CHAD is a proud member of South Dakotans Decide Healthcare, a broad coalition of patients, health care providers, farmers, business owners, educators, and health care advocates working together to pass Medicaid expansion at the ballot box in 2022.

Last week our coalition released a video highlighting the benefits of extending Medicaid eligibility, including increasing access to coverage for hardworking South Dakotas like farmers and small business employees. And thanks to a provision in the recently passed American Rescue Plan Act (ARPA) to encourage more states to expand Medicaid, South Dakota will receive more than $90 million in additional federal funds over and above their current commitment to provide 90 percent of the funding for Medicaid expansion. It’s the right thing to do and the fiscally responsible thing to do.

We hope everyone can see a place for themselves in this effort, centered on the voices of patients, families, health providers, small business owners, and trusted voices from across the political spectrum. For more information, visit the South Dakotans Decide Healthcare website.

CHCs in the News
Mayor TenHaken appointed Dr. Charles Chima to replace Jill Franken as the Sioux Falls public health director. Dr. Chima will also serve as the executive director of Falls Community Health via KELO.
Karly Westra, ambulatory care clinical pharmacy intern at Family HealthCare, received the U.S. Public Health Service Excellence in Public Health pharmacy award via WZFG.
Dr. Amanda Diehl, who specializes in LGBTQ issues at the Community Health Center of the Black Hills, is quoted about her work addressing the mental health impacts among LGBTQ youth in this Capital Journal article.
The University of South Dakota featured Horizon Health Care provider Rachele Vietor in a story about the vital role physician assistants (PAs) play in rural South Dakota health care. She is a PA at the Mission Community Health Center.
2021 CHAD Conference Sponsorship Opportunities Available
CHAD is inviting interested organizations to become sponsors of the 2021 CHAD Conference: The Health Center Journey. This year, CHAD is combining the CHAD Annual Members Conference, the Fall Quality Conference, and the Great Plains Health Data Network Summit into this one in-person event. This conference is an excellent opportunity for health centers across North Dakota and South Dakota to come together for educational and networking opportunities. The theme of this year’s event is "Celebrating Successes, Looking to the Future," and will offer tracks on behavioral health, clinical quality improvement, leadership, health equity, and human resources/workforce.

Held in person on September 14 and 15 at the Holiday Inn Rushmore Plaza in Rapid City, SD, the 2021 CHAD Conference offers a variety of sponsorship opportunities, as outlined in the attachment. Organizations are invited to exhibit on-site to have quality facetime with health care professionals in the Dakotas, including health center CEOs, clinical leadership, CFOs, COOs, providers, human resources staff, and other VIPs. Exhibitor logos will be prominently displayed throughout the conference.

Additional sponsorship opportunities are available for those who wish to support the conference but cannot attend. Exhibit reservations are due Friday, August 13. If you have any questions or would like more information, including non-profit rates or other considerations, please contact Dani Gullickson.
Federal Legislation Updates
HHS Announces $1 Billion from American Rescue Plan Act for Construction and Renovation Projects at Health Centers

On April 27, the US Department of Health and Human Services announced the availability of $1 billion for the Health Resources and Services Administration’s (HRSA’s) Health Center Program-funded health centers to support major construction and renovation projects across the country. The purpose of this one-time funding opportunity is to support construction, expansion, alteration, renovation, and other capital improvements to modify, enhance, and expand health care infrastructure.

HRSA will provide funding in the form of a grant. The amount of funding awarded to each recipient will be determined according to the following formula: $500,000 base amount, plus $11 per patient as reported in the 2019 Uniform Data System (UDS).

Health centers may submit one application to request funding to support one or more of the following project types for up to five total projects. There will be a three-year period of performance from 9/1/21-8/31/24, and applications are due June 24 at 5:00 pm.
  • Construction of a New Facility: This project creates a new building structure. Activities in this project include the construction of a new stand-alone structure.
    Construction/Expansion of an Existing Facility: This project adds square footage to an existing facility and/or includes significant site work.
    Alteration/Renovation of an Existing Facility: This project involves renovations to an existing facility that does not increase the facility’s square footage.
    Equipment Only
  • Construction/Expansion of an Existing Facility: This project adds square footage to an existing facility and/or includes significant site work.
  • Alteration/Renovation of an Existing Facility: This project involves renovations to an existing facility that does not increase the facility’s square footage.
  • Equipment Only: This project involves the acquisition of loose, moveable equipment not affixed to the physical building structure.

HRSA will host two sessions to assist in the development of the ARPA-capital application.

General Overview
Thursday, May 6
1:30 pm – 3:00 pm CT/ 12:30 pm – 2:00 pm MT
Phone (833) 568-8864
Webinar ID: 160 936 3792
Application and Submission
Tuesday, May 18
from 1:00 pm - 3 pm CT/ 12:00 pm – 2:00 pm MT
Phone (833) 568-8864
Webinar ID: 160 895 1863
American Families Plan

President Biden’s speech to a Joint Session of Congress on April 28 introduced the American Families Plan (AFP). Some of the highlights of the AFP include social welfare and family assistance, employment, education, housing, clean air and water, tax increases, accessible health care, and health services. $225 billion will go toward the family and medical leave program, $200 billion to universal pre-kindergarten, $100 billion for free community college, and extending the child tax credit through 2025. The AFP would extend the temporary subsidies for private Affordable Care Act (ACA) plans approved in the American Rescue Plan Act (ARPA). The AFP plan does not include an expansion of Medicare and Medicaid or a strategy to lower drug prices.

President Biden’s speech focused on a few health care items. Over 220 million COVID shots were administered during his first 100 days in office, with the vaccine going to 40,000 pharmacies and over 700 community health centers. An additional 800,000 Americans have enrolled in the ACA. The AFP will create jobs replacing 100% of the nation’s lead pipes and service lines, so every child could have clean drinking water. The AFP will provide caregivers with better wages and benefits to serve the 800,000 disabled on the Medicaid homecare waiting list. In addition, the AFP will lower health care premiums for nine million Americans who buy their coverage under the ACA.
State Legislative Updates
North Dakota Legislation Wrap Up

The 67th Legislative Assembly adjourned late on April 29. This session’s top priority was ensuring North Dakota was in the best position to move beyond the impacts of the COVID-19 pandemic. The Assembly also continued to invest in energy and veterans and took steps to invest in ND’s young people and protect the elderly population. The Assembly’s
final report includes a summary of the balanced budget, economic development, energy, taxes, human services, criminal justice, agriculture, education, water, and COVID-19 summaries.

Olson Effertz Lobbying and Consulting provided a final legislative update for CHAD members on May 3. Updates on key bills included:
  • HB 1154 provides new definitions relating to prior authorization of dental services, dental networks, and payment of dental claims; the insurers are held to pay what they promised in the prior authorization, which will reduce confusion and helps patients and dental offices know the financial impact of the service provided;
  • HB 1087 established an invisible reinsurance pool for the individual health insurance market. It also includes a study on the ways the state may be able to establish an invisible reinsurance pool for the combination of the individual health insurance market with the small group health insurance market;
  • HB 1142 distributes $250,000 for the Area Health Education Center (AHEC) via the ND Department of Commerce budget;
  • SB 2004 allowed for $585,000 over the executive recommendations for student loan repayment to be added to the Department of Health budget;
  • HB 1287 maintained the intent of the "Good Samaritan Law" while enhancing the penalty for the death of an individual as a result of a drug overdose;
  • HB 1247 is a policy change to combine the Department of Health and the Department of Human Services. The Department of Human Services director will be the head of the two combined agencies, and the Department of Health will become a division of that new agency. The two agencies will work on their transition plan during the 2021-2023 biennium and present one combined budget for the 23-25 biennium;
  • HB 1492 inserted an amendment to limit the pharmacy benefits managers (PBM) authority to recover funds from pharmacies through the 340B program. This bill also permitted pharmacists to administer SARS-CoV-2 tests; and
  • SB 2205 added $249,000 to the Medicaid budget to cover interpreter services for the hearing impaired and language.
  • COVID-19 Response in Health Care
  • HB 1175 creates liability protections to shield health care providers, businesses, and others from frivolous claims related to exposure to COVID-19. It applies retroactively to January 1, 2020, covering the entire COVID-19 pandemic.
  • SB 2164 allows occupational licensing boards greater flexibility during emergencies and allows licensed practitioners from other states to provide services in North Dakota during emergencies.
  • SB 2279 allows the state Board of Pharmacy to develop rules for registered pharmacy technicians, after receiving training, to administer medications, including immunizations, under the supervision of an authorized licensed pharmacist.
  • SB 2221 allows pharmacists to administer immunizations, specifically the COVID-19 vaccine.
Legislative Management

North Dakota legislative management scheduled their first full meeting for May 19, with the major item of business of selecting the studies for the interim. In the immediate weeks following, there will be a survey sent out to all legislators to indicate what committees they would like to serve on and the Legislative Council grouping the studies together into committees. Legislative management will meet again on June 9 to select a chair for the committees and select the members for the committees.
South Dakota Impact from American Rescue Plan Act

The legislative executive board received an update on pandemic relief funding from Jeff Mehlhaff, chief fiscal and programs analyst for the South Dakota Legislature. South Dakota is expected to receive approximately $3.397 billion of the $1.9 trillion stimulus package in the American Rescue Plan Act.  The breakdown of the package for South Dakota is:
  • $1.25 billion in fiscal recovery funds: $977.8 million for unemployment and $272.2 million in funding to cities and counties to assist households, small businesses, tourism, travel, and hospitality. Also, investment in water, sewer, or broadband infrastructure;
  • $1.03 billion in local funding, which includes stimulus checks to South Dakotans, the extension of the Paycheck Protection Program (PPP), the Economic Injury Disaster Loan (EIDL), and aid to restaurants;
  • $996.5 million for grants to state agencies;
  • $115.7 million in funds to carry out capital projects in response to the public health emergency; and,
  • Funds to provide an incentive to expand Medicaid.
Update on Adolescent COVID-19 Vaccine Authorization
The Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) will likely meet next week to discuss COVID-19 vaccine recommendations for adolescents ages 12-15. This meeting is in anticipation of the Food and Drug Administration (FDA) authorizing the Pfizer COVID-19 vaccine for adolescents ages 12-15.

Molly Howell, immunization director at the North Dakota Department of Health (NDDoH), listed several suggestions for a successful adolescent vaccine rollout in her weekly communication, including:

  • Ensure pediatricians, family practitioners, and other staff are educated regarding the COVID-19 vaccine. Health care providers should discuss the COVID-19 vaccine at each encounter.
  • Plan to have Pfizer vaccine on hand in the clinic setting. The NDDoH warehouse can break down Pfizer COVID-19 shipments into smaller quantities, so there should not be a barrier to accessing the COVID-19 vaccine for adolescents.
  • When administering the COVID-19 vaccine, be sure to check and see if adolescents are due for other vaccines (i.e., MCV-4, HPV, Tdap) and schedule a future appointment. Also, when administering routine vaccines, please start discussing and scheduling adolescents for the COVID-19 vaccine.
  • The parent/guardian should receive the Pfizer COVID-19 emergency use authorization (EUA) fact sheet before the child is vaccinated.
Updated CMS Toolkit on the COVID-19 Vaccine
Yesterday, the Centers for Medicare and Medicaid Services (CMS) released an updated Coverage and Reimbursement of COVID-19 Vaccines, Vaccine Administration, and Cost-sharing under Medicaid, CHIP, and BHP Toolkit. The National Association of Community Health Centers (NACHC) is involved in ongoing conversations with CMS staff to advocate for COVID-19 vaccine reimbursement policies that ensure health centers are sufficiently reimbursed for their efforts in reaching patients and their communities. NACHC has identified several pertinent updates that will impact FQHCs:
  • The 100 percent federal medical assistance percentages (FMAP) for state expenditures for medical assistance for COVID-19 vaccines and their administration began April 1, 2021. It will last through the last day of the first quarter that begins one year after the last day of the COVID-19 emergency period.
  • CMS will soon offer additional guidance to states regarding implementing the American Rescue Plan Act (ARPA) temporary 100 percent FMAP.
  • For federally qualified health centers (FQHCs) and rural health clinics (RHCs), vaccine administration may be included within the prospective payment system (PPS) rate.
  • Regarding alternative sites, vaccine administration may be provided at drive-through sites when delivered by qualified Medicaid practitioners otherwise authorized to administer vaccines under the state plan, as long as applicable federal Medicaid regulations governing coverage and reimbursement for the applicable benefit are met. An add-on payment may be applied to account for overhead costs associated with the drive-through site.

If you have any questions, please contact NACHC’s state affairs team at
UDS Mapper Webinar Series
The Uniform Data System (UDS) Mapper is a collaboration between the Health Resources and Services Administration (HRSA) and the American Academy of Family Physicians (AAFP) and is part of the HealthLandscape online mapping platform. The webinars are open to the public and free of charge.

2021 Uniform Data System Reporting Changes
Join this technical assistance session for an overview of changes and clarifications to the 2021 Uniform Data System (UDS) reporting requirements, including information on the latest COVID-19 and clinical quality measures for UDS reporting. This webinar is geared toward health center leadership and staff, EHR and IT programming staff, and HRSA/BPHC project officers. Visit the UDS Resources webpage for the 2021 UDS Program Assistance Letter and other technical resources to support complete, accurate, and timely UDS reporting.
Thursday, May 6
12:00pm-1:30 pm CT/ 11:00 am–12:30 pm MT
Introduction to the UDS Mapper
This webinar is a general introduction to the UDS Mapper, a mapping and decision-support tool driven primarily from patient location data within the Uniform Data System (UDS). This webinar will go over basic UDS Mapper functionalities geared toward first-time users or those who need a refresher.
Tuesday, June 8
11:00 am CT/ 10:00 am MT
Important Update for Providing Buprenorphine
The Department of Health and Human Services (HHS) has released new Buprenorphine practice guidelines that remove a longtime requirement tied to training, which some practitioners have cited as a barrier to treating more people. The guidelines exempt eligible physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse-midwives from federal certification requirements related to training, counseling, and other ancillary services that are part of the process for obtaining a waiver to treat up to 30 patients with buprenorphine.

More than 90,000 drug overdose deaths are predicted to have occurred in the US in the 12 months ending in September 2020. That is the highest number of overdose deaths ever recorded in a 12-month period, and overdose deaths have continued to accelerate during the COVID-19 pandemic. The alarming increase in overdose deaths underscores the need for more accessible treatment services, and studies have shown that medication-based treatment promotes long-term recovery from opioid use disorder.

For more information, see this press release or these FAQs.
Look to 211 for Community Resources
When a patient needs food, housing, or other resources, it can be challenging to know where to look. Both North Dakota and South Dakota have active 211 helplines that house a comprehensive statewide community resource database and are available 24 hours a day, seven days a week, to offer information and support. In North Dakota, the 211 agency is FirstLink, and in South Dakota, it is the Helpline Center. FirstLink and the Helpline Center are accredited by the Alliance of Information and Referral Systems (AIRS) and the American Association of Suicidology (AAS).

People can identify resources by dialing 211 and speaking with a support person or searching the agencies’ user-friendly online databases. They also communicate via the text line – individuals can text their zip code to 898211 to be connected via text to their local 211. In SD, 211 also has a mobile app. Common resources found in the database include food, housing, utilities, transportation, mental health, support groups, and more. Both FirstLink and the Helpline Center work with a language line so that they are equipped to answer calls from patients speaking a variety of languages.

Both FirstLink and the Helpline Center offer an evidence-based follow-up call back service for individuals who have seriously considered or attempted suicide and also serve as the local answering service for the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). The National Suicide Prevention Lifeline – Spanish Language Line is 1-888-628-9454. To learn more about what each state has to offer, please visit the FirstLink or Helpline Center websites.
Medical and Behavioral Health Provider Well-Being During a Global Pandemic
CHAD has been working with the Mountain Plains Mental Health Technology Transfer Center (MHTTC) to develop a resource guide titled Building Resilience Among Physical and Behavioral Healthcare Providers During a Global Health Pandemic. This project was partially funded through the Substance Abuse and Mental Health Services Administration (SAMHSA). It is meant to be a useful tool for providers to aid in their self-care efforts through what may be the most difficult year of their practice.

This toolkit lays out some of the struggles that providers described over the past year and provides solid examples of interventions that may help. A case scenario is used to provide an example of how this pandemic has impacted providers and provide an example of potential interventions a provider may select to manage these challenges. This resource is free, and everyone is encouraged to share it with anyone who may benefit from this information.

New CHAMPS Social Determinants of Health Webpage
In partnership with the Northwest Regional Primary Care Association (NWRPCA), CHAMPS will be hosting a three-part Bureau of Health Workforce webcast series. Events will occur on June 2, 10, and 24 at 2:00 pm CT/ 1:00 pm MT. More details and registration are coming soon.

Registration will be opening soon for the CHAMPS 2021 Immunization Update webcast, taking place on Thursday, June 3, from 12:30 pm - 2:00 pm CT/ 11:30 am-1:00 pm MT. The Centers for Disease Control and Prevention’s (CDC) National Center for Immunization and Respiratory Disease will present this 90-minute event. To learn more, please visit the CHAMPS Upcoming Live Distance Learning Events webpage.
Save the Dates for Upcoming Bureau of Health Workforce Webcast Series
In partnership with the Northwest Regional Primary Care Association (NWRPCA), CHAMPS will be hosting a three-part Bureau of Health Workforce webcast series. Events will occur on June 2, 10, and 24 at 2:00 pm CT / 1:00 pm MT. More details and registration are coming soon.
Health Centers Celebrate Nurses’ Week May 6-12
Happy Nurses’ Week! Nurses are an essential part of the health center community, and CHAD is grateful for nurses this week and all year long.
National Women’s Health Week is May 9-15
During National Women’s Health Week each year, millions of women take steps to improve their health. The week serves as a reminder for women to prioritize and build positive health habits for life. Getting enough sleep, eating healthy, and staying active are the foundation of a healthy lifestyle. Health centers are encouraging women who put off any medical care last year like a physical, Pap test, or cancer screening, to make an appointment to get caught up this month.
GP11 Network News
Cures Act Resource Guide

To assist health centers with the complexities of the 21st Century Cures Act (Cures Act), the Health Information Technology, Evaluation, and Quality Center (HITEQ) has created an online information blocking resource guide. The guide is a comprehensive, single resource that contains important information for health centers regarding the Cures Act and includes links to other resources for further information. It is divided into four sections:
  • Information Blocking Overview: Includes links to online resources, including a recorded session by HITEQ for federally qualified health centers (FQHCs);
  • Relationship to Other Privacy and Access Laws: Discusses the differences between the information blocking and HIPAA, 42 CFR Part 2, and state laws;
  • Areas of Concern for Health Centers: Provides example situations, including a review when the patient is a minor; and,
  • Checklist for Steps Forward: A checklist of planning strategies for health centers.

The Great Plains Health Data Network is hosting two webinars on Azara for participating health centers.

Azara: Add-On Function Review
Presenters from Azara will demonstrate the product’s add-on functionality, so health centers can get an idea of what is available beyond the core application. This presentation is intended for clinical, quality, leadership, and finance staff.
Thursday, May 13
10:00 am CT/ 9:00 am MT
Contact Kyle Mertens if you are interested in attending.

Azara: Project Kickoff
This webinar will be the official start of the Azara implementation phase. Speakers will give a short Azara overview, discuss the project timeline, project role definitions, and answer any remaining questions. This presentation is intended for clinical, quality, leadership, and health information technology (HIT) staff.
Monday, May 17
1:00 pm CT/ 12:00 pm MT
Contact Kyle Mertens if you are interested in attending.
Webinars & Meetings
Find these and other events on the CHAD website.
South Dakota Department of Health COVID-19 Update

The South Dakota Department of Health hosts a weekly COVID-19 webinar for health care facilities, medical providers, laboratorians, long-term care facilities, EMS providers, and other health professionals.

Thursdays in May (reoccurring)
10:00 am MT/ 11:00 am CT
For weekly call-in information, please join the listserv here. Find archived calls and slides here.

Cervical Cancer Elimination: A Bold but Achievable Goal

Presented by the American Cancer Society, this webinar will define cervical cancer elimination. Participants will understand the strategy for eliminating cervical cancer and learn evidence-based recommendations for HPV vaccination. This webinar is intended for physicians, nurse practitioners, PAs, nurses, quality improvement staff, leadership, communications & marketing.

Wednesday, May 12
12:00 pm CT/ 11:00 am MT
Register here

Seizure Recognition and First Aid Certification LIVE Session Registration in observance of Asian American and Pacific Islander Heritage Month

Join the Association of Asian Pacific Community Health Organizations (AAPCHO) and Epilepsy Foundation for a live seizure recognition and first aid certification training. In observance of Asian Pacific American Heritage Month, and with generous support from the Epilepsy Foundation, this live certification training is being provided to AAPCHO members and partners at no cost.

To register and enroll for the FREE course, carefully read the steps on the registration page before completing the registration for the live Zoom session. If all steps are not complete, you will not become Seizure First Aid Certified and receive a certificate of completion.

The intended audience for this webinar includes AAPCHO members and partners, including health centers, PCAs, HCCNs, and other health care and community-based organizations, including those serving Asian American, Native Hawaiian, and Pacific Islander communities.

Thursday, May 20
5:00 pm CT/ 4:00 pm MT
Register here

CHAMPS Immunization Update Webcast

Registration is now open for the CHAMPS 2021 Immunization Update webcast. This 90-minute event will be presented by the Centers for Disease Control and Prevention’s (CDC’s) National Center for Immunization and Respiratory Disease. Presenters will discuss the latest recommended immunization schedules and the most recent Advisory Committee on Immunization Practices (ACIP) recommendations for adults, children, and adolescents. In addition, information on improving routine vaccination during the COVID-19 pandemic will be presented.

This presentation is intended for clinical leadership, clinicians, and clinical support staff at Region VIII (CO, MT, ND, SD, UT, WY) health centers, including physicians, PAs, NPs, nurses, MAs, and other interested health care professionals. To learn more, visit the CHAMPS Upcoming Live Distance Learning Events webpage.

Thursday, June 3
12:30 pm -2:00 pm CT / 11:30 am -1:00 pm
Register here

CHAD Network Team Meetings

Thursday, May 6 at 12:00 pm CT/11:00 am MT – Clinical Quality Network Team Meeting
Tuesday, May 11 at 2:00 pm CT/ 1:00 pm MT – Communications and Marketing Network Team Meeting
Friday, May 21 at 12:00 pm CT/ 11:00 am MT– Behavioral Health Work Group
Tuesday, May 25 at 1:00 pm CT/ 12:00 pm MT– Outreach & Enrollment Network Team Meeting
Tuesday, May 25 at 3:00 pm CT/ 2:00 pm MT– CFO & Finance Manager Roundtable

This account is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $1,499,709.00 with 0 percent financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit

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