Last week, the U.S. Department of Health and Human Services (HHS) Regional Director Lily Griego traveled across North Dakota with the goal of learning more about the bright spots and challenges in the state’s health care landscape. Her role at HHS is to be the eyes and ears on the ground, communicating with local partners, and sharing needs across our region with federal policymakers.

Her trip brought her to three of the state’s five community health centers. Other meetings included:
  • A roundtable discussion on the oral health workforce and access to oral health services coordinated by our own Policy and Partnerships Manager Bobbie Will;
  • Meetings with tribal leaders and representatives on primary health care, mental health, and treatment for substance use disorders;
  • Meeting with a rural hospital and community and state rural health leaders; and,
  • Listening sessions with equity leaders (thanks to CHAD Health Equity Manager Shannon Bacon for bringing this great group together!) and legislators.

At the close of her visit, Director Griego was a guest on Main Street, a radio program from the Prairie Public News Room. When asked about the positive things that were happening in North Dakota health care, she responded by going straight to the good work being done in community health centers, noting that they are "being creative with the federal dollars that are coming into communities." She went on to say that FQHCs are a "trusted messenger in their community whether that is someone who is helping them with staying housed, or getting a COVID test or a COVID-19 vaccination, or bringing their baby or their neighbor to get vaccinated because they know the facility and they know the community members working in the health center. Sometimes they show up and want to visit with someone about their resources as it relates to harm reduction or if they are seeking a visit with a dentist and perhaps they don’t have the coverage that some of us are fortunate to have."

HHS is a critical partner as we all work to improve the health and well-being of North Dakota residents. At CHAD, we appreciate all of the hard work that goes into fostering that partnership at the health center level. While meeting the expectations of federal partners isn’t always easy, we know it brings life-saving resources into our communities. It makes our work easier when the team at HHS makes a real effort to understand our environment and the challenges we face. So, thanks to Director Griego and everyone who helped make her visit a success!
Health Centers in the News
South Dakota Urban Indian Health is hosting an open house for their new downtown Sioux Falls location via KELO.
Community Health Center of the Black Hills Continues Practice Transformation Project
The Community Health Center of the Black Hills (CHCBH) continues to participate in a practice transformation project (PTP) focused on increased HIV testing and increasing awareness of available PrEP (pre-exposure prophylaxis) services. The PTP is a region-wide quality improvement model employing longitudinal coaching, training, and clinical assistance to selected clinics. This month, Jenn Sobolik, CNP, presented to all medical, nursing, pharmacy, and front desk staff to highlight the importance of screening those at risk for HIV and offering PrEP to patients.

Providers and nurses at CHCBH are participating in HIV testing and PrEP referral competitions from June to September to increase awareness clinic-wide. When CHCBH started PTP in 2018, less than 6% of clinic patients had been screened for HIV. That number is now closer to 40%. In 2017, CHCBH had one patient living with HIV receiving their care at the clinic. They now have approximately 50 patients. Most recently, CHCBH partnered with the local Ryan White group to host a free HIV testing event on National HIV Testing Day in June.
State Medicaid Updates
Licensed Professional Counselors
As of July 1, the North Dakota Medicaid state plan allows licensed professional counselors (LPCs) to receive encounter payments for behavioral health services provided at federally qualified health centers (FQHCs) in North Dakota. Updates to the general information for providers’ manual and behavioral health manual have been posted on this page.

New Timely Filing Policy
On January 1, North Dakota Medicaid implemented a new "timely claim filing" policy for claims with dates of services dated 01/01/2022 forward. This change decreased the time between a service being provided and when a provider needs to submit that claim. Medicaid providers now have 180 days from the service date to submit an original claim for payment. Initially, providers had 365 days from the service date to submit a claim. See the policy for exceptions to the 180-day timeframe here.

Initial Prenatal Visit Payment
Effective May 1, South Dakota Medicaid will provide an add-on payment for providers who conduct the initial prenatal visit for pregnant recipients. Initial prenatal visit reporting should be billed to Medicaid using CPT code 0500F. Providers should include any other services rendered on that date of service on the claim as usual. The maximum allowable reimbursement for CPT code 0500F is $10.00. Including this code will enable public health staff to better understand when pregnant women are initiating care, which is important to ensure good prenatal care overall. This code is reimbursable once per pregnancy and is paid in addition to the PPS encounter rate health centers receive.
COVID-19 Updates and Resources
In June, Jennifer Saueressig, clinical quality manager at CHAD, attended the North Dakota Immunization Conference held in Bismarck. The conference focused on the COVID-19 pandemic, what health care providers have learned, and the protection now available for the younger population. Presenters also shared current immunization schedules for children and adults and best practices in immunizations.

Chastity Dolbec from Coal Country Community Health Center presented "Improving Population Health through Community Collaboration," highlighting school-based immunization clinics. In her presentation, she discussed community-based options to increase overall child and adolescent immunization rates along with the challenges and successes.

Tara Bowen, RN, homeless health case manager and community outreach nurse at Homeless Health Services, a part of Family HealthCare, gave a presentation on equity-based COVID-19 vaccine clinics, specifically for those experiencing homelessness. Her team visited multiple resource centers and provided street outreach in places such as parking lots, bus stops, abandoned buildings, and detox facilities with the COVID-19 vaccine. They developed trust and provided education to their patients while helping to prevent severe illness from COVID-19.

The North Dakota Department of Health reported 8,457 COVID-19 cases with 62 hospitalizations and one death in children ages six months to 4 years through June 9, 2022. Nationally, over 200 children ages six months through 4 years have died due to the COVID-19 illness. Half of those hospitalized in the US did not have underlying conditions, and one in four were admitted to the ICU.

Both Moderna and Pfizer COVID-19 vaccines in children as young as six months had similar antibody levels to COVID-19 vaccines for older children and young adults. According to the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control and Prevention (CDC), the benefits of COVID-19 vaccination outweigh the risks and provide the best protection against hospitalization and long-term negative effects from COVID-19.

Since the pandemic’s beginning, the spread of misinformation on social media and other channels has affected COVID-19 vaccine confidence. Many parents hesitate to vaccinate their children due to fear and either not enough information or misinformation. Presenters shared multiple strategies during the conference to decrease vaccine hesitancy with families. These strategies included motivational interviewing, trusted patient-provider relationship, follow-up communication, and a strong vaccine recommendation. Voices for Vaccines is an excellent resource for addressing misinformation and talking to families about vaccines.

Pediatricians and primary care providers are at the top of trusted sources of child vaccine information across community types. A recent poll showed that 76% of parents in a rural community trusted their primary care provider for information compared to 45% from the CDC.

Additional Resources
Pediatric COVID-19 Vaccination Operational Planning Guide
COVID-19 Vaccination for Children website
Interim Clinical Considerations for Use of COVID-19 Vaccines
Checklist for Pediatric COVID-19 Vaccination
Telling the Health Center Story July 28
Join CHAD for an educational and inspirational introduction to community health centers. Participants will gain a foundational knowledge of health centers, including defining features, essential services, and populations served. This interactive presentation will provide a context of the greater health center movement and legacy and locations, features, and impact of health centers here in the Dakotas. Attendees will be asked to consider how they will help share the story of their particular health center moving forward.

To be held on Thursday, July 28 at 12:00 pm CT/ 11:00 am MT, this virtual presentation is designed for all health center staff and will be of particular interest to those not yet familiar with the broader community health center movement and key features of health centers. Supervisors should encourage their staff to attend. It will also be great for board members and patients who might be health center advocates. Register here.

Members-Only Data Book Presentation August 4
Join CHAD and the Great Plains Health Data Network (GPHDN) for a comprehensive overview of the 2021 Data Books. The CHAD team has prepared these books for member health centers and the GPHDN using the most current Uniform Data System (UDS) data. These publications were created for use within the CHAD and GPHDN networks and are not publicly shared.

This members-only presentation will walk attendees through the contents and layout of the 2021 CHAD and GPHDN Data Books. Presenters will provide an overview of the data and graphs demonstrating trends and comparisons in patient demographics, payor mixes, clinical measures, financial measures, provider productivity, and economic impact. The session will wrap-up with a glance at individual health center data snapshots. This meeting will provide an excellent opportunity for members to ask questions and share the background story behind the data. This one-hour presentation will be held on
Thursday, August 4, at 3:00 pm CT/ 2:00 pm MT. The CHAD and GPHDN Data Books will be shared with participants prior to the training. Registration information will come soon via email. Contact Melissa Craig at CHAD with questions.
Preparing for the 988 Suicide & Crisis Lifeline
On July 16, the National Suicide & Crisis Lifeline (1-800-273-TALK) will transition to the phone number 988. The 988 number was selected to elevate mental health crisis response awareness to the same level as calling 911 for other emergencies. There is a tremendous need given that suicide is the leading cause of death for individuals aged 10-34, and from April 2020-April 2021, over 100,000 people died from a drug overdose.

Available 24/7, the 988 crisis line will:
  • Connect a person in a mental health crisis to a trained counselor who can address their immediate needs and help connect them to ongoing care;
  • Reduce use of law enforcement, public health, and public safety resources; and,
  • Meet the growing need for crisis response systems.

In South Dakota
In South Dakota, 988 will be answered by the Helpline Center and staffed by individuals with advanced degrees and experience in behavioral health. Partnerships have been formed with 911 public safety answering points (PSAPs), psychiatric inpatient units, stabilization units, and appropriate regional facilities, and 988 staff will provide follow-up calls and referrals. The 988 and 211 call centers are independently operating divisions within the Helpline Center organization. The 211 call center will serve as backup to 988 after July 16. On average, 80% of calls received by trained crisis counselors in a 988-situation can be de-escalated on the phone, reducing the need to dispatch law enforcement in situations that do not have safety concerns. In the event situations necessitate a response, resources can be quickly dispatched.

In North Dakota
Currently, when a North Dakota resident calls the National Suicide Lifeline, a trained member of the local Lifeline crisis center, FirstLink, answers. FirstLink staff listen to the caller, understand how their problem affects them, provide support, and share resources if needed. FirstLink connects the person to their local human service center’s mobile crisis team if additional support is needed. When 988 goes live in July, this process will remain the same.

What can health centers do to prepare for the transition?
  1. Share information about 988 at an upcoming staff meeting;
  2. Leverage a social media presence to share information about the 988 number after July 16;
  3. Update EHR templates and other internal resources to ensure that the 988 number is shared with patients; and,
  4. Consider adding the 988 number to answering machines to indicate if individuals are facing a crisis and need immediate support to call 988.
Continue to direct patients to 1-800-273-8255 until July 16. This number will still be available after July 16.

Additional Resources and Tools
  • The National Action Alliance for Suicide Prevention and its messaging task force developed the 988 messaging framework to provide guidance on developing 988-related messaging. The framework offers strategies related to the timing of messages before and after the transition to 988 in July.
  • The Substance Abuse and Mental Health Services Administration (SAMHSA) created a one-stop-shop, the 988 Partner Toolkit, at The toolkit is intended for SAMHSA’s 988 implementation partners—including crisis call centers, state mental health programs, substance use treatment providers, behavioral health systems, and others. It provides key messages, FAQs, logo and brand guidelines, and more information about 988. Through collaborative efforts, SAMHSA created guidance documents (e.g., "playbooks") for these critical groups to support the implementation of 988.
  • SAMHSA will add social media posts, wallet cards, magnets, and other materials about 988 to the toolkit over time.
Identifying Community Resources in South Dakota
As more health centers implement PRAPARE, CHAD staff often hear the need to identify appropriate community resources for patient referrals. Both North Dakota and South Dakota have active 2-1-1 helplines, which house a comprehensive statewide database of community resources.

In this 15-minute, on-demand video, the Helpline Center shares tips and tricks for identifying community resources across South Dakota. Health centers can use this in staff trainings and onboarding to ensure their staff are aware of the Helpline Center’s database of community resources.

Viewers will learn how to:
  • Find local community resources using the Helpline Center database;
  • Generate custom community resource lists for common patient social needs; and,
  • Connect patients to new transportation assistance programs.

The video also covers 988 as the new 3-digit crisis helpline and the Helpline Center’s role in Get Covered SD health insurance navigation. If there are other ways CHAD can support community work or address patient social needs, reach out to Shannon Bacon with training requests. 
Community Health Association of Mountain/Plains States
(CHAMPS) Updates
Call for Nominations: 2022 CHAMPS Awards
CHAMPS is now accepting nominations for the 2022 CHAMPS Awards in administrative leadership, board leadership, clinical leadership, legislative leadership, advocacy of the underserved, and the Stanley J. Brasher Legacy Award. These awards, presented by CHAMPS, are to recognize and honor staff and board members of Region VIII health centers and related organizations for their exceptional contributions to the health center community.

The criteria for nominations are:
  • Nominees must be affiliated with a current CHAMPS organizational member, except for nominees for the Outstanding Legislative Leadership Award;
  • Nominating organizations may submit only one award nomination per individual candidate, and each candidate may be nominated in only one category; and,
  • Nominations must be submitted by Monday, July 25.

Visit the CHAMPS Awards webpage for additional details about the 2022 CHAMPS Awards as they become available, as well as for highlights of 2021 CHAMPS awardees and lists of awardees from prior years.
Available Now: New CHAMPS Podcast Series
In June, CHAMPS released a three-part podcast series, Emerging Issues in Health Center Workforce: Community Health Workers. While some health centers have utilized community health workers (CHW) for many years, recent funding has significantly expanded the use of this care team member across Region VIII. Interviewees highlight how using CHWs can relieve current and future workforce challenges while improving patient care. Participating organizations include MHP Salud, Association for Utah Community Health, and Tepeyac Community Health Center (CO). Visit the CHAMPS Podcasts webpage to listen.
New CHAMPS Website Resources
CHAMPS has recently published two new web pages for health center staff to utilize in their work. The first, Indigenous Health Resources, was created to support health centers as they engage with Indigenous patient populations and tribal communities. The information provided is up-to-date reports and services for Indigenous-specific health topics, health equity issues, and provider education. The second webpage, Suicide Prevention Resources, was created to support health centers as they provide quality health care to patients at risk for suicide and includes reports, more information, and relevant trainings. All CHAMPS resources are updated consistently to ensure the most relevant, timely information is available to our health centers.
GP12 Network News
New Member Joins Great Plains Health Data Network
The Great Plains Health Data Network (GPHDN) welcomes Health Care for the Homeless (HCH) in Casper, Wyoming, to the network. With the addition of Health Care for the Homeless, the GPHDN now consists of 12 participating health centers, serving 76 sites, and collectively serving over 100,580 patients. The GPHDN represents nearly all the health centers operating in three states.

HCH is a program of the Community Action Partnership of Natrona County and provides primary care services to individuals experiencing homelessness in Natrona County in Wyoming. In addition to treating acute health needs, HCH offers preventative health care and chronic disease management to the patients they serve. In collaboration with local agencies, HCH provides counseling and psychiatric medication management services. HCH also has a certified enrollment specialist who can provide assistance in applying for insurance coverage through the federal health insurance marketplace. An on-site care management specialist works closely with the care team available to help coordinate care between medical specialists and community resources. Additional information on HCH can be found here.

HCH joined the GPHDN during the last year of the existing grant award and will continue, pending award, for the next project period. The next few years will focus on how the network can be leveraged to improve the way comprehensive primary care can be delivered using digital health tools and data to drive performance improvement. The GPHDN will continue to provide collective impact to support members through collaboration and shared resources, expertise, and data to improve clinical, financial, and operational performance.
Child Care Assistance Programs & Advocacy Efforts
In both North Dakota and South Dakota, child care assistance is currently available to income-eligible families while they work or attend school or training. The family may be required to make a co-payment based on the household income and family size. Eligibility in North Dakota was recently expanded, so even if a patient or staff member was not previously eligible, they could be now. The PRAPARE tool many health centers use includes a screening question regarding difficulty affording childcare. Patients who screen positive on that question should be notified of this resource. 

Learn more at these websites:

In addition, CHAD participates in the ND Child Care Action Alliance (NDCCAA), a statewide coalition working to fully understand the impact of access to affordable, quality child care for working families in North Dakota. This work came about after the ND KIDS COUNT Child Care Access Report showed significant childcare challenges for working families across the state.

NDCCAA will host a virtual listening session to hear the stories of families and workers impacted by the lack of accessible, affordable, and quality child care in ND on Monday, July 25, from 6:00 – 7:30 pm CT/ 5:00 – 6:30 pm MT. Registration is required. Sample flyers and social media posts are available by request to promote this session to employees or patients. Contact Shannon Bacon for more information.
Webinars & Meetings
Find these and other events on the CHAD website.
Documentation, Billing, and Coding Webinar Series Continues July 8 on Diabetes
CHAD is pleased to welcome Shellie Sulzberger, co-founder of Coding and Compliance Initiatives, Inc., back to the Dakotas for a webinar series focused on documentation, billing, and coding. This training series kicked off on June 9 with a session on the updated evaluation and management coding guidelines. The recording and materials for that session can be found here.

The next scheduled webinar will focus on billing for services related to the diagnosis and management of diabetes. Attendees will review the importance of specificity for evaluation and management (E/M) services and value-based health care. Participants will review and leave with a pre-visit planning template that clinical staff can use in the health center. The next session on behavioral health will be on Friday, July 29.

Friday, July 8
11:00 am CT/ 10:00 am MT
Register here.
Moderna Pediatric COVID-19 Vaccine Indication
Join Moderna for one of its upcoming webinars detailing the pediatric and adolescent indications for the Moderna COVID-19 vaccine. The same information will be shared at each presentation.

Tuesday, July 12 at 1:00 pm CT / 12:00 pm MT
Tuesday, July 19 at 11:00 am CT / 10:00 am MT
Register here.
NDSU Center for Immunization Research and Education: Bringing the Experts to You
Join the NDSU Center for Immunization Research and Education (CIRE) for a free webinar, including free continuing medical education (CME) credits for live attendees, on why nurses play a crucial role in patients’ vaccine decisions and how they can be vaccine champions in their community. Presented by Mary Koslap-Petraco, DNP, PPCNP-BC, CNP, FAANP, the webinar will also discuss tools and strategies to address vaccine conversations. The event will be moderated by Sharon Nelson, PhD, RN, assistant professor of practice at NDSU nursing at Sanford Health, Bismarck. Time allowing, Q&A with attendees will follow.

Wednesday, July 13
12:00 pm CT/ 11:00 am MT
Register here.
North Dakota Department of Health Monkeypox Lunch & Learn
Join the North Dakota Department of Health for a lunch-and-learn on monkeypox. Participants will learn about the epidemiology of monkeypox, symptoms, testing, treatment, and vaccination. Continuing education (CE) credits are available for nursing. The webinar will be archived for viewing at a later date.

Wednesday, July 13
12:00 pm CT/ 11:00 am MT
Pre-registration is not required. Click here to join at time of meeting.
CHAD Network Team Meetings
Tuesday, July 12 at 2:00 pm CT/ 1:00 pm MT – Communications and Marketing Network Team
Thursday, July 14 at 9:30 am CT/ 8:30 am MT – Emergency Preparedness Network Team
Tuesday, July 26 at 1:00 pm CT/ 12:00 pm MT – Outreach & Enrollment Network Team
Tuesday, July 26 at 3:00 pm CT/ 2:00 pm MT – CFO & Finance Manager Roundtable
Thursday, August 4 at 12:00 pm CT/ 11:00 am MT – Clinical Quality Network Team

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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