Putting the “Care” in Health Care

Frances Fernandez fell in love with health care nearly thirty years ago. It happened when she got her first job in the home health department of a large hospital in Florida. That experience led her to seek a master’s in health services administration. She’s been passionate about the industry ever since.

Fernandez was born in Puerto Rico and lived in Miami for most of her adult life. Early in her career, she led an initiative to provide clients with HIV/AIDS quality health care, "regardless of their social status, place of origin, race, or ability to pay,” she says. After that, she facilitated health service administration courses at a college that served culturally diverse and minority populations.

Fernandez went on to lead a research and education foundation for researchers and scientists at the Miami Veterans Hospital. Since relocating to Minnesota with her family, she has led several health care operations: a community-based home health start-up, a senior housing facility, and a pediatric home care organization. She is also an administrator for Grace Lutheran Church in Andover.

Fernandez became the faculty director of the Health Services Management program at the University of Minnesota in March. Here’s what she had to say about her accomplishments so far, the challenges facing the health care industry, and her dreams for the future.

"It’s really amazing to witness the students' passion about affecting change in their communities."

In your almost 30-year career in health care, what is one of the things you’re most proud of?

I was the senior director of an HIV/AIDS program that served 3,500 clients. That program catered to the needs of the patient regardless of their ability to pay. The diversity of the staff and the people whom we served was really phenomenal, even back then [the program started in 1997]. It was at a time when we were learning that HIV was a disease that could affect anyone, regardless of sexual orientation.

I’m proud of having led that effort. Over 13 years we grew the program and really excelled in the services that we provided. We were the top-quality HIV/AIDS services provider in Miami-Dade County. The beauty of the program was that we developed a network of over 85 providers, from primary specialty and surgical services to mental health, pharmacy, and social services. The client could go see a private physician—not necessarily at an HIV clinic, which had a stigma attached to it—and get top-notch care. That was a life-changing experience for me. It truly honored the "care" in health care.

How did you arrive at CCAPS?

I started at CCAPS as the coauthor of a new course in the HSM program, Inclusion and Equity in Health Care Management (HSM 4521). I just co-instructed the first session of the course last spring and I’ll be the sole instructor this fall. I'll also be co-instructing HSM 3521, Health Care Delivery Systems, which is one of our core foundation courses in the program.

It’s really amazing to witness the students' passion about affecting change in their communities. It is a humbling experience to hear our students express their awareness of the need for the system to improve, and their drive to provide equitable health care for everyone.

What is your top priority as the HSM faculty director?

Influencing our future health care leaders to provide a person-centered approach to addressing health care needs while taking into consideration their cultural needs is my top priority. Respect for the individual and their family's culture and language are key to successful treatment adherence and positive outcomes. Having dedicated my life to executive health care leadership, I understand just how much our system still needs to evolve in order to provide quality individualized care.

One of the ways to get there, and what HSM and CCAPS are focusing on, is to incorporate DE&I [diversity, equity, and inclusion] into our curriculum. Whether it’s in a course on financial reporting or quality and patient safety, it should be through a DE&I lens. HSM is one of the most diverse programs in the entire university. The majority of our students come from emerging minority populations. We’re also working toward expanding the diversity of faculty and board members to make sure that not just our students but our entire program is representative of the populations we serve.

Your family is currently having to navigate the health care system as clients. What are you seeing?

In May, 2021, our 16-year-old daughter was diagnosed with end stage renal disease. That same day, our 15-year-old daughter was admitted to a partial hospitalization program to treat her mental health needs. No longer a provider, I was now a consumer of health care services—in life-threatening situations. I’m now on the other side of the health care "waiting room." Health care delivery continues to be challenging, even for experienced industry workers like me. I have seen the differences in organizations committed to excellence and quality who strive to continuously improve their services while focusing on the individual needs of their patients, as well as those that still need to improve.

I know what it’s like to leave messages for providers just to find out that there are two- and three-month waiting lists for mental health therapy for your child who is in crisis. What are we supposed to do in the meantime? It’s not helpful to be asked what type of insurance you have before even asking what services you're looking for. What if the person lacks insurance but needs the service? A life-saving service? These are some real-world challenges our future health care leaders will be able to address as we prepare them through our program.

Having the opportunity to share my experiences and those of our students and hold challenging, courageous, and constructive conversations in order to help expand the dialogue of how we can effect change in the system for inclusion, equity, and positive health outcomes in a proactive and effective way is both exciting and humbling.

"We’re also working toward expanding the diversity of faculty and board members to make sure that not just our students but our entire program is representative of the populations we serve."

What does an ideal health care system look like?

It would consist of organizations that continuously evolve and care for the changes in populations served, that provide for the needs of not only the patient but also their family and support systems in a respectful and holistic way. It would provide space for prayer, support for siblings and parents, and ask questions in a way that promotes respect for the cultural and language differences of the individual and their family. Those are some of the ways we can experience good health care delivery. By proactively treating the whole person—physically, emotionally, spiritually—we can achieve better health care outcomes. And this is what our program, faculty, and staff strive to impart to our students, our future health care leaders.

To learn more about the Univeristy of Minnesota Health Services Management program, visit the website.