Telehealth has always interested me as a model of care to decrease barriers and increase access to care, but prior to the pandemic state of emergency there wasn’t a reimbursement model for FQHCs in primary care. We were doing some telehealth with remote specialists, bringing patients to the clinic for visits, but nothing in primary care or with remote patients. Then everything changed. Over 2 weeks in March 2020, we went from 100% in-person visits, to only 15%, the remaining 85% remote telehealth. Over the next two years, my team and I wrestled with infrastructure, workforce, and staffing for this new model and how we might implement it in ways that were equitable and meaningful to patients and their families. The objectives were constantly shifting due to a combination of internal and external forces. Ultimately, we achieved a somewhat steady state with 20% telehealth visits which are primarily integrated into our in-person clinics. The bigger issues of equity and patient experience will require continued advocacy and effort to ensure that the disparities that already exist in access do not persist in the expanded telehealth model.