Vermont

State law or statute prohibits or limits the use of prior authorization for buprenorphine containing products by either the state Medicaid plan or private insurance companies.

A health insurance plan shall not require prior authorization for prescription drugs for a patient who is receiving medication-assisted treatment if the dosage prescribed is within the U.S. FDA’s dosing recommendations. VT. STAT. ANN. tit. 18, § 4754

Vermont credentials two types of addiction counselors. An Alcohol and Drug Counselor requires a bachelor’s degree, 270 hours of relevant education courses and 4,000 hours of supervised experience. A Licensed Alcohol and Drug Counselor requires a master’s degree, completion of relevant education courses and 2,000 hours of supervised experience. 26 Vt. Stat. Ann. §3236 and Vermont Alcohol and Drug Certification Board

Clinical mental health counselors diagnose and treat mental conditions or psychiatric disabilities and emotional disorders. Counselors use psychoeducational techniques aimed at the prevention of such conditions or disabilities and provide consultations to individuals, couples, families, groups, organizations and communities. 26 V.S.A. §3261

There are currently no statutory or regulatory standards for the certification of peer support service providers.

Transition to independent practice and prescriptive period required.

Before full independent practice and prescriptive authority, APRNs (includes NMs) with fewer than 2,400 hours and two years of nursing practice must be in a collaborative practice agreement with a physician. Vt. Stat. Ann. §26-28-1613

NMs may prescribe medical, therapeutic, or corrective measures under administrative rules adopted by the board. Vt. Stat. Ann. §26.1572

Transition to independent practice and prescriptive period required.

Before full independent practice and prescriptive authority, NPs with fewer than 2,400 hours and 2 years of nursing practice must be in a collaborative practice agreement with a physician. Vt. Stat. Ann. §26-28-1613

NPs may prescribe medical, therapeutic, or corrective measures under administrative rules adopted by the Board. Vt. Stat. Ann. §26.1572

NPs are authorized to sign clinician orders for life-sustaining treatment forms. Vt. Stat. Ann. tit. 18 §9708

NPs are recognized in state policy as primary care providers. NPs providing primary care may be primary care providers of record. Vt. Board of Nursing Rules §8.5(a)

Optometrists may examine, diagnose and treat abnormalities of the eye, including foreign body removal. Vt. Stat. Ann. §28-1703

Optometrists are limited to the treatment of anaphylaxis only. Vt. Stat. Ann. §28-1703

Optometrists may prescribe Schedule III-V controlled substances. Vt. Stat. Ann. §28-1728

A dental hygienist may provide services in a school or institution under a general supervision agreement with a dentist. The physical presence of the dentist is not required at the practice site of the dental hygienist, but the agreement stipulates that the dentist must review all patient records. The dental hygienist must have three years licensed clinical practice experience. Vermont Board of Dental Examiners Rules 10.2

Dental therapists must practice under the general supervision of a dentist. May prescribe drugs and Schedule V controlled substances. A collaborative agreement is required and must outline practice settings, limitations on services, protocols for prescribing medications, among other items. Vt. Stat. Ann. §26-12 Subchapter 3A

Vermont does not explicitly allow for the practice of teledentistry.

Vermont has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act does allow pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

Vermont does not allow pharmacists to modify prescriptions.

A pharmacist may prescribe and dispense self-administered hormonal contraceptives in a manner consistent with a valid State protocol approved by the Commissioner of Health, after consultation with the Director of Professional Regulation and the Board of Pharmacy (BOP). The pharmacist must have training and education in that area that is sufficient to perform the duties involved and document prescribing, including notifying the patient’s primary care provider within 5 business days. 26 V.S.A. § 2023

A pharmacist may prescribe and dispense tobacco cessation products, approved by the Food and Drug Administration (FDA), in a manner consistent with a valid State protocol approved by the Commissioner of Health, after consultation with the Director of Professional Regulation and the Board of Pharmacy (BOP). The pharmacist must have training and education in that area that is sufficient to perform the duties involved and document prescribing, including notifying the patient’s primary care provider within 5 business days. 26 V.S.A. § 2023

Collaboration allowed with a physician for practice and prescriptive authority.

A PA shall engage in practice as a PA in this state only if the PA has entered into a written practice agreement. A practice agreement shall include all of the following: (1) Processes for physician communication, availability, decision-making, and periodic joint evaluation of services delivered when providing medical care to a patient. (2) An agreement that the physician assistant’s scope of practice shall be limited to medical care that is within the PA’s education, training and experience. Specific restrictions, if any, on the PA’s practice shall be listed. (3) A plan to have a physician available for consultation at all times when the PA is practicing medicine. (4) The signatures of the PA and the participating physician; no other signatures shall be required.

A PA may prescribe, dispense, administer and procure drugs and medical devices to the same extent as may a physician. A PA who prescribes controlled substances shall be registered with the federal Drug Enforcement Administration. VT. STAT. ANN. tit. 26 § 1735a

Vermont does not currently have any provisions related to the number of PAs a physician can supervise or collaborate with.

Vermont does not currently have any provisions related to chart review or chart co-signatures.

Statute allows adaptable proximity.

A practice agreement may specify the extent of the collaboration required between the PA and physicians and other health care professionals; provided, however, that a physician shall be accessible for consultation by telephone or electronic means at all times when a PA is practicing. VT. STAT. ANN. tit. 26 § 1735a

The delegation agreement must identify the PA’s scope of practice and that the delegation of medical care is appropriate to the PA’s level of competence. All medical care must be delegated by the supervising physician. Vt. Stat. Ann. tit. 26, §1735a