CHAD is pleased to announce the release of "Celebrating Health Centers in the Dakotas." The video was created to be a tool for community health centers (CHCs) in recruiting new staff, particularly providers such as physicians, nurse practitioners, physician assistants, nurses, dentists, hygienists, behavioral health providers, and social workers. It describes what a health center is, and it features North Dakota and South Dakota health center staff who speak about their experience working in a CHC.

You are welcome and encouraged to use the video in a variety of ways. You can include a link on your careers page or in your job postings. You can add it to your website’s home page. You can share it on your social media sites. You can use it in recruitment fairs or presentations to local students. You can also add it to your new hire orientation as a way to connect new staff with the health center model.

CHCs in the News
Jayme Tubandt, hygienist at Falls Community Health in Sioux Falls, spoke with South Dakota News Watch about dental care during the pandemic.
Federal Vaccine Allocation Arrives at Health Centers in the Dakotas
The White House announced on February 9 increased access to COVID-19 vaccines through a direct partnership with community health centers (CHCs). Direct federal allocation aims to increase vaccines for underserved populations and those hardest hit by COVID-19.

Three CHCs in the Dakotas: Horizon Health Care, Coal Country Community Health Care, and Spectra Health, were included in the first 250 CHCs selected to order and receive vaccines through the direct Federal allocation process. It will be several weeks before the majority of CHCs have access to direct allocation. CHCs will align with state tiers and priorities as they vaccinate patients. CHCs are well-positioned to support vaccination efforts since they have already been distributing vaccines through state and local partnerships. It is anticipated that the new direct federal allocation process will allow CHCs to slowly increase supply and enable CHCs to reach more patients and community members.

CHCs are particularly experienced in providing care to hard-to-reach populations, including rural and frontier populations, people experiencing homelessness, agricultural and migrant workers, low-income groups, and those with limited English proficiency. Many of these populations have also been disproportionately impacted by COVID-19.
Third COVID-19 Vaccine Approved
The US Food and Drug Administration (FDA) authorized Janssen BioTech’s (a Johnson & Johnson company) COVID-19 vaccine for emergency use. Unlike the other authorized COVID-19 vaccines, Janssen Biotech’s COVID vaccine uses an adenovirus as a viral vector, rather than mRNA, to prompt the body to make and defend itself against coronavirus spike proteins. It also needs only one dose, not two. 

Trial results showed the one-dose vaccine is about ~85% effective at preventing severe cases of COVID-19 and ~66% effective at preventing both moderate and severe cases. While this is lower than the two-dose vaccines from Pfizer/BioNTech and Moderna, it should be noted that all three vaccines have been shown to be very effective at preventing hospitalizations and death due to COVID-19. The vaccine was also effective at preventing severe disease caused by two variant strains first detected in South Africa and Brazil.

The CDC’s Advisory Committee on Immunization Practices (ACIP) voted on Sunday to recommend the Janssen BioTech COVID-19 vaccine for those 18 years and older. The CDC has signed off on the recommendation, and the vaccine has already arrived in the Dakotas for distribution. The Janssen vaccine will be one option for CHCs who are receiving direct federal allocation of vaccines.
HHS Announces Mask Distribution Program
On February 24, to support President Biden’s call to "mask up" for 100 days to reduce the spread of COVID-19, the White House announced the delivery of free masks to Health Resources and Services Administration (HRSA)-funded health centers for distribution to patients, staff, and community members. This initiative recognizes health centers as vital partners in community-based outreach efforts to reach vulnerable populations.

Through this program, health centers will receive no-cost, high-quality, washable masks in child and adult sizes, packaged in pairs of two. The masks will be produced consistent with mask guidance from the CDC. All masks will be made in America, and the distribution will not impact the availability of masks for health care workers. Health centers are encouraged to distribute individually wrapped packages of two masks, as well as a flyer with CDC guidance on how and why to wear masks to patients, staff, and community members for each person in their household.

HRSA will send email communication from the electronic handbooks (EHBs) to each health center with the specific number of masks that will be shipped to the health center’s administrative address on record. The masks will be available beginning in March and into May. Health centers are able to opt-out using the BPHC contact form.
American Rescue Plan Passes House
The House of Representatives passed the American Rescue Plan with a vote of 219-212. The Senate took up the bill on Wednesday, and the expectation is that they will complete their work on the bill with limited changes by early next week. The timeline is still set for the President’s signature by March 14.

Below is a list of the major provisions identified by the National Association of Community Health Centers (NACHC) as of interest to health centers. CHAD is planning meetings with the members of Congress in the Dakotas to rally support on behalf of members.

  • $7.6 billion in flexible emergency COVID-19 funding for health centers and health center program look-alikes (LALs);
  • $800 million for the National Health Service Corps, $200 million for the Nurse Corps, and $330 million for the Teaching Health Center Graduate Medical Education programs, all of which support the health center workforce;
  • Investments in Medicaid to support vaccination efforts and other critical services;
  • $7.5 billion in funding for the Centers of Disease Control and Prevention (CDC) for vaccine administration and distribution, to be dispersed to support states, local, tribal, and territorial public health departments, community vaccination centers, and mobile vaccination units;
  • $47.8 billion to HHS to implement a national testing strategy and contact tracing surveillance; and,
  • $7.6 billion to HHS to expand the public health workforce,
  • $500 million for needs-based grants to facilities that primarily serve rural areas, and that target and bolster certain aspects of the COVID-19 response efforts; and,
  • $5.4 billion to support the activities of Indian Health Services (IHS).
North Dakota Legislative Session Reaches Halfway Point
The North Dakota legislature officially returned from crossover break on March 3. All bills passed in their chamber of origin have now crossed over to the other chamber, where they will have another committee hearing and vote. Several updates relating to bills tracked by CHAD include:
  • Medicaid Expansion: Under HB 1012, the House reauthorized Medicaid expansion for another two years with commercial rates. The House also voted to move 19 and 20-year-olds from Medicaid expansion to traditional Medicaid.
  • Medical Assistance Coverage for Interpreter Services: SB 2205 passed in the Senate and has been introduced in the House. Medicaid expansion already covers translation services, and this bill would extend coverage to traditional Medicaid. CHAD is supportive of this bill. Its House hearing has not yet been scheduled.
  • Workforce Development: The Department of Health budget passed with $250,000 over base funding for student loan repayment. CHAD testified to ask the appropriations committee to make a strong investment in state loan repayment programs.
  • Managed Care Dental Benefits: SB 2343, relating to the state providing managed-care dental benefits, was defeated in the Senate.
  • Expanding Medicaid Primary Care Provider Definition to Include Certified Nurse Midwives (CNMs): SB 2085 passed in the Senate and was heard by the House Human Services committee on March 3. CHAD submitted testimony in support of this bill.
  • Third-Party Reinsurance: HB 1087 passed in the House and was heard by the Senate Industry, Business, and Labor committee on March 3. CHAD signed in as supportive of this bill. This bill would provide an appropriation to offset the cost of insurance through an invisible reinsurance pool for the individual health insurance market.
  • Diabetes Care: HB 1288, relating to Medicaid coverage of continuous glucose monitoring devices for children, passed in the House and has not yet been scheduled for a hearing in the Senate. CHAD is supportive of this bill.
CHAD will continue to monitor key bills throughout the second period of the legislative session. Click here for the North Dakota bill list.
South Dakota Legislative Session Nears End
Thursday, February 25, was Crossover Day in the South Dakota state legislature, and all bills needed to pass at least one chamber to remain viable in the process. The final week of session will focus on the budget. Click here for the South Dakota bill list.

For more information on CHAD’s legislative priorities, visit our website.
340B Updates
Last Wednesday, February 24, Express Scripts, Inc. (ESI) – the nation’s second-largest pharmacy benefits manager (PBM) – sent a brief but very concerning announcement to all pharmacies.  The announcement stated that effective Monday, March 1, pharmacies must inform ESI of every prescription that is filled with a 340B drug within 10 days of filling it, regardless of whether the 340B status was known at the time the prescription was filled. 

Last July, ESI adjusted its provider manual to state that all 340B drugs must be identified as such. Officially, last week’s announcement simply expanded the July 2020 announcement to add the 10-day deadline for informing ESI that a prescription was filled with a 340B drug. This announcement both raises the visibility of last summer’s policy and creates significant new burdens, particularly on contract pharmacies. 

In the immediate term, ESI’s change puts further strain on the contract pharmacy model. For every prescription they fill with 340B, they will now have to submit two transactions to ESI (one when they fill it, and a second later to identify it as 340B) instead of one. Complying with this 10-day deadline would force contract pharmacies to develop new reporting tools, and data systems, which may not be feasible under the timeline ESI has provided. Contract pharmacies that fail to comply with these new requirements risk losing their entire contract with ESI (not just the contract for 340B drugs), and ESI covers around 25% of the national drug market. If ESI successfully implements this policy, the other large PBMs are likely to follow.

The National Association of Community Health Centers (NACHC) is asking that health centers begin documenting and quantifying the harm caused by ESI’s actions. Estimates of lost savings and how those losses may impact health center operations will be incredibly helpful moving forward. For example, Walmart is refusing to identify 340B drugs and instead has stopped using 340B drugs to fill any ESI prescriptions. That means a 20%-30% drop in the 340B savings that many CHCs receive from Walmart, effective March 1.

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.

NACHC COVID-19 Communications Toolkit for Health Centers
Building confidence in the COVID-19 vaccines among health center staff and patients takes many different forms of communication and outreach. It’s essential to be transparent about the vaccine: its safety, development, efficacy, and side effects. People will feel more comfortable with the vaccine as they see friends, family, and others from their community getting vaccinated.

The National Association of Community Health Centers (NACHC) has developed resources to provide health center staff with tools for explaining the COVID-19 vaccines and promoting vaccination among staff, patients, and the community. The toolkit contains simple key messages, FAQs, sample social media posts, and various templates. NACHC also plans to add materials translated into additional languages.
CHAD Offers Mental Health First Aid Training
Mental Health First Aid (MHFA) is a skills-based training course that teaches participants about mental health and substance-use issues. CHAD is offering this certification course to train participants to identify, understand, and respond to signs of mental illnesses and substance use disorders. Intended for patient services, clinical, social work, case management, and other patient-facing staff, this six-hour online training (two hours of self-paced, followed by four hours of instructor-led training) will be offered at different times for sessions specific to both adults and youth. MHFA is a certified training, and the use of cameras during the instructor-led training is requested. Upon completion, the certification is valid for three years.

Mental Health First Aid for Adults teaches people how to recognize signs of mental health or substance use challenges in adults ages 18 and older, how to offer and provide initial help, and how to guide a person toward appropriate care if necessary. Topics covered include anxiety, depression, psychosis, and addictions.

Register here for March 12, 2021.
11:30 AM - 3:30 PM MT//12:30 PM - 4:30 PM CT
Pre-class online work is due March 5.

Register here for April 9, 2021.
11:30 AM - 3:30 PM MT//12:30 PM - 4:30 PM CT
Pre-class online work is due April 2.

Youth Mental Health First Aid is designed for adults who work with youth. Presenters will teach the skills needed to reach out and provide initial support to children and adolescents (ages 6-18) who may be developing a mental health or substance use problem and help connect them to the appropriate care. Topics covered include anxiety, depression, substance use, disorders in which psychosis may occur, disruptive behavior disorders (including AD/HD), and eating disorders.

Register here for March 26, 2021.
11:30 AM - 3:30 PM MT//12:30 PM - 4:30 PM CT
Pre-class online work is due March 19.

Register here for April 23, 2021.
11:30 AM - 3:30 PM MT//12:30 PM - 4:30 PM CT
Pre-class online work is due April 16.

Community Health Centers and CHAD at NatCon21
The National Council for Behavioral Health (NCBH) is one of the largest non-profit behavioral health organizations in the country, with over 3,000 member organizations. The NCBH developed Mental Health First Aid, is a strong national advocacy organization for behavioral health, and has worked with community health centers on several projects. As mentioned in previous newsletters, CHAD, Horizon Health Care, Spectra Health, and the Community Health Center of the Black Hills are currently participating in a Youth SBIRT learning collaborative with the NCBH.

CHAD’s behavioral health and substance use disorder program manager will be presenting at NatCon21, the NCHB annual conference, as part of a panel discussion about building resiliency during and after a global pandemic.
School-Based Service Site Expansion Funding
Fiscal year (FY) 2021 School-Based Service Sites (SBSS) funding is available for Health Center Program award recipients on a competitive basis. SBSS funding will expand access to health center services by increasing the number of patients who access comprehensive primary health care services through Health Center Program service delivery sites located at schools.
Applications must demonstrate using SBSS funds in current service areas to increase the number of patients served at school-based service sites by adding or expanding health care services. Click here for more information.
CHAMPS Spanish Language for Health Care Professionals – April 2021
Submitted by CHAMPS

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.
GP11 Network News
The 21st Century Cures Act

The 21st Century Cures Act (Cures Act) passed four years ago and included a definition for "information blocking." On behalf of the Health and Human Services (HHS) Secretary, the Office of the National Coordinator (ONC) for health information technology was tasked with implementing the definition and its "exceptions" for information blocking. The new regulation published in the Federal Register in May 2020 by ONC identified three types of participants, also called "actors" in health, that is covered under information blocking:
  1. Health care providers;
  2. Health IT developers of certified health IT; and,
  3. Health information networks (HINs)/ health information exchanges (HIEs).

In general, the information blocking rules state that actors can no longer engage in practices that interfere with the access, exchange, or use of electronic health information unless the practices are required by applicable law(s) or if an actor meets an exception established by the HHS Secretary.

The Health Information Technology, Evaluation, and Quality Center (HITEQ) hosted a webinar on the Cures Act, which focused on how it defined interoperability and information blocking and its relation to health centers. With HHS recently extending the provider compliance date to April 5, 2021, HITEQ reviews how ONC’s final rules defined information blocking requirements and exceptions. HITEQ also discusses 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. The recording of this webinar can be found here. CHAD will continue to learn more about the CURES Act and provide more information in future newsletter articles.
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 March (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

Understanding and Building Vaccine Confidence during the Pandemic

Hosted by Immunize South Dakota, presenter Julie Kittelsrud, CNP, Ph.D., will begin with an overview of vaccine attitudes. During the live webinar, participants will learn more about vaccination rates and trends, the pandemic vaccine development process, and ways to build vaccine confidence.

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

Public Health Data for Tribal Nations

The Public Health Data for Tribal Nations presentation led by Dr. Meghan O’Connell (Cherokee), medical epidemiologist with the Centers for Disease Control and Prevention (CDC) Foundation at the Great Plains Tribal Leaders Health Board, will focus on the need for public health data infrastructure during the COVID-19 pandemic. Dr. O’Connell will underscore the importance of tribal data sovereignty and detail various data sharing activities.

Monday, March 15
11:00 am MT/ 12:00 pm CT
No registration required. Join day of meeting 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, March 9 at 1:00 pm MT/ 2:00 pm CT – Communications & Marketing Network Team Meeting
Thursday, March 18 at 8:30 am MT/ 9:30 am CT – Emergency Preparedness Network Team Meeting
Friday, March 19 at 11:00 am MT/ 12:00 pm CT – Behavioral Health Work Group
Tuesday, March 30 at 12:00 pm MT/ 1:00 pm CT – O&E Network Team Meeting
Tuesday, March 30 at 2:00 pm MT/ 3:00 pm CT – CFO & 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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