Andrew Behrman, MBA, is the president and CEO of the Florida Association of Community Health Centers (FACHC), which provides resources such as COVID-19 testing and vaccinations at hundreds of primary and skilled health care centers in federal level (FQHC) across Florida. Across the various clinics, FACHC provides a vital safety net for vulnerable populations, including Medicaid and Medicare.
During the week of December 24-30, the Florida Department of Health reported nearly 300,000 new cases of COVID, double the number of cases of the Delta variant on the rise this summer. In this Q&A, Behrman will discuss the impact of the Omicron variant on the FACHC network and policy solutions that would continue to secure access to care for vulnerable communities in Florida.
Get the latest information on state-specific policies for the healthcare industry delivered to your inbox.
Nicole Pasia: How does the Omicron variant impact your work and the communities you serve?
Andrew Behrman: “Community health centers, the populations we serve, are the populations of the safety net – underserved, uninsured, Medicaid, Medicare. In many places, these are patients with significant co-morbidities. Their management of chronic disease is a challenge for themselves as well as for the providers who provide primary health care services to these patients. So, anytime you come across issues related to chronic disease management situations like this, whether it’s Omicron or Delta or whatever, the sensitivities to these issues are exacerbated by the fact that you have the management of chronic diseases such as hypertension, diabetes, etc.
So, for our patients, we are fully aware of the potential they have, perhaps a little more than the general population. So of course for us, because we have a patient population with which we are in constant contact, our centers have made enormous efforts to ensure that people come to be vaccinated because they know what the value is for them, for the patient they serve. So this is a big problem. Omicron is a different variant. We’ll probably see another variation after this one. But again, I think my most important comment is that staying the course on testing and making sure vaccinations are available to people and getting them done is the best way to do it. And of course, wearing a mask and so on and so on. But when it comes to the patient getting tested and vaccinated, health centers are pushing him to do so. “
NP: Are there any other issues you are concerned about right now?
A B: “Staffing is also a big challenge for us. Hospitals — we all hear about burnout— [it’s] just absolutely awful. That’s a real problem, because it slows down the ability to serve patients, if you will. We had to deal with this like any other health care system. This has been a big problem for us, and we are facing it, but it has been very difficult for the health centers. We have over 800 locations across the state of Florida. It’s a big system for the FQHC. So staffing is a big issue for us.
NP: Whether working with the legislature or other partners across the state, what policies do you hope to see that will help address the labor shortage?
A B: “Representative Colleen Burton has shown a keen interest in workforce issues in Florida, particularly in healthcare. This is a godsend for us, because it is the first time in many, many years that we have had the opportunity to engage in a discussion at the legislative level to see what needs to happen. In fact, at the association, I hired a full-time director of workforce development to come and see where we are in terms of workforce development… I’m talking about approaches. much more aggressive in the development of the workforce: models of personal development, making university health centers within the FQHC. The legislature has really stepped up as we enter this session. So I’m pretty excited about it.
Some of the other policies – there’s a lot of confusion around the CMS vaccine mandates and then the state’s no-vaccination and no-masking mandates. All of this is a challenge because we have to serve two masters. We have federal mandates that must be fulfilled in order for us to maintain Medicaid funding. And at the same time, we have the state pursuing a different model on mandates. It puts us in a rock and in a difficult place. We hope that this will take place, finally, at the federal level, where we have no problem to resolve in terms of the choice between the state mandate and the federal mandate. It’s a big problem. But now, [while] we’re waiting to do that, we’re going to stay the course with the CMS requirements for masks, vaccines and things like that. These are challenges that all of our FQHCs have to face on a daily basis.
NP: How do FQHCs manage both their COVID response, as well as their other health services?
A B: “I think it’s important for people to understand that while we are dealing with a pandemic, we still have to provide health services to people. And I know it’s lost in the reshuffle right now, but for the patients we serve, the safety net population, these are the people who really have a hard time accessing health care, whether it’s because that they don’t have insurance, or they don’t have the funds, or they don’t even have transportation. Community health centers are mandated by federal law to ensure that these patients are served. So it’s a little different from where the hospitals are. We are all primary care facilities. The front line, for us, has many faces besides the pandemic we must fight. I think it’s important for people to understand that we continue to provide primary care services to the populations who need them.
This interview has been edited for clarity and length. Image: Florida Association of Community Health Centers