CHAD Connection May 19, 2022

June is just around the corner, and with that comes lesbian, gay, bisexual, transgender, and queer (LGBTQ) Pride Month. Across the nation, celebrations include pride parades, picnics, and other events which bring visibility and celebration to LGBTQ communities, who often face societal stigma and discrimination. Here in the Dakotas, multiple pride festivities are planned. Most are in June, with a couple of cities moving to July or August.

According to Healthy People, "Research suggests that LGBT individuals face health disparities linked to societal stigma, discrimination, and denial of their civil and human rights." Efforts to create a welcoming and trustworthy environment are important in addressing these disparities. According to the 2015 US Trans Survey, 23% of respondents did not see a doctor when they needed to because they feared being mistreated. The Youth Risk Behavior Survey also found that 61.6% of queer youth seriously consider suicide, and 84.6% don’t turn to adults when feeling sad, empty, hopeless, anxious, or angry.

Appropriately asking about and being supportive of a patient’s sexual orientation and gender identity (SOGI) is one step shown to enhance the patient-provider interaction and use of care. SOGI is a required Uniform Data System (UDS) demographic, and this Guide for Collecting Data on Sexual Orientation & Gender Identity is a helpful resource.

Looking for other ways to get involved in LGBTQ Pride month? Here are some ideas:

Staff education:
Consider playing a short video during a staff meeting in June or sending out an email to all staff celebrating Pride Month and sharing links to online modules. Here are a few resources:

Create an inclusive workplace environment:
Work towards building a culture of affirmation and inclusion for LGBTQ staff and patients alike. This guide has some helpful tips for organizations.

Engage with the community - host a booth, walk in a parade, or attend an event:

South Dakota Pride Events

Aberdeen Area Pride Festival

June 11

Brookings Pride

June 11

Sioux Falls Pride

June 18
REGISTER

Black Hills Pride

July 7 – 10
Vendor Application

North Dakota Pride Events:

Bismarck Pride

June 17 – 19
Capitol Pride Vendor Booth Registration

Turtle Mountain Two-Spirit Pride

June 18
Hosted by Turtle Mountain Two-Spirit Society

Minot Pride

July 8 – 10
Vendor Registration

Fargo-Moorhead Pride

August 11 – 14
Pride in the Park Vendor Registration
Pride Parade Registration

Looking to learn more? The National LGBT Health Education Center provides educational programs, resources, and consultation to health care organizations with the goal of optimizing quality, cost-effective health care for lesbian, gay, bisexual, transgender, queer, intersex, asexual, and all sexual and gender minority (LGBTQIA+) people.

Chastity Dolbec, RN, director of patient care & innovation at Coal Country Community Health Center (CCCHC), has been recognized as a 2022 Caravan Health ACO Champion of the Year. The Population Health Pioneer Award was presented by Caravan Health, part of Signify Health. The award is given to individuals who have demonstrated exemplary work while serving their patients, community, and the health care industry. The criterion for this honor is based on demonstrated overall ACO leadership while improving the quality of patient care and reducing costs. Dolbec not only met but more than exceeded these standards.

Caravan Health selected two population health champions, including Dolbec, who incorporated innovative approaches through leadership, dedication, and innovation while mitigating challenges during the COVID-19 pandemic. Dolbec has played an integral role in helping CCCHC and Sakakawea Medical Center (SMC) demonstrate a commitment to diversity, equity, and inclusion while working to improve patient care outcomes.

"I am honored to receive the ACO Champion of the Year award and to be recognized for my efforts. Our collective teams have implemented best practice methods that have helped to engage our patients and improve upon their care. On behalf of CCCHC, SMC, and my colleagues who have worked with me, I am excited to accept this award and to be included among other leaders and peers who are dedicated to patient-centered care," said Dolbec.

The COVID-19 Omicron variant continues to mutate and cause an increase in infections and unreported cases in the United States. New data can be found here. Dr. Katelyn Jetalina writes in "What now? How pandemics end" how other pandemics have come to an end and how people can prepare, strengthen existing tools, and use them wisely during the hopeful shift to an endemic.

Antivirals and treatments for COVID-19 are now widely available and can be accessed with a provider prescription at pharmacies nationwide and at Test to Treat locations. The South Dakota Department of Health (SDDOH) reports that the Test to Treat approach is currently working well in long-term care facilities. It is currently looking at other entities to provide a "one-stop-shop" where patients may be tested and treated on location. The SDDOH is working to develop options for onboarding other groups in this effort, such as Walmart, Sam’s Club, and CVS, to help with the use and benefits of COVID-19 therapeutics. Information and details on available COVID-19 treatments can be found here.

Along with therapeutics, many test kits continue to be available for order and use at no cost. A third round of test kits is available for order from USPS by accessing this website. Both the North Dakota State Health Department and SDDOH plan to make test kits available for schools, long-term care, childcare, and summer programs. They recommend both traditional and non-traditional testing partners remain vigilant throughout the summer in preparation for the ’22-23 academic year.

Vaccines continue to be the best protection against hospitalization from COVID-19. Next month, the US Food and Drug Administration (FDA) plans to review data on COVID-19 vaccines for children ages six months through four years. If a vaccine is authorized by the FDA and recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP), it will be made available for ordering through the Health Resources and Services Administration’s (HRSA’s) Health Center COVID-19 Vaccine Program and should be administered according to related requirements and recommendations. For helpful information and tips for COVID-19 pediatric vaccination, including resources, readiness reminders, and guidance, please visit the HRSA action checklist for children ages 6 Months - 4 Years.

The HRSA Health Center COVID-19 N95 Mask Program has been extended and will now accept orders through Monday, June 20. Health centers will have three additional opportunities to order masks through this program: Monday, May 23; Monday, June 6; and Monday, June 20.

HRSA encourages health centers to work with community partners (including community and faith-based organizations, HUD-assisted housing, and aging and disability networks) to order and distribute masks to meet community needs. HRSA increased ordering caps to support larger orders and allow for health centers with available space to order masks to store for upcoming months. All orders must be received by Monday, June 20.

COVID-19 Response Programs Office Hours
While these sessions are geared toward participants in COVID-19 response programs, any HRSA-supported health center is welcome to attend. One-hour sessions are 12:00 pm CT/ 11:00 am MT. Register one time and access all office hour sessions until February 2023.

Additional Resources

Both medical and behavioral health providers working in primary care are tasked with helping patients engage in behavior changes to improve patients’ overall health. However, this can be especially difficult due to many factors, including time constraints and complex interplays between medical and psychosocial contexts, making it particularly difficult for patients to create and sustain changes to their behavior.

Join CHAD for a primary care behavioral health series that centers on how you can make your clinical work more compassionate and contextual. Drs. Bridget Beachy and David Bauman, licensed psychologists and co-principals at Beachy Bauman Consulting, have extensive experience delivering integrated care and training providers, nurses, and medical teams about integrating behavioral health care and principles into medical visits.

In the first session, attendees will learn how to gather a patient’s context effectively via the contextual interview. In subsequent sessions, presenters will discuss how a contextual approach can support diabetes, depression, smoking cessation, anxiety, and substance use improvements. This series is intended for providers working in primary care looking to make their clinical work more compassionate and contextual, allowing for a deeper connection in honoring the patients’ journey.

Forty-five-minute sessions will begin Wednesday, June 8 at 12:00 pm CT/ 11:00 am MT and continue biweekly through August 17. Register for the entire series here.

Join CHAD for a summer read-along by reading the book Waheenee: An Indian Girl’s Story. This short book tells the true-life story of Waheenee, a Hidatsa woman born in 1839 amid a tribe devasted by smallpox in what is now western North Dakota. Through reading and discussion, this group experience will foster an exploration of our region’s cultural and historical context and what that means for inclusive health care delivery today.

Two book discussions will be co-facilitated via Zoom by local experts, Dr. Allison Kelliher, MD (Koyukon Athabascan), with the University of North Dakota School of Medicine & Health Sciences, and Michael Barthelemy Jr. (Mandan and Hidatsa) of the MHA Nation Interpretive Center in New Town, ND.

Session 1: Monday, July 18 | 12:00 pm CT/ 11:00 am MT
Session 2: Monday, August 1 | 12:00 pm CT/ 11:00 am MT

The summer read-along is intended for all health center staff passionate about equity and wanting to learn more about our shared history locally and its implications for health today. Participants* are strongly encouraged to attend both Zoom book discussions and actively engage with other readers.

*Participation includes:

A copy of Waheenee: An Indian Girl’s Story mailed to your home;
A reader’s care package with surprise items; and,
Two guided one-hour Zoom book discussions.

Earlier this month, 34 diverse partners gathered in Bismarck for the first North Dakota Oral Health Coalition (NDOHC) meeting in over six years. CHAD received funding from the North Dakota Department of Health to reengage the NDOHC and take the lead in scheduling and facilitating meetings. The agenda for the meeting included a brief history of the NDOHC, an opportunity for partners to connect and share their interest in oral health, and several presentations on state oral health data and resources.

Prior to becoming inactive in or around 2015, the NDOHC had focused on improving oral health outcomes in ND for approximately ten years. The key accomplishments of the coalition were shared with the group and are also available on the NDOHC website. The NDOHC’s mission is to foster collaborative solutions to achieve oral health equity.

Shawnda Schroeder, assistant professor of Indigenous health at the University of North Dakota School of Medicine and Health Sciences, shared utilization data from Smiles for Life, a free online resource with eight educational oral health modules for medical providers. Ms. Shroeder also shared existing resources developed to educate specific populations on good oral health habits, including pregnant persons, children, adolescents, older adults, and tribal populations. In addition, she included the "Dentistry as Primary Care" and "Oral Health in Primary Care" ECHO projects which can be accessed from the North Dakota Oral Health Program website.

Jodi Hulm and Amber Huez from the North Dakota Department of Human Services - Medicaid Services Division provided an overview of the state’s initiative to advance the prevention and reduction of childhood caries, specifically focused on Medicaid’s early and periodic screening, diagnostic, and treatment programs. This initiative is intended to increase the number of fluoride varnish applications by non-dental providers for Medicaid and CHIP beneficiaries ages 0-20 by increasing the number of medical providers applying fluoride varnish. All presentations from the coalition meeting will be posted on the NDOHC website.

The last hour of the meeting was spent in breakout groups that focused on developing goals and objectives for three areas of focus: awareness, uptake, and reimbursement. The NDOHC awareness workgroup will work toward increased awareness from providers and decision-makers about oral health inequities in North Dakota. They will work to increase awareness among dental professionals, medical providers, case managers, families, schools, and legislators to provide education and resources at various community events. The uptake workgroup will work to reduce dental carries and increase overall dental care through education and integration with medical clinics for increased access to preventative dental care services. The goal of the reimbursement workgroup is to increase engagement among North Dakota Medicaid dental providers to increase the number of enrolled providers and patients served.

If anyone has an interest in working to foster collaborative solutions to achieve oral health equality in North Dakota, consider joining the NDOHC. Contact Bobbie Will with any questions.

The Expanded Food and Nutrition Education Program and Family Nutrition Program (SNAP-Ed) through NDSU Extension is collecting information to understand the needs of the communities they serve and better align their programs with them. They are sharing a survey to gather feedback from their target audience, including households with limited resources. Responses are anonymous, and results will not be used for research but for program improvement. Health center staff are encouraged to post or share the flyer with their clients.

The survey will close on May 27. Seven randomly selected people who complete the survey will receive a $25 gift card. Once completed, they will be redirected to a separate link to enter the drawing to maintain anonymity.

Remote Patient Monitoring and Health Centers
During the April Great Plains Health Data Network (GPHDN) strategic planning meeting, one of the topics discussed was remote patient monitoring (RPM) and its role in a virtual care environment. The US Department of Health and Human Services (HHS) recently published an article to help health centers prepare for telehealth and RPM use. Pairing RPM with telehealth, health centers can remotely monitor many symptoms and conditions such as high blood pressure, diabetes, heart conditions, etc., using existing technologies. The monitoring devices are already commonly used, such as weight scales, blood pressure monitors, and pulse oximeters. Here are some suggestions to assist patients as they are introduced to RPM:

Make sure the patient understands why an RPM device has been prescribed;
Make sure the patient understands how to use the device; and,
Talk to the patient about the benefits of RPM.

HHS suggests checking with the patient’s insurance company for billing purposes for information on their billing and reimbursement policies. If the patient is on Medicaid, each state has its own RPM billing and reimbursement policies, which can be checked at the National Policy Center – Center for Connected Health Policy website.

Webinar: Considerations for Sustaining a Culture of Cybersecurity
With the rise in cyberattacks on government agencies and large-scale companies, organizations large and small are questioning if they are doing all they should to protect their data. Hosted by the National Association of Community Health Centers (NACHC), this webinar features a health center and health center-controlled network (HCCN) perspective on how cybersecurity threats impact the bottom line. Speakers will highlight the importance of understanding the basic elements of cybersecurity and practical budgeting to accurately reflect the costs of protecting their patients’ PHI. This series is for IT leadership and other clinical and non-clinical managers to help foster an awareness of IT security at both the executive and staff levels.

Wednesday, May 25
1:00 – 4:00 pm CT/ 12:00 – 3:00 pm MT
Register here.

The Affordable Connectivity Program (ACP) is an FCC benefit program that helps ensure that households can afford the broadband they need for work, school, health care, and more. The benefit provides a discount of up to $30 per month toward internet service for eligible households and up to $75 per month for households on qualifying tribal lands. Eligible households can also receive a one-time discount of up to $100 to purchase a laptop, desktop computer, or tablet from participating providers if they contribute more than $10 and less than $50 toward the purchase price.

The ACP toolkit includes downloadable social media images, fact sheets, and other outreach content and materials that can be customized for consumer awareness campaigns. Check out the ACP consumer FAQ for more information about the benefit.

Integrated Patient Portals and Improving the Virtual Experience
Patient portals offer a secure and convenient connection between the patients and their health care providers. Studies have shown that portals increase patient engagement in their health, identify unmet clinical needs, and reduce downstream health events. With the rise of video visits and the adoption of digital tools during the pandemic, there is an opportunity to re-focus on how to use them best. the California Telehealth Resource Center, this webinar will discuss how health centers can leverage integrated patient portals to improve the virtual care experience.

Thursday, May 19
1:00 pm CT/ 12:00 pm MT
Register here.

Take 20: The Brain-Mouth Connection: Mental Health & Oral Health
May is Mental Health Awareness Month, dedicated to raising awareness about the importance of improving access to mental health care, fighting stigma, and advocating for policies that support individuals, families, and communities. An estimated 45 million Americans live with a mental illness that negatively impacts their daily lives. Poor oral health can exacerbate mental health issues and impede self-esteem, employability, and social engagement. Due to lack of access to care, untreated oral health problems can lead to pain, infection, tooth loss, difficulty chewing, swallowing, poor nutrition, and insecurities when smiling and speaking. This presentation will examine the "brain-mouth" connection, identifying links between mental health and oral health.

Tuesday, May 24
2:00 - 2:30 pm CT/ 1:00 – 1:30 pm MT
Register here.