A Conversation With ... Lynne Meyerkord

APO is seeking designation as a federally qualified health center look-alike. What would that mean for the organization?
We have evolved quite a bit over the last several years, and we are now seeing in our clinic about half our patients do not have HIV. We’ve got a lot of designated funding for HIV, but not for folks that don’t have HIV. And we really want to be able to offer the breadth of services to them that we can for our HIV folks. The main benefits of an FQHC look-alike is better reimbursement on Medicaid and Medicare patients, and also more folks who would be eligible for our 340B pharmacy program, which is what keeps our doors open. 

When do you expect the official ruling?
We got through the most challenging piece, which was the site visit. I’ve been around for a very long time and been through many HIV/AIDS Bureau site visits from (Health Resources and Services Administration). This was a very different beast. Once we receive our official report from HRSA, we have 30 days to correct the things that they found lacking, which we’ve already started on. Then they have 45 days to let us know if our response was satisfactory, and then we would get the designation. There are so many details about that to work out that I’m not sure when we would actually see the effect of the changes. We hired consultants to help us with this. I usually write all of our grants myself, or one or two other staff members. Then we started talking to some other folks that had gone through this process. … I’m really glad we listened to them. Doing this completely on our own would’ve been a tremendous challenge.

What other health services do you provide besides HIV/AIDS care and management? And what are your patient volumes?
Primary care. We also provide preexposure prophylaxis services, PrEP, which is medication that prevents HIV infection. It’s 99% effective. We have gender-affirming services, so we serve quite a few transgender folks – in terms of active patients, probably between 1,200 and 1,400. We’re a little different than a lot of the standard health care services. I think our background in providing services to really marginalized populations with HIV, LGBT community, folks living in poverty, we have developed a really flexible, inclusive model. I think that’s what makes us unique. We were doing a lot of diversity and inclusion before it became something that other businesses were paying attention to. For folks with HIV, we can also provide case management and mental health care. We want to get to that point with folks that don’t have HIV. The other benefit to becoming an FQHC or a look-alike is that you are then eligible for a lot more grants for mental health, for substance abuse services, for community health workers or just a lot more service options. Jordan Valley, [a FQHC], has upwards of 65,000 users. That is not what we are aspiring to. Probably 5,000.

At your main campus on Glenstone Avenue, you have a Grove Pharmacy location attached to the building. How has that partnership impacted your operations?
It’s very important, especially given the 340B pharmacy program. With that program, let’s say I’m on Biktarvy, which is an HIV med, and let’s say that the cost to an insurance company is $1,000. That’s what they’ll pay for that med each month. Because we’re a 340B-covered entity, we’re able to buy that at a discounted rate. So, let’s say we pay $500 for that script. We’re able to then sell it through our contract pharmacy arrangement for $1,000 and then we’re able to keep that difference. We started the 340B program in 2013. Grove has been our contract pharmacy since we started. It’s very convenient for our clients.

Roughly what percentage of your funding does that equal?
I would say 60%-75%. It’s huge.

Workforce shortages are impacting many industries, especially health care. What are you doing at APO to keep the staff you have and recruit others?
We’re definitely a nonprofit, so we try and add other perks. On Fridays, folks can bring their dogs in if they’re vaccinated. We also have a Baby on Board program where for the first six months, a parent can bring their baby to work two days a week. We try and just have a very supportive, lower-stress work environment. We did raise our minimum wage to $15 before everybody else did. We need to pay our folks a living wage. That was important to us. And then COVID came, and the folks with more money are raising their minimum wages way up beyond that. It’s a challenge.

There are nearly 15,500 cases of monkeypox in the U.S. Have you seen any cases locally and do you have any vaccines available to patients?
Very fortunately we've seen very, very few cases. We've seen a lot of folks recently who are concerned that they have it, but right now the testing system is very cumbersome and time consuming and not because of the actual gathering of the sample, but because of all the paperwork required and pictures required. And then you've got to find out if the health department's going to approve that sample even being tested. Unlike HIV and some other illnesses, you can definitely see if someone has monkeypox, so just trying to raise awareness, let people know how you get it, how you don't get it. We've had numerous folks ask for the vaccine, many of the folks that we serve. I get that it's a supply and demand issue and right now happily, we don't have lots of cases. That is a frustration for both us and our clients (that we don't have the vaccine).