Community Health Collective

Section 504 & ADA Compliance: What Every Health Center Leader Needs to Do Before the Deadline

Section 504 & ADA Compliance: What Every Health Center Leader Needs to Do Before the Deadline Hosted by: Jill Steeley | Guests: Steve Weinman, FQHC Associates and Jen Garces de Marcilla, FQHC Associates EPISODE OVERVIEW Section 504 of the Rehabilitation Act has always required organizations receiving federal funding to provide equal access to people with disabilities. The May 2024 HHS final rule made it explicit: digital accessibility is part of that obligation, and FQHCs are squarely in scope. With the compliance deadline extended by one year to May 2026, health centers have a real window to act—but most leaders aren’t yet aware of what the rule requires, where the litigation risk is greatest, or what it actually takes to demonstrate good-faith effort. In this episode, Jill is joined by Steve Weinman and Jen Garces de Marcilla, both of FQHC Associates, to break down what the rule actually covers, what NOT to do, and why digital accessibility is one of the clearest patient experience opportunities health center leaders are going to get this year. DISCLAIMER Nothing in this episode constitutes legal advice. Accessibility compliance is an evolving area. The goal of this conversation is to help health center leaders understand the rule, reduce barriers for their patients, and demonstrate documented, good-faith effort toward compliance. IN THIS EPISODE, YOU’LL LEARN • What Section 504 actually requires now that digital accessibility is explicitly in scope • The new compliance deadline (May 2026)—and why “I have a year” is the wrong mental model • The specific digital surfaces this rule covers: websites, patient portals, online scheduling, mobile apps, kiosks, PDFs, EHRs, and embedded third-party tools • How AI-powered “secret shoppers” are scanning websites for noncompliance—and why even small health centers are exposed • Why accessibility widgets and overlays are NOT a compliance solution (and may make things worse) • The most common, lowest-cost, highest-impact fixes: alt text, color contrast, captions, keyboard navigation, screen reader compatibility, and accessible PDFs • Why “we’ve never had a complaint” is not a defense • What “good-faith effort” actually looks like—especially when your EHR vendor isn’t compliant • How to handle vendor contracts and renewals going forward • The patient experience angle most leaders are missing—and how accessibility supports transformational, not transactional, care • Why accessibility benefits temporary disabilities and aging patients, not just permanent disabilities • Where the budget realistically comes from—and why a properly optimized website pays for itself KEY TAKEAWAYS “It’s not just a compliance issue. It’s not even just a legal issue. It is a patient experience issue as well. Patients are looking for more of a transformational healthcare experience now rather than a transactional one.” — Jill Steeley “By making things accessible for people who might have disabilities, you’re actually making them more accessible for everyone. It’s not necessarily just for people that have permanent disabilities.” — Jen Garces de Marcilla “If you do it right, it pays for itself, because if you’re not running at peak efficiency, you are hemorrhaging visits and patients.” — Steve Weinman FREE 504 TOOLKIT To request a free 504 Toolkit, email http://jill@jillsteeley.comjill@jillsteeley [http://jill@jillsteeley.com].com with “504 toolkit” in the subject line. MENTIONED IN THIS EPISODE • FQHC Associates — Steve and Jen’s firm, available for accessibility audits and consulting at http://www.fqhc.org/fqhc.org [http://www.fqhc.org/] • Steve Weinman direct contact: http://sdweinman@fqhc.orgsdweinman@fqhc.org [http://sdweinman@fqhc.org] • CEO Bootcamp — Jill and Steve’s program for FQHC leaders (www.fqhc-ceo.com [http://www.fqhc-ceo.com/]) • Leadership Academy — Jill’s online masterclasses (www.jillsteeley.com/leadership [http://www.jillsteeley.com/leadership]) CONNECT & SUBSCRIBE If this episode was valuable to you, please: • Leave a rating and review • Subscribe so you never miss an episode • Share with a fellow health center leader who needs to hear this Have a topic request or feedback? Jill would love to hear from you.

Your Best Clinician Just Became Your Biggest Retention Risk

EPISODE 27: YOUR BEST CLINICIAN JUST BECAME YOUR BIGGEST RETENTION RISK In this episode, Jill tackles what she calls the single biggest unaddressed crisis in healthcare workforce sustainability right now — the untrained leader problem. Healthcare is one of the only industries that consistently promotes people into leadership positions based on their technical skills, then expects them to figure out the leadership skills on their own. The result? Brilliant clinicians who are drowning in roles they were never trained for, and entire teams paying the price for a gap nobody is closing. Jill shares the story of a private coaching client — a nurse promoted into a Clinic Director role who was working sixty-hour weeks, losing staff, and starting to wonder if she was cut out for leadership at all. Six months of structured leadership development later, the picture had completely transformed. The skills are teachable. But only if we decide to teach them. If you're a CEO, executive director, medical director, or anyone responsible for developing leaders in a healthcare organization, this episode names what most people aren't naming out loud — and offers a clear path forward. In this episode: * Why healthcare promotes brilliantly and develops terribly — and what it's costing all of us * The question every leader should ask themselves: How did you actually learn to lead? * The pattern of the clinician-turned-leader, and why "she'll figure it out" isn't a strategy * The identity shift every clinical leader has to make to stop drowning * The story of one coaching client's six-month transformation from burnout to sustainable leadership * Why leadership development in healthcare isn't separate from the mission — it IS the mission * Four practical things every health center should do to develop their leaders before crisis hits Statistics cited in this episode: * 57% of employees have left a job specifically because of their manager (DDI Leadership Research) * 58% of employees cite their manager's management style as the primary reason they quit a job, up from 37% just eight years earlier (BambooHR, 2025) * 90% of employees say their boss influenced their decision to leave their last job (BambooHR, 2025) * 50% of employees have left a job at some point in their career "to get away from their manager to improve their overall life" (Gallup, study of over 7,000 adults) * The average cost to replace a single staff RN is now $60,000 (NSI National Health Care Retention Report, 2026) * Hospitals are losing an average of $5.2 million per year to nurse turnover alone (NSI, 2026) * National RN turnover rate is 17.6%; behavioral health is over 22% (NSI, 2026) * Hospitals with high nurse turnover see a 7% increase in patient falls, a 12% rise in medication errors, and a 15% decline in patient satisfaction scores * 35–54% of the US nursing and physician workforce reports symptoms of burnout Resources mentioned: * Jill's Leadership Academy — comprehensive leadership program for healthcare leaders (doors opening soon) * The CEO Connect Bootcamp [http://www.fqhc-ceo.com] — Jill's twice-yearly executive program co-led with Steve Weinman * Jill's Healthcare Leadership Style Quiz [https://quiz.tryinteract.com/#/682b31167585b8001515c383] — free assessment to identify your leadership style and give you actionable next steps to develop your leadership skills Connect with Jill: * Website: https://www.jillsteeley.comwww.jillsteeley.com [https://www.jillsteeley.com] * Leadership Masterclasses: https://www.jillsteeley.com/leadershipwww.jillsteeley.com/leadership [https://www.jillsteeley.com/leadership] * Schedule a conversation (link to Jill’s calendar [https://calendly.com/jill-v7c/30min]) * Email: jill@jillsteeley.com [jill@jillsteeley.com] If this episode resonated with you, please share it with another healthcare leader who needs to hear it. Subscribe wherever you get your podcasts, and leave a rating and review — it helps us reach more healthcare leaders who are doing this hard work. The Community Health Collective Podcast — real, honest conversations about what it actually takes to lead in healthcare.

Just Say Thank You: The "No Strings Attached" Strategy That Builds Patient Loyalty For Life

In this episode, you'll learn: * Why most "patient appreciation" events in health centers are actually marketing events in disguise * The critical difference between referral-source thank-yous (B2B) and patient-facing appreciation gestures * Why healthcare runs on trust — and how no-strings-attached appreciation builds it faster than almost anything else * Small-budget ideas: birthday cards from providers, handwritten milestone cards, monthly coffee mornings * Medium-budget ideas: community BBQs, family movie nights, skating or bowling nights * Bigger ideas: holiday meal kits, new-parent care packages, patient longevity recognition * How to address the "we can't afford this" objection — including funding sources most leaders aren't using * A 5-step framework for rolling out a patient appreciation effort without it dying in a leadership meeting * Why measuring this with marketing metrics will kill it — and what to ask instead Key Takeaway "Loyalty is built through genuine appreciation, not just clinical excellence. Your clinical care is the price of admission — but the thing that turns a patient into a loyal patient is the feeling that you actually see them." Connect with Jill Email: jill@jillsteeley.com Schedule a call: jillsteeley.com If this episode resonated, please: * Subscribe so you never miss an episode * Leave a rating and review * Share with a fellow health center leader who needs to hear this

The Fractional Advantage: C-Suite Leadership Without the Full-Time Price Tag

Episode #25 THE FRACTIONAL ADVANTAGE: C-SUITE LEADERSHIP WITHOUT THE FULL-TIME PRICE TAG Hosted by: Jill Steeley | Guest: Rebecca Mankin, MPA, CGFM, ACHE — Founder/CEO, Mankin Consulting, LLC EPISODE OVERVIEW What do you do when your health center needs C-suite leadership but can't justify—or afford—a full-time hire? In this episode, Jill Steeley sits down with Rebecca Mankin, a seasoned FQHC executive and founder of Mankin Consulting, LLC, to break down the fractional executive model and why more community health centers should be using it. Rebecca has served as interim CEO, COO, and CFO for multiple health centers simultaneously, led financial audits with combined budgets exceeding $100 million, and has a track record of turning struggling organizations around—without the slash-and-burn approach. This conversation is practical, eye-opening, and directly relevant to every health center leader navigating uncertainty right now. IN THIS EPISODE, YOU'LL LEARN * What a fractional executive actually is—and how it differs from a consultant or interim hire * What a typical fractional engagement looks like: hours, duration, and scope * What size and type of health center benefits most from this model * The most common financial blind spots Rebecca finds when she walks into a health center for the first time * How to make the ROI case for fractional leadership over a full-time hire * What health centers need to have in place for a fractional engagement to succeed * How to vet a fractional executive and avoid costly mistakes * Why survival mode is the enemy of strategic thinking—and what to do instead * Red flags to watch for when evaluating fractional candidates KEY TAKEAWAYS "You don't always need more time. You need the right experience at the right time." — Rebecca Mankin "When you're inside the bottle, you can't read the label. Sometimes you need that outside perspective." — Jill Steeley "Every system we improve, every process we fix, ultimately impacts the patients and staff in these centers." — Rebecca Mankin WHAT IS A FRACTIONAL EXECUTIVE? A fractional executive steps into the leadership team—not as a consultant who advises from the outside, and not as a simple interim filling a gap—but as an embedded leader who is in the meetings, making decisions, and accountable for outcomes. The key difference: they work a fraction of the time (typically 10–30 hours per week) at a fraction of the full-time cost, while bringing immediate, high-level impact without a lengthy ramp-up. Rebecca's firm, Mankin Consulting, provides fractional CEO, COO, and CFO services specifically to community health centers—bringing deep FQHC expertise that a generalist accountant or outside consultant simply can't replicate. THE MOST COMMON FINANCIAL BLIND SPOTS REBECCA FINDS * Lack of real-time financial visibility — no KPI dashboards, just backward-looking financials * Revenue cycle inefficiencies — gaps in workflows, undocumented processes, rising denial rates with no root-cause analysis * Misalignment between operations and finance — poor communication between departments leads to costly disconnects * Under- or over-utilization of data — too many KPIs is as dangerous as too few; track 10 meaningful metrics, not 100 THE ROI CASE FOR FRACTIONAL VS. FULL-TIME When evaluating the true cost of a full-time C-suite hire, health centers often forget to factor in: salary, benefits, recruitment costs, relocation expenses, onboarding time, and ramp-up time before the person is productive. A fractional executive eliminates most of these costs while delivering immediate impact. Rebecca's approach: identify revenue cycle gaps that generate measurable new dollars—often enough to pay for the fractional engagement many times over, and leave the health center with sustainable systems after she exits. A real example: one health center went from 6 days cash on hand to 80 days—without a single layoff. HOW TO VET A FRACTIONAL EXECUTIVE * Check references thoroughly—just as rigorously as a full-time hire * Ask state PCAs and national associations for recommendations * Look for outcome-based LinkedIn recommendations, not just tenure * Confirm they have FQHC-specific experience (340B, UDS, HRSA compliance, sliding fee scales) * Beware of executives who only offer a 'slice and dice' approach—look for a holistic, balanced strategy * Make sure they roll up their sleeves and execute, not just advise WHEN FRACTIONAL DOESN'T WORK The model isn't a fit for every situation. If a health center has no foundational finance infrastructure in place—essentially a one or two-person shop with no established processes—a fractional CFO may not be able to operate effectively. In that case, a full foundational assessment of what structure is truly needed comes first. MENTIONED IN THIS EPISODE * Mankin Consulting, LLC — Rebecca's fractional executive and consulting firm for FQHCs | mankinconsultingservices.com [http://mankinconsultingservices.com] | (660) 223-6212 * CEO Bootcamp — Jill's 5-month program for FQHC executives, co-led with Steve Weinman * Rebecca Mankin on LinkedIn — linkedin.com/in/rebecca-mankin-mpa-cgfm-ache-79980baa/ [http://linkedin.com/in/rebecca-mankin-mpa-cgfm-ache-79980baa/] CONNECT & SUBSCRIBE If this episode resonated with you, please take a moment to: * Leave a rating and review * Subscribe so you never miss an episode * Share with a fellow health center leader who needs to hear this Have feedback or a topic request? Jill would love to hear from you! jill@jillsteeley.com [jill@jillsteeley.com]

The Most Powerful Marketing Tool You’re Not Using: A System for Collecting Patient Stories

The Most Powerful Marketing Tool You’re Not Using: A System for Collecting Patient Stories EPISODE OVERVIEW Your patients are having life-changing experiences at your health center every single day. Someone finally has a doctor who knows their name. A farmworker catches a diabetes diagnosis before it gets worse. A parent who had nowhere to turn finds a place that takes care of their whole family. These stories are happening in your community right now - and most health center leaders have no system for capturing them. In this episode, Jill Steeley makes the case that your past and current patients are one of your most underutilized strategic assets, and walks you through how to build a simple story collection system and put those stories to work in three critical areas: attracting new patients, influencing the policymakers who fund you, and generating referrals from external partners like hospitals, schools, and social service agencies. IN THIS EPISODE, YOU’LL LEARN: * Why your past and current patients - specifically their experiences and outcomes - are one of your most valuable and most overlooked strategic assets * Why patient stories have a 270% higher impact on someone’s decision to choose your health center than any brochure or flyer you’ve ever printed * A simple four-step story collection system you can start building this week - no dedicated staff person, no big budget, no complicated HIPAA process required * How to collect stories in a HIPAA-conscious way before formal consent is obtained, using patient ID numbers instead of names * The three places patient stories do the most strategic work: new patient acquisition, policymaker advocacy, and external referral relationships * Why data resonates with Republicans and stories resonate with Democrats - and why you need both every time you walk into a legislative meeting * How to use patient stories internally to combat provider and staff burnout - including the “Happy Hour” channel idea * Why closing the loop with patients who share their stories turns them into long-term ambassadors for your health center * A specific challenge you can act on this week with zero budget KEY TAKEAWAYS “Your patients are already telling their story. The only question is whether you’re part of that conversation.” “Data gets you in the room. Stories change minds.” “A parent who says ‘I didn’t have insurance and I didn’t know where to go, and this health center took care of my whole family’ - that story is more persuasive than a mission statement.” “Patient stories aren’t a marketing tactic. They’re a strategic lever that directly affects your financial health, your standing in the community, and your ability to serve the people who need you most.” “Build the system. It doesn’t have to be perfect. It just has to exist.” MENTIONED IN THIS EPISODE * Vital Interaction — AI-powered patient engagement platform for automating patient communication and story collection touchpoints | Schedule a call with them here [https://guidance.vitalinteraction.com/jill-steeley] * Free Patient Story Starter Kit — includes a simple release form template and patient prompts that work in a healthcare context | email jill@jillsteeley.com with “Patient Stories” in the subject line * CEO Bootcamp — Jill’s 5-month program for FQHC executives navigating financial strategy and leadership | www.fqhc-ceo.com [http://www.fqhc-ceo.com] CONNECT & SUBSCRIBE If this episode was valuable to you, please: * Leave a rating and review * Subscribe so you never miss an episode * Share with a fellow health center leader who needs to hear this Have a topic request or feedback? Jill would love to hear from you. jill@jillsteeley.com [jill@jillsteeley.com]