CHAD Connection

Open enrollment is almost here, and with it comes another opportunity to help those who are uninsured or need coverage take the first step to apply. This is also the time to encourage those who are new to the Marketplace or already have coverage to log in, update their information, and actively re-enroll through healthcare.gov. Open enrollment runs from November 1, 2025, through January 15, 2026.

This year brings several important changes that make early action and clear communication important.

What’s New This Year:

End of the year-round special enrollment period (SEP) for lower-income households. Individuals under 150% of the federal poverty level who once could enroll anytime must now act during Open Enrollment unless they qualify for another life event.
Tighter documentation and verification timelines. Applicants must submit proof of income or eligibility sooner, with fewer grace periods to resolve data issues.
Pre-enrollment verification for life events. People qualifying for coverage due to job loss, marriage, or other life changes must submit documentation before their plan can start.
Anticipated expiration of enhanced Marketplace subsidies. The enhanced premium tax credits are set to expire at the end of 2025, which could increase costs for many consumers in 2026 if they are not extended by Congress.

These changes may create confusion or delay if individuals wait too long, but early outreach, proactive referrals, and strong messaging will help people stay covered.

After a few early delays, the 2025–2026 fall vaccine rollout is officially underway, with updated COVID-19, flu, and RSV vaccines available nationwide. The CDC Director has adopted the latest Advisory Committee on Immunization Practices (ACIP) recommendations, reaffirming that vaccination remains the best defense against severe respiratory illness.

The CDC now recommends COVID-19 vaccination for everyone six months and older through a shared clinical decision-making approach, reinforcing the patient-centered model already practiced in health centers. All available vaccines, Moderna, Pfizer, and Novavax, are updated formulations. New this year is Moderna’s mNexspike, a lower-dose option for patients aged 12 and older. National groups, including the AAP and ACOG, continue to recommend vaccination for young children, pregnant individuals, and adults with chronic conditions to prevent serious illness and long COVID.

As of October 1, eligible community health workers (CHWs) can officially apply for certification through the North Dakota Department of Health and Human Services (HHS). This milestone follows legislative action (HB 1028) and extensive work by the CHW Task Force and HHS to establish clear standards for education, training, certification, and Medicaid reimbursement. Certain services provided by certified CHWs are now eligible for reimbursement, in accordance with ND Medicaid’s coverage policy. Under the policy, federally qualified health centers can receive a fee-for-service (FFS) rate for CHW services.

HHS has approved four pathways to certification. These include: 1.) Completion of an approved CHW training program followed by a 200-hour internship; 2.) Completion of the Indian Health Service Community Health Representative training; 3.) At least 1,000 hours of supervised CHW work within the past three years; or 4.) A current CHW certification from another state with comparable requirements. Individuals who meet one of these four options may be eligible for CHW certification in North Dakota.

CHAD celebrates these milestones and the opportunity for a growing CHW workforce in North Dakota! We are committed to providing continued implementation support to health centers. Please contact Shannon Bacon or Lindsey Karlson with any questions.

Resources

ND Medicaid CHW Coverage Policy

Certification Application & Related Resources

MHP Salud: Online Resources for CHWs

Community Health Association of Mountain/Plains States (CHAMPS) and Northwest Regional Primary Care Association (NWRPCA) will host their Annual Fall Primary Care Conference, October 25-28 in Spokane, WA.

The Primary Care Conference is designed to address the needs of Region 18 (Region VIII and Region X) health center staff and board members. This year’s event will include educational sessions, networking opportunities, keynote speakers, and exhibits from industry experts. Forty-six educational sessions will be offered across a variety of tracks, including Board Governance, Clinical, Finance, Healthy Communities, Hot Topics, Human Resources/Workforce, Leadership, and Operations.

Explore the conference agenda (subject to change) to learn more about the educational and plenary sessions as well as the networking opportunities. CHAMPS Organizational Members qualify for group rate discounts and may be eligible for registration and clinical travel support reimbursement. Visit the CHAMPS Annual Primary Care Conference webpage for more information.

ACA Marketplace insurance allows individuals and families without access to other affordable, comprehensive health insurance to obtain coverage for themselves and their families. To make monthly premiums more affordable, advance premium tax credits (APTCs) ensure that people at or below 400% of the federal poverty level (FPL) don’t have to pay more than a set percentage of their income toward health insurance premiums. During the pandemic, Congress passed legislation that enhanced APTCs to help even more, lowering the cost of monthly premiums for individuals and families. Now, these enhancements are set to expire at the end of the year, meaning folks who get their insurance through the Marketplace will pay significantly more in monthly premiums.

In North Dakota, premiums are expected to rise by 91% and cause 7,000 people to become uninsured. In South Dakota, premiums are expected to rise by 116% and cause 8,000 people to become uninsured. For the 15,000+ Dakotans priced out of health insurance, that means facing crippling medical debt if an emergency arises, which negatively impacts the bottom line of providers and medical facilities and makes the insurance risk pool more volatile, resulting in higher costs for all. Capital Link’s latest projections estimate community health centers in South Dakota and North Dakota will experience a combined revenue loss of nearly $120 million between 2026 – 2029, without an extension of APTC enhancements.

Health Care for the Homeless Collaborative Training

CHAMPS is hosting a four-part collaborative series for Region VIII health center staff who serve people experiencing homelessness and key PCA contacts to hear from experts in the field, discuss challenges, and identify desired training and technical assistance. There is no cost to attend this virtual series. First session is November 19 from 1:00 – 2:00 pm CT / 12:00 – 1:00 pm MT. Register here!

Closing the Gap: Best Practices for Improving Breast Cancer Screening Rates

The American Cancer Society and the National Breast Cancer Roundtable are partnering to provide an in-depth discussion on the current state of breast cancer, understanding the screening guidelines, learning best practices for increasing screening rates, and a review of tools and resources available to community health centers. Session 3 of this webinar series is on October 23 from 12:00 pm – 1:00 pm CT / 11:00 am – 12:00 pm MT. Register here!

National Training & Technical Assistance Partners (NTTAP) Free Webinars:

Optimizing the Role of Integrated Oral Health in Health Centers
October 21 from 2:00 – 3:00 pm CT / 1:00 – 2:00 pm MT
Learn more!

Training the Next Generation: Health Professions Students Roadmap
October 22 & November 12 from 12:00 pm – 1:00 pm CT / 11:00 am – 12:00 pm MT
Learn more!

Strengthening Diabetes Self-Monitoring Education & Support
October 30 from 2:00 – 3:00 pm CT / 1:00 – 2:00 pm MT
Learn more!

Mastering and Maintaining the Mapping Admin: Elevated Data Health and Accuracy

Join Azara for an in-depth training session on DRVS Mapping Administration, designed for users responsible for maintaining data health and integrity. This webinar will provide a comprehensive overview of how to manage and optimize mapping within Azara DRVS, ensuring accurate data capture and reporting. Participants will learn best practices for maintaining data consistency, troubleshooting common mapping issues, and enhancing overall data quality. Whether you're new to mapping administration or looking to refine your skills, this session will equip you with the knowledge and tools needed to effectively manage your organization’s data.

Tuesday, October 21
12:00 pm CT / 11:00 am MT
Register here

Back to Basics: Dashboards

Are you ready to take your DRVS expertise from 101 to 201 and dive head first into Dashboards? Custom dashboards are one of the most complex tools in DRVS, yet they deliver a wealth of potential related to tracking, evaluation, and communication. Join us for a dashboard deep dive as Azara experts walk through how to create an effective and visually compelling dashboard to tell your organization’s story. Azara welcomes participants to ask any questions you have on dashboards in your registration.

Thursday, October 23

1:00 pm CT / 12:00 pm MT

Creating a Data-Driven Medical Home: PCMH & DRVS

Learn how to set up and sustain a meaningful patient-centered medical home program at your practice utilizing tools across Azara products. During this webinar, Azara will review how DRVS’ NCQA pre-validation status can be leveraged for auto-credits during initial recognition, and how the many PCMH-focused reports and features can be used to evaluate and promote an on-going patient-centered, compassionate, and coordinated culture of care at your practice.

Tuesday, October 28

12:00 pm CT / 11:00 am MT

Back to Basics: Population Health Tools

In this webinar, Azara will lay the foundation for success in understanding how data can be leveraged to support the needs of the patients, populations, and communities served by practices on DRVS. Join Azara to learn more about many of DRVS' most unsung heroes - registries, care effectiveness reports, and pediatric reports - and how they can support you in advancing your population health goals. This webinar is recommended for team members responsible for identifying and tracking key populations. This might include the care team, population health, care coordination, care management, and users with Admin privileges, among others.

Thursday, October 30

1:00 pm CT / 12:00 pm MT