In the fall of 2015, when Shannon Burger was hired as a financial consultant to steer Chattanooga CARES back on track, the place was in such disarray from high turnover, loss of grants and audit woes that some staff members were skeptical she could help turn it around.
“I had one person tell me, ‘You seem really nice, but nobody really seems to make it,’” says Burger, 41. “There was kind of a pushback from the aspect of, ‘We’ve kind of given up.’”
At the time, Chattanooga CARES – short for Chattanooga Council on AIDS Resources, Education and Support – had been serving patients impacted by HIV and AIDS for nearly three decades. A few months after coming on board, while fighting the fiscal challenges and internal skepticism, Burger was named interim executive director. She later became CEO and, in 2019, the nonprofit was renamed Cempa Community Care, with a broader mission of community health and a focus on primary and infectious disease care.
Under her leadership, the once-flailing organization now operates a pharmacy, along with walk-in, dental and mobile clinics, and has won many accolades, including the Organizational Excellence Award from the Tennessee Primary Care Association in 2021 and the 2023 Latino Community Champion Award from La Paz Chattanooga. Burger has also spoken at national conferences and testified in congressional hearings.
“I just hit the ground running,” she says of those first few months. “I wasn’t going to accept any kind of defeat.
“As a kid, age five in kindergarten, I wanted to be the first woman president,” she adds. “I knew that I wanted to be an advocate for people. I knew that I wanted to implement change on their behalf. Really, my ‘why’ in life is to make the impossible possible.”
As she heads into her 10th year with Cempa, Burger reflects on rebranding, switching careers and what the future holds.
You were running Vertical Consult, your own rope contracting and training company for those who work in high places, when you got involved with Chattanooga CARES in Oct. 2015. What prompted you to do that?
“I had just gotten my CPA license and I wanted to do some more work. I don’t like just sitting around, and my business was kind of running on its own.
“So I reached out to a friend of mine and they were looking for a financial consultant for Chattanooga CARES because of some of the issues that they had had. I really saw that (a) the patients needed it to keep going and (b) we had the chance to be a valuable health center for the community. And that was desperately needed.
“At that point, I kind of let somebody take over my business and I have since given that business up completely. I put everything I had into what I was doing here because I found something that I love and believe in.”
What were your initial goals?
“They needed someone who could dive in and understand the programmatic requirements that they had in their current state. Being a CPA, I was able to come in and figure out: Here are the things that we’re charged with doing and here are the things we are doing, we’re not doing, we’re not doing well.
“So first, let’s get our business in order, get us back into compliance, and once we get that running, let’s see how we can grow into a sustainable model.”
What were some of the early challenges?
“We had several litigation issues, board issues, personnel issues, you name it, along with the grant obligations and risks and audit findings. What we were able to do was really unify as an organization and say, ‘We’re not going to let our patients down.’
“So we really just got things in order internally. We got a clearer understanding of what was required of us and, department by department, made the right corrections to get everything back on track. And then we talked with patients.”
What did your patients tell you?
“A lot of our patients were telling us, ‘While Chattanooga CARES is a great name and a great brand, when we walk in the doors, we feel like we’re branded and there’s stigma to that.’ The other thing they said is, ‘A lot of us want to bring our family, our spouses, our partners to utilize the health care services.’”
What was the first thing you did differently?
“We had the incredible doctors in place to do infectious disease really well. We were only doing HIV, so the first thing for us was expanding into all infectious diseases, other STIs, particularly hepatitis C. That was our first big expansion.”
How difficult was it to steer the organization in a new direction?
“I am not known to be an overly emotional person, but there were nights that I cried all the way home. It was not easy. However, at the end of the day, I’m a person that doesn’t give up. I know that there are patients’ lives at stake. That outweighed any kind of hardship in making this stuff happen, because I knew what it meant to the patients that walked in this door.”
Was there any resistance to the shift away from just HIV and AIDS?
“Getting the board to buy into that was the first step, and then getting our staff was the second. It did take time, and we did lose some of our staff members along the way. But you can’t make everyone happy.”
Talk about the gamut of services you offer now.
“Our clinical services, where we offer primary care in infectious disease, and our behavioral health – that’s all in the same building. We’re here on the corner of Third and Wiehl, right across from the hospital. On the opposite end of our block, on the corner of Third and Central, we have our dental clinic. And we also have partnered with LifeSpring to offer pediatric services.
“Then the walk-in clinic is housed off Rossville Boulevard, and that’s where we will be expanding our street health program to really combat the opioid crisis. And then we keep our mobile unit parked here, at our main location, but it does go out into the community.”
Tell us more about the street health program.
“When COVID happened, we turned our mobile unit into an incident command bus and rolled out the COVID testing in the community. Well, our next pandemic, or epidemic if you will, is the opioid crisis. We also know that there’s a risk of HIV and Hep C transmission with opioid use. We’re the specialists in infectious disease, so we should be on the front lines of that.
“That’s why we’re launching our street health program, where we have a medical director, a team of nurses, social workers and harm reduction specialists that are going to go out into the field, meet people where they are and try to help them address their opioid issues.”
What else are you planning for the near future?
Expanding our behavioral health integration and offerings has been huge for us. We want to really build out that program and ask: What else is going on in your life that we can help you with? Is it talking with a clinical therapist? Or is it working with a case manager to get these other things kind of squared away in your life?
“We know that if you’re looking at the social determinants of health, access to care is 20%, and 30% is your actual tobacco use, safe practices, things of that nature. The other half is basically what you eat, where you sleep, if you have a job.
“We’re also working on a smaller transitional housing initiative for our patients who just need a little bit of help to get their life back on track. It’s not a long-term, permanent housing solution, but housing is a big issue in our area. And while we can’t solve the entire model, we can do a little bit to help our patients who are in short-term crisis.”
And what about the next 10 years?
We want to build health equity in our community. We want to ensure that there’s access to not just health care, but quality care where people can have healthy, successful lives without their health being a barrier to keep them from that. That’s a lofty goal, but I strongly believe that our team has the knowledge, the capability and the willpower to do so.
“We have a high influx of emergency department use because of various reasons. I want to see health equity and access and usage go up tremendously so that when we do have the next pandemic hit, we’re not seeing so many of our community members losing their lives or having long-term consequences.”
What kind of impact has Cempa made on its patients over the last decade?
Our team, they love the people that we serve. They don’t judge them. They see them as a person, and they meet them where they are. That has been the most incredible experience to watch. All of our patients most likely have a comorbidity, meaning that it’s not just hypertension or an HIV diagnosis. We’re dealing with several issues, so to see the compassion that’s given is just incredible.”
Can you share a success story or two?
“One in particular that speaks volumes to me was a lady that had almost lost everything, lost custody of her child, her home, her family, was living on the streets, to watch her get her life back and her health back, but then also to regain custody of her child and be working successfully. That one spoke pretty strongly to me.
“I can think of a story where a provider was having a hard time getting the patient to take their medicine. The patient was homeless. So this provider went out to the homeless camp that they lived in, every day, to give them their medication, until it became a habit. And then they would come to our health center, every single day, to get their medication.”
What are you most proud of during your time here?
“We were able to expand mostly within the same block. I’m most proud that we were able to build a sustainable model without having to leave our footprint.
“It’s very important that, while we were offering great quality care, we had a way to sustain it, going forward, that we weren’t 100% relying on a grant or a line of credit to pay our bills. That was never going to keep us in a sustainable model.
“So a lot of my work was focused on building our assets, having assets that could generate revenue for us. We purchased the building on the corner; we rent out part of it, we utilize part of it. We brought the majority of our contracts with pharmacies in-house, meaning that we’re no longer paying those management fees. We’ve brought billing in-house. I want to build something that we can sustain.”
How have you grown during your first decade at Cempa?
“This role has helped me see things through a different lens altogether. I’ve always believed in loving people and being good to your neighbor, leaving this world a better place than what you came into. But I never really got to see things through the lens of somebody who walked a completely different life than I walked. That, to me, has been the most meaningful part.
“While I may be great at business operations and creating sustainability out of a chaotic situation, or a losing situation, I never had the human side of what somebody had to live through, day to day. That has given me so much insight and ability to know why we do what we do and then to open my eyes to things that I would’ve never really seen. And it’s changed me.”