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 through hundreds of federally qualified and primary health care centers (FQHCs) across Florida. Through the various clinics, FACHC provides a vital safety net of care for vulnerable populations, including Medicaid and Medicare.
During the week of Dec. 24 – Dec. 30, the Florida Department of Health reported nearly 300,000 new COVID cases—double the amount of cases from the Delta variant surge this summer. In this Q&A, Behrman will discuss the Omicron variant’s impact on the FACHC network and the policy solutions that would continue securing access to care for Florida’s vulnerable communities.
Nicole Pasia: How is the Omicron variant impacting your work and the communities you serve?
Andrew Behrman: “Community health centers, the populations that we serve, are the safety net populations—underserved, uninsured, Medicaid, Medicare. In a lot of places, these are patients that have significant comorbidities. Their chronic disease management is challenging to themselves as well as to the providers that are giving the primary care health care services to those patients. So, anytime you have issues that relate to chronic disease management situations like this, whether it’s Omicron or Delta or anything, the sensitivities to those issues are exacerbated by the fact that you have chronic disease management such as hypertension, diabetes, and so forth.
So for our patients, we’re keenly aware of the potential that they’re at risk, maybe a little bit more so than the general population. So of course for us, because we have a patient population that we’re in contact with all the time, our centers have made tremendous efforts to get people to come in and take the vaccines because they know what the value is to them, to the patient that they’re serving. So it’s a big deal. Omicron is a different variant. We’ll probably see another variation after this one. But again, I think my most important comment to make is that staying the course on testing and ensuring vaccinations are available for people and getting them done—that’s the best route to do this. And of course, mask wearing and so forth and so on. But as it relates to the patient’s getting the actual testing and vaccination, the health centers are out there busting it to get it done.”
NP: Are there other issues that are top-of-mind for you right now?
AB: “Staffing is a significant challenge for us as well. Hospitals—we all hear about the burnout— [it’s] just absolutely horrible. That’s a real problem, because it does slow down that potential for getting patients served, if you will. We’ve had to deal with that just as any other health provider system has had to deal with that as well. It’s been a big issue for us, and we’re coping with it, but it’s been very difficult for the health centers. We have over 800 sites across the state of Florida. It’s a big system for FQHCs. So, staffing is a big issue for us.”
NP: Whether it’s working with the legislature or other partners across the state, what policies are you hoping to see that will help address the workforce shortage?
AB: “Rep. Colleen Burton has shown a strong interest in looking at workforce issues for Florida, particularly in health care. That’s manna from heaven for us, because it’s the first time in many, many, many years, where we’ve had the opportunity to engage in a discussion at the legislative level to take a look at what needs to happen. In fact, at the association, I hired a full time Workforce Development Director to come in and take a look at where we are with workforce development … I’m talking about much more aggressive approaches to workforce development: grow-your-own models, doing academic health centers within the FQHCs. The Legislature has really stepped up there as we go into this session. So I’m pretty excited about that.
Some of the other policies—there’s a lot of confusion in relation to the vaccine mandates from CMS and then the un-vaccine and un-mask mandates from the state. All that is a challenge because we have to serve two masters. We have federal mandates that have to be met in order for us to retain Medicaid funding. And at the same time, we have the state pursuing a different model on mandates. It puts us in a rock and a hard place. We’re hoping that this rolls out, finally, at the federal level to where we don’t have an issue to deal with in relationship to having to choose between the state mandate and the federal mandate. That is a big issue. But right 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. Those are challenges that all of our FQHCs have to face every day.”
NP: How are the FQHCs managing both their COVID response, as well as their other health services?
AB: “I think it’s important that people understand that while we are dealing with a pandemic, we still have to provide health care services to people. And I know that that’s lost in the shuffle right now but for the patients that we serve, the safety net population, those are people that really have challenges in gaining access to health care, whether it be because they don’t have insurance, or they don’t have the funds, or they don’t have transportation, even. Community health centers are mandated by federal law to make sure that those patients get served. So it’s a little bit different than where the hospitals are. We are all primary care-based facilities. The front line, for us, has a number of faces besides the pandemic that we need to address. I think it’s important that people understand that we are still out there providing primary care services to the populations that need it.”
This interview was edited for clarity and length. Image: Florida Association of Community Health Centers