A Conversation with Shreya Kuntawala
Assistant Vice President for Government Relations
UHealth
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 Shreya Kuntawala, assistant vice president for government relations at UHealth, in Miami, about what makes UHealth’s patient population unique, the health system’s recent advocacy achievements, and Florida’s unique standing on the national political stage.
Tell us about the University of Miami Health (UHealth) System and your role as Assistant Vice President for Government Relations. What makes your system and its patients unique?
The University of Miami’s government relations (GR) department spans the entire enterprise, including my role. The university and the higher education portfolio really drive and work in tandem, with the Miller School of Medicine and the UHealth hospital system. It’s really a great vantage point because no two days ever look the same. One day I can be working on hospital reimbursement issues and in the next hour be focused on autonomous air mobility, and then by the end of the week have satellite efforts and climate resilience on my desk. That really is a cool perspective to have as a GR.
A lot of us talk about being in public affairs now, not just government affairs. I think this bodes to the fact that these issues all blend at some points. What our health system is doing is something that our climate resilience folks are also focusing on, and now what our engineering teams are talking about with our nursing schools. Artificial intelligence and technology and those innovations are now bumping elbows with how we’re providing patient care, access, and telehealth. I think that’s probably one of the coolest parts about the role.
One of the best examples is our public health school, which now has a joint degree with our Rosenstiel School of Marine, Atmospheric, and Earth Science to help tackle those issues. Our medical students now can understand public health issues on a level that is backed by science and then applied in the community they’re serving. These innovations and target therapies are at the forefront of a community facing these issues and I think that makes it really unique, especially in Miami. We’re the gateway to the Americas. We’re a diverse community, and our health system and our enterprise as a whole reflects that. If you look around at our patient population, our physicians and those of us that work at the university mirror that and we’re very proud of that. It brings a different cultural awareness, a different perspective.
You spent several years working in the Florida state legislature. What was that experience like, and how did your time as a Chief of Staff for then-Sen. Joseph Abruzzo (D) impact your approach to advocacy now? What are one or two takeaways from your time in the legislature that stuck with you?
I will forever credit that as a founding pillar of becoming passionate about this work. I don’t think people, including myself, until I started working in the field, understood the impact that policy and budget and those decisions have on your day-to-day life. I remember walking into the Senate office and [learning that] in 60 days in the state of Florida, you could change a stop sign from red to green, but you could also revise an entire life insurance policy or change a physician reimbursement, or how a public investment can change the trajectory of a program or lack thereof. I got to work for a member who really was bipartisan and a moderate, so although he was a Democrat in a Republican majority, he was a chairman. How he did things taught me how I would want to function and operate and be a part of that space. There really is more of a middle ground than one might see or hear. I think that’s a big part of how you communicate effectively [as well as] understanding that you must find opportunities. You’re not going to win them all. Our approach is often different, but our end game is often the same. [It’s] okay to take a different route to try to find that happy medium. That really translated [into] how I advocate now. It’s not about the whole all the time. It might be about chipping away at it. It might be the opportunity to start the conversation, to plant the seed, and to then work at it year over year.
Not everything’s going to happen immediately and expediently. We must evolve with that and really choose to find what that looks like.
What are UHealth’s top advocacy and policy priorities at the federal and state levels? How do these priorities align with the health system’s mission to serve the community, and how do you balance your federal and state advocacy?
Health care is a huge part of our overall portfolio. We have a lot going on: Climate resilience, coral restoration and preservation, keeping up with the times and innovation in terms of 3D printing, and navigating a new world of transportation and infrastructure. With the health system, innovation [is a priority]. How do we continue to be at the forefront of quality care with access and find unique ways to continue to reach populations that otherwise wouldn’t have access, especially as a hospital system with specialty care? In terms of our advocacy policies, first and foremost [we’re focused on] reaching those patient populations through unique programs and continuing to grow our clinical care footprint. [From] our uniquely developed cancer care programs and interventions that are now mobile on wheels [and] HIV intervention programs, to school health in our underserved communities, our outreach from lab to community is important.
It’s a pipeline. You start at a young age, you focus on preventative care, you focus on cancer screenings in the community with folks that may not be able to reach you. You get somewhere over time. I think another part of that now is obviously with telehealth and data health science and artificial intelligence (AI). How are we utilizing today’s technologies with efficacy and with ethics in mind [to] really help comprehensive health care move the needle? Our cancer center is involved in clinical trials, but outside of just that scope, we’re working on a program right now that really changed the face of health data science longitudinally. [We follow] patient data that is depersonalized and deindividualized. Rather than being a reactionary health care system, how can we be preventative? How do we get there early and target therapies and change the trajectory of someone’s diagnosis? Everything from that to rare disease and genomic sequencing, [is our way of] trying every such way to build out comprehensive care for someone. That’s unique to be a part of in a community that sees so many varying diagnoses. Everyone has a very different and unique background.
How do you balance the federal advocacy needs and the state advocacy needs or how do you balance those priorities if you can at all?
At times, there are differing stances and it can be a challenge. Sometimes they go directly head-to-head, but I will say we navigate that well and we know that we have great partners. I very much believe in continuing to advocate in a positive light about what we are doing and how that is different. At the end of the day, that is really what resonates.
We’re very grateful to our state and federal partners because I think, regardless of what you hear sometimes and the noise, we are very much benefiting from a lot of the work that is happening and we’re moving the needle. It may not be in the ways that everyone feels and thinks [is best], but whether it’s a budget that gives us funding to try a pilot-scale program or a larger scale opportunity, it’s an investment and a public-private partnership. Maybe [we] don’t even change how someone thinks, but to have them think twice or to help us work through an issue allows us to make a difference eventually, if not in that moment.
What advocacy achievement are you most proud of? This can be any year or at any level (state, federal, local).
Our president says we’re a private university with a public mission, and that’s across the entire enterprise. Our HIV and AIDS prevention mobile vehicles and the PrEP vehicles think outside of what the norm would be. They’re not just a stationary clinic, they’re on wheels and they’re branded differently so that folks feel comfortable enough to come up to them. They’re hosted in a hotel in Miami Beach where we know a patient population needs to be served but wouldn’t otherwise feel comfortable seeing us.
The ‘Game Changer’ vehicles by the Sylvester Comprehensive Cancer Center did just that. They changed the game for how we serve communities. Being a part of advocating for things that move the needle, [like the] Firefighter Cancer Initiative (FCI), a true gem of a program came about because a firefighter called after his friend was diagnosed and ultimately passed away and said, “Hey, something’s happening to our population. Can you all help?” I think it’s one of the highlights of academic hospital systems and the work we do.
We are the national leaders in a program that is a comprehensive, dedicated cancer line for firefighters across the nation. [We have] wearable bracelets that now track carcinogens that are then tested. The incredibly faculty and physicians leading that charge now have a better understanding of how the carcinogens seep in through the pores that are opened up in the heat when our first responders are running into burning buildings for us. FCI got to help change policy due to their science, research, and community efforts — helping firefighters better understand why they should shower within an hour, why that badge of honor for[them] of remaining dirty with soot on [their] gear is no longer what makes [them] a hero in our eyes, and how [they’re] taking that home.
Things of that nature that really change someone’s trajectory. Now FCI has a mobile vehicle. It goes to fire stations, because they learned through their interactions with the firefighters that shift work often precludes people from doing their annual visits or having the time to, especially for female firefighters who have other responsibilities sometimes at the home. Now they get their annual [visit] done and we’re able to provide continuity of care that otherwise wouldn’t have existed. [We offer] decontamination kits that are simple but give [firefighters] some soap and a cloth that hopefully change [their] outcome in the long run. It’s incredible to be a part of a health system that really looks around our community and says, “You know what? How do we better that? Let’s figure it out. Let’s try to tackle it.” It’s an incredible privilege for me.
Tell us about the collaborative efforts that go into achieving your legislative priorities. How do you engage with policymakers, community-based organizations, and additional stakeholders to pursue health care policies that support your patients in the Miami region and Florida as a whole?
One, we listen to our stakeholders, which obviously is the university that we serve, and then the community. We stay at the forefront of what that innovation looks like to ensure the work of our amazing students, faculty, physicians, and others alike is reaching the decision-makers and helping to inform and message on the importance of these programs. Beyond that also, especially in the last couple of years, [we brought in] the data perspective. I know the Association of American Medical Colleges and America’s Essential Hospitals really worked with us on some of the reimbursement conversations that are happening right now.
[We personalize] that outreach. Everyone has a story. Everyone has a background. Someone is touched by cancer, someone understands Alzheimer’s disease, someone has been faced with an unfortunate situation at a hospital system or a doctor’s office. Let’s change that. Let’s talk about that. Ensuring that we continue to tell that story [and detail] what that collaboration looks like [is important], not just with you all as our national associations, but also bringing it back home right to community-based organizations that have the trust of those that see them most often.
Two is listening to the community because they’re a trusted partner. Finding access in ways that resonate, including tailoring messaging [to overcome] language and cultural barriers. Taking into consideration that maybe what we say in certain parts of the community or how we do it is going to look different [for other] populations. All of this plays together.
I think a big part of our work now is not just siloing off the various governments. There’s so much that flows from the federal to the state to the local. We’re all after the same mission, and we all want to do something good.
Could you provide a recent example of collaboration that led to a desired outcome?
Rep. Debbie Wasserman Schultz (D-Fla.), who’s an incredible advocate for cancer research and cancer care, a survivor herself, hosted her first annual cancer survivorship summit, and the Sylvester Comprehensive Cancer Center participated in that with our community outreach vehicles and tabling as a resource fair. Second to that, a panel where our leadership spoke about the work that we’re doing with survivorship care and how it doesn’t end when you walk out of your appointment.
It brought together so many of the incredible moving pieces that occur. From weighing in on important cancer prevention, detection, and survivorship legislation, to advocating for policy change driven by experience and scientific findings, to informing the community of what’s available to them right now — it really showed how things come full circle when you work together and stay at it as a team. Piece by piece.
Florida has increasingly found itself center stage for politics in the United States. In what ways have you felt Florida’s political landscape impact how you do your job? Is this attention beneficial to your policy priorities in any way?
There’s always going to be different sides of an issue and different perspectives. The beauty of what we do is getting to bring all that to the table together and discuss it. Sometimes it’s for education purposes, sometimes it’s to debate, and sometimes it’s to disagree, and that’s okay too. It’s okay to know that we’re going to stand on a different end of [an issue], but we [don’t] always have to be the loudest in the room. It can just be simply, “We’re not there yet.”
It’s a challenge but I do think it’s made me a stronger advocate to understand those nuances and learn to work within them. I’m a firm believer, even working at the state level, you don’t just jump. Every time you see something, you use your discretion. After you’ve been in this industry for over a decade, you get the lay of the land. It’s changed a lot in the last couple of years. You choose when to engage and/or when to stand back and wait it out.
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