It has been a long and sometimes overwhelming year. We are hearing from many of you that you are feeling the strain as you deal with major changes in your own workplaces and lives while also caring for and supporting those impacted by COVID-19. One of the ways we can ensure our continued ability to serve our patients and meet our mission as health centers is to attend to our own wellness and that of our teams.

As a way to point to the importance of wellness and thank health center staff for all the ways you care for and protect our communities, CHAD has developed a Winter Wellness video series that focuses on personal wellness and team health. This series is designed to supplement existing tools for promoting wellness and understanding the ways a pandemic can undermine personal and patients’ wellbeing.

The four-part pre-recorded Winter Wellness series will contain three five-minute videos on self-compassion prescriptions, exploring psychological flexibility, and exploring internal conflict, plus one 30-minute training on organizational healing. A new section will be released every Monday in February via email. Each release is pre-recorded and designed to be listened to at a convenient time or shared as a part of a team meeting. While the series is designed with both video and audio components, the audio can stand alone for listening in the car or on a healthy walk. Pre-recorded videos are available

CHAD is also supporting several upcoming trainings related to leadership, establishing a culture of retention, and approaching crucial conversations. See below for a partnership between CHAD and CHAMPS for a virtual training titled, "Core Competencies for Health Center Supervisors and Managers." CHAD is also planning a six-hour virtual training series titled, "Crucial Conversations," which was a requested follow-up to the supervisor training we hosted last fall. This training will be held May 24-28. And stay tuned for a possible in-person focus on recruitment and retention in the fall.
CHCs in the News
Coal Country Community Health Center will begin to offer eye movement desensitization and reprocessing (EMDR) therapy as reported in The Center Republican.
Falls Community Health is celebrating National Children's Oral Health Month and National School-Based Health Awareness Month via KKRC.
Len Wonnenberg was named Horizon Health Provider of the Year via the Huron Daily Plainsman.
Strengthening Medicaid and the Affordable Care Act
On Thursday, January 28, the Biden Administration announced the Strengthening Medicaid and the Affordable Care Act order. This Executive Order (EO) directs the Department of Health and Human Services (HHS) to open for a special enrollment period (SEP), from February 15, 2021 – May 15, 2021. This SEP will give Americans that need health care coverage during this global pandemic an additional opportunity to sign up.

President Biden will also direct federal agencies to reconsider rules and other policies that limit Americans’ access to health care and consider actions that will protect and strengthen that access. As part of their reviews, agencies will consider whether to take additional actions to strengthen and protect access to health care. Agencies are directed to re-examine:

  • Policies that undermine protections for people with pre-existing conditions, including complications related to COVID-19;
  • Demonstrations and waivers under Medicaid and the ACA that may reduce coverage or undermine the programs, including work requirements;
  • Policies that undermine the health insurance Marketplace or other markets for health insurance;
  • Policies that make it more difficult to enroll in Medicaid and the ACA; and,
  • Policies that reduce affordability of coverage or financial assistance, including for dependents.
State Legislative Sessions Underway
The state legislative sessions are underway in North Dakota and South Dakota. Currently, CHAD is monitoring more than sixty pieces of legislation. Among those are multiple bills in both states that are negatively targeting vaccines. CHAD and many other public health advocates are working with coalition partners to protect and expand vaccine education and access. For more information on CHAD’s legislative priorities, visit our website.

North Dakota bill list
South Dakota bill list
340B Updates
340B Recertification February 1-March 1

Covered entities that do not recertify by the deadline of Monday, March 1, will be terminated from the HRSA 340B Program starting on Tuesday, March 2. They will require a new registration and will not be eligible to participate in the 340B Program until July.

To recertify, authorizing officials and primary contacts must first set up user accounts by visiting the HRSA 340B Office of Pharmacy Affairs Information System (340B OPAIS) and choosing "I am a participant." It is the covered entity’s responsibility to ensure they have created their accounts before recertification to allow successful completion of the process. For questions or assistance, email the 340B call center or call 888-340-2787 (Monday-Friday, 8:00 am-5:00 pm CT).
Sanofi 340B Announcement

Sanofi is one of the three drug manufacturers that began blocking the shipment of 340B-priced drugs to CHCs’ contract pharmacies last year. The other two drug makers implementing similar restrictions – Eli Lilly and Astra-Zeneca – have always offered that CHCs with no in-house pharmacies could select a single contract pharmacy to receive 340B-priced drugs; however, Sanofi never offered that exception. Sanofi changed course on Monday, announcing that CHCs with no in-house pharmacies can have 340B drugs shipped to a single contract pharmacy starting March 1.

CHCs choosing this option are required to register on the website where Sanofi requests extensive data on 340B sales; however, they are not required to provide this data in order to select a single contract pharmacy.

CHAD will inform the 340B group as new information becomes available. To be added to the 340B distribution list, contact Carmen Toft. For more information on the 340B regulation see the resources page on the CHAD website.
2020 UDS Reporting Resources
As a reminder, there are about two weeks left in the UDS reporting period for calendar year (CY) 2020. The 2020 UDS Manual and other resources are available on the Health Resources and Services Administration (HRSA’s) website to help you complete an accurate report.

HRSA added new content to its UDS COVID-19 Resource Guide to address questions about 2020 UDS reporting elements related to COVID-19. The questions answered include:

  • Will health centers need to report on patients who received COVID-19 vaccines; and,
  • If a health center does not spend the provider relief funds that they received, should the funds still be reported (the full amount) on Table 9E?

This new webpage provides guidance regarding outreach and enrollment assists, including what qualifies for UDS reporting, health insurance coverage options, and where to report this information in the UDS.
CHAD Presents Health Equity Transformation Series
Join CHAD for a webinar series focused on health equity transformation to introduce concepts and practical skills focused on bias and inequities in health care. Speakers will include a brief, high-level overview of implicit bias and its association to negative health outcomes. Participants will also use the series to build personal and professional capacity to address inequities in health through motivational interviewing, communication, and advocacy skills. 
Everyone at a health center influences the patient experience and impacts the care they receive. This series is intended for everyone interested in team-based health equity and improving health outcomes for all. Click here to register.

Introduction to Implicit Bias, Inequities in Health and Approaches to Address these Topics 
Friday, February 12
11:00 AM - 12:30 pm MT / 12:00 - 1:30 pm CT 

Recognizing and Reducing the Impact of Implicit Bias on Health Outcomes 
Friday, February 19
11:00 AM - 12:30 pm MT / 12:00 - 1:30 pm CT 

Building Personal and Professional Capacity to Address Inequities in Health 
Friday, February 26
11:00 AM - 12:30 pm MT / 12:00 - 1:30 pm CT 
Leading Cancer Organizations Endorse Resumption of Cancer Screening and Treatment During Pandemic
On January 28, a coalition of 76 leading health organizations, including the National Comprehensive Cancer Network and American Cancer Society, issued a public letter urging the safe resumption of cancer screening and treatment. "The number of people newly diagnosed with cancer has decreased significantly in the United States as well as in other countries across the globe during the COVID-19 pandemic. There is no evidence that the rate of new occurrences of cancer is also decreasing. These distressing trends tell us that many cancers are going undiagnosed and untreated in the wake of COVID-19," said the letter. Experts agree that people should not delay necessary prevention or care during the pandemic. To learn more, view the public letter and accompanying fact sheet here.
ND Department of Human Services to Temporarily Administer Refugee Resettlement Program
With the unexpected closure of Lutheran Social Services of North Dakota (LSSND), Governor Burgum has announced that the North Dakota Department of Human Services (DHS) will temporarily administer the federally funded refugee resettlement program.

DHS previously administered the refugee resettlement program until they transitioned refugee resettlement services to LSSND in 2010. In an interview, DHS Executive Director Chris Jones stated he plans to bring former LSSND employees on as temporary staff until a long-term plan can be developed for the program. DHS is reviewing LSSND’s contracted services and determining how best to continue vital programs. View the Governor’s announcement here.

CHAMPS Virtual Training Opportunities Available
Submitted by CHAMPS

CHAMPS CORE Competencies for Health Center Supervisors and Managers

Managers and supervisors play a pivotal role in the success of the health center. Yet, many are hired or promoted into their roles without the core skills to hire effectively, train, manage, engage, retain, and develop others. This course, specifically designed for supervisors and managers at community, migrant, and homeless health centers, offers intensive, hands-on, and immediately applicable skill-building to successfully navigate management and supervisory roles in the fast-paced and often challenging health center environment.

This training is an excellent opportunity to ensure the nuts-and-bolts knowledge, skills, and strategies to be successful in a management role. Due to our Region VIII state primary care associations’ generous support, discounted registration rates are available to all Region VIII health centers. A limited number of registration scholarships are available. To learn more and to register by March 1, visit the CHAMPS Leadership Learning Opportunities webpage.
CHAMPS Spanish Language for Health Care Professionals – April 2021

CHAMPS will host the annual medical Spanish language training for clinicians at Region VIII health centers in a virtual format. This training is an intensive, conversational, and medical Spanish workshop consisting of medical dialogues, role-plays, visual aids, cross-cultural discussions, and daily practice. The course curriculum provides an experience of immersion learning, an approach that is highly suitable for those with limited time and who must use their new language skills immediately with their Spanish-speaking patients. All courses within the Spanish Language for Health Care Professionals training will be held via Zoom.

In addition to the traditional four-day Medical Spanish Course for Beginner and Intermediate Spanish Speakers course, three new two-day Spanish language courses will be offered: Medical Spanish for Advanced Spanish Speakers, Spanish for Oral Health Providers, and Spanish for Behavioral Health Providers. To learn more and to register by March 31, visit the CHAMPS Events and Trainings webpage.
NACHC Grant and Telehealth Update
Beginning in April 2020, CHAD and the National Association of Community Health Centers (NACHC) began working together on a grant that NACHC was offering to select primary care associations (PCAs) across the country to build a program that would combat opioid use disorders through improved screening and intervention. CHAD learned that the screening, brief intervention, and referral to treatment (SBIRT) and other behavioral health-related screenings were not being completed through telehealth due to COVID-19 and that became the goal of the project.

Early in the pandemic, it became clear that substance use disorders would certainly spike due to the intense stress and isolation. One of the grant requirements was to partner with at least two health centers who could serve as advisors and be willing to implement the new strategy. CHAD is grateful to Horizon Health Care and Spectra Health for their willingness to participate, despite the incredible pressure and strain the pandemic placed on all the health centers.

CHAD has successfully concluded the development stage of the project and will now begin working toward implementation, starting with a survey sent to all health centers regarding their telehealth and substance use disorder capabilities. This survey will be used by a technical assistance advisor through the Opioid Response Network to provide a tailored plan for implementing SBIRT and other potential models through telehealth at the health centers. The implementation of SBIRT through telehealth will improve screening and interventions for patients.

Health Center Employees Encouraged to Complete RTAT Survey
As community health centers (CHCs) across the nation feel the pressures of COVID-19 and the lack of trained and qualified staff, the pandemic has emphasized the importance of growing a diverse and robust workforce. One way to achieve this is by designing training programs for health professionals.
Health centers around the country have been invited to participate in the Bureau of Health Workforce/ Bureau of Primary Health Care strategic workforce initiative. It is important to make sure the Dakotas’ health centers’ input is included by filling out the Readiness to Train Assessment Tool (RTAT) survey.

The RTAT is a survey designed to look at health center readiness to develop and improve health professions training. In partnership with Community Health Center, Inc., CHAD is inviting all CHC staff in the Dakotas to join in the first step of creating an ever-growing and replenishing workforce by completing the RTAT survey.

GP11 Network News
21st Century CURES Act and Information Blocking

In this webinar, the HITEQ Center will discuss how the 21st Century CURES Act defined interoperability and information blocking and how that relates to health centers. With the US Department of Health and Human Services (HHS) recently extending the provider compliance date to April 5, we will review how the Office of the National Coordinator for Health Information Technology’s (ONC’s) final rules defined information blocking requirements and exceptions. Presenters will discuss common scenarios and health center policy practices that might be considered information blocking, and how they can reduce health center risks with early planning and policy definitions.

Tuesday, February 23
12:00 pm MT/ 1:00 pm CT
Register here.
Webinars & Meetings
Find these and other events on the CHAD website.

South Dakota Department of Health COVID-19 Update

The South Dakota Department of Health hosts a weekly COVID-19 webinar for health care facilities, medical providers, laboratorians, long-term care facilities, EMS providers, and other health professionals.

Thursdays in February (reoccurring)
10:00 am MT/ 11:00 am CT
For weekly call-in information, please join the listserv here. Find archived calls and slides here.

South Dakota Department of Health COVID-19 Mass Vaccination Planning

The South Dakota Department of Health hosts a weekly COVID-19 vaccination planning webinar for health care facilities, medical providers, laboratorians, long-term care facilities, EMS providers, and other health professionals.
Tuesdays (reoccurring thru March 2021)
12:00 pm MT/ 1:00 pm CT
Meeting link or call (669) 900 9128
Meeting ID: 845 2763 1820
Passcode: 719500
CHAMPS 2021 Resiliency Collaborative

The CHAMPS Resiliency Collaborative is a facilitated peer support group using concepts from the evidence-based framework, Finding Meaning in Medicine, online. Each session will incorporate the practice of mindfulness techniques and practical body awareness exercises. The remaining time will be comprised of group discussions on topics selected by the participants. For more information or to register, visit the CHAMPS Events and Trainings webpage.

First and third Wednesdays of the month (reoccurring through May 2021)
12:00 pm MT / 1:00 pm CT

211 University

The Helpline Center in South Dakota is offering 211 University, a virtual introduction on how to utilize the 211 Helpline. Presenters will share information about the expansion of 211, its response during the COVID-19 pandemic and new features including the 211 app. There will also be a demonstration on searching the Helpline online database of over 5,000 resources.

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

Psychosis in Primary Care Clinics

Presented by CHAD, this webinar will provide an overview and discussion of common diagnoses that manifest in psychotic symptoms. Participants will learn to identify common etiologies of psychosis in primary care and define common benefits and risks of antipsychotic medication. Dr. Andrew McLean will describe management strategies of psychosis and include evaluation and treatment options.

Tuesday, February 16
11:00 am MT / 12:00 pm CT
Register here.

Innovative Strategies for Home-Based Colorectal Cancer Screening

Sponsored by The American Cancer Society, the North Dakota Colorectal Cancer Roundtable and CHAD, this webinar will explain how a national pilot project is integrating colorectal cancer screening into efforts to provide medically underserved patients the tools they need to manage their health safely in their home. Speakers from the National Association of Community Health Centers (NACHC) will list strategies for providing patient self-care tools (supplies, instructions, education) combined with
follow-up coaching. Participants will leave with sample models and workflows for the use of patient care kits and remote patient monitoring. This webinar includes 1 CEU credit from ND Board of Nursing, pending approval.

Wednesday, February 24
11:00 am MT/ 12:00 pm CT
Register here.

Colorectal Cancer Screening in 2021

Sponsored by the American Cancer Society and GetScreenedSD, this webinar will address current colorectal cancer screening guidelines, screening during COVID-19, and expectations for future disease and trends.

Thursday, February 25
12:00 pm MT/ 1:00 pm CT
Register here.

CHAMPS 2020 Region VIII Health Center Workforce Data Webcast

During the spring and summer of 2020, CHAMPS undertook a survey of Region VIII’s community, migrant, and homeless health centers to collect salary, benefits, and other workforce data from 47 organizations. The CHAMPS 2020 Region VIII Health Center Workforce Data Webcast: Understanding and Utilizing Statistics from the CHAMPS Salary, Benefits, Turnover, and Vacancy Survey Project will explain the history and methodology of the survey and highlight findings relating to salaries and benefits for all health center staff including a look at base vs. additional pay and the structure of health center benefits packages. The presenter will also address trends in additional workforce metrics including vacancies, turnover, challenging areas of recruitment and retention, etc. To learn more, visit the CHAMPS Upcoming Live Distance Learning Events webpage.

Wednesday, March 24
11:30AM-1:00PM MT / 12:30-2:00PM CT
Register here.

CHAD Network Team Meetings

Tuesday, February 9 at 1:00 pm MT/ 2:00 pm CT – Communications & Marketing Network Team Meeting
Thursday, February 19 at 11:00 am MT/ 12:00 pm CT – Behavioral Health Work Group

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