CHAD Connection - August 5

August 8-14 is Health Center Week in the Dakotas, proclaimed by Governor Noem and Governor Burgum. Health centers in North Dakota and South Dakota are taking this moment to celebrate. CHAD staff is gassed up and taking this year’s health center week on the road! Next week, CHAD staff plan to visit every delivery site in both states to attend events, bring treats, and thank our members in person.

The Dakotas’ network of health center organizations will be using this opportunity to thank patients and the communities they serve and highlight the important contributions they make to the health care system in urban and rural communities. It is also an excellent opportunity for health centers to recognize their outstanding staff for all they do and to give back to the communities they call home. See our next issue of the CHAD Connection for a collection of stories and photos.

In July, South Dakota Urban Indian Health (Urban) partnered with South Dakota Voices for Peace and the SDSU Dairy Extension to offer COVID-19 vaccinations for three evenings in the Empire Mall parking lot. The event prioritized accessibility, including signage and other materials in multiple languages, listing bus routes, and allowing patients to stay in their vehicles during the vaccination process.

The three organizations provided education, refreshments, and $30 incentives for each patient. The event was considered a success, with over 100 people vaccinated for COVID-19. The group is planning additional vaccine clinics from August through October. Click here for dates.

The Urban event showcases multiple best practices in the race against COVID-19. The goal to vaccinate as many people as possible necessitates one-on-one conversations, community partnerships, practical solutions to accessibility and childcare issues, and, yes, incentives. CHAD applauds the work of all of our member health centers for their monumental contribution to the fight against COVID-19.

This week, the Centers for Medicare & Medicaid Services (CMS) released new data showing that returning consumers to the Marketplace can save, on average, 40% off of their monthly premiums because of enhanced tax credits in the American Rescue Plan Act (ARPA). Since implementing the tax credits on April 1, 34% of new and returning consumers have found $10 or less coverage per month on HealthCare.gov. A state-by-state breakdown of savings is available here.

In the final two weeks remaining in the 2021 special enrollment period, we encourage all Dakotans who need quality, affordable health care coverage to sign up at HealthCare.gov by August 15. Additionally, consumers who received or who are approved to receive unemployment compensation for any week beginning in 2021 may be able to find even lower-cost plans and save extra money on out-of-pocket expenses through HealthCare.gov due to the ARPA’s enhanced tax credits.

Update on the Infrastructure Bill, Now Known as the Investment and Jobs Act

On August 3, work began on amendments for consideration on the 2,700-page infrastructure package. The bipartisan bill is the first phase of President Biden’s infrastructure plan. It calls for $550 billion in new "physical" infrastructure spending over five years for roads, bridges, waterworks, broadband, and electric grid above projected federal levels. Later this year, the Senate will work on a second $3.5 trillion "social" infrastructure bill to be passed under the reconciliation process that will address health care, education, childcare, jobs, climate change, and other social issues. An August 2 update infrastructure article may be found here.

House Appropriations Passed

The House Appropriations Committee passed H.R. 4502, which includes $7.5 billion for the Health Resources and Services Administration (HRSA), an increase of $1.6 billion above the 2021 enacted level, and $910 million above the President’s budget request. This bill includes $1.8 billion for the Health Center Program, an increase of $148 million above the fiscal year (FY) 2021 enacted level. Within this funding, there is $50 million for school-based health centers, $25 million to establish the new Alcee Hastings Cancer Screening Program, and $152 million for the Ending HIV Epidemic Initiative. There is $1.6 billion for HRSA’s Bureau of Health Workforce, an increase of $341 million above the FY 2021 enacted level, roughly a 50% increase for the National Health Service Corps Loan Repayment Program.

Medicare and Dental Coverage

Medicare beneficiaries who have difficulty accessing and affording dental care would benefit significantly by adding dental benefits to Medicare. A new analysis found that almost half of all Medicare beneficiaries (47%) did not have a dental visit within the past year as of 2018, with rates higher among those who are Black (68%) or Hispanic (61%) compared to White beneficiaries (42%). Rates were also higher among those with low incomes (73%) or those in fair or poor health (63%). In 2020, the Community Action Partnership of North Dakota, the state association of Community Action Agencies, evaluated the needs of and services for individuals. About one out of four 65+ adults had a current need for dental insurance/affordable dental in our state. The House has included a standard dental, vision, and hearing benefit to Medicare as part of a sweeping $3.5 trillion budget reconciliation package. The Senate must now consider the bill. If the request makes it through Congress, it would be the most significant expansion of Medicare benefits since the inception of Part D prescription drug coverage in 2006.

340B Updates

On Friday, July 9, Representatives Abigail Spanberger (D-VA) and David McKinley (R-WV) introduced the first-ever comprehensive federal anti-pickpocketing bill, Preserving Rules Ordered for the Entities Covered Through (PROTECT) 340B Act of 2021. The PROTECT 340B Act protects 340B safety net providers and communities from discriminatory pharmacy benefit managers (PBMs). The bill adds a new section 2730 to the Public Health Service Act, which applies to private insurance plans. The PROTECT 340B Act will prohibit insurers and PBMs from treating 340B providers and their contract pharmacies differently regarding reimbursement, fees, participation in networks, audits, and inventory management systems. It also prohibits interfering in patient’s choice receiving drugs from a pharmacy, whether in person or by mail, requiring 340B providers or pharmacies to identify 340B drugs, refusing to contract with 340B provider or pharmacy, and imposing any other restrictions as specified by Department of Health and Human Services Secretary Xavier Becerra. The PROTECT Act will impose civil monetary penalties through enforcement mechanisms. Read more here.

The Centers for Disease Control and Prevention (CDC) has released new sexually transmitted infections (STI) treatment guidelines for 2021. This document provides current evidence-based diagnostic, management, and treatment recommendations and serves as a source of clinical guidance for managing STIs. Find the main STI diagnostic, treatment, and management updates for providers here.

STIs are common and costly. With 26 million new STIs occurring each year, totaling nearly $16 billion in medical costs, evidence-based prevention, diagnostic, and treatment recommendations are critical to STI control efforts now more than ever. During the COVID-19 pandemic, the CDC provided guidance for the disruption of STI clinical services, focusing on syndromic management and STI screening approaches to maximize the number of people with STIs identified and treated while prioritizing those most likely to experience complications. However, most drug and testing kit shortages have since been resolved. Many health care providers are returning to normal clinical practices, which include conducting STI evaluation and management according to CDC Sexually Transmitted Infections Treatment Guidelines, 2021. Stay informed on the latest STI recommendations and clinical guidance with CDC and partner resources here.

The monthly North Dakota lunch and learn webinar will be held on August 25 at 12:00 pm CT/ 11:00 am MT to review this guidance’s major changes and recommendations. To register, click here.

The Blue Cross Blue Shield of North Dakota (BCBSND) Caring Foundation will provide a limited number of one-year grants annually of up to $50,000 to North Dakota communities and organizations undertaking efforts to support health and community-based wellness and prevention. Caring for Communities SPARK grants aim to enhance collaborative efforts and community involvement that results in long-lasting change.

Those interested in applying for a grant must submit a letter of intent (LOI) form by 5:00 pm CT on February 15 to be considered for the spring funding cycle or 5:00 pm CT on August 15 for the fall funding cycle. Eligible organizations must be North Dakota-based 501(c)(3) nonprofits, municipal entities (i.e., park boards, public health), or school systems. Once an LOI is submitted, applicants may be invited to submit a grant application. All documents must be electronically submitted to caringfoundation@bcbsnd.com. For more information, click here.

The South Dakota Department of Social Services, Division of Behavioral Health invites organizations to apply for several funding opportunities that can be used to support the expansion of evidence-based approaches to the prevention, treatment, and recovery supports for mental health and substance use disorder issues. Applications received before the next deadline on August 11 will be reviewed for projects beginning as soon as October 1. Additional deadlines are available in October 2021 and into 2022, but interested applicants are strongly encouraged to apply sooner rather than later, as funds are limited.

Opportunity #1 | South Dakota SBIRT Mini-Grants
Funds are available to support screening for behavioral health issues and behavioral health integration within primary care clinics as part of the South Dakota SBIRT Program. SBIRT, or Screening, Brief Intervention, and Referral to Treatment, is an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. Successful funding requests have included EMR enhancements to activate screening protocols, purchase of technology to support screening integration, training time offset for clinic staff and providers in select evidence-based practices, staff time to plan for and initiate SBIRT practices on site, and integrated behavioral health supports.

Opportunity #2 | State Opioid Response Mini-Grants

Funds are available to organizations seeking to deliver professional education or training in efforts that prevent, respond to, treat, or support recovery for opioid use. Funds may also address stimulant use disorder. A subject matter expert must provide supported training with developed expertise in addiction.

More information on supported activities for both opportunities can be found in the program descriptions within each application form. Awards for mini-grants will be up to $50,000 and must meet all requirements of each program. To discuss a proposal before applying, please contact the individuals identified in each application or simply call 605-367-5236 and indicate you are interested in learning more about these funding opportunities.

Register now for the 5th annual statewide Immunize South Dakota conference: Getting Back on Track. Held on September 10 in Sioux Falls, this in-person event will bring together health care professionals to network and learn the most recent vaccine news and developments.

This conference is intended to promote immunizations throughout South Dakota by supporting health care providers through education and community outreach resources. Session topics will include vaccine innovations, increasing vaccine confidence, addressing rates of adult and adolescent immunizations, combatting vaccine misinformation, and the most recent information on the COVID-19 vaccines. Attendees will also hear a state epidemiology update from the South Dakota Department of Health.

The conference will be from 7:00 am to 5:00 pm CT. The full agenda will be available soon at ImmunizeSD.org.

The three-part Colorado Community Health Network (CCHN)/CHAMPS 2021 Health Equity Learning Series builds on the foundation from last year’s series and continues efforts in the journey towards a more equitable and just health system. Participants will come away from the series with a greater understanding of organizational and personal position in health equity and tangible strategies and tools to assist in moving forward.

Sessions in the series include:

It Starts with Us: The Journey of Dismantling Institutional Racism

Tuesday, August 31

1:00–2:15 pm CT/ 12:00–1:15 pm MT

Applying the Health Equity Lens: Serving Indigenous People

Tuesday, September 14

1:00–2:30 pm CT/ 12:00–1:30 pm MT

Applying the Health Equity Lens: Weight Bias in Health Care

Tuesday, September 28

1:00–2:30 pm CT/ 12:00–1:30 pm MT

Registration is open and free for participants from Region VIII health centers and Primary Care Associations. To learn more and register for each event in the series, visit the CHAMPS Upcoming Live Distance Learning Events web page.

Thousands of South Dakotans live with at least one chronic condition. Additionally, South Dakota has a significant aging population, and chronic health conditions tend to increase in prevalence with age. Although chronic health conditions are among the most common and costly health problems, they are also among the most preventable.

Better Choices, Better Health® South Dakota (BCBH-SD) is a licensed, statewide program for adults offering a suite of free self-management education (SME) programs facilitated by trained BCBH-SD leaders. This suite includes programs for chronic conditions, pain, diabetes, and cancer available in a variety of workshop formats, including face-to-face, virtual, and toolkit self-study. New in 2021 is the chronic conditions program offered in Spanish. The workshops introduce evidence-based information and skills that are proven to help those with chronic physical and mental health conditions improve their quality of life.

If any health center staff are interested in becoming trained as a leader for the BCBH-SD program, there is a virtual training scheduled August 19 through September 30, meeting twice-weekly (Mondays and Thursdays) from 2:30 - 5:00 pm CT. Click here to register, call 1-888-484-3800, or visit www.betterchoicesbetterhealthsd.org for more information.

Registration is now open for the Northwest Region Primary Care Association (NWRPCA)/CHAMPS 2021 Fall Primary Care Conference. This multi-day, multi-track conference will offer a variety of keynote plenaries, educational sessions, networking opportunities, exhibitors, and more designed to meet the needs of health center staff. The theme for this year’s conference is Re•Connect: Re•Envisioning Community Health for 2022 & Beyond.

The conference will be held on Sunday, October 24 – Tuesday, October 26, in Seattle, WA and is currently planned to include both in-person and virtual options. To learn more and register, please visit the CHAMPS Annual Primary Care Conference webpage.

Governor Noem has proclaimed August as Immunization Awareness Month (IAM) in South Dakota. This annual observance highlights the importance of getting recommended vaccines throughout one’s life. Everyone has the power to protect loved ones against serious diseases, like whooping cough, cancers caused by HPV, and pneumonia through on-time vaccination.

During IAM, organizations like CHAD and Immunize South Dakota encourage people to speak with health care providers to ensure their family is up to date on recommended vaccines, including COVID-19 and influenza. As children head back to school this fall, parents should make sure well-child exams and vaccinations are at the top of their checklist. Adults need vaccines too. Check the Centers for Disease Control and Prevention’s (CDC’s) adult vaccine assessment tool to evaluate personal vaccine needs.

CISA Ransomware Resource Website

The Cybersecurity and Infrastructure Security Agency (CISA) recently announced a new website to be a central resource for public and private organizations to assist with the rise in ransomware cyberattacks. The CISA website will provide partners and stakeholders with ransomware protection, detection, and response guidance in a single place. Resources include ransomware alerts, reports, and information from CISA, the FBI, and other federal partners. GPHDN will highlight and provide additional information on specific website resources beneficial to member health centers in future newsletters.

Measuring and Maximizing Provider Satisfaction

Join CHAD for this three-part series explaining the importance of provider satisfaction, its effect on health center performance, and how to identify and measure provider satisfaction. The webinar series will culminate in a final session at the CHAD in-person conference in September, discussing how to improve satisfaction using health information technology (HIT). Presented by CURIS Consulting, the series will include the process of distributing a survey to providers to evaluate satisfaction and analyze the results of CHAD members and the Great Plains Health Data Network (GPHDN). The intended audience for this three-part series is c-suite staff, HIT staff, clinical leads, and human resources staff.

Measuring Provider Satisfaction
In this final webinar, presenters will share how to measure provider satisfaction and how to evaluate the data. The CHAD and GPHDN provider satisfaction survey results will be analyzed and shared with attendees during the presentation.

Wednesday, August 25
11:00 am CT / 10:00 am MT
Register here.

Whole Person Care: Oral Health Webinar Series

Oral health can play a critical role in systemic health. Integration of oral health and primary care practice is a strategy to increase access to oral health care. Presented by the Wyoming Primary Care Association and the National Network for Oral Health Access (NNOHA), this webinar series will share the framework for integration of oral health, primary care practice, and behavioral health.

This series will also describe the importance of medical and dental integration in primary care to promote whole-person care. Presenters will also review the clinical relationship between diabetes and oral health and the action steps primary care providers can take to assess, evaluate, and manage the impact of oral health status on an individual’s diabetes.

Monday, August 9
12:00 pm CT/ 11:00 am MT
Register here.

Staffing Transformation Following PCMH Recognition among HRSA-Funded Health Centers

Register today for this webinar exploring how a patient-centered medical home (PCMH) recognition at health centers has affected staffing capacity to deliver team-based integrated care. PCMH recognition aims to improve patient outcomes and has been promoted through the Health Center Program with training, TA, and funding support. The speaker will feature findings from a recent data analysis from the UDS and the HRSA accreditation and PCMH recognition initiatives to identify health center staffing infrastructure changes.

Thursday, August 26
12:00 pm CT/ 11:00 am MT
Register here.

2021 CHAD Conference

Registration is open for the 2021 CHAD Conference this fall in Rapid City, SD. Paired with the Great Plains Health Data Network summit, the 2021 CHAD Conference will feature speakers and panelists who will look at the history of the health center movement as a way to inform the current moment and look forward to the future’s potential. Participants will connect to the past through stories and learn how to use stories to continue to be community-driven, equity-oriented, and patient-centered organizations and how we can continue to live out the values of the health center movement in the current context. Tracks include workforce, leadership, health equity, clinical quality, and behavioral health. Visit our conference website for registration, schedule, and room details.

September 14 and 15
Register here.