Health centers play a vital role in connecting patients to coverage. About 20% of patients served by health centers are uninsured in both North Dakota and South Dakota. Thank you for all you do to connect uninsured patients with health insurance counselors or navigators who can help them gain access to insurance.

CHAD has developed a set of marketing tools and videos that can be used to promote access to insurance through the Health Insurance Marketplace. Contact Kayla Hanson at CHAD for a social media toolkit and find videos to share on the CHAD YouTube page.

Open enrollment began on November 1 and continues through January 15, 2023. This year, open enrollment has additional benefits for consumers that deserve special attention:

  1. The American Rescue Plan Act and the Inflation Reduction Act have reduced the cost of health insurance in the Marketplace. Most people will find access to health insurance plans for $10 or less per month.
  2. The family glitch has been fixed! Starting in 2023, family members of a person offered employer-based insurance that is affordable for self-only coverage may be eligible for tax credits to help the family enroll in a Marketplace plan with savings.
  3. More help is available to help consumers choose a Marketplace plan. In South Dakota, CHAD and its partners have 11 full-time navigators assisting consumers with enrollments. Since August 27, navigators have assisted more than 1800 consumers and completed nearly 200 enrollments.
Health Centers in the News
CHAD’s Jill Kesler spoke with the Mitchell Daily Republic about health insurance open enrollment and the family glitch fix.

Michelle Scholtz, chief dental officer at Horizon Health Care, spoke to the Madison Daily Leader about Horizon’s children’s oral health campaign, “Smiles for Miles.”
CHAD Welcomes Nonna Tumbashev as an Outreach & Enrollment Navigator
Nonna Tumbashev joined CHAD in November as an outreach & enrollment navigator. In this role, she educates and assists consumers with accessing assistance programs and enrolling in affordable health insurance plans through the Marketplace. She does outreach to the community to educate consumers about health insurance and provides information about the Marketplace at Falls Community Health and South Dakota Urban Indian Health. 

Before coming to CHAD, Nonna was a case manager at Volunteers of America, where she helped provide case management services to homeless adolescents. She aided clients with accessing community resources, social programs, health care, education, employment, and individualized service plans and taught life skills to adolescents. She also spent ten years as a sous chef at an Avera retirement community, providing meals to residents under all levels of care and backgrounds.

Nonna graduated from Southeast Technical College with an associate degree in early childhood specialist and the University of Sioux Falls with a bachelor’s degree in social work. She lives in Sioux Falls, where she likes to spend time with her family, explore new cities on trips with her friends, go to the lake, and enjoy summer activities.
CHAD and Partners Release Faces of Medicaid Initiative
Faces of Medicaid was born out of a need to help North Dakotans understand whom the ND Medicaid program serves and its life-changing impact. ND Medicaid provides health care coverage for a broad range of people, including adults with incomes below the federal poverty level, children, pregnant people, older adults, and people with disabilities. Chances are everyone knows someone covered by ND Medicaid – a friend, family member, neighbor, or coworker.

Furthermore, ND Medicaid brings valuable peace of mind to its members. When people know they have health care coverage, they may be able to redirect their resources and energy to other critical, basic needs – securing a safe place to live or choosing healthier foods for their families. ND Medicaid supports strong, stable families by helping them avoid disruption and further escalation into crisis. In this way, ND Medicaid is much more than a health care program; it serves to reinforce economic, behavioral, and physical health, the foundations of well-being.

CHAD is proud to partner in this effort with others committed to serving ND Medicaid members across the state, including
Blue Cross Blue Shield of North Dakota Caring Foundation, the North Dakota Department of Social Services, and the North Dakota Hospital Association. To help promote the Faces of ND Medicaid initiative, use this toolkit to share how it can have a life-changing impact.
World AIDS Day December 1
World AIDS Day is observed on December 1 each year. First observed in 1988, World AIDS Day is a time to honor those who have died from AIDS-related illnesses across the globe and recommit to ending the HIV epidemic. The theme for 2022 is Putting Ourselves to the Test: Achieving Equity to End HIV. Watch’s latest “FYI” video with Harold Phillips, the director of the White House Office of National AIDS Policy, to hear his remarks about this year’s theme, its significance, and how it helps move us toward ending the HIV epidemic.

World AIDS Day is a day of solidarity for people around the world affected by HIV and for voices to unite by sharing experiences, remembering those lost, and standing together in the fight against HIV. While great strides have been made over the four decades since the first known reported cases of AIDS, this disease remains a public health challenge. World AIDS Day is an opportunity for every community and each individual to honor the more than 32 million people who have died worldwide from AIDS-related illnesses. For more information on World AIDS Day, visit UNAIDS World AIDS day.

In honor of World AIDS Day, the Health Resources and Services Administration (HRSA) will have a social media campaign using #HRSAHonorsWAD. People are encouraged to follow @HRSAgov on Facebook and Twitter and then like, retweet, comment, and repost #HRSAHonorsWAD posts to social media channels. #HRSAHonorsWAD is intended to honor the lives and share the stories of people with HIV and highlight our collective efforts to end the HIV epidemic. Please also consider posting messages and photos using #HRSAHonorsWAD. Messages can highlight or relate to the 2022 World AIDS Day theme, Putting Ourselves to the Test: Achieving Equity to End the HIV Epidemic, or highlight the HIV care and treatment efforts of health centers.
HRSA Expanding COVID-19 Vaccination Funding
Last week, Health Resources and Services Administration (HRSA) announced a new $350 million initiative for HRSA-supported health centers and look-alikes to increase COVID-19 vaccines in their communities, specifically focusing on underserved populations. This funding supports the Biden Administration’s efforts to get more Americans their updated COVID-19 vaccine before the end of the year.

Health centers can use these one-time funds to expand outreach and education, community engagement, and coordinated events to increase COVID-19 vaccinations through mobile, drive-up, walk-up, or community-based vaccination events, including working with community- and faith-based organizations. The goal is to raise awareness and increase the administration of COVID-19 vaccinations, especially among the hardest-hit and highest-risk populations. Read HRSA’s recent bulletin for more information about the fiscal year (FY) 2023 Expanding COVID-19 Vaccination (ECV) funding.
Reducing Barriers and Expanding Coverage for
Colon Cancer Screening

Colon and rectal cancers continue to be a leading cause of death in the United States, with even higher new cases and death rates for Black Americans, American Indians, and Alaska Natives. Medicare will now reduce the minimum age for colorectal cancer screening from 50 to 45 years, in alignment with recently revised policy recommendations by the US Preventive Services Task Force. Additionally, Medicare will now cover as a preventive service a follow-on screening colonoscopy after a non-invasive stool-based test returns a positive result, which means that beneficiaries will not have out-of-pocket costs for both tests. Read more here.
Fifth Annual “State of Lung Cancer” Report Released
The American Lung Association is excited to share its latest report, the State of Lung Cancer. The 5th annual State of Lung Cancer report examines state-specific measures of lung cancer indicators, including new cases, survival, early diagnosis, surgical treatment, lack of treatment, Medicaid screening coverage data, and screening rates.
This year’s State of Lung Cancer report reveals the importance of screening, which is critical to reducing the burden of lung cancer on families. Lung cancer screening is key to early diagnosis, and early diagnosis saves lives. Unfortunately, in 2021, only 5.8% of those eligible were screened.
According to the report, in addition to lower survival rates, people of color diagnosed with lung cancer face worse outcomes than White Americans, including being less likely to be diagnosed early, less likely to receive surgical treatment, and more likely to receive no treatment. Addressing racial disparities in health care coverage will therefore be critical to improving racial disparities in lung cancer care.
HRSA Funding Opportunity:
Rural Health Network Development Planning Grant
The Network Planning Program provides $100,000 to support one year of planning. It brings together key parts of a rural health care delivery system, particularly those entities that may not have collaborated in the past, to establish and/or improve local capacity to strengthen rural community health interventions and enhance care coordination.
In addition to the regular network planning track, applicants can select the Advancing Health Equity (AHE) track. The AHE track intends to focus on collaboration between entities to establish or improve local capacity and care coordination among rural Black, Latino, Indigenous and Native American persons, Asian Americans and Pacific Islanders and other persons of color; members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons; persons with disabilities; and people otherwise adversely affected by persistent poverty or inequality.
For more information or to apply, click here. Applications are due January 6, 2023.
GP11 Network News
Patient-Centered Medical Home (PCMH) Updates for 2023/2024
NCQA continually evaluates the current state of its recognition programs and has provided the following updates and reminders:
  • Beginning in 2024, PCMH and patient-centered specialty practice (PCSP) practices will be required to use an electronic health record (EHR).
  • Beginning in 2024, standardized measures will be required for PCMH. A standardized measure captures data from the entire calendar year before the submission year; thus, for 2024, the reporting period will be January 1–December 31, 2023, unless stated otherwise in the measure specification. The EHR must be able to generate standardized measure reports for submission. Refer to the measures page for a list of all PCMH-supported measures, as they have been updated this month.
  • Two options for QI 02B: Measures affecting health care costs may not be relevant to all practices. If practices cannot report on one of the options, submit a policy clarification support ticket through My NCQA for an exception allowing submission of a custom measure report.
  • There can be unique challenges to obtaining a full calendar year of data (e.g., changing vendors mid-year). Exceptions to calendar year reporting will be granted on a case-by-case basis. Submit a PCS ticket through My NCQA for consideration.

Please submit any questions to My NCQA or email Becky Wahl at CHAD.

Integration Exploration: Understanding Behavioral Health Tools in DRVS
Primary care providers can act as a gateway for individuals with behavioral health needs, but other areas of care—like oral health and prenatal care, can be avenues for identifying and addressing behavioral health needs as well. This webinar will explore tools in DRVS you can use to integrate behavioral health into a variety of care settings, including tools for depression, anxiety, screening utilization, and medication management.

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

DRVS for Quality Improvement: Applying Six Sigma Methodologies to Succeed in Value-Based Care
As the transition to value-based care marches forward across all areas of the health care sector, primary care practices must be prepared to succeed in new payer contract models that reward both quality performance and cost savings. Data analytics tools offer a pathway to manage patient populations efficiently and effectively across both cost and quality.

In this session, participants will learn the types of reporting that best support this continuum of need, preparing organizations to meet value-based care goals at every level of care delivery. Learn how to utilize newly developed performance improvement packages, which leverage the Six Sigma DMAIC (define, measure, analyze, improve, control) process, to continuously improve clinical quality measures. At the end of this session, attendees will be able to apply Six Sigma improvement strategies, improve clinical quality, measure performance, and ultimately demonstrate the value that their organization delivers to the health care system and the patients they serve.

Thursday, December 15                              
1:00 pm CT/12:00 pm MT                         
Register here.
National Influenza Vaccination Week December 5 - 9
National Influenza Vaccination Week is a critical opportunity to remind everyone six months and older that there’s still time to protect themselves and their loved ones from the flu this season. Currently, flu activity is elevated across the country. This week serves to remind people that there is still time to benefit from the first and most important action in preventing flu illness and potentially serious flu complications: get a flu vaccine today. CHAD released a social media toolkit promoting flu shots earlier this fall. Contact Kayla Hanson to receive a copy.
Webinars & Meetings
Find these and other events on the CHAD website.
Understanding SDOH and Structural Barriers Affecting Diabetes Care
The Special and Vulnerable Population Diabetes Task Force presents its fall 2022 national learning series “Improving Health Systems & Infrastructure Interventions.” Use the diabetes website to access past webinars or any resources. The following NTTAPs are part of this task force: Health Outreach Partners,
the Corporation for Supportive Housing, and the National Health Care for the Homeless Council.

Tuesday, December 6
1:00 pm CT/ 12:00 pm MT
OE 10: Finishing Strong and Laying the Groundwork for the Future
The 10th open enrollment period (OE 10) of the Affordable Care Act began on November 1 and runs through January 15, 2023, in states that utilize Webinar faculty includes the National Association of Community Health Centers (NACHC), the Illinois Primary Health Care Association, and a federally qualified health center.

This webinar will provide a detailed overview of the important role health centers play in conducting outreach and enrollment activities and highlight the immediate steps your health center can – and needs – to take to conduct outreach and enrollment activities and finish OE 10 strong. It will focus on steps health centers need to take in states and elevate strategies for engagement and outreach that health centers in all states can deploy.

Wednesday, December 7
1:00 pm CT/ 12:00 pm MT
Register here.
HIV Prevention: Combating PrEP Implementation Challenges
Expert faculty will present case-based scenarios illustrating common challenges to integrating HIV PrEP in primary care. As part of improving clinical workforce development, this session will delve into a variety of specific PrEP implementation challenges. Participants will leave with strategies to overcome these obstacles to establish or strengthen their PrEP program. Presented by the National Health Center Training & Technical Assistance Partners (NTTAP).

Monday, December 12
12:00 pm CT/ 11:00 am MT

Register here.
Online & In-The-Know: Taking Vaccine Advocacy the Final Mile
Join Immunize South Dakota for the next session of the Online & In-the-Know series and learn how to take vaccine advocacy the final mile. Becky Christensen, state campaigns director & founder of the SAFE Communities Coalition, will show why advocacy is critical in maintaining the policies that have kept us safe from preventable diseases for decades.

Tuesday, December 13

12:30 pm CT/ 11:30 am MT
Register here.
Colorectal Cancer Learning Collaborative
The December CRC Learning Collaborative session will focus on incorporating a colorectal cancer patient risk assessment in the EHR utilizing the Cologuard dashboard and reports to reach patients needing screening and CRC updates for 2023. Speakers include Mark Cali, MS, PA, from Horizon Health Care - Martin Clinic, and Jackie McPherson with Exact Sciences.

Wednesday, December 14
12:00 pm CT/ 11:00 am MT
Register here.
Community Inclusion and Cultural Humility in Diabetes Prevention
Join the National Nurse-led Care Consortium (NNCC) in a webinar focused on cultural humility and strategies for community inclusion in diabetes care. Participants will learn how to apply cultural humility to diabetes care while engaging community members in culturally and linguistically responsive health care practices to address racial and ethnic health disparities. Speakers will showcase best practices of implementation and real accounts of developing patient-centered diabetes prevention programs, treatments, and educational interventions tailored toward residents of public housing. This webinar is for clinicians, nurses, and all health center staff who serve residents of public housing and other special populations.

Wednesday, December 14
1:00 pm CT/ 12:00 pm MT
Environmental Impacts on Diabetes Access to Care
The Special and Vulnerable Population Diabetes Task Force presents its fall 2022 national learning series “Environmental Impacts on Diabetes Access to Care.” Use the
diabetes website to access past webinar or any resources. The following NTTAPs are part of this task force: the National Center for Farmworker Health, the Association of Asian Pacific Community Health Organizations (AAPCHO), Farmworker Justice, and the National Network for Oral Health Access.

Thursday, December 15
1:00 pm CT/ 12:00 pm MT
CHAD Network Team Meetings
Tuesday, December 6 at 12:00 pm CT/ 11:00 am MT – Behavioral Health Work Group
Monday, December 12 at 1:00 pm CT/ 12:00 pm MT – Operational Excellence/ Compliance Workgroup
Tuesday, December 13 at 2:00 pm CT/ 1:00 pm MT – Communications and Marketing Network Team
Tuesday, December 27 at 1:00 pm CT/ 12:00 pm MT – Outreach and Enrollment Network Team
Tuesday, December 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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