CHAD Connection March 16, 2023

This past week, health center leaders and CHAD’s policy team attended the National Association of Community Health Centers (NACHC) Policy & Issues conference forum. We had the pleasure of seeing health center champions from across the political spectrum speak about the value of health centers, including Senators Bill Cassidy (R-LA) and Bernie Sanders (D-VT), who are the ranking member and chair of the Senate Health, Education, Labor and Pension (HELP) Committee. This committee will be charged this year with reauthorizing federal funding that supports about 70 percent of federal health center funding.

We spent the most time with our congressional delegation, including meetings with Senators Cramer (R-ND), Hoeven (R-ND), Thune (R-SD), Representatives Johnson (R-SD), and Armstrong (R-ND). We briefed them on the reauthorization of health center funding, the health care workforce issues we face, Medicare reimbursement for telehealth, and the introduction of a new coalition to modernize and stabilize the 340B drug pricing program.

These urgent priorities impact our patients in the Dakotas daily, and we urged our delegation to support us in these federal requests. We had a warm welcome and a listening ear in each meeting. We anticipate an uphill battle, given federal budget restraints, but we are confident that our members of Congress will continue to stand up and support community health centers and the patients we serve.

Based in Turtle Lake, ND, Northland Health Centers (NHC) recently celebrated 20 years of providing quality health care to its communities. CEO Nadine Boe kicked this fun, formal event off by recognizing NHC’s board members, past and present, the executive leadership team, medical providers, the oral health team, nursing staff, and administrative staff. Lastly, she thanked everyone, including spouses and significant others, for their daily dedication to the NHC mission. Linda Haggerty, LPN at NHC’s Rolette location, was recognized for 20 years of service, having been there from day one. The evening entertainment was a fun and interactive show with dueling pianos. Guests were challenged to sing and dance and compete with one another in fun, music-filled games.

Northland Health Centers opened its first locations in 2002 in Turtle Lake, McClusky, and Rolette, ND. In 2009 a clinic site was added in Rolla. In 2014, Bowbells and Minot were added to the list of locations, followed by Ray in 2015 and Bismarck in 2016. In 2021, the Rolla site closed, and a new site was added in the community of St. John. In addition to these eight medical clinics, NHC also delivers dental and oral health services in several locations.

Congratulations to Northland Health Centers for serving your communities for over 20 years!

South Dakota
The South Dakota legislation session is in recess, with the final day scheduled on Monday, March 27. The big news coming out of session is full funding for Medicaid expansion, which passed as a ballot initiative last November and is scheduled to take effect July 1. There was a bill considered that would have allowed the legislature to bring a work requirement for Medicaid beneficiaries to the ballot in 2024. That bill was defeated in committee, though there is a possibility it could return next year.

Workforce is always a big focus for health centers, especially as it relates to the health care workforce. CHAD was pleased to see full funding for the rural Recruitment Assistance Program and disappointed to see that the proposed funding for mental health provider loan repayment was not funded. There was also housing infrastructure funding that was framed as workforce housing, and those funds were released early in the legislative session based on a new agreement between the legislature and the Noem administration about that funding authority.

Postpartum coverage for pregnant people was extended through the budget process and will take effect in the context of Medicaid expansion. The legislature allocated $2 million for a maternal medical home in the Medicaid program. They also allocated $2 million in funding for suicide prevention. Targeted providers, including mental health and substance use providers, were funded at 100% of their methodology with some additional dollars to address workforce salaries compared to similar state positions. Funding to provide the mandatory inflation increases for federally qualified health centers (FQHCs) was included in the final budget.

Governor Noem is signaling that she may not approve the budget the legislature passed. The disagreement appears to be with the legislature’s decision to approve a sales tax reduction instead of the grocery tax repeal. She is also unhappy that her proposals to increase foster care funding and offer paid family leave to state employees and incentives for businesses were not adopted. She has until March 26 to issue a veto for consideration on the final day of session on March 27.

North Dakota
Over the last two weeks, CHAD has provided supportive testimony for bills that have crossed over to the alternate legislative chamber.

SB 2155 was heard in the House Human Services Committee this week. Family HealthCare CEO Patrick Gulbranson provided oral testimony, and the other health centers in North Dakota submitted written testimony. CHAD is working to restore the full funding request of 2 million dollars across the biennium from the Senate-passed 1 million dollars.
HB 1028 would create a task force, including a federally qualified health center (FQHC) representative, to outline community health workers‘ scope and reimbursement structure.
SB 2301 would stabilize childcare worker wages. SB 2301 was given a “do not pass” recommendation from the House Industry, Business, and Labor Committee. CHAD supports coalition partners at the ND Child Care Action Alliance, which has put out an action alert.

Refugees and immigrants often face unique challenges in accessing and navigating health care, including language barriers, cultural differences, and unfamiliarity with the health care system. This can result in reduced access to care, poorer health outcomes, and increased health care costs. Navigators from Get Covered South Dakota joined representatives from The HUB SD, South Dakota Voices for Peace, and the Lutheran Social Services Center for New Americans at the “Alternative Avenues to Health Care for Immigrants and Refugees” panel discussion at the University of South Dakota in February.

To address some of the key issues refugees and immigrants may face in the health care system, providers can take several steps, such as:

Providing interpreter services or using multilingual staff to communicate with patients with limited English proficiency;
Offering health education materials in different languages and using plain language to explain health information;
Developing culturally sensitive health care services and training healthcare providers in cultural competency;
Supporting access to health care insurance and offering financial assistance to help refugees and immigrants afford medical care; and,
Offering mental health services that are culturally sensitive and trauma-informed to address the unique needs of refugees and immigrants.

Early bird registration for the 2023 CHAD Annual Conference: Celebrate the Difference ends on Friday, March 17. In partnership with the Great Plains Health Data Network, this annual event allows leaders from community health centers across Wyoming, North Dakota, South Dakota, and South Dakota Urban Indian Health to come together for educational and networking opportunities. Check out the conference webpage for agenda details. For questions, more information, or sponsorship opportunities, please contact Darci Bultje at (605) 273-5669. The deadline to register at the regular rate is Wednesday, April 19.

Attention health care professionals! Become part of the solution to increase access to health care while qualifying for $50,000- $100,000 in tax-free educational loan repayment. In addition to tax-free loan repayment, people receive a competitive salary and a chance to impact underserved communities significantly.

The National Health Service Corps (NHSC) is now accepting applications for three loan repayment programs. Each program has a different award level and varying eligibility.

NHSC Loan Repayment Program provides up to $50,000 for a two-year service commitment.
NHSC Substance Use Disorder Workforce Loan Repayment Program provides up to $75,000 for a three-year service commitment.
NHSC Rural Community Loan Repayment Program provides up to $100,000 for a three-year service commitment.

Join a community of over 20,000 NHSC members providing culturally competent care to 21 million medically underserved people nationwide. The application deadline is Tuesday, April 25, at 6:30 pm CT/ 5:30 pm MT.

Health centers are designed to be community-based, but what does this look like in practice? In this virtual session, participants will discover the value of engaging the ultimate experts: patients! Presenters with firsthand experience will share a wide range of strategies to gain patient insight and involvement in program & process design at health centers. They will also address common barriers to patient and family participation and strategies for overcoming these.

Join CHAD on Wednesday, April 5, from 11:00 am – 12:30 pm CT/ 10:00 am – 11:30 am MT in discovering the value of genuine consumer engagement. This presentation is intended for health center leadership, quality improvement staff, community health workers, and community development and engagement employees. Register here.

Upstream USA and Azara: Partnering to Promote Data-Driven Contraceptive Equity

Join Azara and Upstream USA, a nonprofit dedicated to increasing equitable access to the full range of contraceptive options, to hear how they partnered together for the past five years to support Upstream’s work in reducing unplanned pregnancies across the US. During this webinar, Upstream will give an overview of its mission and program and discuss how they provide free program implementation to partner health centers, including training and guidance on expanding contraceptive access and how they monitor results. Azara works with Upstream USA to develop program-centered measures and reporting tools, a key tenant of any population health initiative and one central to Upstream’s monitoring and evaluation team.

Thursday, March 23
1:00 pm CT/ 12:00 pm MT
Register here.

Reflecting on UDS: Lessons Learned in February
Get ready to take a deep dive into UDS with Azara support. Meg Carley, application support team lead, will speak to common questions, the total number of tickets received, and introduce some best practice considerations to prepare for UDS 2023.

Thursday, March 30
1:00 pm CT/ 12:00 pm MT
Register here.

Identifying Local Resources to Meet Patient Social Needs
Health centers have long responded to the social drivers of health: social and economic factors which have a major impact on health outcomes. Knowing where to find the needed community resources can be challenging when food insecurity, housing, transportation, and other needs arise. Luckily, there are local organizations that take the guessing work out of this. 2-1-1 resource databases, area extension agents, and community action agencies are critical in facilitating access to vital community resources.

Join CHAD for this panel-style webinar with speakers from the Helpline Center, FirstLink, Community Action Partnership of ND, SD Community Action Partnership, and NDSU and SDSU Extension. Social workers, community health workers, navigators, nursing staff, care coordinators, and others who facilitate community resource referrals are encouraged to attend.

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

Online & In-The-Know: Effective Communication to Build Vaccine Confidence
Join Immunize South Dakota for the next session of Online & In-the-Know and learn effective communication tools to help build vaccine confidence. First, attendees will hear from a local mother who shares her vaccine journey from being hesitant to entirely anti-vaccine to accepting to promoting vaccines. Dr. Suzanne White will then discuss different perceptions towards vaccination, vaccine hesitancy across populations, and strategies to help build vaccine confidence, such as motivational interviewing.

Tuesday, March 21
12:30 pm CT/ 11:30 am MT
Register here.

CMS webinar: What to Know and How to Prepare

Join the Department of Health and Human Services and the Centers for Medicare & Medicaid Services (CMS) Medicaid and Children’s Health Insurance Program (CHIP) continuous enrollment unwinding partner education webinar: What to Know and How to Prepare. Topics include reviewing recently released CMS unwinding resources to help partners with their outreach efforts and an extended Q&A session with CMS experts to address questions related to Medicaid renewals and terminations, Medicaid to Marketplace transitions, Medicaid to Medicare transitions, communication and outreach strategies, and more.

Wednesday, March 22

11:00 am CT/ 10:00 am MT

Informational Webinars: South Dakota Medicaid Unwinding
Join Get Covered South Dakota for this informational webinar about the Medicaid and the Children’s Health Insurance Program (CHIP) continuous enrollment unwinding. In the next three months, as many as 19,000 South Dakotans will lose the continuous Medicaid coverage they have experienced since the public health emergency (PHE) started.

Navigators from Get Covered South Dakota and CHAD will discuss the upcoming Medicaid unwinding, including a general overview, the challenges enrollees could face during the unwinding process, special enrollment periods (SEPs), and next steps. This 45-minute presentation is intended for any patient-facing health center staff. The same information will be repeated during the two remaining webinars so attendees can choose the best date and time.

Wednesday, March 22
1:00-1:45 pm CT/ 12:00-12:45 pm MT
Register here.

Thursday, March 23
9:30-10:15 am CT/ 8:30-9:15 am MT
Register here.

Introduction to Innovative Workforce Development Programs

Join CHAD for a presentation introducing health centers to different nursing and medical assisting apprenticeship programs and CareerSteps on-the-job training options for dental assisting and health center billing and coding. This webinar will give participants a first look at the programs offered, the time requirements for each program, and the commitment required by the health center and the trainee with time at the end for Q & A. This webinar will be an introduction to a two-part session at the upcoming CHAD annual conference in May with content experts from Lake Region Technical College, the University of South Dakota School of Nursing, and CareerSteps.

This webinar is intended for HR and leadership, clinical leads, and oral health program leads. You do not have to register for the CHAD annual conference to attend this webinar.

Thursday, April 6

12:30 pm – 1:15 pm CT/ 11:30 am – 12:15 pm MT

Building Inclusive Health Care Experiences for Persons Living with Disabilities

How do organizations design health care environments that are fully welcoming and inclusive of persons with disabilities? This requires thoughtful practices and policies designed to identify and remove barriers, such as physical, communication, and attitudinal. Often these practices benefit people of all ages and abilities. In this session, the presenter will define disabilities and discuss the health inequities experienced by these populations, as well as tangible strategies to build inclusion and accessibility into everyday health care practices. This CHAD Equity Talk is open to all health center staff & partners.

Thursday, April 13

12:00 pm CT/ 11:00 am MT

HRSA Deeming Application Clinic Registration Ends April 17
The Health Resources and Services Administration (HRSA) is thrilled to announce the Deeming Application Clinic, an exciting virtual event that replaces the annual deeming-and-redeeming application call. Join this hands-on journey and learn directly from industry experts in the risk management field. Participants will expand their knowledge and gain insights into completing their deeming application like a pro.

The clinic is free for all health centers. Attendees can attend the training sessions and workshops relevant to their work or required for annual training requirements. Register today and secure your spot. Everyone who joins must register independently to obtain certificates of fulfillment.

Wednesday and Thursday, May 3-4
12:00 pm - 5:00 pm CT/ 11:00 am – 4:00 pm MT
Register here.

CHAD Network Team Meetings
Tuesday, March 28 at 3:00 pm CT/ 2:00 pm MT – CFO and Finance Manager Roundtable
Tuesday, April 4 at 12:00 pm CT/ 11:00 am MT – Behavioral Health Work Group
Thursday, April 6 at 12:00 pm CT/ 11:00 am MT – Clinical Quality Network Team
Monday, April 10 at 1:00 pm CT/ 12:00 pm MT – Operational Excellence/ Compliance Workgroup
Tuesday, April 11 at 2:00 pm CT/ 1:00 pm MT – Communications and Marketing Network Team
Thursday, April 13 at 9:00 am CT/ 8:00 am MT – Emergency Preparedness Network Team