Community Health Centers: Rising to Meet the Challenges of a Global Pandemic – Part Two

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After a year of navigating the COVID-19 pandemic, Shelley Spires, CEO of Albany Area Primary Health Care, a community health center in southwest Georgia, sat down with Draffin Tucker partner Wes Sternenberg to share her experiences.

Albany Area Primary Health Care (AAPHC) currently provides family medicine, women’s health, dentistry, podiatry, behavioral health, vision care and pharmacy services over approximately nine counties at 28 different locations. The organization employs just under 400 employees.

Shelley shares with Wes her thoughts on the role of community health centers, challenges faced during the pandemic, embracing telehealth, and the vaccine rollout.  Excerpts of their conversation follow.


WS:  We have had an interesting last 12 months through the pandemic and the challenges that it has brought to individuals as well as the healthcare industry. What have been some of the biggest challenges in your eyes for AAPHC?

SS:  We have experienced some internal challenges and some external challenges.

Internally, I would say that being prepared for a pandemic, although we had an emergency preparedness plan all written out and pretty and ready to go, it really did not fit the situation.  Until you’ve lived the pandemic, you really don’t understand what it entails.

One of the things we realized quickly was we had to figure out a way to reach our patients.  We also had to figure out a way to take care of our staff at the same time.  Simultaneously, trying to balance those two was a bit of a challenge.  Especially when your IT infrastructure is not exactly where we wanted it to be to make that happen.

We knew that telehealth visits were going to be huge to ensure our patients received the care they needed.  Because everybody kind of stopped going out in public and people were scared, in particular our elderly population, we had to figure out a way to reach those patients.  One way we overcame that barrier, was deploying iPads and remote monitoring kits to our patients.  When we deploy those kits, we actually send a medical assistant out to provide a demonstration on how to use the kit.  That allowed us to have some confidence that the patient was getting accurate information back to the provider during the telehealth visit.  We actually had a telehealth visit where the physician asked for the O2 status, and the patient responded 70.  The doctor told the patient that they were going to hang up right now and call an ambulance.  Because of the telehealth visit the patient was able to receive the care they needed.

Broadband is, of course, an issue in our rural areas.  And when I mentioned IT infrastructure, it was that we didn’t have laptops that would allow our people to work from home.  So, remoting-in was not an option initially.  Those were some challenges we faced from the internal perspective.

External challenges include managing partnerships within the community to make sure we all had the supplies and resources needed in a community that was hit so hard initially.  Having medical agencies as close partners certainly was a huge benefit.  We were able to overcome some of the some of the challenges with PPE as a result of these relationships.

WS:  With so many internal and external pressures, I know it was difficult moving from one challenge to the next, but it really sounds like that you were very successful navigating through them this past year. Telehealth was one of your solutions for the pandemic.  Do you think that telehealth is here to stay?

SS:  I think that it certainly has the potential to stay.  It is kind of hard to tell, in my opinion, right now just because of the fact that people are ready to get out.  So, even if it’s a doctor’s visit, they’re ready to get out and they might decline the telehealth visit.

I definitely think you are going to find more of the younger generation, middle age and younger, that will likely utilize telehealth services.  They are more likely because they embrace technology and just because it’s easy and it’s accessible.

In the beginning of the pandemic, our telehealth visits accounted for about 35% of the visits and now they have decreased to about 5%.  I think it is because people are feeling more comfortable now and want to get out and see something different besides their four walls.

WS:  I understand that as well.  I do think it still can be an effective means for a visit in the right circumstances, and I hope funding will follow to enable providers to continue with this approach.

The CARES Act and subsequent legislation issued in response to the pandemic have provided significant funding for community health centers.  How impactful have these payments been to your organization?

SS:  The payments really helped when I was sitting there, trying to figure out how to make ends meet when we were operating at 40% production capacity and I was trying to maintain staffing at 100%, as well as trying to care for our patients at the same time.

So when the stimulus money, or the HHS money, and the paycheck protection program funding was presented, it was like a blessing in disguise because we were able to do exactly what I strived to do, which was keep our people employed and maintain adequate staffing levels to be able to take care of our patients.  Without that funding, I’m not sure we would have been successful

I think it certainly helped us gain a lot of respect from the employees because they know we worked really hard to make sure they stayed employed.  I think it also helped us gain a lot of respect within the community that we did not close our doors.  If we had not had the extra funding, I’m not sure that would have been the case.

WS:  I’m glad to hear that.  Hopefully, we are turning the corner on the pandemic with the vaccine now available.  What do you want the public to know about the COVID-19 vaccine?

SS:  Of course.  We have, since December 28, 2020, been providing the vaccine to our community and our patients.  I think that the biggest thing that we face now is vaccine hesitancy.  It seems to be a real problem, not just here, but everywhere.

We certainly support and advocate for the vaccine because we want to get our community back to normal if we can.

I think the important thing to know is to go to reliable resources, valid resources that you can trust and depend on to get your facts related to the vaccines, and to make a decision as to whether or not you will take the vaccine.  One of the things that I’ve learned is when you go to reliable resources to get your information, it gives you an opportunity to ask questions based on those facts.  And we have had the pleasure of our providers not only being advocates but being educators.  We have done several outreach and awareness videos and have tried to do panel interviews that will allow the community to see the importance of the vaccine and hopefully demystify any nonfacts or nontruths about the vaccine.

I would just encourage everyone to go get it.  I have had mine.  I think that I would just highly advocate for the consideration of everyone getting their vaccine.

WS:  Fantastic.  As we wrap up, what do you see on the horizon for community health centers?  What are your thoughts on the outlook for the industry?

SS:  I think that something good always comes out of something bad, and if nothing else, from this pandemic that we all have weathered and are hopefully close to being through, is the fact that community health centers have been there.

There is a misconception, if you will, that community health centers receive a lot of federal funding to keep our doors open.  That’s not necessarily the case for all community health centers.  If you’ve seen one, you’ve seen one.  We all have to do things a little differently to sustain.

I think the important thing to know is that we didn’t close our doors.  We have not turned our back.  We have been readily available for the community.  Readily available to serve as a partner with our medical agencies and to serve a purpose. I felt like we did it well and that most community health centers do.  I would love to see more emphasis on community health centers in the communities that they serve.

WS:  Absolutely.  AAPHC is such an asset to the communities that you serve, and you are an asset to the organization.  I have witnessed firsthand you and your team’s response to the pandemic, and it’s been fantastic.  Many people received care that they otherwise would not have received it, and I want to congratulate you on a job well done.

SS:  Thank you.


Read Part One here.