CHAD Connection

Last week, Congress passed a continuing resolution (CR) to fund the government through the end of the federal fiscal year, September 30, 2025. The bill also included an extension of mandatory funding for the Community Health Center Fund, the National Health Service Corps (NHSC) fund, and the Teaching Health Center Fund and an extension of the current Medicare telehealth flexibilities through the same date. It also maintains advance appropriations for the Indian Health Service and extends the Special Diabetes Program for Indians. While we were pleased to see that funding was maintained and extended for these important programs, we will continue to advocate for long-term funding that meets the moment by making an increased investment in these vital programs.

Total mandatory and appropriated funding for Section 330 (community health center funding) represents flat funding for the remainder of the year if you use the math employed by Congressional Republicans. Democrats calculate the baseline slightly differently such that $4.4 billion in mandatory funding would have been needed to sustain level funding, rather than the $4.26 billion that was provided, health centers in the Dakotas requested $5.8 billion and a three-year funding extension. Level funding means that no New Access Points will be funded this year.

Level funding for the NHSC means that only about 50% of the NHSC applications will receive funding. They expect the rural and substance use disorder treatment tracks to have much higher rates of funding.

Health centers have been under the strain of years of short-term funding extensions as shown here:

This uncertainty along with now 10 years of funding whose value is falling relative to inflation severely impacts health centers’ ability to recruit and retain staff, expand services, and invest in long-term solutions for the communities they serve. Nearly half of health centers nationwide are currently operating with unsustainable margins and 42 percent of health centers have only 90 days or less of cash reserves. According to a study of funding between fiscal years 2015 and 2022, community health center federal funding fell 9.3% in real terms and 27% in per patient funding.

We look forward to working with our members of Congress to pass a long-term funding bill that reflects needed increases, an investment in workforce that addresses the health care workforce crisis the Dakotas are currently facing, and a permanent extension of telehealth payment in the Medicare program.

Don't miss your chance to take advantage of early bird registration for the 2025 CHAD/GPHDN Annual Conference on June 3-5 in Fargo, ND! Check out the agenda here—featuring engaging sessions on workplace culture, care management, financial sustainability, leadership development, and more.

Pre-Conference: Tuesday, June 3

Project Management for Non-Project Managers: From Idea to Action!

Steve Bourgois

Have you ever found yourself leading a project without formal training? Whether you’re a volunteer, “volun-told,” or an accidental project manager, this interactive pre-conference workshop is designed just for you!

Join Steve Bourgois for a hands-on, no-jargon introduction to project management tailored for health center teams. Learn the essential tools and techniques to confidently plan, execute, and manage projects. Bring an idea and leave with a structured project plan that is ready to implement.

Through engaging activities, real-world applications, and practical templates, you’ll gain tips, tricks, and strategies to simplify project management and ensure success from start to finish. Whether tackling a minor initiative or a more significant undertaking, this session will empower you to think like a project manager, stay organized, and drive results!

Sponsorship & Exhibitor Opportunities

As a sponsor, you will have the unique opportunity to connect with influential health center professionals, including CEOs, CFOs, COOs, clinical leaders, and other key decision-makers.

Exhibitor Opportunities: Showcase your organization on-site for direct engagement with attendees. Your logo will be prominently displayed throughout the event.

Remote Sponsorships: Can’t attend in person? You can still support the conference through various sponsorship packages.

Join us in supporting the growth and success of health centers in our region. We look forward to partnering with you to make this event a success.

For more information, view our Sponsor & Exhibitor Opportunities brochure.

The 100th legislative session concluded after an intense few months, shaped early on by former Governor Kristi Noem’s budget proposal, which outlined deep funding cuts across multiple programs. Lawmakers entered the session focused on major issues, including property tax reductions, education savings accounts, carbon pipeline regulations, and plans for a new state prison. However, the session took a significant turn when Noem was confirmed as U.S. Secretary of Homeland Security and resigned, leaving Governor Larry Rhoden to step in. Rhoden, known for his accessibility and willingness to engage with South Dakotans, has prioritized strengthening relations with the state’s nine tribal nations while upholding many of Noem’s policies.

Health centers came out of legislative session with a few key victories, particularly with the passage of SB 154, which safeguards the 340B program, ensuring health centers can continue offering discounted medications and vital services in rural communities. Another win came with HB 1071, granting greater independence to physician assistants who have met education, certification, and supervision requirements. Several bills that we supported related to access to coverage were not adopted, including a bill to increase access to breast cancer screening and a bill to limit the financial impact of medical debt. A ballot initiative was passed in spite of health center opposition that would allow the legislature to eliminate Medicaid expansion if the federal contribution goes below 90 percent. See below for a more detailed bills that CHAD tracked during legislative session.

Appropriates $1,627,346 to the Department of Health, for the purposes of reimbursing six family physicians, one dentist, three physician assistants, and three nurse practitioners who will be fulfilling the requirements of their RAP agreement with the State and Appropriates $489,047 to the Department of Health to reimburse 68 eligible healthcare professionals who have complied with the requirements of the RHFRAP agreements. Due to an error in the FY25 budget request, this special appropriation includes $429,776 to support health professionals fulfilling their commitment to serve in rural communities during FY25.

Health center leaders from across North Dakota attended the CHAD Health Center Day at the Capitol on March 10 & 11 in Bismarck. They met with Governor Kelly Armstrong, leaders from Department of Health and Human Services, including those working in both the public health and Medicaid areas. Kim Kuhlmann with CHAD, Nadine Boe, CEO of Northland, and Mara Jiran, CEO of Spectra, testified in support of adding an adult dental benefit for Medicaid Expansion. Shelly Ten Napel, CEO of CHAD and Margaret Asheim, CEO of Family, testified the following day in support of protecting the 340B program from contract pharmacy restrictions. They set up information in Memorial Hall and visited with legislators and the public about the health centers and the impact they have on the communities and patients they serve. Thank you to those who were able to attend!

CHAD is pleased to welcome Kyle Vath, BSN, MHA, RN, and CEO of RegLantern, for an in-depth review of HRSA’s 2025 Federal Tort Claims Act (FTCA) application requirements. This essential training session will guide health centers through the necessary steps to successfully complete and submit their 2025 FTCA application.

Kyle will provide a comprehensive overview of key components, including:

Required documentation and submission guidelines

Risk management systems and compliance considerations

Quality improvement/assurance plans best practices

Credentialing and privileging requirements

Claims management strategies

Attendees will gain valuable insights, practical guidance, and actionable steps to ensure a smooth application process. The session will also include dedicated time for Q&A, allowing participants to address specific concerns and clarify application requirements.

Don’t miss this opportunity to enhance your understanding of FTCA application expectations and set your health center up for success in 2026!

The North Dakota Chapter of the American Foundation for Suicide Prevention is providing a training called Clinical Approach to Preventing Suicide: An Introduction for 500 primary care providers, including advanced practice professionals and nursing staff.

Health care professionals have a role to play in identifying patients at risk for suicide, taking steps to provide support and reduce risk, and providing treatment or developing a long-term plan to help patients.

Wednesday, March 19 | 7:00 – 8:00 am CT, 12:00 – 1:00 pm CT, OR 4:30 – 5:30 pm CT (choose one)

Objectives:

Describe a model for understanding the risk & protective factors of suicide;

Enumerate the warning signs of suicide risk;

Identify at least two evidence-based screening tools for assessing suicidal risk;

List the key components of a patient-driven, collaborative safety plan;

And identify treatment options for patients at risk.

Intended Audience: Clinicians serving adults 18+ and clinicians in training (PA students, nurse practitioner students, physician residents, etc.)

Continuing Education Unit: 1.0 contact hours approved by the ND Board of Nursing ND Board of Nursing Course Number: 2298

Join us for a dynamic four-part webinar series designed to equip health centers with the latest insights and strategies in health care management and reimbursement. Led by industry expert Meri Harrington, CPC, CRC, CEMC, from Brown Consulting Associates (BCA), this series will dive into key topics affecting health centers in 2025. From the introduction of Advanced Primary Care Management in FQHCs to Social Determinants of Health (SDOH) services, Medicare dental billing, and an attendee-driven final session, each webinar will provide essential guidance for clinical, operational, and billing professionals. Don’t miss this opportunity to stay ahead of regulatory changes and optimize your health center’s performance!

Session 1:
Advanced Primary Care Management: What Health Centers Need to Know
April 8

Advanced Primary Care Management services are making their debut for federally qualified health centers (FQHCs) in 2025. According to the Centers for Medicare and Medicaid Services, this change will better align payments to rural health clinics (RHCs) and FQHCs for these services with other providers who furnish similar care coordination. This seems like a huge win for the FQHC, especially with the opportunity for billing of the add-on codes associated with these services. With CMS providing a transition period of at least six months to update our billing systems, there are several components health centers need to consider to ensure compliance.

In this session, we will introduce Advanced Primary Care Management (APCM) and how it relates to existing care management services. We will explore documentation and care delivery requirements, consider reimbursement rates, and discuss performance monitoring. Finally, we’ll consider current tools for care management activity tracking and determine whether additional tools will be needed.

This session is beneficial for clinical, operational and billing and coding staff.

Data-Driven Care for Justice-Involved Populations 

Transitioning from an incarcerated setting back into the community is a precarious time for many justice-involved individuals. Competing priorities such as finding stable housing, securing employment, and integrating back with friends and families means health care can fall to the wayside. A recent federal grant awarded almost $52 million to support health centers in providing access to quality care to support transitions in care for people leaving incarceration. This webinar will highlight the Azara tools practices can leverage to support chronic disease management, mental health and substance use disorder needs, and infectious disease control.

Tuesday, March 25

12:00 pm CT/11:00 am MT

Lean Six Sigma 101: Improving Healthcare with Data 

Lean Six Sigma is a powerful methodology for improving efficiency, reducing waste, and enhancing quality in health care. In this introductory session, we’ll explore the fundamentals of Lean Six Sigma, discuss its relevance in population health and clinical quality improvement, and demonstrate how DRVS can be a valuable tool in applying these principles. Through a real-world case example, attendees will see how data-driven decision-making and process improvement techniques can drive meaningful change in health care settings.

Thursday, March 27

1:00 pm CT/12:00 pm MT

Reclaiming Your Referral Program Using the Referral Management Module 

With one in three primary care visits resulting in a referral, the referral represents a critical inflection point in a patient's care journey. The success of that referral is dependent on a high-functioning, synergistic collaboration between patients, providers, and specialists. Given so many variables, practice staff may feel as though much of the process is out of their control. However, management insights can offer practices perspective into their communication strategies, practice workflows and coordination, and resources available within the network, which together can be harnessed to better support patients throughout their referral journey. In this webinar, we will explore how to track referrals from order to completion, understand referral coordinator workload, and father information to assist with relationship and expectation setting with your referral partners. This webinar is recommended for centers with the referral management module, and health center staff responsible for managing the referral program.

Tuesday, April 1

12:00 pm CT/ 11:00 am MT