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CEO Note: Community Health Centers Receive Short-Term
Funding Increase
After nearly six months of continuing resolutions and impasse on the federal fiscal year 2024 budget, it looks like there are some short-term answers about health center funding at the federal level that will play out over the next couple of weeks. The result will be a short-term extension for community health center funding through the end of the calendar year and about a 10 percent increase in resources. As a reminder, health center funding comes from two sources, the mandatory side (in orange below) which requires renewal at regular intervals and the appropriated side (navy) that is part of annual federal budget negotiations as displayed below.
 
On the mandatory side, health center funding will be extended to December 31, 2024 with an increase in the annualized funding amount from $3.9 billion to around $4.27 billion, which represents a small but meaningful increase over FY23 funding. Congress does not direct the Health Resources and Services Administration (HRSA) on how that money should be spent, so we will stay in touch with HRSA leadership as those decisions are made and announced over the next several weeks. This sets up an additional debate over a long-term funding approach for the end of 2024 (post election) or the beginning of the next Congress in early 2025. The short-term extension also includes increases for National Health Service Corps (17%) and the Teaching Health Centers program (59%). On the appropriations side, we expect one more extension on the current continuing resolution to March 22, 2024 with the understanding that there is enough support to get something passed. Since the House and Senate appropriations bills both called for level funding, that is what we’re expecting in the final bill.

While the funding extension is not the long-term policy solution we were looking for, we definitely have a few things to celebrate across the Dakotas. First, this agreement is far better than the possible option of having no funding bill passed which would have resulted in level or reduced funding through the end of the year. Also, we had the chance to meet with several of our members of Congress and their staff in Washington DC in February, and they all express strong and continued support for the health center program. In fact, every member of our delegation was honored with an award though the National Association of Community Health Centers (NACHC) for their votes in support of our program or advocacy for health center funding:

North Dakota:
  • Senator John Hoeven - Distinguished Community Health Center Advocate Award. 
  • Senator Kevin Cramer - Distinguished Community Health Center Advocate Award. 
  • Congressmen Kelly Armstrong – Distinguished Community Health Center Advocate Award. 

South Dakota:
  • Senator John Thune - Distinguished Community Health Champion Award. 
  • Senator Michael Rounds - Distinguished Community Health Center Advocate Award. 
  • Congressmen Dusty Johnson - Distinguished Community Health Center Advocate Award. 
 
In addition, the CHAD Policy Team led an Advocacy Week of Action, including a contest from February 16 – 25 to reach our Members of Congress immediately following the in-person visits to their offices in D.C. Our goal was to get at least 100 messages to Members of Congress in the Dakotas to support increased health center funding. It was great to see health center supporters meet and exceed our goal with 119 phone calls and emails to our Members of Congress. Each person who participated in making phone calls and sending emails was entered into a drawing for their health center to win treats. The winning health center is Complete Health. Congratulations! Thank you everyone who participated.

Much of our advocacy work is currently being led through the CHAD Advocacy Action Team, which meets regularly to discuss ways to build support for the health center mission at the state and federal level. If you are interested in joining, please contact
Kim Kuhlmann on our team.
 
Health Centers in the News
 
BreAnn Raymond from Northland Health Centers, was featured on ND Today Business Highlight.

South Dakota Urban Indian Health’s Street Team was featured in Sioux Falls Simplified.

HHS Awards Coal Country Community Health more than $1.3 Million
 
Early Bird Registration Open – Annual Conference
 
The Community HealthCare Association of the Dakotas (CHAD) and the Great Plains Health Data Network (GPHDN) invite you to attend the 2024 CHAD/GPHDN Annual Conference "IMPACT: The Power of Health Centers" on May 14-16 in Rapid City, SD. This annual event invites leaders like you from community health centers across Wyoming, South Dakota, and North Dakota to come together.

This year's conference is packed with informative sessions on building culture, strengthening your workforce, emergency preparedness, integrated behavioral health care, and using data to advance the health center program. Additionally, two pre-conference workshops are offered specifically for workforce development and emergency preparedness.


Early bird registration is now open until March 31. Register here today, and don’t miss out on great sessions and essential networking opportunities.
 
CHAD Welcomes Emily Haberling as Outreach and
Enrollment Navigator

 
Emily Haberling joined CHAD in February 2024 as the outreach and enrollment navigator, where she plays a crucial role in assisting and educating community members regarding their eligibility for assistance and insurance programs, focusing on enhancing access to healthcare coverage for underserved populations in South Dakota.

Even though Emily is new to the working world, she has experience as a certified nurse assistant and medication aide throughout her high school and college days. Most recently, Emily worked for Avera as an admissions specialist where she coordinated patient admissions to ensure a smooth and seamless process.

Emily is a graduate of South Dakota State University with a bachelor’s degree in community and public health. She also has minors in health science and health communications. Emily lives in Sioux Falls. She enjoys attending any and all SDSU Jackrabbit sporting events, reading, and spending time with family and close friends.
 
Equity Talk: Implementing Culturally & Linguistically Appropriate Services
The National Culturally and Linguistically Appropriate (CLAS) Standards are a set of 15 action steps intended to advance health equity, improve quality, and help eliminate health care disparities. Join this session on April 3, to learn more about the CLAS Standards framework developed by the Health and Human Services Office of Minority Health. Presenters will discuss specific strategies and will share practical resources to support implementation.

Register here
 
March is National Colorectal Cancer Awareness Month
Colorectal cancer is the third most common cancer diagnosed in the US. According to the American Cancer Society, about 1 in 23 men and 1 in 24 women will develop this cancer at some point in their lives. Current estimates for the number of colorectal cancers in the US for 2024 are 106,590 new cases of colon cancer and 46,220 new cases of rectal cancer with about 53,010 expected deaths. Additional statistics can be found in the American Cancer Society’s Colorectal Cancer Facts & Figuresreport.
Age is one of the most important risk factors for colorectal cancer. The incidence ofearly-age onset (EAO) CRC diagnoses under age 50 is expected to increase by more than 140 percent by 2030. The number of patients in the U.S. diagnosed under 55 years of age doubled from 11 percent in 1995 to 20 percent in 2019. Colorectal cancer is estimated to be the number one cancer killer for those ages 20-49 by 2030. Rates of colorectal cancer incidence are higher in Black adults and American Indian and Alaskan Native adults, people with a family history of colorectal cancer, and people with other risk factors (such as obesity, diabetes, long-term smoking, and unhealthy alcohol use). However, all adults 45 years or older should be offered screening, even if these risk factors are absent.

Deaths from colorectal cancer can be reduced by 68 percent with screening. Unfortunately, there are more than 20 million Americans eligible for colorectal cancer screening who have not been screened. There are many reported barriers as to why people delay or refuse colorectal cancer screening, including fear of invasive testing, cost, lack of knowledge of what is considered at risk, and transportation. Health centers can reinforce the importance of colorectal cancer screening by promoting and educating the public and their patients on the importance of early screening starting at age 45. Additionally, the Great Plains Health Data Network Clinical Advisory Committee has identified colorectal cancer screening as a clinical priority measure. In 2022, health centers participating in the Great Plains Health Data network reported that 42 percent of patients aged 45-75 had appropriate screening for colorectal cancer. The committee has set a goal for 50 percent of patients aged 45-75 to have appropriate screening by 2026. 

The North Dakota Colorectal Cancer Screening Initiative (NDCRCSI) is designed to reduce colorectal cancer morbidity and mortality. The North Dakota Department of Health offers this program to provide colorectal cancer screening and diagnostic follow-up testing where appropriate to age and income-eligible patients. For more information on connecting patients who are underinsured or uninsured to CRC screening opportunities, visit the North Dakota Department of Health and Human Services Colorectal Cancer Screening website. For South Dakota colorectal cancer information, resources, and other programs to help clinics increase access to CRC screening visit the South Dakota Department of Health’s Get Screened website.  

Additional Resources:
 
 
Turn ND Blue
In observance of Colorectal Cancer Awareness Month this March, the North Dakota Cancer Coalition is sponsoring its 8th annual Turn ND Blue Photo Contest.

Education and awareness are key to improving colorectal cancer screening rates. Please join us and help raise awareness in your communities across North Dakota. Let’s TURN ND BLUE this March! Together we can make a difference!

You can access instructions and details of the photo contest here. If you have any questions please contact Nikki Medalen, nmedalen@qualityhealthnd.org
 
Capturing Experiences from Those Who Provide Colorectal Cancer Screening and Treatment
A research team at the University of North Dakota School of Medicine & Health Sciences has teamed up with health care providers and surgical oncologists practicing in North Dakota to complete a study on the barriers to, and supports for, colorectal cancer prevention and treatment in North Dakota. Part of this work included reviewing colorectal cancer mortality-to-incidence ratios, as well as hosting focus groups with community members living in North Dakota counties with the highest and lowest ratios.
Now, the researchers are looking to schedule interviews with North Dakota physicians and other health care providers who either prescribe or perform colorectal cancer screening for patients, or those who provide treatment for patients with colorectal cancer. These key informant interviews will be conducted via videoconference and will last around 30 minutes. Learn more or volunteer to participate here.
 
NACHC Winter Strategy Meeting Recap Video Interview
Watch this video to hear from Shelly Ten Napel and David Aas about their experience attending the NACHC event.
 
Horizon Health Care’s Chief Strategy Officer Honored with National Advocacy Award
 
The National Association of Community Health Centers (NACHC) has honored Lexy Eggert from Horizon Health Care of South Dakota with the Elizabeth K. Cooke Advocacy MVP Award. The award recognizes advocates’ dedication and mobilization efforts to generate public and political support for the nation’s Community Health Centers. Lexy was presented the award during NACHC’s 2024 Policy and Issues Forum (P&I) in Washington, D.C. “As a lifelong rural South Dakotan, I am inspired to advocate for community health centers because of our commitment to access to care for everyone,” said Eggert. “I am also inspired when I hear patients’ stories of how their lives would be impacted if our health center services were not available. Congratulations, Lexy!
 
SD Legislative Update
The 2024 South Dakota Legislative session wraps up this week on March 7. CHAD came into the session supporting workforce programs, protection of Medicaid expansion, and some school lunch and nutrition-related bills and the final results were mixed. Here is a link to CHAD’s 2024 legislative policy priorities.

CHAD supported several workforce-related bills during session, all of which passed.

HB 1074 was passed and expanded the active practice requirements for dental hygienists. Four licensing compact bills were also passed. The bills will assist in the licensure process for counselors, social workers, psychologists, and Advanced Practice Registered Nurses (APRN). Three of the bills CHAD supported (two license compacts and the dental hygiene bill) have been signed by Governor Noem, and the remaining are expected to receive her signature.

CHAD weighed-in to oppose SJR 501 to place the issue of Medicaid expansion back on the ballot to allow a work requirement to be added for the expansion population. The outcome of this bill puts the option of work requirements for the Medicaid Expansion population to a vote in November 2024.  Unfortunately, despite our best efforts to educate and challenge SJR 501, it was approved and will go to voters later this fall. CHAD will work with these groups to continue to build support for the Medicaid program, raise awareness about its impacts, and tell the story of the many ways health coverage enables work and supports healthy communities.

Other Items Addressed
  • 4% increases for K-12 education, state employees, and most Medicaid provider payments
  • HB 1001 attempted to repeal the sunset clause on the sales tax reduction the legislature passed last year to make it permanent. HB 1001 did not pass so the sales tax is still set to return from 4.2 percent back to 4.5 percent in 2027.
  • The bill to require the State to accept federal funding to provide enhanced EBT payments for families during the summer was defeated.

The last day of session is this Thursday. After that, the Legislature will convene again on March 25 for Veto Day and then officially conclude this session. Jennifer Stalley with Midwest Solutions will facilitate a Legislative wrap-up with CHAD and health center members on March 13 at 12:00pm CT. If you’d like to learn more, please contact James Craig.
 
Mobile Health Clinics Spring Intensive Training Course Scholarships
The Mobile Healthcare Association (MHA), a NACHC partner, is hosting their annual Mobile Health Clinics Spring Intensive Training Course on May 2 and May 9 from 11:00 – 2:00 pm CT. This two-day, comprehensive virtual event is taught by mobile healthcare experts and is designed for anyone new to mobile or looking to start a mobile program. NACHC is awarding 25 scholarships to members to attend this event. Each scholarship will cover up to two staff members’ participation. These scholarships will be awarded on a first-come, first-serve basis. Contact partnership@nachc.org to request scholarship participation. Learn more and apply.
 
Funding Opportunities
NACHC’s Center for Community Health Innovation (CCHI) announces the Innovation Incubator 2024, powered by the global healthcare company Abbott. This year the incubator will align with social drivers that are essential to good health – and the focus for 2024 is on improving health equity through access to nutritious food. With initial seed funding ($30,000), access to leading experts, and training on human-centered design principles, selected health centers will design and test their solutions – all with the broader goal of sharing what works with health centers nationwide. Apply today here.  Applications are due March 22.

The South Dakota Tobacco Control Program (TCP) has opened two funding applications. One for Tobacco Youth & Community Engagement, and the other for Tobacco Disparities. The funding awarded can be up to $25,000. Applications close on March 15. For more information, please see the Request for Applications.

The SD Department of Health’s Cancer Programs have announced an Implementation Grant Request for Applications. The programs are seeking applications that support the 2021-2025 SD Cancer Plan, focus on evidence-based intervention implementation, and promote equitable and accessible cancer prevention, early detection, and cancer survivorship efforts in South Dakota. The RFA aligns with the South Dakota Prevention Framework. Applicants may request up to $25,000. Applications close March 15

The South Dakota Department of Health’s Opioid Program is pleased to announce the release of the Overdose Data to Action – States (OD2A-S) Community Health Work Program Request for Applications (RFA). The Opioid Program is soliciting applications from organizations that employ an existing Community Health Worker (CHW) or a Community Health Representative (CHR) in South Dakota to assist with the goals outlined in the OD2A-S Workplan. Applicants may request up to $15,000 per CHW or CHR employee per project period. Applications are due by March 15.
 
GP11 Network News
 
 
Transitions of Care Lunch N’ Learn
Join us for a hands-on review of the Transitions of Care module in Azara! Catch up on last week's webinar and come with your questions. During this hour, we will be fielding Q&A from attendees working to implement and operationalize the module, as well as from attendees who hope to learn more about it.

Thursday, March 12
1:00 pm CT/12:00 pm MT
Register here

Reclaiming Your Referral Program Using the Referral Management Module
With one in three primary care visits resulting in a referral, the referral represents a critical inflection point in a patient's care journey. The success of that referral is dependent on a high-functioning, synergistic collaboration between patients, providers, and specialists. Given so many variables, practice staff may feel as though much of the process is out of their control. However, management insights can offer practices perspective into their communication strategies, practice workflows and coordination, and resources available within the network, which together can be harnessed to better support patients throughout their referral journey. In this webinar, we will explore how to track referrals from order to completion, understand referral coordinator workload, and gather information to assist with relationship and expectation setting with your referral partners. This webinar is recommended for centers with the referral management module, and health center staff responsible for managing the referral program.

Thursday, March 14
1:00 pm CT/12:00 pm MT

Register here

Referral Management Lunch N' Learn
Join us for a hands-on review of the Referral Management module! Catch up on last week's webinar and come with your questions. During this hour, we will be fielding Q&A from attendees working to implement and operationalize the module, as well as from attendees who hope to learn more about it. 

Thursday, March 19
12:00 pm CT/11:00 am MT

Register here

Reflecting on UDS: Lessons Learned in February
 Get ready to take a deep dive into UDS with Azara Support. During this webinar, Application Support Team Lead, Meg Carley, will take us on a walk down memory. Meg will speak to common questions, the total number of tickets received, and introduce some best practice considerations to prepare for UDS 2024 (too soon?). This webinar is recommended for team members involved in UDS reporting, data quality management, and quality improvement efforts.

Thursday, March 21
1:00 pm CT/12:00 pm MT

Register here
 
Upcoming Trainings
 
Find these and other events on the CHAD website.
Front Desk Rx: A Prescription For Exceptional Patient Experiences
You play a vital role in your health center, whether you hold the title of front desk staff, receptionist, patient services representative, patient support, or patient access. As the first person patients encounter when they walk into your clinic, you set the tone for their appointment. You are also the voice on the phone when a patient has a question or needs an appointment reminder. Your reassuring presence can make all the difference when a patient is nervous about their visit.

This training series is designed specifically for you. Our goal is to equip you with new tools and strategies so that you can continually improve in your role and feel more confident in your job.

March 19, 26 & April 2, 9
3:00 pm CT/2:00 pm MT

Register here

Even if you cannot attend the live webinars, please register so that you will be put on the mailing list for the recorded webinars and presentations.
CHAD Network Team and Workgroup Meetings
Monday, March 11 @ 1:00 pm CT/12:00 pm MT – Operational Excellence/Compliance Workgroup
Tuesday, March 12 @ 2:00pm CT/1:00 pm MT – Communications & Marketing Network Team
Thursday, March 14 @ 9:00 am CT/8:00 am MT – Emergency Preparedness Network Team
Thursday, March 14 @ 2:00 pm CT/1:00 pm MT – HR/Workforce Network Team
Wednesday, March 20 @ 12:00 pm CT/11:00 am MT – HCAN Webinar Series
Thursday, March 21 @ 10:00 am CT/9:00 am MT – CHAD SDOH Workgroup
Tuesday, March 26 @ 1:00 pm CT/12:00 pm MT – Outreach and Enrollment Monthly Call
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 HRSA.gov.

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