Frontline Fellows: Q&A with Roland Gardner and Faith Polkey of Beaufort-Jasper-Hampton Community Health Services

Committed to progress in South Carolina, fellows of The Riley Institute’s Diversity Leaders Initiative (DLI) seek to develop real solutions for real social issues. As the COVID-19 outbreak has drastically changed the way we live, these state leaders are quickly adapting the ways they support the communities they serve. We’re shining the spotlight on their exemplary leadership during this unprecedented time in our new Frontline Fellows series.

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Published May 22, 2020

In this interview, we speak with two leaders at Beaufort-Jasper-Hampton Community Health Services, Chief Executive Officer Roland Gardner and Chief Clinical Officer Dr. Faith Polkey. Both Riley Fellows, Gardner and Polkey shed light on the challenges that lie ahead for community health centers like their own as well as the actions they’re taking to protect vulnerable patients and keep their clinics in operation.

Studies have shown that black communities have been disproportionately affected by the COVID-19 outbreak. Can you shed some light on the unique challenges black communities face at this time and how those challenges have taken shape in the South Carolina counties you serve?

Polkey: There are a lot of reasons why African-Americans might be more at risk for severe symptoms and higher death rates. The first of which has to do with some of the health issues that are more common in the black community, especially in South Carolina. High rates of hypertension, diabetes, and heart disease tend to disproportionately affect African-American communities. There are also social determinants of health: where people live, who they live with — there are a lot of multigenerational families — where people work. A lot of African-Americans tend to be frontline staff — “essential workers” as we’re finding out what that term means now — even within the medical community. These are all the things that allowed us to predict that it’d hit the black community more.

Gardner: People are fearful about the virus’ unknowns and the cost of being tested. Plus, access to healthcare is limited. That’s what we have found along with some of the other community health centers. For us to able to provide care to our patients, we’ll need help from local churches. If we affiliate with churches and they encourage people to come to our clinics, we can address their needs.

Polkey: I will just say that our patients are staying away. They are not necessarily coming in droves to be tested or evaluated. It seems like people are mostly staying home in Beaufort, Jasper, and Hampton counties. Our visits are down.

Gardner: We’re seeing more and more patients now with the telemedicine. I think most of our business right now, 75 percent, is telemedicine. Normally we see 1,100 to 1,200 patients a week in the clinics. It’s less than 300 now. Along with other community health centers across the state of South Carolina, we’re trying to ramp up our COVID-19 screenings and identify a site where we can do those screenings. We hope to continue to get the word out in the African-American community that we’re available to screen those patients.

You’ve been phoning some of your most vulnerable patients, including those with unmanaged chronic illnesses and substance abuse issues, to check in on them and their health at this time. Is that a common practice among other health centers, and why have you made it a priority for Beaufort-Jasper-Hampton Comprehensive Health Services (BJHCHS)?   

Polkey: We’ve definitely found that it has been a practice for health centers as we all know that our patients are more vulnerable. When there was a stay-at-home order, we knew that we were going to have to reach out to those folks. There were people who already had scheduled appointments, so we reached out to see if they still wanted to come in or do a telehealth visit. But then there were people who weren’t on the schedule who we knew needed attention, so each center identified a list of people to reach out to.

Gardner: We typically provide transportation to our patients also. With social distancing, we could no longer put 12 to 14 people in a van. We discontinued transportation after the first week of consolidating our clinic sites.

We’ve kept our pharmacies open. The pharmacies have been very, very busy despite medical visits being down. We’ve been trying to educate patients about the importance of continuing to take medication. People say that once they get well, they don’t take their medication. We’re trying to guard against that. Business was down for the first week or so, but now people are coming in every day to get their refills.

What has your patients’ reception been to telehealth?

Polkey: A lot of people have been really excited about that. I think it’s going to be hard to put that genie back in the bottle. One person told me they had a patient who was supposed to have an in-person visit but opted for a telehealth visit instead because he was an essential worker who had to report to his workplace. He was able to do his telehealth visit on his break. It makes it a lot easier for some people, but there some people who have barriers. Some of our patients have flip phones. You can’t do a telehealth visit with flip phones, but you can call that patient to keep in touch.

As you quickly adapted your operational model to respond to COVID-19, your team managed to train all 20 of your providers on telehealth in just a few weeks. What enabled you to mobilize so quickly, and how successful has the program been?

Gardner: I’m going to say it’s Dr. Polkey. Her public health background was key for us. She’s our Chief Clinical Officer, and we lean on her. She’s taught me so much about what we need to do.

Video conferencing on Zoom has also helped us keep our staff of 280 people, up to 300 sometimes, informed. If you’re not getting the information out to them and getting it out to them early, the rumor mill goes on and they get wrong information.

Polkey: Well, thank you, Mr. Gardner. As far as the telehealth is concerned, I think what helped us ramp up so quickly was the fact that we were already training on this system. Even though we hadn’t planned to implement it so soon, I asked our chief technology officer, “OK, can we turn this on? Like tomorrow?” And he did! Actually, it wasn’t tomorrow. He sent me a link that very day saying the portal was live. The next day, we trained one of our providers. The day after that, we trained a couple more. We just really hit the ground running because otherwise we wouldn’t have been able to connect with our patients, especially at a time when we were still dealing with the lack of personal protective equipment.

You mentioned that you’ve been getting the word out about COVID-19 through local churches and discouraging big gatherings in a season when people wish to celebrate Easter, Mother’s Day, and the like together. How receptive has the community been to these messages, and what do you wish everyone across the state understood about the gravity of the situation?

Gardner: In part, they’ve been staying home out of fear because they understand and see what’s going on nationally. We try to educate them by repeating the message over and over and over again. At BJHCHS, we’ve only had one test come back positive for COVID-19, though there have been some patients who went to non-BJHCHS testing sites. Keep in mind, we have a total of 17,000 patients who use our services.

Polkey: In a way, that’s laudable but it’s also not because it means that testing continues to be an issue. Some of that has evolved. If we really were testing all the people who need to be tested, including asymptomatic and pre-symptomatic people, those numbers would be a lot higher. I think we’re there with the state now. We’re seeing a lot of mobilization of resources, and people just really trying to come together and make sure that happens for our citizens.

Like many businesses, your medical centers have not been spared from financial hardship during the COVID-19 outbreak. Can you share what your experience has been? What will it take to ensure that community health centers like your own are able to keep their doors open in the months ahead? 

Gardner: To continue operation, we need to be generating $1.1 to $1.3 million a month. With patient visits down, we’re doing less than $300,000. We’ve been monitoring that very closely. The Paycheck Protection Program loan we received is going to help us for about five pay periods. The benefit of that is as long as we have people working, the entire loan will be forgiven, but that’s not going to go far. Our total budget is $22 million. We get $8 million from the federal government, so we have to generate $15 million through patient fees, Medicaid and Medicare reimbursement, and other grants. We have to work on getting patients back in, increase revenue for each billing cycle, and monitor the situation very, very closely.

In this time of crisis, what has been the most important lesson you’ve learned about leadership?

Gardner: We’ve got to be very honest and upfront with staff about what we know. We’re trying not to guess at it. We get information on a daily basis. Where there’s good leadership, there are good staff members. In every department — from nursing to medical to dental — we have good people we can depend on.

Polkey: “Communication” is my word. You can’t overcommunicate in this time. It has been so important to get the message out and let people know exactly what we need them to do. Our senior staff is used to having time to talk about things, but we don’t have as much time to do that right now. We have to call on each other to step up and just roll with it. Each day has been so different, and the staff has really risen to the occasion.

Gardner: I think they bring different ideas to the table. We need a decision to be unanimous. Once we make a decision, everybody is on board. If the lower staff see a crack in the armor with my senior management staff, then the whole thing falls apart. I try to make sure everyone has some input. We go out unified as one team.

How has your participation in DLI influenced your leadership and the kinds of programs you have instituted at Beaufort-Jasper-Hampton Comprehensive Health Services?

Gardner: Everybody may have different ideas about how things should be done. We may not all agree about how to arrive at a solution, but when it comes time for a final decision, unity is important. The conversations we had in DLI are the same conversations we’re having now on our team.

Polkey: After that experience you’re able to hear different perspectives better. A lot of times you’re in your own kind of echo chamber with people who are like you and who think like you, but having conversations like the ones we had in DLI helps you be a better leader because you can’t just do what you think is right all the time. There’s somebody else who might have a better idea, and you’ve got to be open to listening to that.