Based on concerns over COVID-19, on Aug. 30, 2020, the BOT called to convene a Special Meeting of the AMA House of Delegates (HOD) on Nov. 13-17, 2020. The purpose of this meeting as defined by the request of the BOT is to conduct priority and urgent business of the Association. This Special Meeting will be convened on a virtual platform. The HOD speakers' have provided updates on this decision as the meeting time approaches.

Online Forums: Reports/Resolutions & Testimony

Members are urged to post comments on all HOD business in the online forums. Comments will be given the same weight as testimony in virtual hearings.


We are pleased to let you know that the business from November’s Special Meeting of the House of Delegates has been posted in preliminary form on the Proceedings page and can be accessed at the following address:

https://www.ama-assn.org/house-delegates/special-meeting/proceedings-november-2020-special-meeting-house-delegates

Please note that the Proceedings are subject to change based on review of the transcript and related files. Should you have corrections or questions, contact [email protected] or reach us at the HOD address below. These files will be updated over the next several weeks as actions are incorporated into PolicyFinder.

The following observations from the November Special Meeting may be of interest: 

  1. As many as 1516 people viewed the meeting on Zoom. That figure includes voting delegates, alternate delegates, AMA trustees, other members, and staff from across the Federation.
  2. Even with the prioritization process, the business sessions of the House took nearly twice as long as a typical interim and as long as a typical annual meeting, 13.5 hours. This does not include the reference committee hearings, which, despite limited agendas, actually required relatively more time than at an in-person meeting.

We are most appreciative of the comments we have received regarding the meeting, and we welcome additional comments. While we do not know what format June’s meeting will take—and we certainly hope to meet in person—suggestions for that meeting are welcome, particularly if you believe the virtual format can be improved or simplified.

2021 Annual Meeting

Finally, June’s meeting, the 2021 Annual Meeting, is scheduled for June 12-17. The meeting will be held on those dates, irrespective of the meeting format. We ask that you keep your schedules open on these days, but do not schedule any flights or hotel accommodations at this point. If the meeting is held virtually, we will probably convene the House on Friday evening, June 11. We simply cannot say definitively at this point whether we will be able to meet in person. Illinois and Chicago regulations are outside our control, for example, as are the status of the pandemic and vaccinations. Please be patient, and know that we will keep you apprised of plans as they develop.

We wish all a safe and happy holiday season! 

--
Responses should be directed to [email protected]

Our November Special Meeting is rapidly approaching. As we continue our best efforts to keep you informed, please read carefully the information below.

Handbook addendum posted

The handbook addendum which includes one report from your Board of Trustees and four resolutions has been posted on the meeting website. In addition, the combined handbook which incorporates the previous reports and resolutions and the addendum is also available. NEW FOR THIS MEETING, as requested by multiple delegates, is a downloadable handbook Google sheet, which includes all of the recommendations of reports and resolved clauses of resolutions and can be utilized by delegations,

Note that business in the addendum has not been reviewed by the Resolution Committee, which will provide its final recommendations Nov. 10. Comments as to the urgency/priority on these and previously posted resolutions are welcomed by the Resolution Committee.

Online forum

We continue to encourage everyone to post comments in the Online Forum, but as of this date few people have done so. Our observations of other online meetings indicate that live testimony during a virtual meeting, even on the best platform, is awkward and significantly more time consuming. This is true both for reference committee hearings and for the actual policy making sessions. We remind you that reference committees will incorporate testimony from the Online Forum as well as the live hearings into their recommendations. In addition, there is no limit to the testimony you can place in the Forum; however, verbal testimony WILL be limited to 2 minutes per comment.

If you are delaying your comments with the intention of testifying during the live hearings on Saturday and Sunday Nov. 14-15, please reconsider. Submitting your comments in the Online Forum now will greatly increase the efficiency of the meeting.

Congratulations

Several sharp-eyed members of the House have noticed that the date at the bottom of page 1 of the printed version of the Speakers’ Letter is not correct. If perchance you glossed over the page, note that business sessions of the House will convene at 1 pm on Monday, Nov. 16 and 9 am on Tuesday, Nov. 17 (Central Time).

Our congratulations to those who noticed the incompatible day–date combinations. One might wonder whether they have found anything lurking in later pages.

Instructional material and training sessions

An information sheet and a video tutorial will be posted on the AMA website in the near future. We will notify you when they are available and encourage you to review them prior to the meeting and prior to the practice sessions. We encourage you to review again the information contained in the Speakers’ Letter.

In addition, as noted earlier this week, we will be offering training sessions on the evenings of Wednesday, Nov. 11 and Thursday, Nov. 12. Both sessions will begin at 7 pm Central Time. The URLs for the training sessions will be provided in a subsequent email.

Recommended devices for participation 

For those who intend to speak during reference committee or the HOD or to vote

You will need a computer with very good WiFi or if possible, an ethernet connection, that has the Zoom app downloaded, and with a microphone and a camera (if you want to be seen). We suggest using a headset with a microphone for best clarity. We strongly recommend using Chrome for Lumi.

You can use a single computer or monitor with both Lumi and Zoom in two windows either split on the screen or toggling back and forth. Another option is to have two devices. If you choose this option, we recommend Lumi be on the smaller device. In addition, you will want a method to communicate with your alternate and others in your delegation (text, call, email, groupme, etc.) on a different device from Zoom.

As a reminder, you will want to be able to review meeting materials such as the handbook and reference committee reports during the meeting. This can be accomplished with another device such as a tablet or  another laptop. Others may find it simpler to print out the necessary material on hard copy. 

For guests and those that do not intend to speak or vote:

You will only need a single device to watch the proceedings via Zoom. Again, we recommend downloading the app for this.

Meeting URLs

While listening to the Opening Session of the HOD on Friday night only requires login to Zoom, to fully participate in the reference committee hearings and HOD sessions, it will be necessary to join both Lumi and Zoom. We will be providing the necessary meeting URLs for Lumi and Zoom in the near future. Please watch your email. Be aware that each reference committee and the HOD will have unique login addresses. 

Your Speakers thank you in advance for your diligence in carefully reviewing this and previous communications. Your attention to detail will hopefully facilitate the success of this Special Meeting.

Nervously yours,

Bruce and Lisa

--
Responses should be directed to [email protected]

We are pleased to provide the following information on reference committees, practice sessions, the Resolution Committee’s initial recommendations on business for November’s Special Meeting of the House of Delegates, and a reminder about delegate logins.

Reference Committee schedule

Though potentially subject to change, we have established this tentative reference committee schedule:

  1. Saturday, first session (noon to 3 pm) – Amendments to Constitution & Bylaws and Reference Committee D
  2. Saturday, second session (3:30 to 6:30 pm) – Reference Committees A and B
  3. Sunday, first session (9 am to noon) – Reference Committees E and G
  4. Sunday, second session (12:30 to 3:30 pm) – Reference Committees C and F

Again, all times are Central Standard Time (Chicago).

Special Meeting practice sessions

We are currently making arrangements for practice sessions on Wednesday and Thursday evenings, Nov. 11 and 12. Details are being worked out, although  both sessions will be scheduled in the evening, not earlier than 7 p.m. in Chicago (or 5 p.m. Pacific Time). All are encouraged to hold one or the other of those evenings open. We hope that these sessions will make for an efficient and smoothly running meeting. Parliamentary procedure makes the proceedings more complicated than the typical Zoom (or similar) meetings to which we have all become accustomed.

Preliminary Resolution Committee recommendations

The Resolution Committee met October 25 to consider resolutions that appear in the initial handbook. The Committee has determined that the following items (the list is also attached) have met the criteria for urgency/priority. While you are encouraged to submit comments in the online forum regarding the merits of the proposal, further comment regarding the urgency and priority of these items is not necessary. They will be considered in November.

  • 005 - Racism as a Public Health Threat
  • 007 - Access to Confidential Health Care Services for Physicians and Trainee
  • 008 - Delegate Apportionment During COVID-19 Pandemic Crisis
  • 010 - Racial Essentialism in Medicine
  • 011 - Elimination of Race as a Proxy for Ancestry, Genetics, and Biology in Medical Education, Research and Clinical Practice
  • 101 - End of Life Care Payment
  • 105 - Access to Medication
  • 202 - Cares Act Equity and Loan Forgiveness in the Medicare Accelerated Payment Program
  • 203 - COVID-19 Emergency and Expanded Telemedicine Regulations
  • 205 - Telehealth Post SARS-COV-2
  • 206 - Strengthening the Accountability of Health Care Reviewers
  • 211 - Creating a Congressionally- Mandated Bipartisan Commission to Examine the U.S. Preparations for and Response to the COVID-19 Pandemic to Inform Future Efforts
  • 212 - Copay Accumulator Policies
  • 213 - Pharmacies to Inform Physicians When Lower Cost Medication Options are on Formulary
  • 307 - USMLE Step Examination Failures During the Covid-19 Pandemic
  • 404 - Early Vaccination for Correctional Workers and Incarcerated Persons
  • 406 - Face Masking in Hospitals During Flu Season
  • 508 - Home Infusion of Hazardous Drugs
  • 602 - Towards Diversity and Inclusion: A Global Nondiscrimination Policy Statement and Benchmark for our AMA
  • 710 - A Resolution to Amend the AMA's Physician and Medical Staff Bill of Rights
  • 712 - Increase Insurance Company Hours for Prior Authorization for Inpatient Issues

No decision has been reached for the remaining resolutions, and no inference should be made regarding their eventual status. However, the Committee would welcome and indeed urges delegates, alternate delegates and other AMA members to comment on the urgency and priority of the remaining items of business. Likewise the Committee encourages you to comment on the urgency and priority of the resolutions that will be included in the handbook addendum and posted later in the forum. The Committee intends to monitor the forum specifically for such comments.

Delegate login codes and meeting URLs

We recently sent the Speakers’ Letter by U.S. mail (i.e., a paper copy) as well as by email. Delegates whose credentials had been confirmed by the time of the mailing should have received with their printed copy of the Speakers’ Letter a yellow sheet of paper with their login code for the upcoming Special Meeting. As noted in the Speakers’ Letter, delegates must share their code with their alternate delegate if they wish to allow the alternate delegate to vote or speak during House business sessions, so no code was sent to alternate delegates.

Delegates will also  be sent their login code by email at least twice before the meeting. The URLs for House business sessions and each reference committee will also be sent via this group communication or posted on the meeting website.
Responses should be directed to [email protected]

As we approach the 6-week mark before our upcoming Special Meeting, your speakers wanted to update the HOD on several items:

Business: At an in-person Interim meeting, we deal with about 150 items of business. Given the constraints inherent in a virtual meeting, your speakers do not believe that we will be able to handle this volume at the upcoming Special Meeting of the HOD and have asked that all delegates and delegations submit only those items that are urgent and of the highest priority. This request is also consistent with the expressed purpose of the Special Meeting which has been called to conduct priority and urgent business of the Association.” We note that your Board and Councils have all completed a prioritization process and are holding half or more of their reports for later submission. In addition, some delegations have taken this request to heart submitting only 1 or 2 resolutions, but we have also heard that other delegations are considering submitting as many as 20 resolutions. Therefore, your speakers are again requesting that you review the resolutions you are considering submitting for their urgency and priority to our AMA.

Prioritization Process: By necessity a prioritization process has been developed to identify which resolutions will be considered at this Special Meeting. A Resolution Committee, similar to the resolution committee that is convened to determine which resolutions meet the criteria for consideration at our Interim Meetings, will make recommendations with final determination of the business of the House to be decided by the HOD.

Resolution Committee: A committee with members from diverse geographic regions, specialties, modes of practice and career stage representative of the HOD has been appointed and is charged with reviewing all submissions for their urgency and priority. To encourage fairness and objectivity in the review process the members of the committee have been asked to remain anonymous and the items sent to them for review will be de-identified. The committee has adopted the attached Prioritization Matrix to score all submissions and the prioritization process is further detailed below.

To assist delegations in determining if their resolutions meet the defined purpose of urgency and priority, the Prioritization Matrix to be used by the Resolution Committee is attached.

For those submitting resolutions, we remind you of the opportunity to include a statement (250 words max) delineating why your resolution meets the threshold for urgency/priority for this meeting. If submitted, your statement will be shared with the Resolution Committee to aid in their deliberation. Your speakers are aware that some delegations are compelled by their society’s rules to submit resolutions that are adopted by their assemblies even though some or all of these resolutions may not be considered urgent or priority by the society’s AMA Delegation. In these instances, it would be appropriate for the submission to include a statement from the delegation noting that they believe the resolution does not meet the urgency/priority threshold for this meeting. In addition, if you have already submitted one or more resolutions that upon reviewing the Prioritization Matrix you now recognize are not urgent or priority, you may email the HOD office to withdraw the resolution to be held for resubmission at a later date.

The Committee will complete an initial review of resolutions in late October which will be posted on the Online Forum. Once identified as meeting the threshold for urgency/priority, no further comments need be made regarding urgency/priority as the item will be considered as business of the Special Meeting. Any delegate may post comments in the Online Forum regarding those items identified as not meeting the threshold for urgency/priority. All comments posted will be reviewed by the committee. Another review, including consideration of any new resolutions submitted between their initial review and the resolution submission deadline (November 8), will be completed on November 9. Those resolutions not meeting the threshold for urgency/priority will be posted on the committee’s report on November 10.

Extractions of Resolutions: Those resolutions identified as not meeting the threshold of urgency/priority on the Resolution Committee’s report may be extracted by any delegate beginning once the report is posted. This can be accomplished by emailing the speakers to request extraction. This request should be accompanied by a statement (150 word max) presenting testimony regarding the resolution’s urgency or priority. Extractions may be submitted until Friday, November 13 at 9 pm CT and ONLY via email. There will be no other opportunity to extract after this deadline. Once extracted, the item will be clearly marked as such on the Resolution Committee’s report and on the Online Forum. Further arguments can be presented on the Online Forum, but only the first extraction statement received will be presented to the HOD at the second opening session of the HOD on Saturday, November 14. In addition, a brief statement from the Resolution Committee will be included with the 150 word statement from the extractor. All resolutions identified by the Resolution Committee as urgent/priority will be considered and thus not subject to extraction. The Committee’s report will be considered as a consent calendar. Once the remainder of the report is accepted, each extracted item will be put to a vote to either sustain the recommendation of the reference committee or to overrule their recommendation, without further debate. All items that are deemed by the HOD to meet the urgency/priority threshold will be accepted as business of the Special Meeting.

Items Recommended for Reaffirmation: Items that are identified to be reaffirmation of existing policy will be considered by the resolutions committee to not meet the threshold of urgency/priority. There will not be a separate reaffirmation consent calendar at this Special Meeting.

Informational Reports: Your board and councils may present informational reports to this Special Meeting. Any informational report may be extracted for debate in the same fashion as items to be extracted from the Resolution Committee report, i.e. by email to the speakers. This extraction statement should include the intended action items to be added and the urgency/priority of such action items.

Online Forums: As with the June Special Meeting, the Online Forums will again be utilized for testimony prior to this Special Meeting. Resolutions and the author’s statement of urgency/priority, if received, will be posted as they are received and will be clearly identified as not having been through the prioritization process. All members are encouraged to provide testimony and to offer suggestions for amendments as has been done in the past. In addition, comments regarding the urgency/priority of the resolution may also be posted and will be reviewed by the Resolution Committee. Your speakers would like to urge all delegates and delegations to take advantage of these forums. Robust testimony on the forums will greatly ease the work of the virtual reference committees.

Reference Committees: Your speakers have decided that the most appropriate slate of reference committees for this Special Meeting is to use those typically convened for an annual meeting. Thus, we plan to use the following reference committees:

Constitution & Bylaws

A: Medical Service

B: Legislation

C: Medical Education

D: Public Health

E: Science & Technology

F: Finance

G: Medical Practice

As per the tentative agenda included with the Call for the November Special Meeting, reference committees will be convened following the conclusion of the second Opening Session of the House on Saturday, November 14 and will conclude on Sunday, November 15. The reference committees will then convene in executive session to deliberate and present their final reports for action of the HOD beginning on Monday, November 16 at 1 pm CT. Reference committee reports will be available online as early as possible for review by delegations on Monday morning.

Your speakers will be appointing members of these reference committees (excluding F, which has been appointed previously) in the upcoming weeks. As a reminder, if you are interested in serving on one of them please fill out and submit the interest form found on the Speaker's Page by Friday, October 2 and return it by email to [email protected] as instructed.

You are reminded that the Call to the Special Meeting (copy attached) included important information that you may want to review again. This is posted on the Speaker's Page.

Thank you for your ongoing understanding and flexibility as your speakers continue to develop a process that will allow the robust debate and policy development that is the hallmark of our AMA.

Bruce and Lisa

The Special Meeting of the AMA House of Delegates will be held virtually Nov. 13-17, 2020.

The agenda and other meeting materials will be posted as they become available.

Official call for meeting

Pursuant to the action of the American Medical Association (AMA) Board of Trustees (BOT) on August 30, 2020, this notice will serve as the official call to convene a Special Meeting of the AMA House of Delegates (HOD) on November 13-17, 2020. The purpose of this meeting as defined by the request of the BOT is to conduct priority and urgent business of the Association. This Special Meeting will be convened on a virtual platform with the Opening Session to commence at 7 pm CT, Friday, Nov. 13.

We encourage you to read this entire message carefully and save it for future reference as it includes important information and dates. These are the details that are known at this time. We will share more details as they are developed.

Your speakers recognize the challenges that physicians and their practices are facing during this pandemic. We have thus created a schedule that is confined to the previously scheduled meeting days to the extent possible. The total number of hours needed to conduct our business will be dependent upon the volume of business submitted and accepted for consideration.

Please check the Pictorial Directory to assure that we have correct email addresses for you. It is essential that we have correct email addresses for ALL members of the HOD including alternate delegates and any other involved individuals. While this document is being sent electronically and by postal mail, delivery delays and the need to expedite communication as we approach the upcoming meeting require that we can communicate with you electronically. Accordingly, we strongly suggest that chairs and/or staff confirm that all members of their delegation have received this communication electronically. In some cases it may have been sent to “spam” or been removed by a security filter. If a member of your delegation needs to correct or update their email address, please contact the HOD office at [email protected] as soon as possible.

All delegates and delegations are reminded that only urgent or priority items of business will be considered at this Special Meeting. Our councils and the board have already responded favorably to this request. In fact, the BOT has decided to hold half of their reports for later consideration.

Urgency may be thought of as requiring action before the 2021 Annual Meeting; taking no action before that time would have some detrimental effect. Priority is a bit more nebulous and weighs both the subject matter and the recommended actions. For example, a high priority topic that recommends a study, monitoring a situation, or reaffirmation of current policy is likely not a priority resolution, while a resolution on a priority topic that calls for some specific, near-term action or fills a policy void may be considered a priority resolution. Priority might also be determined by the relationship to our strategic arcs as well as the number of physicians or their patients affected. More details on determining urgency and priority will be shared in subsequent communication.

A Resolution Committee, similar to our regular interim meetings, will be convened to review all submitted resolutions for urgency and priority. As promised, the typical interim meeting focus on advocacy will not be applied at this Special Meeting and all resolutions will be measured equally. Also similar to interim meetings, the Resolution Committee recommendations for this Special Meeting will be presented for consideration and the final decision of what becomes the business of the House will be determined by the HOD.

To facilitate the work of the Resolutions Committee, delegates submitting resolutions are encouraged to submit a statement of urgency and/or priority. This statement should not exceed 250 words. A concern has been expressed that alternate delegates had limited access during the June Special Meeting. Be assured that arrangements are being made for alternate delegates to be able to fully engage in all sessions of the HOD including reference committees. As in our in-person meetings, the delegate and their alternate will share a single vote, and alternates will only be allowed the privilege of the floor when they are “seated” for their delegate. Accordingly, all delegates are reminded to establish a method to communicate with their alternate in real time during the meeting that is separate from the device that they will use to join the meeting.

Your speakers are sensitive to the fact that our schedule begins after sundown on Friday November 13 and continues through Sunday. The Friday evening Opening Session will not require any votes of the House, and the session will be recorded in order to make it available to be viewed at a different time. The Second Session of the HOD will be held on Saturday morning and will include voting on the rules and the Resolution Committee report; delegates with religious concerns may wish to coordinate with their alternate delegates for this portion. Saturday and Sunday will also include reference committees where attendance is optional, and individuals are reminded of the opportunity to present testimony in the open forum which will be active for several weeks. If further accommodations are needed please contact us at [email protected]

Rules and credentials and reference committees

In response to multiple requests from members of the House, it is our intent to hold “live” virtual reference committees for this Special Meeting. To facilitate robust discussion of ALL items of business on our Online Forums prior to the live reference committee hearings, we have moved the final deadline for resolution submission a week earlier. At this time we have not determined how many reference committees will be needed. This will be dependent on how many items of business will be considered. We hope to limit the number of items in each reference committee so that the hearings will be more easily managed in the virtual setting.

Given the unique nature of our virtual meeting, your speakers are seeking volunteers who are comfortable working via the Zoom platform. We ask that all who are interested in serving on one of the Reference Committees or the Rules & Credentials Committee submit a “November 2020 Reference Committee Volunteer Form” which is included with this call or can be downloaded from The Speaker's Page on the AMA site. Note that due to the unique nature of this meeting and the need for multiple volunteers comfortable with a virtual meeting format, our usual embargo on those who have served in the recent past will not be observed.

Resolutions committee volunteers

A Resolutions Committee will be convened for this Special Meeting and charged with determining if resolutions submitted are urgent or a priority. The details for this committee’s responsibilities, including when and how often it will meet, have not been finalized. Any Delegate or Alternate Delegate interested in serving on this committee is asked to indicate their interest by email to the speakers at [email protected]

While we are saddened by yet another meeting going by without seeing all of you in person, your speakers are looking forward to an opportunity to interact with you virtually in a more robust fashion than at our June Special Meeting. Again, as noted above, please take the time to confirm that we have valid email addresses for all Delegates, Alternates and other participants of our HOD. Please watch for further communication from us as more details become available.

We look forward to “seeing” you in November.

Static Up
76
Featured Stories