Whether taking vitals, introducing new paperwork, or conducting screenings, communication is often at the heart of a positive patient experience. It’s no surprise, then, that CHAD members have requested more in-depth communication training for their health center teams. That’s why we are excited to launch the Person-Centered Communication in Health Care virtual learning series later this month. This series will be relevant to people in almost any patient-facing role, including front-desk staff, medical assistants, nurses, providers, care coordinators, navigators, and community health workers. Sessions 3 & 4 will be particularly relevant to people who facilitate screenings and referrals, health education, care planning, care management, or care coordination.

Through this interactive, skills-based series, participants will learn communication best practices. Each session will feature practical skills that can be easily applied in a health care setting. These include techniques such as reflective listening, the “ask-offer-ask” method for providing referrals and health education, and the use of plain language and “teachback” as a health literacy strategy. Ariel Singer, MPH, will lead the trainings. Ariel is the creator of Collaborative Screening, a guidance model for person-centered screening and referral.

To truly embody a person-centered approach, we have integrated lived experiences and stories from local people throughout this series. Each session will feature the personal perspective of a health care consumer from our region and their recommendations for person-centered communication in health care settings coupled with Ariel’s evidence-based practices. Indigenous, working class, transgender, and New American perspectives will be highlighted. After each session, we will provide a copy of the lived experience testimonial, along with a discussion guide that participants can utilize to share person-centered communication concepts with additional colleagues at their health centers.

We hope you can join us! The first session kicks off on Wednesday, September 28, and you can register for the full series (or specific sessions) here. Questions? Reach out to Shannon Bacon at CHAD.

Health Centers in the News
Northland Health Centers attended the Oak Park overdose awareness event via the Minot Daily News.
Dakotas’ Health Centers Receive
Community Health Quality Recognition

The Community Health Quality Recognition (CHQR) badges recognize Health Center Program awardees that have made notable quality improvement achievements. Criteria areas include access, quality, health equity, health information technology (HIT), social risk factors screening, and COVID-19 public health emergency response using Uniform Data System (UDS) data from the most recent reporting period. View UDS data for additional information on health center clinical performance. Visit the CHQR overview and CHQR FAQ webpages for answers to learn more.

Congratulations to the following health centers that received recognition:
  • Coal Country Community Health Center – Health Center Quality Leader (Silver), Advancing HIT, Addressing Social Risk Factors to Health
  • Community Health Center of the Black Hills – Access Enhancer, Advancing HIT, Addressing Social Risk Factors to Health, Health Disparities Reducer
  • Community Health Services, Inc. – Access Enhancer, Health Disparities Reducer
  • Falls Community Health – PCMH
  • Family HealthCare – Advancing HIT, Addressing Social Risk Factors to Health, PCMH
  • Horizon Health Care – Advancing HIT, Addressing Social Risk Factors to Health, PCMH
  • Northland Health Centers – Access Enhancer, Advancing HIT, Addressing Social Risk Factors to Health, Health Disparities Reducer
  • Rural Health Care, Inc. – Advancing HIT
  • Spectra Health – Health Center Quality Leader (Bronze), Advancing HIT, Access Enhancer, PCMH
Family HealthCare Nurse Practitioner Featured in New Documentary, "Who Cares: A Nurse’s Fight for Equity"
Whitney Fear, a psychiatric nurse practitioner at Family HealthCare, is featured in a new documentary produced by SHIFT, with support from the Robert Wood Johnson Foundation. The film is intended to encourage, motivate, and inspire this generation of nurses to be advocates for health equity – and see their potential as leaders in the community.

As a psychiatric nurse practitioner, Whitney Fear extends the compassion, empathy, and respect at the foundation of her Lakota culture to the many people she cares for at Family HealthCare, a community health center in Fargo. Her story is one of adversity, compassion, and the difference it can make when one person cares, especially when that person is a nurse.

Those in the Fargo-Moorhead area can join SHIFT at the Fargo Theater in downtown Fargo at 7:00 pm CT on Monday, September 19, for the theatrical debut of “Who Cares: A Nurse’s Fight for Equity.” This event is free for nurses and their allies. A panel discussion will follow the film. Masks are encouraged, and complimentary popcorn and beverages will be provided. To learn more and register for the event, visit here. The 30-minute documentary is also available to view online for free at this website:

Amendment D Campaign to Expand Medicaid in South Dakota Readies for Election Day
South Dakotans Decide Healthcare, the campaign to expand Medicaid in South Dakota via Amendment D, is full-steam ahead with a number of new endorsements, including the South Dakota League of Women Voters. “The League of Women Voters of South Dakota is proud to stand in support of a vote for Amendment D this November,” stated Cheryl Otto, South Dakota League of Women Voters president. “We take our role educating voters about elections and our policy choices very seriously. We recognize the benefits South Dakota and South Dakotans will see from passing Amendment D and expanding Medicaid, and we are ready to use our voice to ensure South Dakota voters know we need to vote yes in November.”

Several events are planned for the next two months, including film screenings and educational forums. CHAD CEO Shelly Ten Napel will speak at an Amendment D community forum at City Hall in Vermillion on Thursday, September 9, from 6:30 - 8:30 pm. There is also a statewide “Love Your Neighbor” tour making stops in multiple communities from Tuesday, September 20, through Saturday, September 24. Check out tour stops and times here.

Important deadlines to remember for the 2022 election in South Dakota include:
  • Absentee/ early voting begins – September 23
  • Voter registration deadline – October 24
  • Election Day – November 8
South Dakota Navigators Spend Time at the Fair
The Get Covered South Dakota Collaborative and its navigators, who are trained and certified individuals providing consumers with fair, impartial, and accurate information about their health insurance options, were at the South Dakota State Fair last week. Navigators answered questions, made appointments, and handed out hundreds of promotional items to fairgoers. They will continue attending community events throughout open enrollment and spreading the word about all the services a local health insurance navigator offers.

The navigators are getting ready for the tenth season of health insurance open enrollment. Some keys dates to remember for health coverage in 2023 are:
  • Open enrollment starts Tuesday, November 1;
  • Enroll by Thursday, December 15, 2022, for coverage that starts January 1, 2023; and,
  • Open enrollment ends Sunday, January 15, 2023.
North Dakota Health Tracks
North Dakota has lower than average completion rates for well-child visits compared to national benchmarks. Currently, there is a statewide effort to increase well-child visits to improve kids’ health throughout North Dakota. These visits allow providers and parents to track growth and developmental milestones, discuss child health concerns, and provide scheduled vaccinations.

North Dakota Health Tracks is a comprehensive benefit through North Dakota Medicaid that focuses on prevention, early detection, and treatment for children and young adults under the age of 21. The program is to assure the availability and accessibility of required health care resources and help members and their parents or guardians effectively use these services. North Dakota Health Tracks is key to ensuring that children and adolescents receive the right preventative dental, mental health, developmental, and specialty services, also known as the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program. This website includes Health Tracks brochures, flyers, and other resources.

The North Dakota Medicaid Provider Manual pages 57-60, includes a Health Tracks overview, screening tool requirements, periodicity schedule, diagnosis, treatment, covered services, limitations, and documentation requirements. Health Tracks assessments follow the Bright Futures Well Child Periodicity Schedule.

Join organizations and coalitions in the initiative to encourage health care providers and families to increase well-child care. The Health Tracks screenings include exams, hearing and vision checks, dental visits, fluoride varnish applications, behavioral health screenings, and other important health services. North Dakota community health centers may bill either a well-child visit or a Health Tracks screening for the preventative service, as they are viewed as synonymous. For questions, call the Health Tracks provider outreach team, Bailey Smith, at 701-795-3987, Cheri Langei, at 701-239-8976, or Laurie Kramer, at 701-253-3021. Find resources available
Fluoride Varnish in Primary Care
North Dakota Medicaid, the ND Department of Health’s oral health program, and the ND Oral Health Coalition are teaming up to encourage primary care providers who conduct Health Tracks or well-child screenings to apply fluoride varnish to a child’s teeth during their appointment. This simple step can decrease cavities and improve a child’s oral health. The Centers for Disease Control & Prevention (CDC) study shows fluoride varnish prevents almost 40% of cavities in primary teeth. ND Medicaid has developed resources for primary care providers on fluoride varnish applications. These include:
  • Informational sheet;
  • Dental fluoride varnish payor comparison; and,
  • Medicaid fluoride varnish coding guidelines.

Training is also available on how to apply fluoride varnish. Free continuing education credits are available through the Smiles for Life Curriculum. If health centers have questions or are interested in learning more about applying fluoride varnish, contact Bobbie Will at CHAD via email or at 701-581-4534.
Marketing & HR: Team Up & Dream Up for Success
CHAD is hosting a hands-on workshop targeted at human resources and workforce development professionals to team up with their communications and marketing colleagues to strengthen their organization’s recruitment strategies. The in-person, interactive training is planned for November 2 and 3 in Fargo, ND. It will focus on marketing health centers and their communities to attract high-quality job candidates. Attendees will learn how to polish each facet of the recruitment process to ensure great candidates don’t pass by health centers in the Dakotas when exploring where they want to work.

Consultants specializing in health center recruitment and retention efforts from 3RNET will lead the training. They are experts in helping health centers identify strategies to bolster workforce development efforts. The health care workforce is approaching a critical nationwide shortage. This training will add valuable tools to a health center’s recruitment toolbox to stay ahead in this highly competitive market. 

In addition to the 3RNET training, the HR and workforce and communications and marketing network teams will take advantage of this time together and hold separate meetings with their peers. For questions about this event, contact Shelly Hegerle, HR and workforce manager, or Kayla Hanson, communications and marketing manager at CHAD.
Local Transportation Resources
Transportation can become a significant barrier impacting people’s ability to access health care, maintain employment, and complete other essential activities. The information below spotlights local transportation resources that may be useful in serving patients.

North Dakota
Medicaid expansion patients in North Dakota can qualify for transportation assistance to medical and mental health appointments. For patients who need help with transportation, these services may be available at no cost but must be pre-approved by Blue Cross Blue Shield of North Dakota (BCBSND). Those who need to be away overnight for an appointment can also qualify for meals and lodging. Requests should be made at least two days in advance. To request transportation, meals, or lodging, call 1-833-777-5779 on weekdays between 8:00 am and 6:00 pm. To learn more about this program, visit here. A printable brochure is also available here.

The North Dakota health equity office has also compiled various other transportation resources across the state. View this document to see the full list.

South Dakota
In South Dakota, the Helpline Center offers the Ride United Transportation Access program through a partnership with United Way Worldwide and the South Dakota Department of Health. Individuals in need of assistance with transportation may call 211 for intake and may qualify for up to six rides. There is a minimum 24-hour notice to schedule a ride.

In addition, the Helpline Center and the Community Health Worker Collaborative of South Dakota are piloting a community health worker (CHW) transportation program, whereby CHWs have direct access to schedule rides. The benefit of participating is that the 24-hour notice requirement is waived, and it is at the discretion of the CHW to provide more than six rides if needed. If the CHW determines that more than six rides are needed, they will document the reason, the barriers, and other transportation avenues that were explored, such as the local bus. In this program, CHWs may also provide transit vouchers in an amount they deem appropriate and applicable to their client. To learn about future opportunities to participate in the CHW transportation program, reach out to CHAD staff Eugene Giago or Shannon Bacon.
2 by 10: Improved Best Practices for
Routine HPV Vaccination

Human papillomavirus (HPV) vaccination is critical in the fight against cancer to protect the individual and create community immunity. However, immunization rates are dangerously low. Only about half of adolescents in South Dakota are fully vaccinated against HPV. In addition, the COVID-19 pandemic has caused a decrease in routine immunization rates in adolescents, including HPV vaccination.
Join Immunize South Dakota for a virtual training focusing on the importance of routinely recommending timely vaccination against preventable cancers caused by HPV. Presenters will share state-based immunization rates for 9 – 12-year-olds. They will present key strategies to support practice change for recommending vaccines, including conversations to address misconceptions and vaccine hesitancy to improve vaccination rates. Additionally, participants will hear the new best practice of starting the HPV vaccine series at ages 9-10, established by the American Academy of Pediatrics and the American Cancer Society.

This training is intended for all health care team members who impact adolescents’ medical care, including medical providers, nurses, pharmacists, school nurses, community health workers, and others. Immunize South Dakota will offer this one-hour live webinar three times to allow people who want to learn more to choose the date and time that works best for them. Register for one of the three sessions below.
  • Friday, September 9 | 12:00 pm CT/ 11:00 am MT | Register here.
  • Wednesday, September 21 | 11:00 am CT/ 10:00 am MT | Register here.
  • Friday, October 7 | 12:00 pm CT/ 11:00 am MT | Register here.
Application Cycle Now Open:
Student Leaders in Public Health Project

During the 2022-2023 academic year, the Rocky Mountain Public Health Training Center (RM-PHTC) will award 27 students in higher education $3,500 in financial support to assist with public health-focused field placements and faculty-student collaborative projects. This program aims to increase the supply and diversity of the public health workforce in the Rocky Mountain region, specifically in underserved communities and populations, by supporting students conducting applied public health projects and providing opportunities for mentoring and professional development.

Application deadlines are October 1 and December 15. For more information, join an information session held on Wednesdays in September at 1:00 pm CT/ 12:00 pm MT or visit the Student Leaders in Public Health website.
CCHN/CHAMPS 2022 Health Equity Learning Series
The Community Health Association of Mountain/Plains States (CHAMPS) is pleased to announce that registration is open for two free upcoming distance learning events as part of the 2022 CCHN/CHAMPS Health Equity Learning Series.

The 2022 Health Equity Learning Series examines foundational topics in health center equity and highlights a path towards accessible health care for all communities. Each speaker will address a different topic to help participants equip themselves with actionable strategies to progress care for their patient base. This year’s events build on the topics investigated in the 2021 Health Equity Learning Series to help educate participants on issues of racism in the health care community, equity burnout, and LGBTQ+ health care access. Each event is designed to help create actionable plans to work towards health equity within the health center community.

Participation in the live versions of these webinars is free for health centers and primary care associations in Region VIII (CO, MT, ND, SD, UT, WY). Recordings will be available. This series is intended for any health center and PCA staff in Region VIII (CO, MT, ND, SD, UT, WY). Register here.
COVID-19 Updates
On Thursday, September 1, the Centers for Disease Control & Prevention (CDC) recommended the Pfizer-BioNTech bivalent booster for patients 12 years and older and the Moderna bivalent booster for patients 18 years of age and older.

These new boosters are called “bivalent” because they protect against two different COVID-19 strains: the original and the highly contagious omicron variant. The single-shot bivalent booster recommendation is to replace all other boosters at least two months after their last COVID-19 vaccine regardless of previous monovalent booster doses. Patients are up-to-date if they have completed a primary series and received the most recent booster dose recommended by the CDC. 

The Food and Drug Administration’s (FDA) authorization rescinded the authorization for monovalent boosters. The monovalent (original) vaccines will continue to be used for primary vaccination in patients that have never been vaccinated against COVID-19.

Last week, the federal government suspended ordering at-home self-tests through due to a lack of funding. COVID-19 testing resources are available for anyone in need of a COVID-19 test. These resources include insurance reimbursement for at-home self-test kits and locations by state where uninsured individuals may receive a free antigen or PCR COVID-19 test. The HRSA COVID-19 Testing Supply Program remains available for HRSA-supported health centers to order free, FDA-approved COVID-19 at-home self-tests for distribution to their communities.

Additional Resources
GP11 Network News

HITEQ Highlights: Cybersecurity Ask Me Anything

This session will seek to motivate and educate health center staff and leadership on current critical cybersecurity threats, concepts, and methods for defending health data. Register to hear a panel of cybersecurity experts address questions on how to best protect health centers from internal and external network leaks, malware such as ransomware, and through physical means on-site. 

Thursday, September 8
1:00 pm CT/ 12:00 pm MT
Register here.

Back to School: DRVS Tips and Tricks

Hear Azara experts share their favorite tips and tricks for streamlining DRVS. Learn how to create pins, saved filters, saved columns, and much more.

Thursday, September 8
1:00 pm CT/12:00 pm MT
Register here.

Health Care Workforce Stress and Resiliency: The Role of Technology
This webinar is part of HRSA’s telehealth learning webinar series. It will feature expert panelists discussing best/promising practices and examples of how technology can be leveraged to address provider stress and promote health care workforce resiliency. The webinar will be interactive with a discussion session following the panelist presentations, and resources will be provided.

Tuesday, September 13
11:00 am CT/ 10:00 am MT
Register here.

Back to School: Basics of DRVS Admin
Hosted by Azara, this webinar will review the basics of the DRVS administration permission, including cohorts and registries, provider and location groups, targets, shared filters, and email subscriptions. Follow along in DRVS and ask questions of DRVS experts.

Thursday, September 15
1:00 pm CT/12:00 pm MT
Register here.

School-Based Health
School-based health centers play a key role in improved educational and health outcomes while demonstrating an “upstream” approach to preparing youth for successful adulthood. However, many organizations struggle with getting and using the data that can drive creative programming in their school-based programs. This webinar will cover DRVS reporting to help track and improve clinical outcomes, understand access and capacity and inform decision-making in school-based centers. With a focus on data transparency, school-based data can promote collaboration between the school, the larger community, and health center providers to target the needs of school-aged children. Don’t get caught “after the bell!” Join this session to learn more about the available data tools to help share the challenges and success of your school-based programs.

Thursday, September 22
1:00 pm CT/12:00 pm MT
Register here.

Patient Visit Planning Part 1: Steps to Success
The health care industry strives to establish the best care possible. This can be through better efficiency, tackling care gaps, and improving overall satisfaction. The first part of Azara’s two-part patient visit planning webinar focuses on the importance of huddles as part of pre-visit planning. Through interactive components and strategies, Azara hopes to assist in making the work environment and patient care delivery much more manageable.

Tuesday, September 27
1:00 pm CT/ 12:00 pm MT
Register here.

Patient Visit Planning Part 2: Measuring Success
Join Azara for part two of their patient visit planning webinar. Azara’s clinical transformation team will provide insight into the benefits of utilizing a pre-visit planning tool during this session. Azara will provide insight into other practices’ success and areas of struggle. This will allow for a greater understanding of what steps organizations can take to ensure a positive impact on overall goals.

Thursday, September 28
1:00 pm CT/12:00 pm MT
Register here.
#CallYourPediatrician Campaign
Using humor and real-world conversations, the American Academy of Pediatrics has launched the #CallYourPediatrician campaign, which aims to reach parents with timely reminders that going to the pediatrician, even during COVID-19, is important and safe.

Click on each campaign to find everything you need to share on social networks. They include sample texts, videos, and photos sized for Facebook, Instagram, Twitter, LinkedIn, and Pinterest. All posts should include the hashtag #CallYourPediatrician.
Webinars & Meetings
Find these and other events on the CHAD website.
CDC: 2022-2023 Influenza Vaccination Recommendations and Guidance on Co-administration with COVID-19 Vaccines
During this CDC clinician outreach and communication activity (COCA) call, presenters will provide updates on the Advisory Committee on Immunization Practices (ACIP) recommendations for the 2022-2023 influenza vaccination season, including information on a new preferential vaccine recommendation for adults ages 65 and older. In addition, presenters will outline guidance for the co-administration of influenza and COVID-19 vaccines.

For those unable to attend the live COCA call, the recording will be available on the COCA call webpage a few hours after the live event ends. Free continuing education credits will be offered for this COCA call. Registration is not required.

Thursday, September 8
1:00 pm CT/ 12:00 pm MT
Passcode: 759488
Dial in: (669) 254-5252
Building Capacity in Primary Care: Prevention, Diagnosis, and Treatment of STIs and HIV in the Dakotas.
Join CHAD and the Dakotas AIDS Education Training Center (DAETC) for the new monthly Communities of Practice meeting series, beginning with Building Capacity in Primary Care: Prevention, Diagnosis, and Treatment of STIs and HIV in the Dakotas. Health centers and partners are invited to connect with peers, review case scenarios, and share best practices to improve access to care and quality of life for people with or at increased risk of HIV. Providers, nurses, case managers, and clinicians passionate about ending the HIV epidemic in the Dakotas and working in the continuum of care surrounding sexual health and prevention and treatment of HIV are the intended audience for these informal sessions.

Thursday, September 15
12:00 pm CT/ 11:00 am MT
Sign up here to join the Communities of Practice calls. After signing up, participants will receive an Outlook meeting invitation for monthly calls.
Online & In-the-Know: Shingles and Vaccination
Join Immunize South Dakota for a discussion on herpes zoster (shingles) and its complications. The speaker will discuss the currently approved vaccine (RZV) for the prevention of shingles, patient expectations, and strategies for second-dose completion. The presenter will also discuss immunization rates among the current population and the impact of lowering the age recommendation from 60 to 50 regarding the number of patients eligible in the general population.

Tuesday, September 20
12:30 pm CT/ 11:30 am MT
Register here.
South Dakota Association Healthcare Organizations 96th Annual Convention
Join the South Dakota Association of Healthcare Organizations (SDAHO) for its annual convention in Sioux Falls on September 21-23. This year’s event will be packed with insight and experts addressing workforce, public policy, Medicaid expansion, and violence in the workplace. SDAHO created several panel sessions to allow members to learn from others addressing issues impacting South Dakota health care. In addition, SDAHO has partnered with nine affiliated societies to provide specific education on quality, engineering, leadership, finance, human resources, health information management, technology, social workers, and nursing. These two days will feature amazing speakers, innovative ideas, and countless opportunities to network and share ideas with colleagues.

Wednesday – Friday, September 21-23
Register here.
Mental Health First Aid Training in Watertown, SD
Mental Health First Aid (MHFA) is an eight-hour course that gives people the skills to help someone developing a mental health problem or experiencing a mental health crisis such as contemplating suicide. MHFA is an evidence-based program widely used throughout the United States. The training aims to help support an individual until appropriate professional help arrives. Participants learn strategies, including assessing risk, respectfully listening to and supporting the individual in crisis, identifying appropriate professional help, and other supports. This training will be held in person at Prairie Lakes Healthcare System in Watertown, SD, and is free to attend.

Wednesday, September 21
8:00 am – 5:00 pm CT
Register here.
Special and Vulnerable Populations COVID-19 Forum
Join to hear a discussion on how COVID-19 has impacted health centers and the special populations they serve. Suma Nair, Ph.D., director of BPHC’s office of quality improvement, will provide up-to-date information about assistance for health centers. HRSA-funded national training and technical assistance partners (NTTAPs) have extended this ongoing series. However, please note that previous registrations will not carry over.

Friday, September 23
1:00 pm CT/ 12:00 pm MT
Person-Centered Communication in Health Care
Join CHAD for a virtual training series focusing on broadly relevant person-centered communication concepts and skills, offering participants an interactive, skill-based learning experience. The sessions will include best communication practices and draw connections between evidence-based and consumer-voice guidance. The series will consist of four 90-minute web-based trainings, and each session will feature a lived experience testimonial you can access after the training. After each session, CHAD will provide a copy of the lived experience testimonial and a discussion guide that participants can utilize to share person-centered communication concepts with additional colleagues.

This series will be relevant to people in almost any patient-facing role, including front-desk staff, medical assistants, nurses, providers, care coordinators, navigators, and community health workers. Sessions 3 and 4 will be particularly relevant to people who facilitate screenings and referrals, health education, care planning, care management, or care coordination. All health center staff are welcome to attend.

Wednesdays: September 28, October 12 & 26, November 9
12:00 pm – 1:30 pm CT / 11:00 am – 12:30 pm MT
Register here.
SD Cancer Coalition Fall Meeting
Registration is now open for the 2022 SD Cancer Coalition (SDCC) fall meeting. Join the SDCC on Thursday, October 13, for an opportunity to learn, network, and get involved in SDCC efforts. The planning committee has pulled together an excellent agenda for the first in-person meeting since 2019. Participants will hear about partnership opportunities with the Community Health Worker Collaborative of South Dakota, new data dashboards and resources, the latest legislative updates, and engage with a panel of cancer center directors from across the state. Task forces will also convene to begin action planning for the upcoming year. Registration is free, and all members of the SDCC are encouraged to attend.

Thursday, October 13
10:00 am - 3:30 pm CT
Register here.
CHAD Network Team Meetings
Monday, September 12 at 1:00 pm CT/ 12:00 pm MT – Operational Excellence/Compliance Workgroup
Tuesday, September 13 at 2:00 pm CT/ 1:00 pm MT – Communications and Marketing Network Team
Tuesday, September 27 at 1:00 pm CT/ 12:00 pm MT – Outreach and Enrollment Network Team
Tuesday, September 27 at 2:00 pm CT/ 1:00 pm MT – CFO and Finance Manager Roundtable

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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