. Registration is not required.

This call will give clinicians an overview of the Pfizer-BioNTech COVID-19 vaccination in adolescents who are 12 to 15 years of age. Clinicians will learn about the safety and efficacy of the vaccine, vaccine recommendations, and clinical guidance for using the vaccine in this age group. If you are unable to attend the live COCA call, the recording will be available for viewing on the COCA Call webpage a few hours after the live event ends. The slide deck will be available under "Call Materials" on the COCA Call webpage the day of the call.

For more information and to obtain instructions to join the call, please access the COCA Call webpage.
COVID-19 Vaccine Survey For Parents of 12 to 15-Year-Olds
DPH Wants to Hear From You
Are you the parent of a 12 to 15-year-old? The Delaware Division of Public Health (DPH) wants to hear from you! The FDA has expanded authorization of the Pfizer-BioNTech coronavirus vaccine for this age group, showing a high antibody response from the vaccine and 100% protection against the virus. DPH wants to gauge the willingness of parents to get their children vaccinated. The survey is anonymous and should take five minutes or less to complete. Click this link to begin:  https://s.alchemer.com/s3/29e2747e9e4b. The survey will be active through next Thursday, May 20. 
Highmark Announces Extension of Cost-Sharing Waiver For In-Network, In-Patient COVID-19 Hospital Care
Cost-Sharing Waived for COVID-19 Treatment Through End Of The Year
Patients who need in-network, inpatient hospital care for COVID-19 will not be required to pay deductibles, coinsurance, or copays through December 31, 2021. Highmark has also waived all in-network telehealth cost-sharing through June 30, 2021. Access to telehealth is still available after June 30th, however, patients will be responsible for any associated cost-sharing. Read more.
Updated Instructions For Business Contacts Entering Medical Facilities
Waiver No Longer Required For Entry
Effective April 21, 2021, hospitals and physician's offices are no longer required to request a waiver from the Division of Public Health to allow business contacts to enter these medical facilities. Business contacts, such as medical sales associates and non-essential deliveries, are permitted in medical facilities at the facility or office's discretion. Medical facilities are still required to follow all applicable restrictions under the COVID-19 State of Emergency Declaration. Read more.
DPH Opens New Standing Vaccination Clinics in Four Locations
Clinics Will Offer Pfizer Vaccine
The Delaware Division of Public Health (DPH) announced on Tuesday that it has opened four standalone COVID-19 vaccination clinics this week, serving as an option for vaccine distribution with or without an appointment, including those newly eligible 12 and older age group. Appointments can be made at these four new clinics, as well as at Public Health clinics located in state service centers, by calling 1-833-643-1715. Walk-in traffic is accepted as well. For a full list of DPH clinic sites, as well as other vaccination opportunities, visit de.gov/getmyvaccine. Read the press release and view a list of the new clinics and their locations across the state.
Delaware COVID-19 Vaccination "Waiting List" Ends
DPH Website to List Appointment and Walk-In Opportunities
The Delaware Division of Public Health (DPH) has announced it closed the COVID-19 vaccination waitlist to new sign-ups as of Friday, May 7th. The focus will now be on providing the public with information about available vaccination opportunities throughout the state. From January 20 to May 6 more than 200,000 individuals signed up on the wait list, which was used by the Office of Emergency Medical Services to coordinate the drive-through and other large vaccination events. Recent multiple communications of vaccination events to those remaining on the waitlist have resulted in few appointments being made, indicating that those remaining likely have been vaccinated elsewhere. DPH revamped the de.gov/getmyvaccine website to include appointment and walk-in information for pharmacies, medical providers, hospitals, FQHCs, public health clinics, and Curative clinics. Read more.
COVID-19 Resources At A Glance
Where To Go For Information For You and Your Patients
MSD has culled information for you to access to get the latest statistics, weekly updates, or information on vaccine administration and testing sites for you and your patients.

Delaware COVID-19 Statistics
For the latest Delaware COVID-19 statistics, visit the Division of Public Health My Healthy Community data portal. Information includes Delaware's key public health metrics on confirmed cases, total deaths, number of current hospitalizations, and new admissions, as well as testing and vaccination statistics. Updates to the site are usually completed early afternoon each day.

Top Questions of the Week
In order to keep our members current with the latest information, we are sharing the frequently asked questions the Division of Public Health and Governor Carney's office fielded this week along with important answers to those questions. Please share this information broadly with your patients and contacts. Read this week's vaccine questions.

Testing Sites
Flyers listing COVID-19 testing sites by county can be obtained from the Delaware Division of Public Health (DPH) "Weekly Pop-Up Testing Flyers" website to post or distribute to patients. Flyers are available in English, Spanish, and Haitian Creole languages. It still remains important to limit community spread. Visit de.gov/gettested to learn more and to sign up for free COVID-19 testing.

Where Can I Get My Vaccine?
As the Delaware Division of Public Health (DPH) has shifted away from holding larger drive-thru events for COVID-19 vaccine distribution, they have created a website (de.gov/getmyvaccine) to help navigate opportunities available to receive COVID-19 vaccine. The page includes appointment and walk-in information for pharmacies, medical providers, hospitals, Federally Qualified Health Centers, public health clinics, and Curative clinics.

DPH also established vaccine walk-in hours at five public health clinics. Flyers are available in both English and Spanish that display walk-in COVID-19 vaccination hours. Second dose appointments can be either scheduled or by walk-in.

The CDC also has a federally supported website (vaccines.gov) to assist in finding COVID-19 vaccine opportunities by zip code and vaccine type, as well as information about the vaccine. In addition to the website, people in the U.S. are also now able to utilize a text message service, available in both English and Spanish. People can text their zip code to 438829 (GETVAX) and 822862 (VACUNA) to find three locations nearby that have vaccines available. The vaccines.gov website is meant to complement the number of state and pharmacy websites that have been successfully connecting many Americans with vaccinations by providing a unified federal resource for Americans to use no matter where they are. In addition to the website and text messaging service, the National COVID-19 Vaccination Assistance Hotline is now available to help those who prefer to get information by phone on where to get a vaccine. To find the nearest location call 1-800-232-0233.

Vaccine Information Specific for 12 to 15-Year-Olds
The Delaware Division of Public Health has created a website with information specific to vaccinations for 12 to 15 year-olds. Please visit de.gov/youthvaccine.

COVID-19 Vaccines Are Free
The federal government is providing the COVID-19 vaccine free of charge to all people living in the United States, regardless of their immigration or health insurance status. The Delaware Division of Public Health (DPH) has developed a "Vaccines are Free" website page to understand what vaccination providers can and cannot do; answer questions about financial, ID, and insurance requirements for getting a vaccine, and each person's right to access the vaccine; where to report complaints (Office of the Inspector General); and resources for those who have concerns related to immigration barriers.
Upcoming MSD "Hot Topic CME" Event
The next MSD "Hot Topic CME" virtual event will be COVID-19 in the Pediatric Population with a Focus on Cardiac Manifestations taking place on Tuesday, June 22 from 6:30 - 7:30 p.m. Presenters include Deepika Thacker, MD and Neil G. Rellosa, MD. This virtual event has been approved for a maximum of 1 AMA PRA Category 1 Credit(TM). To register.
In the Spotlight
Delaware Health Information Network (DHIN)
MSD is pleased to highlight another of its 2021 Premier Educational Partners, the Delaware Health Information Network (DHIN). DHIN was the first live, statewide health information exchange in the nation. Launched in 2007, today it serves all of Delaware's acute care hospitals and nearly 100% of the state's medical providers. More than 14 million clinical results and reports are delivered through DHIN each year. There are over three million unique patients with results on DHIN, including patients from all 50 states. DHIN shares real-time clinical information to improve patient outcomes, eliminate the duplication of services and reduce the cost of healthcare. For more information about DHIN, visit https://dhin.org/ and connect on Facebook, LinkedIn, Twitter and Instagram (@DHIN_hie).  
In Memoriam
Marvin V. Andersen, MD
It is with sadness that we share MSD member Marvin V. Andersen, MD passed away on April 28, 2021, from complications of pancreatic cancer.

Dr. Andersen dedicated his life to the service of others. Specializing in obstetrics and gynecology, he practiced medicine for more than 40 years and delivered thousands and children before retiring. He was active in the Rotary Club of Wilmington and also formed a CSA (Community-Supported Agriculture) with his wife Kathryn and their children on Charlestown Farm in Phoenixville, PA. The CSA has become a mainstay of the community, providing sustainably grown produce for 170 families each year. Dr. Andersen also served as the chair of the MSD Physician Emeritus Section from 2015-2016.

Dr. Andersen is survived by his wife, Kathryn, and their four children. Relatives and friends are invited to celebrate the life of Dr. Andersen at Charlestown Farm on Saturday, May 22nd at 1 p.m. Read the obituary.
Stanley Verbit, MD
We also recognize the loss of MSD member Stanley Verbit, MD who passed away on May 4, 2021, at the age of 97. Dr. Verbit was an Internal Medicine physician and has been a life-long MSD member since 1957.
"Rerum Cognoscere"
The Latin phrase Rerum Cognoscere translates to learn, examine, or become aware of facts or things. In this section we highlight measurable items of interest in health care from MSD, Delaware, the US, and the world.
60%
Percentage of adults targeted to be fully vaccinated against coronavirus by July 4th.
Biden Administration
20%
Approximate percentage of physicians failing to find a fellowship match.
4%
Percent drop in the U.S. birth rate last year compared to 2019.
Upcoming Events
May 18 - Delaware Division of Public Health, Office of Primary Care, "2021 Primary Care Provider Recruitment Conference," 9:00 a.m. - 2:30 p.m., virtual event.
May 19 - Delaware BioScience Association, "Innovating Bioscience to Improve Patient Lives," 8:30 a.m., virtual event.
May 26 - Quality Insights webinar, "A Low Pressure Approach to Controlling High Blood Pressure," 12:00 - 1:00 p.m.
May 27 - MSD Practice Management & Education Session presented by SecureNetMD and MSDIS/USI, "Cyber Security," 12:00 - 1:00 p.m., virtual event.
June 15-19 - 43rd Annual Eastern Shore Medical Symposium, virtual event.
June 17, 18, 24 & 25 - Certified Medical Office Manager (CMOM) Course and Exam, virtual event.
June 22 - MSD Hot Topic, COVID-19 in the Pediatric Population with a Focus on Cardiac Manifestations, 6:30 - 7:30 p.m., virtual event.
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