All a Balancing Act: A Conversation With Curtis Byrd
Each quarter, we feature a Federal Action Network (FAN) member leading the charge on Capitol Hill to protect essential hospitals.
This quarter, we spoke with Curtis Byrd, MPA, director of advocacy and community relations at Chesapeake Regional Healthcare, in Chesapeake, Va., about how his previous role as a congressional district director prepared him for hospital advocacy, his top advocacy priorities, and how essential hospitals can best amplify their message on Capitol Hill.
Tell us about yourself, your background in federal advocacy, and your current role at Chesapeake Regional.
For the last 15 years, my career has focused on advocacy for constituents. I spent eight years working for [Rep. Randy Forbes (R-Va.)], [and I’m] coming up on seven years at the hospital. Primarily, I have been the voice of those I represent, whether it was a constituent who had a problem with a particular agency of the federal government [in my previous role], or, in the case of the hospital, representing the policy and regulatory interests of the hospital vis-à-vis the community we serve.
You worked as district director for Rep. Forbes. How did this work influence the way you advocate for essential hospitals like Chesapeake Regional?
A big part of that is constituent service. For every constituent that reaches out to you, they have a different and unique need. It required that you really listen to the needs of the constituents and then go on their behalf and advocate directly with the federal agency to say, “What’s going on? Can you provide us an update, or is there more information that’s needed to complete whatever this individual is asking the agency to do?”
[It is] very similar when in a setting like Chesapeake Regional that serves a large percentage of people who either are not insured or underinsured. Again, it’s listening to what they need and understanding the access they need to the health care that’s going to make them healthy. In many cases, they don’t know where to go, and because they don’t know where to go, they don’t go. That leads to being unhealthier, maybe developing comorbidities and other more serious illnesses that can become life-threatening, or certainly even more expensive to treat.
I have learned that, through understanding the needs of the community and how our hospital can meet those needs, we’ve been able to very effectively advocate for policies that help us be strong and viable as a health care provider. It’s important that we balance our fiscal health so we can remain viable and then operate to provide the health care people need in our community.
Tell us more about Chesapeake Regional and the patients and communities you serve. What makes your system unique?
There are a few things that are unique about Chesapeake Regional. To begin with, we are a non–state -owned public hospital. In 1963, the city of South Norfolk and Norfolk County merged to create the city of Chesapeake. That was at a time when it was about as rural as you could get in this part of Virginia, so there was no real health care infrastructure or access unless you were willing to travel into the urban center of Norfolk. The people and leaders of Chesapeake decided they wanted to have their own hospital and offer their own services.
In Virginia, you must have the state’s permission to do certain things. One of them is to open a hospital. In 1966, the legislature created what today is known as the Chesapeake Hospital Authority. That is our governing body. Its members are appointed by the Chesapeake City Council. Then, it took 10 years for the community to come together through bake sales, car washes, people just contributing money from their paychecks to get enough money to build what at the time was called Chesapeake General Hospital. In 1976, we opened our doors. We continue to be the only hospital in Chesapeake, the commonwealth’s second most populous city. We border the commonwealth’s most populous city, Virginia Beach. In fact, a good portion of Virginia Beach is in our primary service area.
This includes what used to be a 25-acre wooded site that I think at one point was where a replacement hospital would be built. We’re currently in the middle of an expansion and modernization of our general hospital, Chesapeake Regional Medical Center. Our governing board looked at those unused acres and felt strongly it would be a great location for the new Veterans Affairs (VA) outpatient center planned in this part of the region.
Currently, the contractor is building a 196,000-square-foot facility for veterans to provide outpatient care, including dental, vision, and behavioral health services. As you can imagine, there may be additional services needed by veterans who would rather not have to go across the water to the main VA hospital in Hampton. Hopefully, through the relationships and the partnerships we have and will continue to develop with the VA, we will have services that supplement what they’re doing at that facility. We believe veterans need access to care in the community as opposed to having to drive an hour or more to get that care.
What are some of your health system’s top advocacy priorities for this Congress?
What keeps me awake at night is what’s going to happen to the 340B Drug Pricing Program. Our hospital just received another letter from a drug manufacturer putting us on notice that they’re changing the way they do business in the 340B program.
That is going to mean a big fiscal hit to our hospital because we take the money we save through the 340B program and reinvest it in the communities that need it. One of the things we do is provide a prescription drug card to people who qualify [based] on the federal poverty level, so they can have either greatly reduced or, in some cases, no charges for their medication.
When drug manufacturers change the rules, it means significantly less dollars for our hospital to invest back into the community. That’s a big, big concern for us because we’re a new 340B hospital. We’ve been 340B for the last year or two. That’s a huge, huge thing we’re going to be looking to our federal partners to address. I think from a federal perspective, 340B is our biggest priority and our biggest concern.
How do you prioritize your needs and asks, and balance state and local level advocacy with federal advocacy?
It’s hard to get things done in Washington because of the hyper-partisanship — the drifting away from what I call “regular order,” even for something like the budget process. You really must pick and choose the battles you take to Washington.
We’re kind of waiting and following America’s Essential Hospitals’ lead on the 340B issue, but that’s different in the state because the state constitutionally has a 30-day session every year. It’s extended in budget years to 60 days, and they come in, they get their work done, and then they leave, theoretically, and for the most part they do. What that means is we’re able to more actively engage at the state level on policies because we know they’re going to be presented, debated, and voted on, and then they’re either going to pass or fail on the merits of what we bring forward or what we support through the state hospital association.
That’s not necessarily the case in the federal government, but for something as important as 340B and the types of hospitals that depend upon the revenue savings from 340B, the cry is going to get so loud that I think the federal government is going to have to step in and clarify a lot of things that otherwise are not being properly done through this program, because it’s just not being properly administrated.
We are now in the second quarter of the 118th Congress. Where do you see this Congress making headway in health policy and what do you think the biggest challenges are?
The first thing that comes to my mind is the COVID-19 pandemic. It really forced people to look at health care delivery in this country, and, as you know, Congress appropriated a lot of money to the health care infrastructure to respond and to deal with the pandemic. I’m hopeful that, as COVID-19 is in the rearview mirror, policymakers in Washington will be careful to assess, if this ever happens again, what can be done to be more targeted in terms of the relief they would provide.
I think essential hospitals by definition, because of what they mean to the communities they serve, should always have top-of-mind consideration as Congress looks to provide relief.
Special designation for essential hospitals is important so, as Congress looks to further provide relief downstream, it’s already clear to what hospitals that money would be going. [It would be] no different than if you’re, for example, a rural referral center or some other kind of specially designated hospital through the federal statute. Let’s make sure it’s going to the places it’s needed most.
What is your advice for other advocates on how best to get their message across to Congress?
It’s important to have strong relationships. We’re not the only advocates asking for our partners in Washington to do something for those we represent. There are hundreds of other sectors equally pressuring members of Congress to do something for their constituency.
When you have relationships, you’re often able to cut through a lot of the perfunctory things you have to do to meet with someone. When you know someone, you can send [them] an email or pick up the phone and say, “Hey, I’m going to be in Washington at the end of the month, can I get 15 minutes of your time?”
Make sure when you’re communicating with your partners that you’re very clear and succinct about what you’re saying and what you’re asking them to do. When I was up in Washington for Policy Assembly, we met with some folks on the Hill. There is no doubt that, when we left those meetings, they knew specifically what we were asking. That doesn’t mean they’re going to have a decision for you, but they’re going to be clear on what you’re asking them to do. I think they appreciate that because, believe me, they are hit by a lot of different people and have a lot on their plate, and the clearer they are on something, the better they can represent you.
You are an essential hospital leader. Beyond being an active member of the Federal Action Network, you also are an alumnus of America’s Essential Hospitals’ Government Relations Academy What do you find most valuable about these association networks and what advice do you have for your peers who are looking to get more involved?
The Government Relations Academy was an incredibly valuable investment in the work I do as an advocate.. There are two things I really took away from it. Number one, the relationships I made not only with America’s Essential Hospitals staff but also with others in the essential hospital community across the country. How are they meeting those challenges? What are some of the things they’re doing to address these challenges? The relationships I made through the Academy are something I hold very, very close to me because it was that important. I stay in touch with many of those who were in the Academy.
The other thing is this exercise to create an advocacy plan centered around an issue that could be used and would be impactful to the organization and specifically Chesapeake Regional.
[It was helpful] to have [a mentor] who had been through the Academy and is seasoned in advocacy. [They] work with you and shepherd you through the formation of that plan that can then be vetted and tweaked and fine-tuned to the point to where it was a real plan that could be implemented back home. It wasn’t just something that was nebulous, it was real.
We’ve done that here to really move the needle on some important things in Washington. I just can’t emphasize enough how important it is to take this opportunity the association has created for its members, because you’ll get relationships that yield dividends for your own organization. You’ll get something tangible you can walk away with. You could not put a price tag on being able to put together a plan that was real, that, when implemented, could be very valuable. It is absolutely worth it. And I got a great certificate, too!
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