CHAD is pleased to announce a new partnership with the University of North Dakota (UND) School of Medicine and Health Sciences (SMHS). The UND SMHS houses three National Institute of Health (NIH) funded research centers that jointly share a community engagement & outreach core (CEOC). The CEOC focuses on engaging populations disproportionately affected by health disparities to develop community-based research priorities that can be translated into improved health outcomes. In CHAD’s collaboration with UND, I will serve as co-director for the CEOC, which will give the health centers and us the ability to weigh in on the goals and direction of these local research centers from a community-based lens. The below graphic displays the community engagement framework used by UND.
Keep reading for a brief overview of the three research centers supported by the CEOC.

Dakota Community Collaborative on Translational Activity (DaCCoTA)
The DaCCoTA aims to bring together researchers and clinicians with diverse experiences from the region to develop unique and innovative means of combating disease in North Dakota and South Dakota. The CEOC will help identify health concerns and priorities of local communities, which will inform the priorities of the DaCCoTA. "Community" is defined broadly and could refer to a particular geographic area or a population of focus.

American Indian Collaborative Research Network (AICoRN)
The AICoRN is our region’s first practice-based research network (PBRN). It will serve as a network of health care clinicians and practices working together to answer community-based healthcare questions and translate findings into practice. By design, PBRNs directly engage participants and work to shorten the lag between research and practice/health outcomes. The AICoRN will bring various benefits to our region, including professional development, translation of research into practice, provider-driven research to address clinic priorities, empowered patients and communities, and grant opportunities.

Indigenous Trauma & Resilience Research Center (COBRE)
The goal of the COBRE will be to address the impact of historical and unresolved trauma on health inequities within the American Indian and Alaska Native populations. The data suggest that the need for such a center is great. American Indians in this region suffer from significant health disparities relative to non-Native people. Much of this is related to historical trauma, adverse childhood experiences, forced boarding school participation, social marginalization, and toxic stress. For example, on the Pine Ridge Reservation in South Dakota, life expectancy is lower than anywhere in the western hemisphere except Haiti.

Interested in learning more or sharing your community’s perspectives about top health concerns? Consider attending the 2022 Annual AICoRN Summit & DaCCoTA Symposium, August 4 – 5 in Sioux Falls. There is no cost to attend, and CHAD will co-facilitate afternoon workshops focused on gathering input on community-based health needs and priorities. Learn more & register here.

Also, be sure to watch for future grant opportunities through these research centers, which CHAD will post in upcoming newsletters. Questions? Reach out to me at
Health Centers in the News
Horizon Health, First Bank team up to help children in need via the Madison Daily Leader.
Dr. Chima, Sioux Falls public health director, was quoted by Dakota News Now regarding the recently released community health assessment and improvement plan for Sioux Falls.
Mara Jiran Awarded Outstanding Rural Health Professional
Mara Jiran, CEO of Spectra Health, was awarded Outstanding Rural Health Professional by the Center for Rural Health University of North Dakota School of Medicine & Health Sciences. This award is presented to a professional located in rural North Dakota who has demonstrated leadership in the delivery of rural health services and is unselfishly committed to making a significant and sustained impact on the health of their community and service area. Watch Mara’s award video here.

From the CHAD nomination letter: "Ms. Jiran has a long-standing history of health care leadership that has impacted health outcomes for thousands of patients and the overall health care landscape in the Dakotas and neighboring states. Under her direction since 2014, Spectra Health has become a respected leader in its ability to deliver comprehensive primary care services through a lens of health equity and holistic care. Spectra leads the state in providing substance use disorder (SUD) and medication-assisted treatment (MAT) services in health centers. Ms. Jiran’s commitment to high-quality health care delivery is evidenced when looking at 2020 Uniform Data System health center data. Spectra Health meets or exceeds the national averages for 11 out of 15 clinical and dental quality measures.

Mara was instrumental in leading Spectra Health and its patients through the novel SARS-CoV-2 public health emergency. At the start of the pandemic, many difficult and complex decisions had to be made, often with very limited information. Mara successfully led Spectra through this crisis with grace and competence, tackling issues related to staffing, decreasing patient visits, modifications to patient intake, funding concerns, lack of supplies, and many challenges on a day-to-day basis. This is truly a reflection of the leadership and management skills Mara exhibits.

Since 2020, Ms. Jiran has served in a leadership role as president of the CHAD board of directors. Through this role, she guides discussion and board decisions on priorities for the health centers throughout North Dakota and South Dakota. It is evident in board meetings that Mara’s peer health center leaders look to her with trust for experienced guidance and advice."

COVID-19 Update & Resources
COVID-19 Pediatric Vaccine Evaluated by VRBPAC
COVID-19 vaccines are back in the news as the Food and Drug Administration’s (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) reviewed emergency use authorization (EUA) requests from Moderna and Pfizer-BioNTech for use in children six months to four and five years of age, respectively. In a clinical trial, the pediatric Pfizer-BioNTech vaccine demonstrated an efficacy of 80.3% when children under five received three 3-µg doses. Trial data from Moderna indicates children under six years of age demonstrated vaccine efficacy of 51% (ages six months to <2 years) and 37% (2 to <6 years) after they received two 25 μg doses of the vaccine. This is comparable to the response in adults.

The vaccines received approval from VRBPAC and will next face review from the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control & Prevention (CDC). As a reminder, the pediatric COVID-19 vaccine cannot be administered until EUAs are issued, staff training is completed, and standing orders are in place.

Long COVID Research Study Underway by National Institute for Health
The National Institute for Health is expanding its research on long COVID through its latest initiative, Researching COVID to Enhance Recovery (RECOVER). The study will seek to identify people with post-acute sequelae of SARS-CoV-2 infection while developing approaches for prevention and treatment.

Currently, two RECOVER study sites are identified in South Dakota, one at Avera Research Institute in Sioux Falls and another at the American Indian Clinical Trials Research Network in Rapid City. Providers may encourage patients suspected of long COVID to consider enrolling in research trials.

NDDoH Funding for Vaccine Storage and Handling Equipment
The North Dakota Department of Health (NDDoH) has announced the availability of funding for vaccine storage and handling equipment. This one-time funding is available to health care providers unable to purchase vaccine storage and handling equipment using their own funds. Allowable purchases made on or after May 18 will be reimbursed up to $5,000 per individual facility location. To be reimbursed, all storage and handling equipment must follow CDC’s storage and handling recommendations. Providers must receive pre-approval from the NDDoH before they submit a reimbursement request. Facilities should seek that prior approval using this short Qualtrics survey by September 15. For questions on allowable expenses and those eligible for reimbursement, contact the NDDoH Division of Immunization at 701-328-3386 or
Dakotas’ Health Centers Reflect on World Refugee Day
World Refugee Day is celebrated on June 20. This is a great opportunity to highlight the important role local health centers play in welcoming new refugees to our area and providing ongoing primary care services to former refugees. We sat down with three local health centers that provide refugee health services (Falls Community Health, Spectra Health, and Family HealthCare) to learn more.

"When you hear the term refugee and when people are defined as being a refugee, that means that they are actually unable to return to the country they fled, and they fled due to specific reasons that include being persecuted," says Vanessa Sweeney, clinical services manager with Falls Community Health. Vanessa says it’s important to understand that international law defines and protects refugees.

Falls Community Health, Spectra Health, and Family HealthCare are each contracted with local resettlement agencies to provide initial immunizations, physicals, and other care for newly arriving refugee individuals. Often, the health centers then become the medical home for these patients. These health centers provide onsite interpretation (phone interpreters might not understand facial expressions or dialects), social work, and behavioral health services to create a welcoming environment.

They also spend time orienting newly arriving refugees to the United States health care system (such as understanding the differences between primary care, urgent care, and the emergency room). At Family HealthCare, a diverse and multilingual staff team strives to be reflective of the population served, and waiting rooms have visual/color cues (rather than only language) to increase accessibility.

When asked why World Refugee Day is important, Courtney Ali, refugee nurse case manager at Family HealthCare, says, "World Refugee Day is a recognition and a celebration of the strengths refugees have. It means that we honor the journey they’ve taken and the courage they have. It’s important because it’s a reminder to step back and take time to celebrate these individuals and how lucky we are to have them in the community."

Hafsa Aden, a social work intern at Spectra Health, says, "As a former refugee, I got all my health care services here at Spectra about seven years ago. That’s why I am here right now because I was having the services I got as a new refugee, and the work they were doing was wonderful, and it was what we needed when we came here." When asked for advice on creating a welcoming environment, Kayla Hochstetler, social services manager at Spectra Health, recommends incorporating people with lived experience throughout the clinic, from boards, executive teams, and clinic staff. "If people have experience, they are going to be the best ones to educate you on how to develop programming and best serve the refugee population." She also recommends identifying any language barriers related to how people enter services across the clinic. Hafsa adds, "Be respectful to their culture and religion … be open-minded, don’t be judgmental. They need to feel safe. They need to feel that they are home."

Thank you to these health center teams for helping people feel at home. Check out more from the recorded conversation here.
Palliative Care Network Brings Education to SD Communities
The South Dakota Palliative Care Network is working to improve access to quality palliative care for all South Dakotas by advocating for community-based resources and greater awareness of services. Palliative care is medical care for people living with a serious illness. This type of care focuses on relieving the symptoms and stress of illness to improve the quality of life for the patient and family. The network is currently engaged in several activities, including promoting the availability of free continuing education for healthcare professionals and educating communities, including patients and their families.
Horizon Health Care provider Diane Inch, PA-C, recently hosted a palliative care education event in Chamberlain. Diane shares why she got involved in this issue and her encouragement for other providers in the interview below.

Q: Why is palliative care important to you?
A: "Palliative care is an important topic because we live with chronic medical diagnoses longer and longer. Palliative care provides a bridge that connects our healthy selves to the end-of-life phase of our lives. This middle phase can include many happy years of life. Once a life-limiting medical diagnosis has been given, such as cancer, COPD, kidney disease, etc., palliative care steps in to support the patient’s goals and decisions in their care and treatment. While life-limiting, it is not hospice, and these patients continue to seek and use curative measures and have hope of remission or not having their illness worsen. Palliative care focuses on the patient’s spirit, mind, and body. Palliative care also includes support and education for family and friends. Palliative care reaches past medicine and helps patients find ways to be in the least amount of pain while enjoying as much of their life as possible."

Q: What inspired you to host a meeting for your community?
A: "I was inspired to assist with the community meeting because there are topics that can be difficult to talk about, but people still need to hear about them. Some of these topics include having conversations with families about end-of-life choices and ensuring they have a will and advanced directives. These discussions are important to have before families are in the midst of an illness and may have to make quick decisions under stress."

Q: What message do you want to share with other primary care providers about palliative care?
A: "As health care providers, we like to fix things. It is important for us to remember that while we cannot always cure our patients, we can provide them with the tools to make more informed decisions. We can help initiate discussion on some of the difficult topics with their family. We can help our patients and their loved ones understand that a life-limiting diagnosis is not the end of one’s life; it’s just a change in the direction we are taking."

The Palliative Care Network plans to host multiple community education events across South Dakota. If you are a provider interested in co-hosting a session in your community, please reach out to Charlene Berke, project co-director.

The South Dakota Palliative Care Network has also developed a palliative care education series for health care professionals. Sessions include "What is Palliative Care?," Basic Ethical Principles, Physical Aspects of Palliative Care, Advanced Care Planning, and Goals of Care Conversations. To access the training series for free continuing education (CE) credits, follow these instructions:
  • Create an account on the Avera CE Portal - Instructions;
  • Complete palliative education session registration;
  • Receive a code (KEEP THIS CODE) to access all the palliative CE content; and,
  • Enter code for each session, view the video and take the test.
Notice of Funding Opportunity:
Rural Communities Opioid Response Program - MAT Access

The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy (FORHP) will be making approximately ten awards of up to $1,000,000 per year (three-year period of performance) for the Rural Communities Opioid Response Program medication-assisted treatment (MAT) access. This program aims to improve health care in rural areas by establishing new MAT access points and increasing the capacity for sustainable MAT service provision in rural areas.
FORHP will host a webinar for interested applicants on Thursday, June 23, at 1:00 pm CT/ 12:00 pm MT, via Zoom. A recording will be made available for those who cannot attend. Registration is not required for this webinar.
South Dakota Seeks Nominations for Immunization Champion Award
The Association of Immunization Managers is seeking nominations for immunization champions! Individuals can be recognized for their work in either flu, HPV, or COVID-19 across the lifespan or routine childhood vaccination. Please consider nominating a colleague for this state and national award opportunity. Nominations will close at 5:00 pm CDT on Monday, June 27. Send completed nomination forms via email to Tim Heath.
GP12 Network News
Regional Health Systems Impacted by Security Breaches
In June, Sioux Falls-based Avera Health released a notice that they had been a victim of a security breach where a cybercriminal accessed the personal identifiable information (PII) and protected health information (PHI) data of 700 patients. The data consisted of name, date of birth, addresses, social security numbers, emails, protected health information, etc. Since the breach exceeded 500 records, Avera Health is required to send out a public notification and notify each individual of the breach, which is part of the HIPAA breach notification rule. This is the second known cybersecurity incident in the Dakotas within the last year. In August 2021, Sanford Health was able to thwart a similarly attempted cyber-attack. In both cases, the vulnerability was exposed in the third-party software applications the health systems used. This is a great reminder to review business associate agreements and also discuss security practices used with partners that have access to PII or PHI. Health centers could easily become victims if their partners lack security.
Operations and Retention Measures
Do you want to better and more specifically track new patients and patient turnover? Azara Healthcare has 14 new operational measures designed to display where new patients are coming from. Do they already exist in the center but are new to a specific service line? Or are they new to both the center and a particular service line? In this webinar, presenters cover these measures and situations where they can help reduce manual Excel work.

Thursday, June 23
1:00 pm CT/ 12:00 pm MT
Register here.
SDDOH Health Improvement Innovation
Request for Applications

The South Dakota Department of Health (SDDOH) requests Health Improvement Innovation grant 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
Webinars & Meetings
Find these and other events on the CHAD website.
Wildfire Preparedness for Health Centers
Hosted by CHAD, this one-hour session is for health centers at risk from wildfires. The training includes steps such as identifying service priorities, communications plans, and ways to remain aware of nearby fires. Speakers will provide actionable steps for health centers to take before, during, and after wildfires and information to support staff mental health during times of disaster.

Thursday, June 16
12:00 pm CT/ 11:00 am MT
Register here.
Commemorating Juneteenth: A Journey to Equity
Join the Association of State and Territorial Health Officials (ASTHO) today, June 16, for a webinar highlighting the importance for public health to commemorate Juneteenth in the effort to heal relationships and achieve health equity among the Black community. The featured speakers will discuss the connection between racism and its impact on public health.

Ms. Opal Lee, the "Grandmother of Juneteenth," will share her journey advocating to make Juneteenth a national holiday. Arthur R. James, MD, a retired OBGYN and pediatrician, will highlight the legacy of racial injustice to the health inequities we experience today.

Thursday, June 16
12:30 pm CT/ 11:30 am MT
Register here.
Counter-Narratives as a Strategy for Promoting COVID-19 Vaccination with Patients
Hosted by the National Association of Community Health Centers (NACHC), this session will provide an overview of the rapid ethnography study component of the SARS-CoV2 Vaccines Information Equity and Demand (COVIED) creation project. It will present findings from health center staff and patient interviews about the complexity of the information "ecosystem" surrounding the introduction of COVID-19 vaccines and the key "narratives" that emerged to people used to justify the avoidance of COVID-19 vaccines. Speakers will also address targets and specific strategies for developing and delivering "counter-narratives" to undermine false or misleading narratives and examples of how counter-narratives can be developed and used as a strategy for promoting the COVID-19 vaccines with patients.

Thursday, June 16
2:00 pm CT/ 1:00 pm MT
Register here.
Online & In-The-Know: Preparing for Back-to-School
Join Immunize South Dakota for the next session of Online & In-the-Know for a comprehensive look at getting your patients ready for the upcoming school year. Presenters will discuss forgotten diseases such as measles and polio (plus the one we wish we could forget!), immunization trends and considerations, and tips for increasing immunization rates in time for the 2022-2023 school year. They will also review school requirements and recent vaccine-hindering proposed legislation in South Dakota.

Friday, June 17
12:30 pm CT/ 11:30 am MT
Register here.
The Path to Sustainable Financing for Community Health Workers
Community health workers (CHWs) have a rich history of improving health outcomes, particularly in underserved communities. They are especially involved in the ongoing COVID-19 pandemic response by providing essential public health education and delivering health services in resource-constrained areas. Despite the power and promise of CHWs, the public still lacks an understanding of their role and value in the health care system. This is directly related to the absence of long-term, sustainable funding to support and appropriately sustain the CHW workforce. This Families USA webinar will allow attendees to hear from CHWs and other stakeholders. They will share their thoughts on the current financing landscape, including what works and where there may still be gaps in the public health workforce. The webinar will also include time for Q&A with attendees.

Thursday, June 23
12:00 pm CT/ 11:00 am MT
Register here.
Register Today: Grow-Your-Own Clinical Workforce with HP-ET Strategic Planning Webinar

Grow-your-own is a core element of health center workforce planning. Health professions education & training (HP-ET) programs are a proven strategy for the next generation of health center clinical providers and staff. Hosted by CHAMPS, this webinar will feature Nataly Diaz, deputy director of workforce development from the California Primary Care Association (CPCA), and Kelly Rondou, senior consultant, organizational performance from Wipfli LLP. Participants will learn about the CPCA and Education Health Center Initiative (EHCI), review key elements of strategic workforce planning for HP-ET programs, and understand how they can leverage this free resource for their workforce efforts.

Thursday, June 23
1:00-2:30 pm CT / 12:00-1:30 pm MT
Register here.
PHE Unwinding Readiness for Health Centers: Strategies for Preparing Medicaid Beneficiaries for Eligibility Determinations
When the COVID-19 public health emergency (PHE) ends, the current continuous Medicaid coverage requirement enacted by the Families First Coronavirus Response Act (FFCRA) in March 2020 will no longer apply. State Medicaid agencies will be tasked with resuming normal eligibility determinations and enrollment operations after a more than two-year pause. With more than 80 million people enrolled in Medicaid, many states and experts estimate that tens of thousands of enrollees are likely to lose coverage. Speakers will share the unique tools, resources, messaging, partnerships, and other strategies they are deploying to prepare Medicaid enrollees for the end of the PHE. This webinar will be hosted and moderated by the National Association of Community Health Centers (NACHC).

Wednesday, June 29
12:00 pm – 1:15 pm CT/ 11:00 am – 12:15 pm MT
Register here.
Documentation, Billing, and Coding Webinar Series Continues July 8
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 guidelines for evaluation and management coding. The recording and materials for that session can be found
here. The next scheduled webinar is on July 8 at 11:00 am CT/ 10:00 am MT and will focus on billing for services related to the diagnosis and management of diabetes. More details and registration for this session are coming soon.
CHAD Network Team Meetings
Tuesday, June 28 at 1:00 pm CT/ 12:00 pm MT – Outreach & Enrollment Network Team
Tuesday, June 28 at 3:00 pm CT/ 2:00 pm MT – CFO & Finance Manager Roundtable
Thursday, July 7 at 12:00 pm CT/ 11:00 am MT – Clinical Quality Network Team
Tuesday, July 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

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