CHAD Connection - October 21

In South Dakota, CHAD is gearing up to provide support to consumers across the state who will enroll in the Health Insurance Marketplace. CHAD has supported outreach and enrollment services statewide and across our health center members since 2013, but this year our efforts will reach further thanks to grant funding and a cooperative agreement with the Centers for Medicare and Medicaid Services (CMS).

In partnership with Community Health Center of the Black Hills, Falls Community Health, Helpline Center, Horizon Health Care, South Dakota Urban Indian Health, and Western South Dakota Community Action, ten full-time people, known as assisters or navigators, will be available to provide support to consumers who have questions or would like assistance with the insurance enrollment process. Consumers can reach out to health centers and partner organizations or dial 2-1-1 to be connected to an assistor.

While all communities benefit from outreach, education, and enrollment assistance, some experience additional barriers to accessing coverage and care. Our trained assisters, with ties to their local communities, have the knowledge to educate and give impartial guidance to those seeking affordable health coverage.

Seasoned assisters like me know that being a part of the process to help people enroll is not only a job; it’s a calling. Many in this profession have been personally touched by the difficulties of navigating the health care system. We are in this to make it easier for others. I remember the woman who was able to get on the kidney transplant list because I helped her obtain an affordable health care plan. Another favorite is the man who was diagnosed with throat cancer shortly after enrolling in his health plan. Today, after a surgery paid for mainly by his insurance, he is doing well and often thanks us for helping save him.

Open enrollment for the Health Insurance Marketplace begins November 1 and runs through January 15, 2022. Consumers need to sign up before December 15 for coverage to start on January 1, 2022. CHAD has provided a marketing toolkit to support health centers and partners to promote open enrollment to their patients and communities. Contact Kayla Hanson at CHAD for access to the materials.

We invite you to consider how your organization can work to ensure that every uninsured patient has the opportunity to learn about health insurance and meet with an assistor or certified application counselor to see what resources may be available to them.

To say that we are excited to embark on this new endeavor is definitely an understatement. Helping individuals and families enroll in affordable health care options, receive preventative care and treatments for preexisting conditions makes this an opportunity I am thankful for every day.

Penny Kelley joined CHAD in September 2021 as the outreach and enrollment services program manager, where she manages the outreach and enrollment program in South Dakota, providing planning and development for the O&E program strategies and practices. She also coordinates navigator activities and provides training and expertise to South Dakota health centers and partners.

Previously, Penny was a certified application counselor (CAC) at Rural Health Care, Inc., where she assisted consumers in applying and enrolling in Marketplace health care plans. She also worked for the State of South Dakota Department of Social Services - Division of Economic Assistance, helping develop the online applications for Medicaid and the Children’s Health Insurance Program (CHIP). Penny serves as a volunteer for the National Alliance on Mental Illness (NAMI), and in 2021, she was appointed to the Governor’s Behavioral Health Advisory Council.

Penny graduated from Black Hills State University with a bachelor’s degree in composite business administration and sociology with a minor in American Indian studies. She lives in Pierre with her husband and children, where they enjoy camping with their two rescue dogs.

Thanks to Senator Thune for taking the time to visit Falls Community Health and to Dr. Charles Chima and Alicia Collura for leading the tour. Senator Thune and his staff had a chance to visit the primary care and dental clinics as well as to learn about their behavioral health services and their work to address the social and economic barriers that sometimes prevent people from prioritizing their health. The team at Falls Community Health emphasized the need for federal telehealth legislation and the importance of protecting the 340B program, which was authorized by Congress to make medications more affordable for health center patients.

The Advisory Committee on Immunization Practices (ACIP) meets this week to discuss their recommendations for Moderna, Johnson & Johnson, and mixed series boosters. Pending ACIP approval, the Food and Drug Administration (FDA) will issue an updated Emergency Use Authorization (EUA). At that time, providers can initiate booster doses for recommended patients who received Moderna and Johnson & Johnson vaccines.

A CDC COCA call is scheduled for Tuesday, October 26 at 1:00 pm CT/ 12:00 pm MT to provide an overview of the most recent recommendations for administering COVID-19 booster vaccines.

Pfizer has submitted its Emergency Use Authorization (EUA) application for children ages 5-11 to the Food and Drug Administration (FDA). The FDA’s advisory committee, VRBPAC, will meet to discuss the pediatric Pfizer COVID-19 vaccine on October 26. The Advisory Committee on Immunization Practices (ACIP) plans to meet on November 3 to review recommendations. Pending approval, pediatric COVID-19 vaccinations could begin as early as November 8.

The Pfizer pediatric vaccine is a new formulation of the vaccine. The current formulation will not be used for children ages 5-11. Vaccine supply will be allocated to jurisdictions through the federal government. As such, health centers should begin working with their respective health departments to understand how vaccines will be distributed. If health centers do not receive state allocation, vaccines will also be available to order through the federal vaccine program.

Health centers are urged to begin planning for pediatric vaccination, including assessing the feasibility of vaccination clinics, storage requirements, and staff training. A draft Pfizer reference chart outlines the adult and pediatric formulation information. The pediatric formulation does not allow for regular freezer storage but instead allows storage in a refrigerator for up to 10 weeks.

A CDC COCA call is scheduled for Thursday, November 4, at 1:00 pm CT/ 12:00 pm MT to provide an overview of its recommendations and clinical considerations for administering primary series in children ages 5-11 years old.

Health centers play a key role in ensuring our nation’s underserved communities and those disproportionately affected by COVID-19 are equitably vaccinated against COVID-19. The continued efforts to educate and vaccinate unvaccinated adults and adolescents are greatly appreciated. Health centers have provided almost 15 million vaccinations, including more than 555,000 COVID-19 vaccine doses to children between 12 and 17. COVID-19 vaccination is the best way to mitigate the spread of COVID-19 and protect our nation’s health.

An email has been sent to the project director identified in the Health Services and Resources Administration’s (HRSA’s) electronic handbooks for each health center. This email came from BPHCAnswers@hrsa.gov and had the subject line, “Your Health Center’s Plans for Pediatric Vaccinations.” They would like a single representative for each health center (regardless of the number of sites) to share whether or not the organization plans to conduct pediatric vaccine clinics in partnership with schools and/ or school-based health centers pending CDC and FDA approval of pediatric vaccines. Refer to question 12 in the Health Center COVID-19 Survey User Guide for definitions of vaccine clinics. Please respond by 11:59 pm local time on Friday, October 22.

Join CHAD for the 2021 Uniform Data System (UDS) training sessions on November 2, 3, and 4 from 1:00 to 3:30 pm CT/ 12:00 -2:30 pm MT. These free web-based trainings are designed to provide assistance navigating and preparing the 2021 UDS report. This training is for people of all levels of prior UDS experience and covers all aspects of the UDS report.

The first session will allow participants to gain an understanding of the UDS reporting process, review key materials, and a walk-through of the patient demographic tables 3A, 3B, and 4. The presenter will cover the staffing and clinical information required on tables 5, 6A, and 6B during the second session. The third session will focus on the financial tables 8A, 9D, and 9E and share valuable tips for success in completing the UDS report. Each session will allow time for questions.

Effective reporting of a complete and accurate UDS submission depends on understanding the relationship between data elements and tables. This interactive training is an excellent way for new staff to understand their UDS reporting effort role. This training has been designed for attendees of all levels. All financial, clinical, and administrative staff are invited to learn updates, hone reporting skills, and share questions and experiences with their peers. Click here to register for the entire series.

Hosted by CHAD and DAETC, this four-part webinar series will enhance cultural awareness and understanding of the Great Plains Tribes. Participants will be introduced to cultural customs, norms, protocols, and healing practices to help health care teams improve their delivery of care when working with Native American populations. This series is intended for providers and health care teams who are passionate about providing high-quality, culturally-informed care.

Led by Dee Le Beau-Hein, each session will include one hour of content followed by time for interactive dialogue. This is a safe learning environment where open questions and discussion are encouraged. Participants will be encouraged to submit questions or scenarios that they would like addressed at any time throughout the series. Learning will build from the previous sessions, so participants are encouraged to attend the complete series; however, it is not required. Click here for more information and to register for the entire series.

On October 12, North Dakota legislative appropriations committees started listening to proposals on spending $1 billion of federal American Rescue Plan Act dollars allocated to North Dakota. The House and Senate appropriations committees will review approximately 200 proposals for one-time projects from state lawmakers and Governor Burgum. The committees will advance proposals to the legislative management panel, which will put forth bill drafts for the full legislature to consider in the reconvened session on November 8. The omitted proposals will wait until the 68th Regular Legislative Assembly in 2023.

CHAD will monitor proposals around childcare, family leave, food insecurity, Medicaid coverage for postpartum people, infrastructure, education, and workforce. All the proposals may be accessed here. A few are summarized below:

Childcare proposals range from increasing the maximum income for the state’s Child Care Assistance Program to creating programs to assist employers and employees with stipends.
There is a proposal to develop a paid family leave fund program to continue an employee’s wages if they are unable to work due to COVID-19 and other options for paid leave.
The Department of Human Services (DHS) proposed possible funding to create a Hunger-Free North Dakota coalition to address ongoing and emerging food distribution challenges.
The Department of Human Services proposed extending Medicaid coverage for postpartum people from 60 days after giving birth to 365 days.
Senator Hogue proposed extra funding for a previously funded Bank of North Dakota revolving loan fund for medical facility infrastructure.
There is a proposal to provide tuition waivers for students pursuing early childhood degrees to assist in the workforce shortage in childcare and funding for area career centers which could open up opportunities for high school students entering healthcare professions.
The Governor had a handful of workforce proposals incentivizing professionals to move to and stay in North Dakota.

The U.S. Department of Health and Human Services (HHS) has announced they will be opening an additional opportunity to apply for Provider Relief Fund payments for Medicaid and Children’s Health Insurance Program (CHIP) providers.

The application for Provider Relief Fund payments to Medicaid and CHIP providers is completed through the enhanced Provider Relief Fund payment portal. The portal allows providers to report their annual patient revenues, which HHS will use to determine how much money providers are eligible to receive. Additional information from HHS regarding the provider relief payments can be found here. The portal will close on October 26.

This month, the U.S. Department of Health and Human Services (HHS) issued a final rule to address changes to the Title X family planning program. For more than half a century, Title X family planning clinics have played a critical role in ensuring access to a broad range of family planning and preventive health services, including breast and cervical cancer screening and STI/HIV testing for more than 190 million low-income or uninsured individuals. Title X is the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services.

A hallmark of the Title X program is its essential role in supporting access to high-quality services delivered by highly qualified providers regardless of a patient’s ability to pay. This new rule replaces the 2019 Title X Rule, reversing the Trump administration’s changes to the program. Specifically, the 2021 rule:

Eliminates the requirement established under the 2019 Title X rule for providers to maintain strict physical and financial separation of abortion services;
Requires that Title X-funded sites provide a prescription to the client for their method of choice or referrals;
Clarifies that the program’s income verification requirement should not burden patients with low incomes or impede their access to care;
Reaffirms adolescent confidentiality protections;
Enables a broader range of clinical services providers to direct Title X services and consult medical services; and,
Incorporates the allowability of telehealth for Title X family planning services.

For community health centers that also serve as Title X grantees, please note that 330 funding has its own restrictions related to abortion services. Click here for a guide to advancing family planning services in the health center environment.

The final rule will become effective on November 8 and was issued in advance of a national competition for Title X service delivery grants anticipated later in the fall. Read more about the
new rule here.

The South Dakota Department of Health is currently seeking partners for the Communities That Care (CTC) program. CTC is a community-based prevention system proven to reduce youth health and behavior problems to prevent, reduce, or respond to risk factors like substance abuse, overdose, and suicide. CTC helps local community groups develop community-specific prevention plans based on their unique levels of behavioral health problems and risk and protective factors. Applications are due October 29. To learn more about the opportunity, click here.

CTC’s five-phase process:

Provides communities with a step-by-step guide and tools to build a high-functioning community prevention coalition;
Develops a community profile utilizing a community youth survey;
Creates a community action plan for prevention work; and,
Implementation and evaluation activities.

Health Link Announces Expanded Grant Award

Health Link has announced that they have received an expanded grant award that will allow them to cover their organizational membership fees for one additional year through September 2023.
Current Health Link members can continue to use and expand usage of all the Health Link interoperability tools at no fee for an additional year through September 2023. If interested in becoming a member, call 605-256-5867 to discuss onboarding options available to improve the care provided to patients and consumers. Funding is available to assist with membership fees, training, and engagement with the Health Link network.

Cybersecurity CIO Roundtable: Strategic Investments in Cybersecurity for Health Centers in 2021 and Beyond

Presented by HITEQ, this two-session roundtable series will bring together chief information officers, chief information security officers, and other IT leaders from health centers. Speakers will discuss strategic investments in cybersecurity, including those that can leverage recent American Rescue Plan Act (ARPA) funding and sustain those investments for the future. Participants will have the opportunity to connect with each other and subject matter experts about implementation, considerations, and the future of cybersecurity and data protection in health centers.

Monday, November 4
1:00 pm CT/ 12:00 pm MT

Monday, November 18
12:00 pm CT/ 11:00 am MT

Register here.

EHI and Information Sharing for Improved Care Quality

Please register for the next webinar in the Office of the National Coordinator (ONC) for Health Information Technology’s clinician-focused webinar series on information sharing and the information blocking regulation. ONC experts will explain how ONC supports secure, appropriate sharing of electronic health information and how information sharing leads to more affordable and equitable care and improved care quality.

Wednesday, November 17
12:30 pm CT/ 11:30 am MT

Register here.

The Community Health Association of Mountain/ Plains States (CHAMPS) has partnered with the Rocky Mountain Public Health Training Center (RMPHTC) to develop the Working on Wellness on-demand learning modules to promote resiliency and wellness in Region VIII health centers. These pre-recorded presentations offer Region VIII health center and primary care association personnel the chance to engage in educational content on their schedules. Please note that continuing education credit is typically NOT available for CHAMPS on-demand learning sessions unless otherwise indicated below.

One Hour of Happiness: The Psychology of Happiness
Dr. John Sommers-Flanagan, professor of counseling at the University of Montana, distills the content of his very popular semester-long course, The Psychology of Happiness, to one hour of just the essentials.
The Science and Art of Meditation
Dr. Jay Moreland details the benefits of mindfulness and personal mediation practice while walking through several examples of meditation practice.
Burnout and Well-Being: Regenerating Your Balance
Dr. Abbie Beacham, director of behavioral science at the University of Louisville School of Dentistry, defines burnout and its impact on individuals, organizations, and systems. She introduces the PERMAH module of well-being to help individuals, teams, and organizations identify the areas most in need of change so they can begin to build lasting balance.
The Inner Critic: Friend, Foe, or Neither?
The seeming paradox between imposter syndrome and perfectionism (or even ego) are manifestations of the same source. This presentation will focus on recognizing and meeting the inner critic for sustained well-being in clinical practice.
Leveraging Neuroscience and Mindfulness to Maintain Well-Being in the Pandemic (and Beyond)
This presentation will address the stress response and the “tend-and-befriend” concepts, drawing upon neuroscience and mindfulness to understand current levels of distress as well as potent applications of these concepts to enhance well-being.

Halloween is around the corner! The Centers for Disease Control and Prevention (CDC) recommends that all adults and children aged 12 and older get a COVID-19 vaccine. Still, many trick-or-treaters aren’t eligible to get vaccinated yet. To enjoy a sweet and safe Halloween, remember to: track local transmission rates, take precautions like wearing a mask and frequent hand washing, and avoid activities that put children at increased risk for COVID-19. Check out these resources from the Public Health Communications Collaborative for more guidance and activities.

What Clinicians Need to Know about the Recent Updates for COVID-19 Boosters

This Clinician Outreach and Communication Activity (COCA) call will provide an overview of the most recent recommendations for administering COVID-19 booster vaccines. The Centers for Disease Control and Prevention will provide updates about the latest recommendations and clinical considerations for administering COVID-19 boosters, including an update on early safety monitoring for additional COVID-19 vaccine doses.

Tuesday, October 26
1:00 pm CT / 12:00 pm MT
Webinar link. Click to join before the webinar before. No registration is required.

Diabetes Lunch-and-Learn Training – November 2021

Diabetes is almost twice as prevalent among health center patients when compared to the general population. Moreover, rates are on the rise – a combination of delayed care and other barriers caused by the COVID-19 pandemic.

Join CHAD and the Great Plains Quality Innovation Network (GPQIN) for a diabetes lunch-and-learn series featuring health experts from North Dakota and South Dakota. The series will provide relevant updates, actionable information, and resources to primary care teams as they celebrate National Diabetes Awareness Month and work to ensure all patients receive high-quality preventative and chronic care.

Mondays, November 1, 8, 15, and 22
12:00 - 12:45 pm CT/ 11:00-11:45 am MT
Register here.

Pediatric COVID-19 Vaccines: COVID-19 Primary Series in Children 5–11 years old

Save the date for this Clinician Outreach and Communication Activity (COCA) call. The Centers for Disease Control and Prevention will provide an overview of its recommendations and clinical considerations for administering primary series in children between 5–11 years old.

Thursday, November 4
1:00 pm CT / 12:00 pm MT
Webinar link. Click to join before the webinar before. No registration is required.

Lung Health Forum and Policy Symposium

The Walking Forward Program will present study findings from a provider and community lung cancer screening education project as part of the lung health forum. Presenters will also provide information regarding lung health and lung cancer screening. The policy symposium will include presentations by national speakers related to lung cancer screening policy and the future of lung health research. Find conference details, including the agenda, speaker biographies, and hotel information, here.

Wednesday, November 3 – Friday, November 5