In March, I am observing my sixth year with CHAD. It has been a real joy to work alongside health center leaders in the Dakotas and around the country. We have continually asked how we can be better together and so – as I take stock of the last few years – let’s have some fun as we celebrate what we have accomplished together.

CHAD is a place where health center staff can network and learn. We use a network team structure that enables clinical, communications, human resources, and other similar staff to meet regularly, learn from one another, ask questions, and guide our training plan. One way we measure engagement in those network teams and training opportunities is through total participation. Between the 2017-18 fiscal year and the most recent fiscal year of 2020-21, we saw a nearly 50% increase in total participants from 1896 (in 187 trainings) to 3085 (in 215 trainings).

We also provided almost 400 hours of coaching and technical assistance in FY20-21. Training topics broke out as follows:
As we have evolved as a provider of training and technical assistance, we have worked to develop an initiative-based model of training. That means rather than primarily providing one-off trainings and webinars, we work with health centers to identify strategic initiatives where we can collectively learn and progress toward shared goals. We consistently try to ask how we can be better together. Examples of collective initiatives currently underway include: implementing social driver of health (SDOH) screening tools to enable us to better address social and economic factors that impact health;
joint purchasing of a population health tool to drive quality improvement and shared data analytics;
and a shared security risk assessment tool and training that resulted in 10 of 11 GPHDN members completing an information technology security assessment.
CHAD also was a new grantee in the Navigator program in 2021, which enabled us to support health centers and other partners in enrolling people into health coverage. Collectively, with health center staff, during the first seven months of the project, we have achieved:
  • 120% of target on consumers receiving 1:1 assistance (6,478);
  • 77% of target on consumers assisted with enrolling in a qualified health plan (671); and,
  • 67% of target on consumers assisted with Medicaid/CHIP applications or referrals (148).

Another exciting development in 2020 was the inclusion of a new association member in South Dakota Urban Indian Health (SDUIH). We have loved learning from the care model they have developed that embeds health care in Native values and culture. Our shared commitment to health equity and whole-person health care has made SDUIH a great fit at CHAD!

In order to achieve all of these goals, we have brought additional resources into CHAD and health centers which has resulted in revenue growth from about $1.5 million in FY18 to expected revenue in FY22 of over $4 million.

We are excited about where we are headed next. Our current strategic plan reflects a commitment to investing in people and communities.
We will continue to pair our training and coaching support with strong advocacy for access to high-quality health care for all Dakotans. Our state and federal policies priorities include:
  • increased investment in the health care workforce, especially for those providing care to underserved communities (we were pleased to see both states increase their investment in loan repayment for providers in underserved communities this year!);
  • increased investment in programs that improve access to care such as coverage programs and investment in primary care for all (supporting Medicaid expansion and increased investment in the health center programs);
  • support for value-based payment (engaging in the Medicaid payment reform conversations in both states); and,
  • equitable payment for telehealth services and others.

Together – health centers, CHAD, and our many community partners – we have made enormous progress toward our shared goals over the last six years, and we look forward to what the next years will bring.
Health Centers in the News
Family HealthCare and CHAD are quoted in this Public News Service article on health equity issues in North Dakota.
A member of the Horizon Health Care board of directors retired after 25 years via the Sanborn Journal.
“It’s All About Respect” – Community Health Center of the Black Hills on Transgender Day of Visibility
March 31 is the International Transgender Day of Visibility. It’s an annual awareness day dedicated to celebrating transgender and gender-nonconforming people and the determination it takes to live openly and authentically. To mark this day, Shannon Bacon, health equity manager at CHAD, sat down with Kara Roland, a registered nurse with the Community Health Center of the Black Hills (CHCBH) Iris Clinic for LGBT+ Youth. At the Iris Clinic, Kara works alongside pediatrician Amanda Diehl, MD, to provide primary care for LGBT+ youth up to age 21. For Kara, Transgender Day of Visibility is an opportunity to pause and say, “I see you, and I respect you, and I recognize who you are, and I celebrate you.” They add, “For a group who is far too frequently pushed to the side or ignored, it’s really important to have days and times when we say, ‘I see you.’

This sentiment is baked into the daily culture at CHCBH and the Iris Clinic. Together, Dr. Diehl and Kara work to provide a safe and affirming space for LGBT+ youth, who experience discrimination in both big and subtle ways. This also extends to the broader clinic, where all staff have participated in LGBT-affirming trainings and are committed to creating a safe space. Kara expressed special appreciation for the front desk staff, who are so welcoming to all patients.

At the Iris Clinic, Kara spends a large portion of their time helping to coordinate care, referrals, and other resources. It can be challenging for transgender youth and their parents to locate supportive and informed care providers. The Iris Clinic can be a central point for care coordination, ensuring that all referral sites are safe, affirming, and familiar with transgender care. Kara coordinates care with affirming therapists, endocrinology, and plastic surgery and has established relationships with these partner providers. Patients can also have their endocrinology labs completed at CHCBH to be more affordable. It is deeply fulfilling work for the staff involved too. “Getting to know these youth, the bravery, and fortitude of these adolescents, it blows me away,” says Kara.

The Iris Clinic views all of this as suicide prevention. LGBT+ youth are more likely to seriously consider, plan, and attempt suicide. And for transgender youth, having even one supportive adult in their life is shown to significantly lower the risk of suicide. Kara draws from both lived experience and professional training to build that supportive space and is honored to do so. “I hope that I’m one of those people who makes a difference in their lives … to be for somebody else what I needed,” they say.

When asked if there is one thing they’d want all primary care providers and staff to know about working with transgender youth, Kara says it is all about respect. “It may feel a little weird or strange to use different pronouns for someone than your brain wants to use right away, but it’s ultimately just about respecting that person. So, in the same way, that we would adjust our language or our interactions to be culturally sensitive and competent to any other person, it’s the same. It’s just a different way of referring to them that shows them care and respect and opens yourself up as a safe person and your clinic as a safe space.” Watch a short clip of Shannon and Kara’s interview here.

Celebrate Transgender Day of Visibility by checking out these resources:
  • The Iris Clinic website includes resources for providers, parents, and more. Their team also welcomes questions at
  • The National LGBT Health Education Center provides educational programs, resources, and consultation to health centers to optimize culturally affirming, patient-centered, high-quality, and cost-effective health care for all sexual and gender minority people. Online CMEs are available.
  • In North Dakota, check out the Harbor Health Initiative. Harbor Health Initiative seeks to better the health care infrastructure that is already in place by advocating for trans-inclusive health services and cultural competency training.
Telling the Health Center Story April 21
Join CHAD for this educational and inspirational introduction to community health centers. Participants will gain a foundational knowledge of health centers, including defining features, key 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.

This 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
Federal Updates
On March 15, the President signed the omnibus appropriations bill to fund the federal government for federal fiscal year 2022, which covers spending from October 2021 through September 2022. The Bureau of Primary Health Care (BPHC) shared the following implications for health center funding:

Overall, health center funding will see a small year-over-year decrease when sequestration is considered; however, they expect to be able to cover that decrease and do not anticipate any funding cuts.
  • There was a $25M increase in funding for school-based health centers. They plan to fund additional applications from the previous funding opportunity for this program.
  • They have remaining funding from the capital funding opportunity they offered last year. They plan to redistribute that to support UDS + implementation, which should be distributed before the end of this fiscal year and is expected to be one-time funding.
  • $5M was allocated to support cancer screening in underserved communities.

Omnibus appropriations also included a 6.3% increase for the Indian Health Service, including a 17.1% increase for the Urban Indian Health program. There were several provisions supporting the prevention of violence against Native American women.

omnibus also included an extension of telehealth emergency provisions to 151 days past the official federal public health emergency (PHE). The soonest that the PHE could expire is July 15; if that occurred, current telehealth flexibilities would run through December 13. Note that the PHE could be extended past July 15. Two other themes across the Health Resources and Services Administration Budget were increased funding for ending HIV and improving maternal health.

The President’s fiscal year 2023 budget is expected to be released on Monday, March 28.

South Dakota Legislative Session Update
2022 Legislative Session closed on March 10. After a two-week recess, the final day of session, which is reserved for gubernatorial vetoes, will be March 28. The legislature considered 339 House bills, 19 House commemorations, 24 House resolutions, 212 Senate bills, 28 Senate commemorations, and 10 Senate resolutions. Below is a highlight of the bills CHAD tracked throughout the legislative session.

House Bill 1340 contains spending for state government for FY2023 and includes a 6% increase for education, state employees, and Medicaid providers.
Senate Bill 155 authorized one-time payments to home and community-based providers with American Rescue Plan Act (ARPA) funds ($80.7 million), one-time funding for nursing home staffing grants ($10.1 million), a one-time correction to the rate for children’s international classification of functioning (ICF) rates ($1.2 million) and one-time funding for Court Appointed Special Advocates (CASA) programs ($1 million).
Senate Bill 43, Senate Bill 44, and Senate Bill 61 provide workforce development options in health care, specifically nursing workforce development.
House Bill 1038 establishes a fund to accept money received by the state as part of the national opioid settlement. Money in this fund will be used to remediate the effects of opioid addiction.
Senate Bill 26 includes advanced practice registered nurses as a provider who can certify a patient for medical cannabis use under the medical cannabis program.
House Bill 1030 provides funding to reimburse certain health care professionals who have completed their service to rural communities through the rural tuition reimbursement programs.

House Bill 1258 and Senate Bill 211 both aimed to give exemptions from COVID-19 vaccination requirements based on various factors.
Senate Bill 102 proposed to set up a separate fund to account for money received by the state if the voters approve Medicaid expansion in November.
Senate Bill 134 proposed to allow physician assistants to practice to their full scope of practice without the requirement of a collaborative agreement with a physician.
Senate Bill 163 proposed to add transparency in prescription drug pricing by providing restrictions on and protections from pharmacy benefit managers.
Senate Bill 186 proposed to expand Medicaid eligibility.
House Bill 1086 would have created a system by which certain drugs could be accepted for redistribution by pharmacies that meet the requirements for accepting donated prescribed drugs.
House Bill 1242 proposed to allow a health care practitioner to practice consistent with their own personal conscience. A provider at any level could decide to provide or not provide care or treatment regardless of the patient’s wishes, other health care personnel’s recommended treatment plan, or state or federal law.
COVID-19 Updates, Resources, and Upcoming Webinars
Pfizer has submitted a request to the Food and Drug Administration (FDA) for emergency use authorization (EUA) of an additional booster for adults ages 65 years and older. More information on the studies analyzed for vaccine effectiveness during the Omicron wave can be found here. Second booster doses cannot be administered until the FDA has authorized this and the Centers for Disease Control and Prevention (CDC) makes its recommendation.

Moderna announced last week it has submitted a request to the FDA to authorize its COVID-19 vaccine to be used as a second booster dose for adults 18 years and older. Providers cannot administer any second booster doses of this vaccine until the FDA has approved and the CDC makes the recommendation.

The FDA announced the approval of a shelf life extension for the Johnson & Johnson’s Janssen COVID-19 vaccine for an additional three months. This shelf-life extension applies to all inventory dates to expire on March 7 or later. Vaccine providers should visit the Janssen COVID-19 Vaccine Expiry Checker webpage to confirm the expiration dates. This shelf-life extension applies to refrigerated vials of the J&J/Janssen COVID-19 vaccine that have been held per the manufacturer’s storage conditions.

The CDC recommends all eligible people get a booster vaccine, continue to mask in areas of moderate or high levels of COVID-19 and order the at-home test kits to continue to have available in our communities. The government has made it possible for community members to order a second round of two free home test kits through the USPS. Health centers may continue to order home test kits through the HRSA testing supply program.

Health centers play a crucial role in testing, treating, and vaccinating uninsured individuals or those with limited health care coverage in their communities. Please see the recent updates regarding submitting claims in the Health Resources & Services Administration (HRSA) COVID-19 Uninsured Program.

The Role of Telehealth in Expanding Access to Health Care and Social Services, with a Focus on Pediatric Behavioral Health Sustainable Strategies Panel 
This panel session will discuss health center and hospital-based perspectives. It will highlight sustainable strategies to enhance access to pediatric behavioral health, early intervention, and preventive services for children during the COVID-19 pandemic and beyond.

Tuesday, March 29
11:00 am CT/ 10:00 am MT
Register here.
Long COVID ECHO Webinar Series
This series, beginning March 10, is a Centers for Disease Control & Prevention (CDC)-funded monthly webinar-style ECHO learning session to disseminate Post-acute Sequelae of COVID-19 (PASC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) findings and emerging best practices.

March – June 2022
2:00 pm CT/ 1:00 PM MT
Register for any or all sessions here.
Inaugural South Dakota Community Health Worker Conference
April 28

The Community Health Worker Collaborative of South Dakota (CHWSD) is excited to host the inaugural South Dakota Community Health Worker Conference. This conference is an opportunity for community health workers (CHWs), CHW allies, and CHW supporters to come together for a day of networking and education and learn more about CHW initiatives and workforce development in South Dakota.

This conference will be held in persona at the Hilton Garden Inn in Sioux Falls on Thursday, April 28. This year, it is offered at no cost due to grant funding made available through the South Dakota Department of Health, Office of Disease Prevention and Health Promotion. For agenda, registration, and lodging information, click here.

GP11 Network News
Russia Escalating Cyberattacks
As America and other countries continue to impose additional economic sanctions against Russia in response to its invasion of Ukraine, intelligence agencies are warning that Russia will respond by increasing its malicious cyber activity by exploring options for potential cyberattacks. On March 21, the White House released a fact sheet to warn organizations of this potential and provide resources and tools to the private sector since it is responsible for protecting its critical infrastructure. The fact sheet lists several steps companies can execute to help protect their security. In addition, the Cybersecurity & Infrastructure Security Agency (CISA) has also published the “Shields Up” website, which lists the latest updates, guidance, and helpful information to help protect businesses.
Registration is Open for the 2022 Great Plains Health Data Network Summit
The Great Plains Health Data Network (GPHDN) Summit will feature national presenters who will share their health data success stories, lessons learned, and ways health centers can work together through a health center-controlled network (HCCN) to optimize health technology and data. In the morning session, speakers will outline the challenges and opportunities of virtual care and lead participants in a workshop discussion of how virtual care might align with health center strategic goals. The afternoon session will focus on capturing data and conducting data analysis – including what the GPHDN has accomplished so far and where it might consider heading next. This event will culminate with the GPHDN strategic planning, and it will result in a new three-year plan for the network. Registration closes on April 1.
Azara 2022 Annual User Conference May 2-4
The Azara 2022 Annual User Conference will return to Boston this spring at the Boston Park Plaza located in Boston’s historic Back Bay. Azara DRVS users from community health centers, physician practices, primary care associations, health center-controlled networks, and clinically integrated networks are invited to join us for a day of pre-conference workshops and two days of general sessions, breakouts, and networking events.

Our growing national conference, now back in person, is the ideal opportunity for Azara DRVS users to meet, share best practices and ideas, further their knowledge and skills, and collaborate with the Azara team. Sessions cover topics appropriate for all levels of DRVS users—new to advanced—and aim to broaden and deepen the use of solutions. Click here for more information.
SDDOH Health Improvement Innovation
Request for Applications

The South Dakota Department of Health (SDDOH) has announced the Health Improvement Innovation request for applications. This funding opportunity is intended to support strategies that focus on health improvement and include supportive activities to address barriers, or unintended outcomes underserved populations may face. Successful applicants will be awarded up to $25,000. Applications will be accepted and awarded on a rolling basis. For more information, please visit
Stand Against Racism Challenge:
A Virtual Community of Growth!

Join the Cass Clay YWCA for the 2022 Stand Against Racism Challenge: A Virtual Community of Growth! This challenge is an opportunity to join a free, online learning community dedicated to racial equity and social justice designed to push people out of their comfort zone, think critically, and move communities forward.

Together, participants will explore the intersections of race and equity with the following topics:
  • Homelessness and housing;
  • Gender-based violence;
  • Film and television; and,
  • Education.

In addition to daily resources (articles, podcasts, videos, and more), discussion questions and action steps will help you continue the conversation with others in workplaces, community organizations, families, or friend groups. Whether people are just starting the journey into racial justice or have been doing this work for years, participation in an activity like this connects people, identifies innovative ways to dismantle racism and other forms of discrimination, and reminds people of the impact injustice has on the community. The challenge goes live Monday, April 4, and continues weekdays through May 2. Spots are limited, so register soon.
Webinars & Meetings
Find these and other events on the CHAD website.

NACHC Briefing on Medicaid Redeterminations and State Flexibilities
Join the National Association of Community Health Centers (NACHC) for a webinar with national Medicaid policy experts and primary care association staff to discuss the impact and implications of the end of the federal public health emergency (PHE) and related Medicaid redetermination and flexibility processes.

Topics will include the new Centers for Medicare & Medicaid Services (CMS) guidance on Medicaid redeterminations and renewals and state efforts to keep patients covered by Medicaid and Marketplace plans. The end of the PHE will be the most significant coverage event since the Affordable Care Act passed – join this call and stay informed. If you have any questions, contact

Monday, March 28
3:00 pm CT/ 2:00 pm MT
Register here.
Schools and Health Center Partnerships
Caring for the school-aged population is critical for community health centers and expanding school-based health sites and services is a growth and development strategy. Health centers must have the ability to creatively partner with schools, school systems, educational leaders, school boards, and parents/guardians. The National Association of Community Health Centers and the School Based Health Alliance are collaborating on this two-hour workshop that provides learners with a foundational overview of starting a school-based health center.

Thursday, April 7
1:00 pm – 3:00 pm CT/ 12:00 pm – 2:00 pm
Register here.
The Power of Prevention: South Dakota Oral Health Summit April 12
Join the South Dakota Oral Health Coalition on Tuesday, April 12, at the Sioux Falls Convention Center for the 2022 South Dakota Oral Health Summit. Presenters from across the country will share information about prevention initiatives to improve oral and overall health. Registration is free and includes a light breakfast and lunch. The deadline to register is Wednesday, April 6.

Alan Morgan, CEO of the National Rural Health Association, will give the keynote presentation on the national oral health landscape. Register here. If you have any registration questions or need assistance, please contact Cori Jacobson or Donna Mullett.
Workplace Violence: Risks, De-Escalation, and Recovery
Workplace violence exists, and health care organizations are not immune to its effect. Hosted by CHAD and presented by Connect Consulting, this webinar will review key terminology and regulations related to workplace violence. Presenters will also review different types and risks of health care workplace violence and requirements for protecting personnel. Attendees will learn predicting factors of aggression and violence and techniques to de-escalate a potential violent workplace incident. The group will also discuss the importance of stress management and recovery from the potential impact of workplace violence.

Thursday, April 14
9:30 am CT/ 8:30 am MT
Register here.
North Dakota Oral Health Coalition Meeting May 6
During this in-person meeting, the NDOH coalition will collaborate on strategies to implement the goals outlined in the North Dakota oral health action plan that was developed during the state engagement meeting in May 2021. The group will work toward increased availability, accessibility, and utilization of oral health services for underserved populations and communities throughout the state. The deadline to register is April 14. Click here for the agenda.

Friday, May 6
10:00 am – 2:00 pm CT/ 9:00 am – 1:00 pm MT
RSVP here.
Do School-Based Health Models Expand Your Community Reach? Yes! Learn the Recipes for Success
Join the National Association of Community Health Centers and the School-Based Health Alliance for a 3-hour virtual workshop designed for health centers looking to partner with schools and expand services through planning and implementing school-based health centers (SBHCs). Caring for the school-aged population is critical for community health centers. Expanding school-based health sites and services is a growth and development strategy. Health centers must be aware of the unique operational considerations, competencies, and models along a continuum of possible school-based or school-linked health services.

Tuesday, May 17
1:00 pm – 3:00 pm CT/ 12:00 pm – 2:00 pm MT
Register here.
Save the Date – North Dakota Immunization Conference June 21-22
The North Dakota Department of Health Immunization Division is excited to announce that the North Dakota Immunization Conference will be held June 21-22 in Bismarck, ND. Topics include routine immunization updates, ways to increase vaccination rates, improving vaccine confidence, motivational interviewing strategies, and more. Speakers include are Dr. Katelyn Jetelina, Your Local Epidemiologist, pediatrician Dr. Nathan Boonstra, and Dr. Andrew Kroger from the Centers for Disease Control and Prevention. Nursing contact hours and Category 1 CME credits will be offered. The conference will be held both in-person and virtually. For more information and to register, visit
CHAD Network Team Meetings
Tuesday, March 29 at 1:00 pm CT/ 12:00 pm MT – Outreach & Enrollment Network Team
Tuesday, March 29 at 3:00 pm CT/ 2:00 pm MT – CFO & Finance Manager Roundtable
Tuesday, April 5 at 12:00 pm CT/ 11:00 am MT – Behavioral Health Work Group
Thursday, April 7 at 12:00 pm CT/ 11:00 am MT – Clinical Quality Network Team
Tuesday, April 12 at 2:00 pm CT/ 1:00 pm MT – Communications and Marketing 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

Email Marketing by ActiveCampaign