Join us for this episode of Digital Health Talks, where Megan Antonelli, CEO of Health Impact Live, sits down with Dr. Adam Aponte, CEO of East Harlem Council for Human Services and Neighborhood Health Center. A board-certified pediatrician with 25 years of experience, Dr. Aponte was born and raised in East Harlem and has dedicated his career to serving one of America's most underserved communities. In this conversation, he makes a compelling case for why the fight to protect federally qualified health centers is not just a community health story. It is a health system leadership story.
In this episode:
Adam Aponte, MD, MSc, FAAP, CEO, East Harlem Council for Human Services
Megan Antonelli, Founder & CEO, HealthIMPACT Live
00:00:00 Intro: Welcome to Digital Health talks. Each week we meet with healthcare leaders making an immeasurable difference in equity, access and quality. Hear about what tech is worth investing in and what isn't as we focus on the innovations that deliver. Join Megan Antonelli, Jenny Sharp and Shahid Shah for a weekly no BS deep dive on what's really making an impact in healthcare.
00:00:30 Megan Antonelli: Hi everybody. Welcome to Digital Health Talks. This is Megan Antonelli, CEO of Health Impact Live. And this is where healthcare operators come to have conversations that actually matter. Today's guest is someone that's doing work every single day on the front lines of one of America's most underserved communities. Doctor Adam Aponte is a board certified pediatrician trained right here in New York City with twenty five years of experience in community health. He is now the CEO of East Harlem Council for Human Services and leads Neighborhood Health Center, a federally qualified health center that has been the backbone of East Harlem since nineteen sixty five. They deliver comprehensive care, regardless of insurance status or the ability to pay. H.R. one is threatening three hundred million dollars in funding for New York in just New York alone. Doctor Aponte is here to make the case that this is not just a community health story. It is a health system leadership story. And the stakes could not be higher. Doctor Aponte, welcome to digital health talks.
00:01:28 Adam Aponte: Hello, Megan. Thank you so much for inviting me on this podcast. Really excited. This recording. Really excited to join you and share our perspective from here in East Harlem from the front lines, as you say.
00:01:39 Megan Antonelli: Yeah, I know, it's amazing, you know, looking at your career and your experience as a pediatrician. You know, I think you've, you know, you trained at Mount Sinai. You have, um, you know, been, you know, working in this community for so long. And I think, you know, I noticed in your bio that you, you joined right at the pandemic in terms of, you know, really what that was taking hold in New York City. And that kind of speaks volumes about, you know, what this work means to you. But in your own words, tell our audience a little bit about, you know, your journey and, and how you got to where you are now.
00:02:12 Adam Aponte: Great. And, you know, thanks for allowing me that opportunity because I often tell people, I say, you know, my glory, but you know my story, right? And I wish I would have quoted that line. I didn't quote that somebody else quoted it, but it just resonates with me as far as, you know, like, how did you get here? And, you know, born and raised in East Harlem, New York. This is this is my community. This is what really kind of the major reason why I feel compelled and feel a responsibility to this community because I was born and raised here. I was joking earlier with you that, you know, from the time I can talk, I knew I wanted to be a doctor. And my mother says, I've always said that I was going to go to Mount Sinai School of Medicine, where I grew up, right around the corner from. Um, and so that's, that's what really drives me. Right. That's my passion for this work. Because seeing firsthand what we now describe as health disparities, something I really witnessed. And and you're a New Yorker, so you know this, right? You know that distinctions between the Upper East Side and East Harlem, a community divided by ninety sixth Street, that double yellow line and how that line represents so many disparities between that community in so many ways economic disparities, health disparities, housing disparities, you name it. And so witnessing that firsthand is what really drives me to want to make a difference in my community. So I've had a very, you know, blessed, uh, you know, journey, uh, to, to this point, including, you know, public school systems in New York City, City College of New York, shout out to City College, went to Mount Sinai, as you said, to do my medical school education there, stayed there for my pediatric education and have really stayed connected to East Harlem in one way or another throughout my entire career. You know, I did work in Brownsville, Brooklyn, but my work has always been focused on underserved communities, marginalized communities, which, by the way, because they're underserved and marginalized doesn't mean that they don't have special characters, right? East Harlem is a very rich, vibrant, culturally rich community food arts resiliency, but unfortunately, it has a significant share of health inequities and health disparities. And it's it's time to change that. And so I had the chance to rejoin this particular organization that I've known for many, many years, the East Harlem Council for Human Services. During the pandemic, I was actually working somewhere else. I was working for New York City Health and Hospitals at the time, and reached out to the then CEO and said, look, you guys must be facing challenges because we're all facing challenges. And really, we just want to offer my assistance. And, you know, that conversation led to me coming on to chief medical Officer. And then almost three years now, I've been the chief executive officer for the council. And as you mentioned, one of our major programs is the Neighborhood Health Center, a federally qualified health center located here in East Harlem. The very first one actually in East Harlem that's been serving this community for over fifty two years now. The council since nineteen sixty five, so sixty one year serving. But the health center was created in nineteen seventy four.
00:05:08 Megan Antonelli: So yeah, what a what an amazing journey. And really, you know, we were neighbors. We were just, you know, a few blocks apart. But as you said, that ninety sixth Street, you know, sort of border there, you know, puts two neighborhoods that are so, you know, so disparate next to each other, you know, and, and Mount Sinai, you know, kind of sits in the middle there. Um, you know, serving both communities. But, you know, I think it's very important to recognize kind of the importance of fqhcs and we talk about them a lot. We've heard about them quite a bit recently with, with H.R. one. But tell us a little bit in terms of, you know, what, what role does that Fqhc play there in East Harlem?
00:05:49 Adam Aponte: Yeah. So, so so for your listeners and those people listening on this, on this, on this, uh, on this show. So federally qualified health centers are also known as community health centers. They came about during the Johnson administration, during the war on poverty. And it was a real effort to make sure that all communities had access to primary preventive care services. Fast forward sixty years. Today in this country, there are over fifteen hundred Fqhcs actually closer to sixteen hundred, serving over thirty five million US residents. So one in ten US residents gets their care in a fqhc in New York. We're about eighty Fqhcs with nine hundred locations serving two point five million New Yorkers. So one in eight New Yorkers get their care and efficacy. And our goal and our purpose is to provide access to primary and preventive care services. That's the core of what we do. Um, over the years and decades, we've adopted some other additional services that we think are equally important to that whole person care. And we'll talk about whole person care what that means, but our major goal is to make sure that no one's falling through the cracks. Everyone who needs and deserves primary care get it? And so we are equipped to see anyone, regardless of their ability to pay, regardless of their immigration status. We are a safety net. That's what we represent in the health care system. And over the last six decades, we have really evolved to be a major contributor to the provision of primary care services for so many individuals, such that if we did not exist, um, the health outcomes in this country, in this country would be so much more worse off. And so that that's really in a nutshell, what we do. Um, and those services include, you know, prenatal care, pediatric care, adult medicine, dental care, behavioral health services. We often have a pharmacy on site, really make that one, stop shopping for individuals and help them navigate this very complicated health care system. Right. And, and when I say complicated, it's complicated for all of us. I don't care what your educational attainment is. Uh, it's a very complicated and not easy healthcare system to navigate. So you imagine someone who's a recent immigrant, someone who doesn't speak the language, uh, and, and now dealing with all these chronic conditions like diabetes or hypertension and having to see all these specialists, all these ologists, as we often say, right? And the chronologists podiatrists, optometrists, right. And navigating all that stuff, or someone who just gets diagnosed with colon cancer, very scary disease, breast cancer, um, and helping to make sure that they get the care that they need at the time that they need it and the place that they need it. Right. So that's what we represent in the healthcare ecosystem of this country. And, um, you know, we have to make sure that we continue to get the support that we need to do this work.
00:08:34 Megan Antonelli: Yeah. I mean, the, the importance of the safety net can't, can't be understated. And, and the fact that, you know, it is, you know, it's part of the community, right? And it's perceived as part of the community. Let's talk a little bit about, you know, kind of what's going on with HR one, what that means for a center like broken and you know, what's what's at risk.
00:08:56 Adam Aponte: Right? So we're gonna, we're gonna get you to say the right way, Megan, but I know you're making a good effort at it. We talked about it earlier. Uh, and for those of you who don't know, the, the way we actually spell boarding gang with a K, uh, a derives from the original name of the island of Puerto Rico, so that the Tainos used to call the island of Puerto Rico. Borinquen and that's why you'll hear some Puerto Rican people call themselves Boricuas. It's a play off of that word. And then the Spaniards came in and changed the name to Puerto Rico, which means rich, poor, uh. And then that history goes a different way. That's a that's a, that's another session for us to do in terms of
00:09:31 Megan Antonelli: Yeah.
00:09:32 Adam Aponte: But, um, but HR one is very challenging in that it really is, um, focusing on Medicaid, which is a lot of the work that we do is on Medicaid recipients. The next population is uninsured, but our biggest population of individuals that use health centers like ours across the country are individuals who are recipients of Medicaid. And so with HR one, there is going to be diminishing individuals on Medicaid rosters. So with some of those changes in terms of how often someone has to recertify for Medicaid, you used to have to do that once a year. It's not a daunting process, but it is a challenging process. And if you miss that window, you can be uninsured for a period of time. So having to do it now twice a year is going to be more challenging for our patients. Um, the lack of continuous enrollment for children from newborn to six years old. So in a state like New York state, when a child was born in the state Medicaid, they had continuous enrollment until they were six years old. And the reason the state did that was to ensure I'm a pediatrician. As you mentioned, at the top of the hour, right, is that children get the the early child care that they need to ensure that they start off life healthy, right? All those really, really important things. Despite what you hear, immunizations are important monitoring developmental issues, monitoring height, weight, all those issues that we want to address early on. We know that when we address them early, that that child will have a much more healthier life. So New York State did that intentionally so that children would never face not having insurance to get the services they need. So that's going to go away with HR one. Um, and we anticipate in New York State alone that the revenue loss because of people getting off of Medicaid becoming uninsured, is estimated three hundred million dollars in revenue for Fqhcs that already operate on such tight margins. Uh, and so how are we going to make up that gap? And by the way, those people who lose insurance, we are still going to see them. We're just not going to get paid to see them. Right. And in New York State, they have these charity care pool dollars that get distributed. But that's a zero sum game. It's a tight pool. There's no talks about increasing that allocation yet. We're going to have an increased burden of uninsured individuals either coming to our health center, which preferably they come to, but if not, they're going to start going to the emergency room, urgent care. And those are not places where you get primary care.
00:12:01 Megan Antonelli: Right? Of course. I mean, the patients don't there. They don't stop getting sick just because they don't have coverage. And I think, you know, the point you're making around the requirement to, you know, reinstate and reapply is so important because that's one of the barriers in the first place, right? I mean, so often patients come who need Medicaid, who qualify for Medicaid, but maybe aren't already on it, and they have to go through that, you know, as they're when they're sick, let alone, um, having to redo it every year and, you know, talk a little bit more in terms of the, the pediatric piece of that, what that, what those implications are, you know, for the health care system as a whole, uh, you know, for kids to be losing that coverage, you know, between.
00:12:43 Adam Aponte: So, so they'll have to be. Just to clarify, they have to recertify twice a year versus once a year. And by the way, what I didn't mention, I failed to mention I'm sorry, is the new work requirement as well? Right. So there's going to be a work requirement for able bodied individuals who don't have children under fourteen years old, between fourteen and sixty four, that they have to either work, volunteer or go to school for eighty hours a month. That's a part time job. Um, and so how are people going to fulfill that requirement as well? Getting back to children. Right. Again, you know, this is the key place where we should be making the most investments in terms of our health care system versus the tail end of life. And when you look at the when you look at the health care system and you look at expenditures, a lot of the expenditures are in the latter years of someone's life versus the formative years of their life. And so clearly, a parent who has a child who doesn't have access to health insurance may not be able to get to a doctor unless there's an fqhc in their neighborhood. Uh, and while we take care of two point five million New Yorkers. There's still a lot of places that we don't exist. When you look at, you know, rural upstate New York in particular, the distance between shacks is tremendous. Here in the city, the five boroughs, you can probably find someone easier. But, you know, a large part of our state is rural upstate New York. And so where are those individuals going to go to seek care? And so, you know, you're going to see certain preventable illnesses manifest themselves in children due to this lack of coverage, this continuous coverage or loss of coverage, most of these children will be eligible. But to make that barrier, and that's what I really think about is an obstacle. You're making it more difficult for people who are already dealing with so many challenges. Why are we making it more difficult for them to get the healthcare that they deserve? And by the way, that's an investment, right? The more we invest in that early sort of childhood health care, the less likely that they're going to be a large expenditure at the tail end of life. Right. It's that sort of ounce of prevention palliative cure analogy that we use. It sounds very cliche, but it is. It is so true in medicine beyond, you know what you may apply that to in other places. It really is so true in medicine. And so that's why it's important for us to really focus on that if we want to curb healthcare expenditures in this country. And I do agree that there is some some elements of fraud, waste and abuse. It's not in the fcac world, though. It's not what we're doing. Right. There are other areas that we need to focus in on, and that's okay. I think there's a prudence for that, but I think the impact that it's having on organizations like ours is extremely significant, and the consequences are going to be dire.
00:15:28 Megan Antonelli: Right. And, you know, I mean, obviously the, you know, the financial elements of that and the, you know, the, you know, paperwork requirements to have people to, to re re-up their membership, you know, their eligibility status. And, and in an environment where we already talked so much about kind of a lack of trust and, and lack of usage of services, right? I mean, part of pediatric medicine is about getting people in the habit to go to the physician, to go to, you know, to trust their doctor to build those relationships. And in these communities where that's even, you know, that's more needed and more necessary. You're, you're creating barriers to that. So, you know, I think talk a little bit about, as you know, as you've seen, you know, sort of working in that community for so long, that importance of the community, you know, expecting those, those health systems to be there for them and how that trust, you know, kind of matters for for care delivery and the continuity of care.
00:16:25 Adam Aponte: Yeah. And, you know, you're so right. The key to pediatrics is helping children to adopt healthy lifestyle choices from early on. Right. And one of the reasons I went into pediatrics was because I felt like it's going to get it's going to be very difficult for me to take an adult who's been smoking thirty years to get them to quit. It's going to be a lot easier for me to take a child who's never smoked and get them to never smoke. Adopting healthy lifestyle choices. And then you talk about trust, right? And so what the way this manifests these changes to Medicare, Medicaid, and our populations is that people feel like they're being their back. You know, people are turning their back on them. Right. And the communities already where they have this sense of distrust for sort of, you know, establishment. Right. Um, because rightly so, because, you know, you look at East Harlem and there's just so many health inequities that people have had to deal with for decades. Um, and so now we're dealing with further compounding that distrust by doing, taking these kinds of measures. And so it makes people feel like, ah, the hell with it. What am I going to do? They throw up their hands. They feel like the system is out to get them. And, and, and that kind of behavior leads them to start to do different behavior, interact differently with the health care system, including neglecting their own health for fear of the cost of it. Right? You go to the emergency room, you get a bill for five hundred dollars, six hundred dollars the next day. And when you're living on, you know, paycheck to paycheck, if you're living that well, um, that is a tremendous fear, uh, for individuals, right?
00:18:01 Megan Antonelli: Yeah. No, I mean, there's no question and just the impact of, you know, thinking you have coverage, but coverage lapsing because you didn't, you know, sort of jump through the hoops of that eligibility piece of it. And then, I mean, as you said, in terms of the work requirements, well, on one level, you know, seemingly, you know, a reasonable ask. But then on the other hand, you're talking about, you know, a population of single parents and, and, you know, where, where that level of, of work might be difficult, you know, to, to achieve or disabilities or what have you so, or, you know, various age and various reasons. So in, you know, in a time where, you know, completely able bodied, you know, fully whatever People are having trouble getting jobs, you know.
00:18:44 Adam Aponte: Well, you know, not only getting jobs, but making livable wages. Right. I think that's the other part of it. Right. You know, I think the misconception with people is that people want to live off the system. I. No one wants to live off the system. It's not that luxurious to live off the system. I grew up poor in East Harlem because we just didn't have the means, right? That wasn't a luxurious lifestyle for me as a kid. Right. My father tried to work as much as he could, raising the family that he had, but it was very challenging to make that livable wage. Most people, if not the vast majority of the individuals that I work with, they want to work. They want to contribute to their own well-being, but they can't find work. They can't make livable wages. They're taking care of several generations of families that prevent them from being in the workforce. You know, people have a misconception of these sorts of things. You know, I, you know, when I used to teach students a lot at Mount Sinai, and actually even when I was a student, um, many of my colleagues did not have the perspective that I had growing up in East Harlem. Right. And so they see someone who uses substance use, has substance use disorder, and they feel that that person made conscious choices in their life to use, you know, illicit drugs. And I pushed back on them. I was like, you know, no one I know ever grows up to say, I want to be a drug addict when I grow up. I want to be homeless when I grow up. There are circumstances that lead people to these situations that often are beyond their control. And then once you're there, how do we help them move out? More importantly, how do we prevent them from going down that route? That's where I want to focus my time and energy. But once they're there. Right. But nobody chooses their circumstance. Nobody says, I want to grow up to be poor and homeless, right? That's not a conscious choice that we make. Those are circumstances that create that. And so we have to really think about what contributed to that person. And yes, you know what? If they can't work, no problem. But where are they going to work? What kinds of jobs can they find depending on the skills they have? So, you know, is there vocational assistance to get them a skill so they can have meaningful work? And trust me, if you put that in place, so many people would be excited to have that because it gives them purpose in life.
00:20:50 Megan Antonelli: Right? Which, of course, is the role of these safety net organizations is to build that trust, be there for the community and help them to understand that that's that those resources are there and available to them. And when you take them away, it just breaks the trust and breaks the, you know, the willingness and an interest in using the services that are there. I mean, and I think that's, that's been such a huge problem. You know, sort of the fundamental problem of Medicaid is exactly what you said, that people don't want to use it. They don't want to be on, you know, sort of that service. And, and so taking it away to those who do and who are who are benefiting from it and making it more difficult to use is counterintuitive to the whole program, let alone just, you know, to capture some, you know, some levels of fraud and abuse or whatever might be there. Um, but to talk a little bit, you know, we're digital health talks, we're technology and there, there are components of this bill in terms of, you know, kind of telehealth and technology to become available. And certainly where I sit and we try to talk about technology as, as, um, a means for improving access to, you know, all communities, whether rural or, um, less, less, you know, underserved communities and how telehealth and all of that might do, you know, might improve access. Again, it kind of comes back a little bit to that trust piece because if they don't trust what, what you have there, and if they're not giving you the right data or, or you're not able to, to kind of engage them using those tools, then the tools aren't going to deliver on that promise. Right. And I think there's this assumption that like, oh, we can take this, you know, the trusted way we can put in some of these, you know, sort of easier technology tools. But if we've broken the trust, that kind of falls apart. So tell me about, you know, kind of where you sit and what you're seeing in terms of both, you know, digital adoption tech, you know, literacy, what's available and, and kind of frame that in, you know, for the, the populations that you serve.
00:23:00 Adam Aponte: Yeah. So, you know, so telehealth has not, is not new, but I think obviously with Covid, we put fuel on that fire, right? We had to really escalate telehealth and it did play a role. I will tell you, though, my experience here in East Harlem in this community was that it was slow in the uptake. And still today, many people do not trust the technology. You know, there's still a very old school mentality as well. Like we like to come in and see the physician be in person and develop that relationship. You know, you want to develop a relationship with this camera in front of me, right? I want to see the doctor and be in their presence or the provider. And so, you know, most of our patients did not adopt telehealth or embrace it to a degree that perhaps some other communities did. And of course, being in the city, it was a little easier. We never closed during Covid, so we always remained open. And so in that sense, we didn't have the adoption. It is a great tool. It is an absolutely wonderful tool that we can augment and utilize within the health care system, and it really will help us to deliver care. But we got to make sure that people know how to use it, want to use it and understand the benefit and make sure that they know that it's not being used against them. You talked about the data piece, right? It's amazing to me when patients walk into our health center and we ask them just fundamental questions about who they are, where they're from, income, they don't want to share that. They feel like, what are you going to do with that information? How are you going to use that against me? Right. And part of it has to just be like, you know, decades of feeling like, you know, people are taking advantage of you, right? So we do a lot of we take a lot of time in education to say, you know, it's important for us to know your income. It's important for us to know your race ethnicity, because we use that to benefit and improve the services we offer to understand you more. But most places don't take the time and effort to explain to people. So what happens? They leave those questions blank. They don't answer those questions. Right? And so we lack that data that we need that will help us to further improve the health care delivery in the community. So it's kind of a vicious cycle in a bad way, right? We can't get the data. The data will help us to say, okay, we need to do more for this community, but the community doesn't want to provide the data, right? And so, you know, we get in other ways, but it's, it's one of a challenge, but it's, it's, it hasn't been the, the solution for our communities. I think we need to do a better job of making people feel comfortable. But on that note, I will tell you there are challenges today for telehealth, for Fqs. So in the world of telehealth reimbursement in New York State, if my patient and or my provider are not within my brick and mortar health center, I get paid a third of the rate for that visit. Yet I still hired that provider. I'm still paying that provider the same amount of salary. I'm still providing that patient with the care that they need when they need it. But New York State doesn't reimburse us fully for that. I don't understand that. Right. And that creates further barrier for us to adopt telehealth technology, because we're going to be challenged in terms of how do we afford that? Right, right.
00:26:15 Megan Antonelli: Right. And while we're seeing progress kind of on the national level that if that still exists there, you know, building that trust, you know, which is fundamental, and then the sort of, you know, resiliency of using the systems, it's not there. You know, it's certainly not going to be a safety net to the safety nets, if you will. So, um, yeah, no, I think it's really Interesting. And I think the discussion around the data, you know, so much as we talk about, you know, the usage of, of social determinants of health and how to provide better care. But if we're not explaining why we need that data and that takes time and we're, you know, we know that our physicians and our nurses don't have a lot of time to make those explanations and to, to make people feel comfortable with that sharing, you know, and if they did, you know, we'd be we wouldn't have to have this conversation about the broken health system. There would be those resources there. Um.
00:27:07 Adam Aponte: So you mentioned something I want. I'm gonna see if I can get you to change your terminology right today. So you mentioned social determinants of health. A lot of people know that term, right? I, I'm adamantly opposed to using the word determinants in that for those of you who don't know social drivers or influences of health, and I'm gonna define that in a second are things that are outside of the health center, right? That equally, if not more so, impact someone's health, housing, food, Transportation, right? Poverty, all those things equally, if not more so. And I would dare say in the case of homelessness, it's even more powerful, right? Because my diabetic patient doesn't care where the insulin is. They care where they're going to lay their head that night. Right? So those social. And so the reason I don't like the word determinants is because determinants denotes this inevitability that if you're born in a community like East Harlem, you will have these outcomes, right? And we know that while poverty, food insecurity, uh, housing, all those things can influence someone's health, it doesn't necessarily have to determine it. And I'm evidence of that, right? A kid born and raised in East Harlem, poor family. You know, here I am now leading a health center. So, Megan, I'm going to challenge you to start using drivers of health.
00:28:19 Megan Antonelli: I knew I'd learn a lot in this conversation. I may not be able to pronounce Barack, and by the time the conversation is.
00:28:26 Adam Aponte: Right there.
00:28:27 Megan Antonelli: But I will get social determinants of health and change it to social drivers of health, because I get it and I and I love that. And I think it's you know, and I think it's so important as we frame these, you know, these topics and these conversations to build the trust and to be, you know, talking about it in that way to, to drive that. So I love that.
00:28:48 Adam Aponte: Where is a really powerful in our communities, right? And so especially when you're in a community like ours where you already feel like you're way behind the eight ball to say to someone a determinant, it really makes them feel like, why should I even bother now? Right? Because based upon all this data, this is what's going to happen to me. And we know that you can change that. And those are some and you know, you said this earlier and I meant to comment on something you said earlier was around, um, FK season, what we do, right? So I talked about the health care delivery that we do, right? Very, very comprehensive. I often tell people, you know, we do everything from womb to tomb, right? Prenatal care all the way through the life cycle, and then everything in between, including dental care, behavioral health care, navigation. And then we do a lot of other stuff that we don't get reimbursed for, but we know is important. For example, our health center has a food pantry. We have every two weeks. We offer fifty families food that we work with local, uh, you know, folks to procure and offer them, right? That's not something we get reimbursed for. But we know that's important that if someone's hungry, that's we gotta address that hunger issue, right? We give away clothing, we do clothing drives, we give away toys during Christmas, oftentimes representing the only toy that child gets. So that goes back to that, that concept I shared earlier, that whole person, we gotta look at the whole person, right? What's the environment that they live in? What are the challenges they're facing in, and how do we address as many of those things as possible as Fqhcs? We feel we have a great relationship with these patients. I will tell you, my patients show up here two hours before the appointment because they just want to be here and, and talk to friends and socialize. It's a social area as well for them. Right? And so while they're there, we're trying to address more of their needs that we know will also impact their health. And that's the beauty of Fqhcs. And I would dare say that most fqhcs that you encounter. You'd be surprised. All the things they do in that that one, that one health center. It's a true one stop shop for many individuals.
00:30:52 Megan Antonelli: Right. And that can't be understated either. I mean, it's just it's that importance of taking care of the whole person. And, and, you know, that's how you serve the community. It's how you serve the population. And I think that's missed a lot. You know, when we sort of in the global discourse around health care in the ecosystem, it's like fqhcs and you're just sort of it becomes a conversation about reimbursement, about Medicaid. And they really are community hubs that are taking care of, you know, the population. And, and, you know, without that, as you said before, those patients don't go any, they don't go away. And those needs don't go away. They, you know. So, um, you know, there's just, there's so much. So, so when we think about that and we like to, to give people kind of what can they do? So, you know, beyond just, you know, general advocacy and speaking out about, you know, the, you know, what, what we can do, what can our health, health system leaders who listen to us, um, who may not be at Fqhcs but certainly work in communities with them, what can they do, um, to, to sort of support their partners in their community?
00:31:59 Adam Aponte: Yeah. Thank you. Thank you for that question. So first of all, obviously in New York State, you know, for any of my state legislators, uh, still talking, the budget negotiations are still going on. You guys have a chance to do it right, three hundred million dollars investment for telehealth parity. Three forty preservation. That's my shameless plug, Megan, I'm sorry, but I had to get that in there. Um, you know, obviously working with us in partnership, right? And, and being real, a true relationship with Fqhcs not transactional. And that's something I've been talking about for the last couple of years as CEO. What I've witnessed is that oftentimes, particularly large health systems will want to do some work with with an organization like this to their benefit only, not to our benefit. It's what I call transactional, right? I don't need transactional relationships. I need someone to lock arms with us and help us to do our work. And that doesn't mean just to give us money. Of course, money is a big factor here, but there's so many other things that you can do to help support the work that we're doing and working in concert, working collaboratively. This health care system is way too siloed today. And that's what's failed our communities. And I'm trying to change that in East Harlem so that we work as a collaborative and, you know, create this concept that I use. Again, I didn't coin this term, but I love this term. No wrong door. Wherever a patient goes, they get the care that they need and deserve, regardless of who is with it's with me. Health center b c d e f it doesn't matter if I know that you can do something for my patient that I can't. I'm gonna get that patient to you. And that's something that doesn't happen in our health care system. And then obviously, you know, we do as much fundraising and fundraising as possible. As a matter of fact, you know, we're hosting our annual gala on May twentieth here in New York at capital. If you guys want any information, visit us at w w w dot that's B o r I k e dot org. Backslash gala and find out, uh, it's a fun party. You learn more about the work that we do, greater detail than you heard today. Um, and then, you know, there's you, you learn about ways that you can help us to deliver on our mission that we're committed to. We've been working on this for sixty years. We plan to be here another sixty years. And we really want to change what's happening in our communities and not just talk about it. We want to be about it. And that's really what drives me, right. I'm in a position today to really make a difference, and I'm not going to let this this opportunity go to waste for us.
00:34:21 Megan Antonelli: Amazing. And that that is a, a calling, a call to arms and it gives people really something to to do, particularly those in New York. But across the country, this is happening in, you know, in every area. Um, and I think there's, there's a lot we can do to make sure that both from a partnership, a financial and just recognizing the importance of it, you know, and the, the role that fqhcs play in the community and, and how they can, um, you know, how we can support them. So I love the gala will certainly promote it on our channels too. Um, and I wish I could make it, I don't know if I can, but that would be super fun. Um, but it's been such a pleasure to, to kind of talk to you and, and to, to learn about Birkin Birkin.
00:35:09 Adam Aponte: And you putting the emphasis on the wrong syllable.
00:35:14 Megan Antonelli: Uh, I will learn, um, but the work that you do across East Harlem is, is really a model for community centered care. And I think the, the connection between the data and the trust and the importance of that, that safety net can't be understated. So I really appreciate your time and the work that you do. And I think in terms of how folks can, can kind of follow up, we'll put that in the show notes, and we'll be sure that they can find it online and to our audience. If this conversation has moved you, please hit the like and subscribe button and share it with a colleague who needs to hear it. And you can visit us on Health Impact live dot com for the full library of Digital Health Talks episodes. This is Megan Antonelli, CEO of Health Impact Live, signing off for digital health talks where healthcare operators do the real work that makes healthcare better for everyone. Until next week. Let's keep fixing health care one conversation at a time.
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