Care Share Health Alliance
Helping communities coordinate care and other resources for underserved people through collaborative networks and models
Episode 10: The Power of Community Created Solutions | Listen Here
In this episode, we talk with Daniella Runyambo, Co-Executive Director, Programs & Community Impact at Refugee Community Partnership about RCP’s community led efforts to make language justice a reality for their members.
Want more Equity+ Podcast? You can find past episodes on our Care Share Podcast page or listen on Youtube!
Care Share Health Alliance is excited to welcome our new Director of Innovation and Capacity Building, Renee Harvey, MAHEd, CHES.
Harvey is a native of Washington, North Carolina. She holds an Associate in Applied Science-Medical Laboratory Technology from Beaufort Community College, as well as a Bachelor of Science in Public Health Studies and a Master of Arts in Health Education from East Carolina University. Additionally, Harvey is a Certified Health Education Specialist (CHES), and a North Carolina Rural Center Homegrown Leaders East Alum.
Harvey has a strong background in community health. She previously worked with the Health Assist Program as the Community Health Program Specialist where she assisted the uninsured population. Harvey also served as the Catalyst Coordinator for Healthy Eating and Active Living for Beaufort County with the North Carolina Public Health Foundation. Most recently, Harvey held the position of Community Health Improvement Manager for the Healthy Opportunities Pilot with Access East. The Healthy Opportunities Pilots (HOP) is the nation’s first comprehensive program to test and evaluate the impact of providing select evidence-based, non-medical interventions related to housing, food, transportation and interpersonal safety and toxic stress to high-needs Medicaid enrollees.
“We are thrilled to have Renee join our team here at Care Share Health Alliance,” says Executive Director, Weyling White, “Renee’s wealth of knowledge and passion for community is essential to our collaborative efforts, as we further expand our support of the NC Medicaid Healthy Opportunities Pilots. I look forward to our work together as we strive to improve health equity in the state.”
Harvey is passionate about supporting community based organizations’ capacity to address the social drivers of health and believes authentic community engagement is one of the keys in advancing health equity.
As Director of Innovation and Capacity Building, Harvey will guide all aspects of the NC Collaborative on Medicaid Transformation, including supporting the collaboration and alignment of interests and priorities between partners impacted by Medicaid Transformation and the continued shift towards value-based care across the state. Harvey will also lead Care Share’s work with the Healthy Opportunities Pilot to convene key partners to facilitate successful collaboration between different parts of the Pilot, as well as strengthen the capacity of Human Service Organizations for service delivery and community members’ well-being.
“Care Share is thrilled to continue to convene partners invested in strengthening health equity in North Carolina through Medicaid transformation and the Healthy Opportunities Pilots,” says Care Share Health Alliance Board Chair, Alice Pollard, “I am excited that Renee has joined the talented team at Care Share to lead this work.”
Care Share Health Alliance is a North Carolina based non-profit that builds capacity, creates networks, and partners for systems change so that communities are healthy and equitable. Learn more about Care Share at: www.caresharehealth.org.
NC Medicaid’s Section 1115 Demonstration Renewal has been posted for public comment, which includes language about the Healthy Opportunities Pilot. Please see the e-mail notice below from the Centers for Medicaid & Medicare Services about how to share public comments:
North Carolina will be requesting the Centers for Medicare & Medicaid Services renew the NC Medicaid Section 1115 Demonstration Waiver for a second five-year period, from Nov. 1, 2024 through Oct. 31, 2029. The Demonstration Waiver application has been posted for public comment through September 20, 2023.
The Demonstration Waiver, initially approved in October 2018, supports the state’s goal to improve health and well-being for all North Carolinians through a whole-person, well-coordinated system of care that addresses both medical and non-medical drivers of health, while advancing health access by reducing disparities for historically marginalized populations.
Renewing the Demonstration Waiver will allow North Carolina to build on successes and continue the work of the state and its partners, in addition to requesting four new initiatives that will help drive the Department’s overall goals. North Carolina is requesting:
· extensions of ongoing managed care authorities;
· expansion of and refinements to the Healthy Opportunities Pilot program; and
· implementation of four new initiatives focused on streamlining Medicaid enrollment for children and youth; improving care for justice-involved individuals; and investing in behavioral health.
The Department knows that public input is crucial to ensuring the Demonstration Waiver will best serve the people of North Carolina. Five public hearings will be held; three will be in-person throughout the state and two will be online. These public hearings will provide an overview of the renewal application and gather comments. To ask questions about accessibility or request accommodations, please email Medicaid.NCEngagement@dhhs.nc.gov. At least two weeks’ advance notice will help us to provide seamless access.
Tuesday, Sept. 5, 2023, from 9:30-11 a.m. (in person)
Mountain Area Health Education Center (MAHEC)
Blue Ridge A & B in the Education Building
121 Hendersonville Road, Asheville, NC 28803
Wednesday, Sept. 6, 2023, from 9:30-11 a.m. (in person)
McKimmon Conference & Training Center
NC State University, 1101 Gorman Street, Raleigh, NC 27606
Wednesday, Sept. 6, 2023, from 5:30-7 p.m.
Virtual via Microsoft Teams, join on your computer, mobile app or room device.
Click here to join the meeting
Call in (audio only)
+1 984-204-1487, 902948880# United States, Raleigh
Phone Conference ID: 902 948 880#
Thursday, Sept. 7, 2023, from 2:30-4 p.m. (in person)
Greenville Convention Center
303 SW Greenville Blvd., Greenville, NC 27834
Friday, Sept. 15, 2023, from 11:30 a.m.-12:30 p.m. (during the Medical Care Advisory Committee Meeting)
Virtual via Microsoft Teams, join on your computer, mobile app or room device.
Click here to join the meeting
Call in (audio only)
+1 984-204-1487, 412615457# United States, Raleigh
Phone Conference ID: 412 615 457#
Written comments also will be accepted by email or U.S. Mail through 5 p.m., Wednesday, Sept. 20, 2023. Please include “NC Medicaid Section 1115 Waiver” as the subject.
Email: Medicaid.NCEngagement@dhhs.nc.gov
U.S. Mail:
North Carolina Department of Health and Human Services
NC Medicaid Section 1115 Waiver Team
1950 Mail Service Center
Raleigh, NC 27699-1950
More information on the Demonstration Waiver renewal along with the draft proposed application are available on the NC Medicaid website at medicaid.ncdhhs.gov/meetings-notices/proposed-program-design/nc-section-1115-demonstration-waiver.
Yesenia Cuello may only be 30 years old, but she has a lifetime of experience to inform her work as Executive Director of NC FIELD, a non-profit working with farmworker youth, families, and H-2A guest workers by utilizing grassroots organizing principles to teach leadership, promote education, health and safety, and facilitate access to opportunities, including internships, certifications, and higher education.
Cuello was born in California; her mother is originally from Mexico and her father the Dominican Republic. When she was just 5 years old, her mother decided to move Cuello and her siblings to North Carolina, hoping to provide a more peaceful environment for them to grow up in. They eventually settled in the small town of Pink Hill in Lenoir county.
“I’m pretty sure that making the transition from California to rural Eastern North Carolina was like from one country to another,” Cuello says about her mother’s experience.
Her father had stayed in California, so Cuello remembers her mother working long hours to support her daughters. The type of work that was available for her – an undocumented immigrant who spoke little English at the time – was in agriculture, specifically tobacco, a labor-intensive crop that poses significant risks to the workers who harvest and process it.
Cuello says that growing up watching her mother leave early in the morning for work and coming back late in the evening made her and her siblings understand the sacrifices she was making for them. So, when Cuello was around 14 years old, she and her 12 and 13-year-old sisters decided they wanted to help their mother out.
“They would call us “las chicas poderosas” even back in the day,” Cuello recalls the nickname given to the three of them (which is the Spanish title for Power Puff Girls.) Like their cartoon heroes, “They said that whenever we got together, there was little that we couldn’t accomplish.”
That summer, Cuello and her sisters told their mother they were coming to work with her in the field. They wanted to help pay the bills, and maybe earn some spending money of their own to buy new school supplies. Their mother agreed to take them, which might come as a surprise given the difficult nature of working with tobacco.
“Oftentimes we do receive that question, ‘who would let their child go work in such a dangerous industry?’” says Cuello, “My mom said she looked at us and she was like, ‘these girls, they’ve just never worked a day in their lives. They don’t know what they’re asking, so I’m going to let them come with me one day. They’re going to be out there the entire time with me, and they’re going to see how hard it is, and they’re never going to want to come back.”
On what their mother had planned to be their one day in the field, Cuello and her sisters woke up very early in the morning to get dressed like any North Carolina teenager would during the summer: in t-shirts, shorts, and flip-fops.
“We were out there like we were going to a beach,” Cuello recalls, “My mom took one look at us walking out of the room we shared, one behind the other, and said, ‘I don’t know where you think you’re going.’”
“She sent us right back in. She said socks. She said tennis shoes. The most rundown jeans you have. One of those long sleeve thin plaid shirts. Definitely a hat. And we were like, it’s so hot outside!”
But Cuello’s mother had the right idea. Unbeknownst to her daughters, two of the top dangers of fieldwork are chemical exposure from pesticides and heat stress. Working with tobacco adds the extra risk of Green Tobacco Sickness – also known as “nicotine poisoning” – which can cause nausea and vomiting severe enough to require hospitalization. It also puts workers at a greater risk for heat stroke, which is the leading cause of work-related deaths among farmworkers.
Covering up the way Cuello’s mother instructed her daughters can help reduce the risk of these dangers by providing a barrier between the skin and hazardous chemicals or nicotine.
When Cuello got to the work site, she says no one asked about her or her sisters’ ages. “The gentleman just asked if we had ever done farm work before, and we said yes, even though none of us had really ever worked before. ”
She soon realized how difficult the work she had signed up for was. “For the first couple weeks I dreamed of tobacco,” she recalls.
She would work in long rows of tobacco where she couldn’t see the beginning or the end. Sometimes Cuello, who is 5’10”, would work with plants taller than herself. To keep an eye on one another, she, her sisters, and her mother would call out to each other or sing songs to keep themselves entertained. Whoever finished first would go back to help the others still working to make sure they all left the field at the same place. Usually, their mother finished first and would go back to help her daughters keep up.
“We knew she was watching out for us, but we also thought: who is watching out for her?” Was part of Cuello’s motivation to continue with field work years after the “one day” her mother had expected.
At the age of 17, while she was still working in tobacco during the summer, she became one of the founding members of NC FIELD’s Poder Juvenil Campesino (Rural Youth Power) group for children of farmworkers and youth working in the fields. It helped teach her skills for public speaking, the importance of advocacy, and provided health and safety education. In fact, joining the PJC was the first time Cuello learned about the danger of working with pesticides.
While in the youth group, Cuello also worked on a study with Wake Forest examining Migrant Farmworker Housing.
“The goal was to be able to collect data as to how farmworker housing was having a direct impact on farmworkers’ health.” She explains. During the study she learned more about the structure of farmwork in the US, such as workers who come on H-2A visas and how the migrant stream works. And, through hearing farmworker stories, about the lack of transparency in the industry.
“The youth group played such a huge role in my life,” says Cuello, “ After a few years in the youth group, I’d worked my way to the president.”
From there, she joined NC FIELD’s Board of Directors, working as the public relations chair for a couple of years before transitioning to hired staff as Program Manager, which included managing the PJC. After three years as Program Manager, she became NC FIELD’s Executive Director.
“It was a decade’s worth of transition,” she says, “But every step of it led me to where I am today.”
Some of the work Cuello has been part of has had major impacts on farmworkers all across the country. Through NC FIELD , Cuello worked with Human Rights Watch on a study that informed how the EPA revised Worker Protection Standards in 2015 – the first time since they had been created. The standards were updated to better protect farmworkers and their families from pesticide exposure by increasing the frequency of mandated safety education, which must be provided in the language the worker speaks. The advocacy also resulted in the first-ever minimum age for pesticide handlers in US agriculture.
“The fact that we were able to be a part of that, and realize that this is the kind of positive change that we can make encouraged us to continue this movement in the right direction,” Cuello recalls.
Like most organizations, NC FIELD had its work cut out for them during the COVID-19 pandemic, which in North Carolina began while the farmworker community was still feeling the effects of Hurricane Florence.
“In rural areas, we lack a lot of infrastructure, so a lot of the roads were damaged,” says Cuello, “As if transportation wasn’t already hard, during the hurricane we had to find different ways to get to the families that weren’t able to get out of their homes.”
There was another serious concern for some farmworker families beyond the difficulty of getting out of their homes after the hurricane. Cuello describes walking into one home and, “Seeing a mother who was scared to leave her house because we had a situation where somebody documented that there was an ICE vehicle parked outside of Walmart. So we were running into situations where families were scared to leave their homes to even go to the store. So they were starving in their homes with their families.”
“The things that we saw and that we witnessed were absolutely devastating,” she recalls.
Then there was a direct transition from the aftermath of Hurricane Florence to the COVID-19 pandemic, which no one was prepared for.
“We realized that because we are a fairly small nonprofit we have very little room for trial and error, so we have to expand,” Cuello says.
There was a surprising equalizing effect from the pandemic that allowed NC FIELD and other organizations like it to provide access healthcare and other services for populations like the farmworker community that may have been excluded before.
“The pandemic didn’t exclude anybody,” explains Cuello. “COVID didn’t care if you were documented or undocumented; it didn’t care where you sat in terms of society. It didn’t discriminate at all.”
Through that NC FIELD was able to, “Expand and grow and realize that the only way that we’re going to be able to even create one positive dent in this pandemic is if we work together.”
One way NC FIELD found to work together was by establishing an advisory board made up of organizations involved with the farmworker community, and reaching out directly to local health departments and community health centers. Gathering partners allowed different organizations to help one another in their missions to serve their community while also avoiding the duplication of services.
“So NC FIELD could focus on a service gap that exists that nobody else is doing.” Cuello says, “A lot of the work that we’re doing now is making sure that the community has the tools it needs to be able to advocate for themselves as well.”
An example of that work was a challenge from the community that was very familiar to Cuello: finding ways for young people to help provide for their families without having to work in the field.
Agriculture in NC contributes over $90 billion to our economy. We’re also the country’s top producer of tobacco and sweet potatoes, two crops that bring in over $500 million to the state, and could not be harvested without intensive labor from farmworkers. Despite that, a farmworker’s median salary is $29, 680. Many of our H-2A guest workers earn less than $12,000, which makes them ineligible to receive subsidies to help pay for health insurance through the Health Insurance Marketplace because they don’t earn the minimum amount to qualify.
“We did need to teach people that, yes, take children out of the field,” explains Cuello, “but this is a much larger issue in terms of how much farm workers are making and how much the industry is bringing in. The reality is, as long as extreme poverty and systemic discrimination exist, children will work in agriculture to help their families and have money for school supplies, clothing, technology, and other needs.”
And while NC FIELD actively campaigns against child labor in agriculture, Cuello says, “Sometimes that child was providing for that family and putting food on that table. So we’re advocating for a child to be at least 18 to work in a tobacco field, but that means that now that child can’t work in agriculture. That means no food is put on the table. So what are you doing to supplement some of that?”
According to Cuello, what NC FIELD did was develop a sustainable solution for farmworker children and their families:
“With PJC a lot of the work that we do is around internships on a very small scale, with help from Z. Smith Reynolds Foundation and Resourceful Communities Creating New Economies Fund, and more recently the Louise Oriole Burevitch Endowment. We’ll create educational internships over the summer; whether that looks like a garden project, or farm worker children going to labor camps with an adult ally to provide occupational health and safety education.”
“That model is our way of being able to supplement some of that income the child would have received, ensure they understand health and safety when they work in fields, and seek to limit the number of children that we have work in agriculture.”
NC FIELD, in collaboration with partners, also hosted an extensive, four-day healthcare access event in Mt. Olive that offered COVID-19 rapid testing and essential health screenings, with the help of Dr. Joseph Cacioppo and Campbell University Community Care Clinic medical students.
“We are based in the heart of agriculture at our office in Duplin County, surrounded by 30 plus farm worker labor camps, and hundreds of field and meat processing workers sustaining their families.” says Cuello, “We were able to screen 606 members from the farmworker community. Even people that had been doing work supporting farmworkers a lot longer than I have said, “We’ve never seen a response like this in the last – I don’t know how many years!”
The event helped NC FIELD not only provide services for the farmworker community but also get a deeper look into how to support them in caring for their long-term health.
“We ran into the issue that now we’ve done the screenings. Now they have a general idea of their health. But we’re realizing that some people are pre-diabetic or have some other health concern, and they want to be able to prioritize their health, but at the same time with the work schedule that farmworkers sometimes have they’re not able to get to clinics. Or transportation is a big issue.”
There are more than 20,000 H2A guest workers in the state between March and November, and over half of them are in eastern North Carolina. It’s estimated there are at least as many seasonal workers, plus family members, so farmworker communities expand to between 40,000-50,000 vulnerable people during that time.
However, despite the large need in the community, and how essential farm work is to North Carolina, these workers who are part of the backbone of our state’s agricultural economy often lack access to basic healthcare
One reason, as Cuello explained, is the difficulty of getting to a healthcare provider during regular clinic hours. Many farmworkers can work from sun-up to sundown, which could mean 6:00am-8:00pm during the summer growing season. Even healthcare facilities that have a large farmworker patient base, such as certain Federally Qualified Community Health Centers, still may not have hours to accommodate that kind of schedule.
Additionally, even if they are able to get to a provider, farmworkers frequently speak little or no English, so run into a language barrier if no interpreter is available.
Finally, like the mother afraid to leave her home to get food for herself and her children after Hurricane Florence, many of our country’s 2.5 million undocumented farmworkers fear deportation as a consequence of seeking care at the wrong facility.
With the barriers the community faces, large-scale positive change for its members often has to come as a result of an indiscriminate crisis like the pandemic (where farmworkers were recognized as essential workers, although what protections they received from that is questionable) or an “act of God” like Hurricane Florence.
In fact, during the hurricane, Cuello remembers that many members of the farmworker community originally could not understand the alert messages they were sent about the storm because they were only in English, until the necessity for emergency messaging to be sent out in Spanish was brought to the attention of state authorities.
“You know, it did take a hurricane in order for that to happen,” Cuello says, “but we’re glad that it got done.”
Due to many of the same reasons it’s difficult for farmworkers to receive care, people who are not part of the community are often unaware of how it’s been excluded from basic resources.
This is something that’s not lost on Cuello, “Whenever we do highlight the work and the life of farmworkers, I still receive shocked faces, and realize there’s still a lot of work that needs to be done.”
“I oftentimes do tell people that, we’ve been knowing about these problems for a while, but we’re just glad that the rest of the world is catching up with this.”
As for her leadership advocating for her community, when asked about her leadership style, Cuello first recalls her time working at McDonald’s, “Within the first year I was transitioned into the management position. I don’t necessarily think that I’m a bossy person, but I want to say that I am a good leader in the terms of the fact that I’ve been there and I’ve done this work and I don’t ask anybody to do anything that I wouldn’t expect myself.”
She also brings up the importance of transparency with staff and within the organization, “I maintain the highest regard for full transparency and communication. It’s the only way that this is going to work even amongst us. Our communication is that we remain a hundred percent transparent.”
An example of that transparency is helping ensure staff is set up for long-term success in their careers while working at a small non-profit, “ A lot of the funding that we received throughout the pandemic has been COVID response money” She says, “So even though it supports a lot of our staff as well, they realize that some of the funding is very short term.”
“So whenever we hire staff on, we say, ‘yes, we’re going to make sure that this is how you arrive, but we’re going to make sure that with the training you receive while you’re here, you’ll be able to take that and implement it somewhere else if funding gets cut off.”
Whether they will eventually move on or not, it’s clear NC FIELD’s staff is dedicated to their work, “The current staff do not make enough for the work that they do. I don’t pay them enough.” Cuello admits, “But they also realize that with the experience they have, they can go somewhere else and make more money. And yet they choose to continue to stay with us.”
Cuello also feels that her experience and background have had a big impact on her leadership. In many ways, it’s a benefit to her work, especially in the sense that, “People are more likely to open the door to me if I look like them.”
However, she has experienced difficulties even within her own community, “I have gotten the feedback of, ‘Yesenia, you’re from the United States. You don’t know what it’s like [to be undocumented].”
“To be honest, that one sometimes ticks a nerve. I become extremely defensive, but that’s because they don’t realize that even though I am documented, I did grow up within an undocumented background.”
While many people assume that having a child who is a US citizen provides citizenship to the parent as well, that is not the case. Over 4 million American children live with at least one parent who is undocumented.
“It had a huge, huge impact.” Cuello says of her own experience, “I remember that growing up, one of the first things that I kept from people was where my mother was from. Through school, you ask questions like, ‘oh, why doesn’t my mom go on field trips with me?’ ‘Why can’t I do sports?’”
Both parents who are undocumented and their children often have worries that most of us wouldn’t even consider. “If you don’t feel good, you hop in the car and you go to the doctor. If you need to buy food for your family, you hop in the car and go to the grocery store,” explains Cuello. But it wasn’t the same for her, and isn’t for many in her community, “For us, you know, if my mom would hop in a car and leave, the possibility that she wouldn’t return was always very present.”
Studies have found having an undocumented parent has significant psychological effects on children. Just like Cuello described, these children face fears of losing their parent to deportation or have the responsibility of hiding their family member’s legal status. They, unsurprisingly, face higher rates of anxiety, depression, fear, attention problems, and rule-breaking behavior than children whose parents are not undocumented.
Still, Cuello allows her experiences to be a learning opportunity. “I made some very interesting friends, in terms of politics and how people think,” she says, “ After I share, and we can have adult, mature conversations, I let them know my mom is ‘undocumented’ – because people oftentimes use the word ‘illegal’ – and now that you know me, how can you look at me and tell me I don’t belong?”
“That is my way of helping people understand that we’re human, and we belong, and we deserve to be able to live long healthy lives.”
To organizations and individuals advocating for the farmworker community, Cuello shares an important piece of advice, “In all of my experience within this field, I’ve learned to definitely celebrate every win.”
“Realize that we’re not out there alone. We are a community and we are making a change in it. I’m very hopeful that with what attention this community has been able to garner within the last few years, we’ll be able to continue to push on this movement for positive change.”
And, of course, her passion for her community will inform Cuello’s future work,
“I am very much not only embedded in the community but a part of the community that I support,” she says, “Being able to see that direct impact and realizing that this is something great that we’re doing here, and wanting to see that forward is what has kept me with NC FIELD for as long as it has.”
“And if I can do anything to better the lives of my community and my neighbors and my family, then that’s what I’m going to continue to do.”
To learn more the work of NC FIELD visit: https://www.ncfield.org/
Safe and affordable housing has always had a major impact on the life of Josie Williams, Executive Director of the Greensboro Housing Coalition.
Williams spent her youth in an area many would consider not fit for children. “It was funny,” she says, “I was reading an article that described my old neighborhood, and it brought back memories I had forgotten about. When I reflected on that, the visuals came back,” Williams describes a neighborhood where she could turn a corner and see prostitutes, or people openly selling crack cocaine, “The cops were not around to do anything. It was out of control.” She remembers. Unsurprisingly, her parents didn’t feel safe letting her out to play or even walk around the corner to a friend’s home. “I had a lot of restrictions, especially as a girl.” she says, “I always felt trapped, and I just wanted to feel like I was free.”
Williams saw going to school as a certain kind of freedom. She was always intelligent, and regularly on the A-B honor roll, but also saw it as an escape from feeling trapped at home, “You’re a kid, you don’t get it. I didn’t understand how my environment was. I didn’t know how dangerous it was.” So, with the excuse of going to school, she had an outlet, “I skipped class a lot. I’d have this whole day I can just be out having fun like I can’t have fun in the neighborhood.”
In Williams’ senior year of high school, she gave birth to her daughter. “I know, I’m a young black girl living in a poor neighborhood. I’m a statistic.” She says, “I didn’t like that narrative. I heard it and I saw it. Even with my family I know they were thinking ‘Ugh, get your life together!’ and that fueled me, because I knew I always had a strong sense of self despite my insecurities. You can be insecure, but still know who you are.”
So Williams left school, focused on taking care of her daughter and eventually went on to gain her GED. “They give you a test to check what classes you need to take. I aced the test.” She remembers the man who reviewed her test results incredulously asking her what she was doing there. “I was like, I had to take care of my kid. I remember him saying ‘You should be doing so much more.’”
“I agree,” Williams responded.
After receiving her GED, Williams worked minimum wage jobs to support herself and her daughter, “We see the statistics all the time,” she says, “You’re making these small wages that are not necessarily a livable wage – and it’s not a housing wage. You need to make a certain amount to afford a certain apartment. I never really made that, so I was always living paycheck to paycheck.”
Tragedy struck in 1998 when her father passed away. “He was the nurturer between my parents. He was the nurturing force in my life, and a very supportive force and, a very loving and generous force in my life.” She recalls, “I say force intentionally because he was a force that held me up when I struggled. A lot. When he died, I lost that force.”
Losing the safety net of her father, along with other compounding factors of being working poor, became the catalyst that forced Williams into homelessness. “I could not afford to live.” She says, “I could not pay rent on time. I lost everything with my apartment and my father within a 30-60 day time span.”
During that period, Williams asked her mother to take care of her daughter, but couldn’t bear to tell her the real reason why, “My mother was taking care of my dad, he was dying, and she also had my uncle who had a mental issue, and my brother was living with her. I could not bring myself to put more on my mother.”
Which meant that Williams had no place to stay. For the next year, she lived in her car. All the while, she worked every job she could find, but none ever paid enough that she could afford a place to live. Sometimes she would manage to stay with friends, or could pay for a hotel room, but there were times she had no other option than to sleep in her car. One of those nights, sitting in a parking lot in the middle of a thunderstorm with nowhere else to go, she made a promise. “I was like, ‘God, if you ever get me out of this, I will always try my best to help somebody in this position. I will always try to build somebody up and help them get to self-sufficiency. I will always try to help them find housing.’”
Eventually, Williams landed a full-time job that paid 9 dollars an hour, but at that wage it was still difficult to afford a place to live, so she looked for assistance, “I went to try to get housing at social services and they told me I was 5 dollars over the limit.” She remembers, “They told me to sell my car that I had been living out of. That was my livelihood. That’s how I got around. It’s honestly how I got the job, so I couldn’t sell my car.”
Reflecting on that experience, Williams adds, “It’s not that I condone it, but I understand why someone would work the system. That’s why I don’t speak on that – I don’t speak on it because I understand why you work the system. The system doesn’t help you elevate or build up. It confines you.”
What ultimately brought Williams out of homelessness was the generosity of a stranger. Although she only had 50 cents in her bank account, she went on a tour of an apartment complex. At the end, she told the property owner, “Well, I really like it and I’d like to move in, but I don’t have any money.” Then, she had to tell him her story, “I had never told anybody. At that time nobody knew and so he was the first person I told. I remember I was like, ‘I just need some help. I just need somebody to give me a break.’”
Somehow, he gave her a break. The property owner not only gave her the keys to the apartment but also kept the lights and water on for three months in his name. “In the midst of that, I learned what support is.” Says Williams, “I understood that generosity is oftentimes the only thing that will help elevate someone when they’re coming from such a low place. I understand that no matter how hard you work and hustle, you will come up short every single time unless someone gives you the support that you need to elevate.”
It took Wiliams a decade to fully recover financially from being unhoused for a year, but even while she was struggling, she made her daughter’s education a priority. “I didn’t know honestly how she was going to get to college. I just knew it was never an option for her not to go.” She even offered her daughter an extra incentive, “I was like, ‘If you go to school, I’ll go to school.’”
By the time her daughter was accepted into UNC Charlotte, Williams was finally in a stable place in her life. For the first time, she had affordable housing and a decent paying job. “I was so comfortable, living my best life,” she recalls, “Enjoying freedom from a kid, living pretty much healthier than I had ever in the last almost decade.” But then she describes one evening where she was sitting on the couch, eating Cheetos, when out of the blue, “I heard this feeling saying, “Remember your promise.’ In that moment it was so clear. I got up immediately, went to my computer, and started looking for colleges.”
The promise wasn’t just the one she’d made about attending school with her daughter, but also what she had promised God on that stormy night in the parking lot: to help others out of situations like the one she had been in.
Williams started to look for an academic program that would help her develop skills to do just that. “I wanted to learn how to create change, like what I just experienced. In homelessness is where I learned systems, I learned systems perpetuate homelessness, systems perpetuate the racialized social structure that we live in, and I needed to understand how to fix that.”
Eventually, Williams found what she was looking for at Guilford College, where she graduated in 20016 with a degree in Community and Justice studies.
“If you can imagine criminal justice, community justice and social change wrapped into a degree that’s community justice studies,” Explains Williams, “You can imagine how when I read the description of it, it resonated so profoundly with me.”
After graduating, Wiliams was hired by Greensboro Housing Coalition, where she worked with Collaborative Cottage Grove, a Community Centered Health group of partners working on social determinants of health and focused on alignment of health and housing. “When I started, they had four partners,” she says, “I know in six months they went to 10, maybe 15, and I know those relationships are still going on.”
Despite her success with Cottage Grove, as well as being the recipient of various awards, and giving at least seven national presentations – one of which was at the National Academies of Sciences, Engineering, and Medicine – Williams finds it difficult to see her accomplishments in the same light that others do, “I just feel like I’m helping people.” She admits, “I don’t even comprehend the depth and the breadth of the work that I’ve had my hands on.” Describing her reaction to being asked to speak at the National Academies of Sciences, Engineering, and Medicine, she says, “I didn’t see that as a success. I saw that as they asked me to speak, and I was helping them out.” To be clear, Williams doesn’t say that out of arrogance, but humility. “When they asked, I didn’t even know what the National Academies of Sciences was because of how I grew up. My life experience just contributed to me not being able to do a lot of things.”
Perhaps because of her humility, Williams had a difficult time entertaining the idea of applying for her current position. “The only reason I did,” she says, “Is because I started feeling like a hypocrite.” She describes feeling a force rising deep up inside her, that made her realize she wasn’t applying because she didn’t feel like she could do the work. “That started bothering me.” She says, “Honestly, I feel like it was a divine presence, or I just had this epiphany: if you don’t apply for it, you’re a hypocrite. You’re out here sharing and helping to lift voices, helping people understand that they have the power to create change, so if you don’t believe that you have the power to create change, what says that about you?”
Williams began her role as Executive Director of Greensboro Housing Coalition in April 2020 and was immediately faced with the challenge of keeping her organization’s doors open during the height of the Coronavirus pandemic while also having to pivot to a model where services could be provided safely during a global pandemic. “I refused to lay off my staff,” says Williams. Rather, she leveraged the relationships she had developed with funders while working with Collaborative Cottage Grove, “I had that connection where we were able to have the communication and to identify what we needed that not only helped maintain but sustain us. That’s how we got the money to update our technology to keep providing the services. So right now, here we are a 30-some-year-old organization that never did virtual, and we are forever changed because we have the tech and capability to work hybrid.” Williams also notes that the ability to provide services virtually makes them more accessible to her clients, “It broadens our scope and reach where you don’t have to come inside the building to get something done. We can just take care of you remotely.”
Williams brings a unique ability to relate with the people she serves at the housing coalition, which she attributes to the hardship and lack of security she experienced while growing up and experiencing homelessness, “You feel like you don’t have the support,” she explains, “You feel like no one’s going to do the changes that they claimed. You just feel inadequate and so when you feel like that, you’re not always quick to move in a direction that could be very positive because you just feel so inadequate.”
“I get very defensive when you come at people wrong; when you don’t know their story and you assume that they’re just lazy,” she adds, “Or you assume that they don’t want something good in their neighborhood like you definitely want in yours. My advocacy wheels get very high.”
She brings that same energy of support and relatability to her staff, “I like consensus. I like group work and teamwork.” She says about her leadership style, “I thrive in that, and I like a democratic process. I lead and treat people in the way that I want to be treated.”
While deeply committed to her work, Williams admits that the role of Executive Director has sometimes been difficult for her. She is explicit when she talks about the challenges she’s faced as a black woman leading a non-profit, “I wholeheartedly believe if I was a white male, I would have a different type of support financially.” she says – and she isn’t wrong. Studies show that black led nonprofits receive considerably less funding overall than white led non-profits, and non-profits led by black women receive less than those led by white women or black men.
There were times when Williams doubted if she’d made the right choice to apply. “I know the non-profit world is hard. It is a man’s world; you have to fight harder when you are a woman. Then you couple on my black skin, and the stuff that you read about became alive and in color.” She says, “I don’t think I was fully prepared for that. It was very unfair and it’s sad when people are walking in racial bias and don’t even know it.”
Her advice to other people of color in leadership roles is to “Remain true to who you are.” She says she fought the urge to act in certain ways when it wasn’t true to her personality. “I think people lose sight of who they are sometimes because they feel like they have to show up a particular way to be heard. I’m here to say I don’t believe you have to do that all the time. I don’t believe you have to do that as much as we think we have to, because your work and your value system will show up and speak for itself. Being yourself and operating in your value system, that’s the best path that you can be on.”
Williams also has a new project on the horizon. Her work with Collaborative Cottage Grove will be featured in a short documentary coming out later this year that highlights three communities across the US working together for change. After the production crew worked with Williams, they realized they needed her help with their project. “They asked me to come along to help them understand what they need to highlight, because they have recognized that their experience is unlike the experiences of the folks in these communities, and they want to make sure that they really have the essence of our work.”
Given everything she’s experienced and accomplished, it isn’t a surprise that Williams is sometimes amazed by the path her life has taken. “I went from living in a neighborhood where I could have been killed or raped, on drugs, got involved with crime or anything, to finally getting into school after being homeless, and now I’m running an agency where the priority is helping people get housed.” She says, “The evolution of that – God is bringing my dreams to fruition. I am very grateful and humbled by it.”
References:
The Chronicles of Philanthropy, “Nonprofits Led by People of Color Win Less Grant Money With More Strings (Study)”
Emergent Pathways, LLC prepared for ABFE: A Philanthropic Partnership for Black Communities, “The Case for Funding Black-Led Social Change. Redlining by Another Name: What the Data Says to Move from Rhetoric to Action“
Care Share Health Alliance is excited to share a new series of articles on North Carolina’s BIPOC leaders working in the health equity space. Our first entry features Chester Williams, founder and Chief Empowerment Officer of A Better Chance, A Better Community.
A Chance, a Better Community (ABC2) is an organization serving Northeastern North Carolina that connects rural communities with resources to activate youth power and advocate for realistic solutions and healthier lifestyles.
Chester Williams, Chief Empowerment Officer and founder of ABC2, says the idea for the organization originated in a journal assignment he was given in the eighth grade that asked him what change he’d like to see in his community. “I literally wrote A Better Chance, A Better Community,” says Williams, “but more so, allowing young people a part in community change.”
Growing up in rural northeastern North Carolina, in the small town of Enfield, Williams was taught a traditional road to success as a young man: focusing on school to get into college and start a career – a type of success that meant leaving his community.
“That was the plan, and I followed that plan, but I didn’t understand the vision that I wrote down was something that was going to come back to me later on in life,” he says.
Williams graduated from Southeast Halifax high school as an honor student and went on to A&T University where he majored in mathematics and professional theater, with a minor in business. After graduation, he spent time in Switzerland working with a math symposium, then returned to NC to work at Halifax Community College, where he started their math lab. He then went on to pursue a master’s degree in mathematical physics at Indiana University (“Yes, I am a nerd,” he laughs), afterward teaching in the Indiana school system for a time.
At the end of 2011, Williams’ grandmother became ill, so he returned to Enfield to help support his mother. Now back in his hometown as an adult, he began to think about what it was he really wanted to do with his life.
“To be in a space with family and reconnected with the home was a very interesting time,” says Williams, “Because me leaving Enfield was to get away, because I felt there was nothing here, the rural community was boring, but, then coming back in 2012 was a different perspective. I saw the hidden beauty in the gems of Halifax county that I took for granted as a child because I didn’t have access or exposure to it.”
Williams especially saw the value in Halifax county’s youth, although he initially didn’t have the reception from them he might have hoped for. He recalls the reaction from students at an alumni day he attended at his former high school along with some of his peers who had also been successful in their education and careers, becoming doctors and lawyers.
“I don’t want to say the students rejected me, but they could not believe that we actually came from Halifax county or that we were a product of that school.” Williams recalls, “I was like, ‘I come from here!’. I used to use ‘I is’, ‘you is’ those things that we say, and I walked the halls, I know about the snakes in the lockers, and they were just so amazed that someone from here can have these experiences that I’ve had.”
That day sparked the creation of A Better Chance, A Better Community. “From there I identified five students to come together to start ABC2,” says Williams, “It was a way of giving the voice to them that I wanted to give to myself as an 8th grader.”
“Sometimes in a rural community, we’re looking from a hopeless lens vs a hopeful lens,” he explains, “so I wanted to be that catalyst to show to the hopeful, ‘do not be doubtful’, because you may not have the experiences, but I am a result of the experiences that I was afforded. I too have the same experiences of being in a rural community not having assets, having to go the extra mile to do the extra work in school, because I didn’t have that strong foundation in education or I wasn’t exposed to a lot of things, so that was important for me to bring that back home.”
The first area the ABC2 youth decided to work on was agriculture. So, they went on field trips to different farms and came up with the idea for a raised bed garden in the town of Enfield, over the site of torn out building. They grew onions and peppers in three raised beds and turned the abandoned plot into a town conversation piece.
“It grew and the town adopted the town square.” says Williams, “The youth saw that within their idea they sparked ideas and change in others. They saw it become part of the town culture, and even now they use it for Christmas tree lighting, and a place where they have farmers markets and events. They still feel pride in themselves for sparking that.”
ABC2 saw the success of their first project and began to implement the same type of work in other communities. Over time, they identified key areas they wanted to address: healthy foods, active living, and civic engagement. The organization is one of only two youth group councils in the state, and has also been involved in work with climate justice, party at the polls, and census and redistricting efforts.
“We take students or young people where they are in their passion and provide them the support and the resources to turn their passion into community change,” says Williams.
He recalls a young woman name Shaquesia who ABC2 helped to achieve her passion. She was one of the first five members of ABC2, a class valedictorian with a passion for cooking and baking who wanted to become a chef. Initially, she was not supported by her family, who were concerned about her ability to support herself.
“That’s not one of those common occupations that we talk about in rural communities where you can make a living,” Williams explains.
However, with the help of ABC2, she was able to get her parents on board with the idea of her attending Johnson and Wales in Charlotte, NC. Williams saw her again in 2017 when ABC2 hosted an event on their community farm and Shaquesia registered as a vendor with her very own food truck. The first thing she did when she arrived was to give Williams a hug.
“She said it was because of you. You gave me the purpose and the passion to believe in myself that I could be a chef”, he recalls, “And today I’m a chef because of you and ABC2. When everybody else was telling me no, you told me yes and you provided me the support and the resources I needed’
William remembers at that moment, “It became real for me that we’re impacting lives”
Not only does the type of youth-led community change undertaken by members of ABC2 inspire young people like Shaquesia to strike out and pursue their dreams, but it also helps them develop a deep connection to their rural community that encourages them to want to stay there.
“So they’re not leaving how I left here,” says Williams, “feeling hopeless, feeling disappointed, feeling like a failure leaving my community where I had to go somewhere else to find happiness.”
He tells the story of another ABC2 member who ran for school board at the age of 22, “He was freshly out of school, so he still had a perspective. He didn’t think he would win, but he ran, and he won. That was passion for us, that you can be young and run for office and be civically engaged. He’s still serving as a board member, and now other young people are thinking of running for office.”
However, it’s not always been easy to change the culture of a rural area. Williams admits that one of the challenges of working for change in the town where he grew up is that it’s sometimes difficult for the adults who knew him as a child with to see him as an equal.
“The intergenerational thing is real,” he says “The older generation are traditionalists, they don’t want to give up power, so I’ve found that struggle there that you were supposed to stay in a child’s place and wait until your turn. That’s a challenge for a lot of us young people in rural communities as we begin to come into our leadership and want to make change.”
Part of ABC2’s role is to change that narrative and to demonstrate how having the experiences and expertise of young people at the table can be a part of solving community issues. ABC2 is also intentional about having youth members take leadership roles in their organization. For example, during their weekly Northeastern North Carolina Connections meeting a young person has always been the facilitator.
“A young person leading the conversation, guiding the conversation, adding to the resources, has changed the whole dynamic.” says Williams, “Now they respect young people. Now they see, wow, we need more for young people. How can we get young people? But also understanding how to support other organizations and support young people and their voices without tokenizing them.”
Williams’ passion for empowering youth may stem from his own propensity for leadership roles at a young age. In high school, he was junior and senior class president, and even staged a sit-in at the principal’s office when administrators were making decisions the students didn’t like about their prom or threatened to take away their senior trip.“Now that I look back, I was a natural leader because I love people,” he says, “I love helping people find their own purpose.”
He describes his leadership style as focused on shared leadership, having multiple voices and representation at the table to get a full perspective on the issues (or, as Williams, calls them: opportunities), with a desire to, “Understand what our assets are that make us strong, build a strong foundation and then understand what those opportunities are and how do we go after them.”
Of course, like all leaders, Williams has had his share of challenges. Speaking specifically on challenges he has faced as a Black man, he says there was a learning curve for himself when implicit bias showed up in his interactions with others, based on their expectations of who and what success looks like. Sometimes, when people had only heard of his work, or not met him in person, they assumed he was White. “Then when they see I’m a black man,” says Williams, “Then the question is, ‘How did you purchase a school?’ Or ‘How did you start your own nonprofit in Halifax county?’, like a black man can’t do that.”
When asked what advice he would give to other BIPOC leaders, Williams says it’s the same as what he gives himself every day, “Be open, be honest, be transparent. Never deny who you are and your experience for others, because it’s not just for you and your people, it’s for everyone.”
“We’re in an opportune time now where we are setting the standard, setting the curve of what it means to be Black, and it doesn’t have to come from the place of hurt that we’ve experienced in the past, but of a place of being champions to show people how we as Black people want to be recognized and treated. So it’s about being accountable to ourselves and to our community.”
There’s also the challenge of going against the stereotype of what a person who is a product of an underserved, rural school system like the one Williams attended can accomplish.
“It’s been a learning curve for others to see the potential,” says Williams, “because when we talk about Halifax county schools, and say that it’s one of the lowest performing schools in the nation, but yet some of the product, like myself and others, people see us and think ‘you can’t be from Halifax county!’ Yes we are from Halifax County Schools. So stop trying to tell our stories for us and let us tell our stories ourselves”
However, Williams says he’s embracing these struggles because of the impact he sees being made by ABC2, “It’s a learning curve on both sides. It’s been awkward in the beginning, but I’m leaning into it now that I understand and we’re changing people’s perspectives.”
It’s now been 10 years since founding of ABC2. After a decade of leading the organization, Williams believes that the young man who first wrote about “A Better Chance, A Better Community” all those years ago would be proud of what it’s accomplished.
“The 8th grader in me is pleased.” Says Williams, “He has a voice, but he also gives that voice to everybody else. Young people’s voices are here, and they’re being recognized, and they’re able to make positive community change in a valuable way that’s meaningful to the community, but also meaningful to themselves, so that they are proud of where they’re from.”
Not only does Williams see young people as the future in rural communities, but also in the organization he founded, “Young people are really leading the organization. Yes, I’m the CEO, but I’m actually at a point where I’m ready to step away and let ABC2 really truly become its own. I think this year is the next level, and our young people are taking it to the next level.”
“I gave birth to something to the community, and my baby has grown and my baby is about to be a preteen, and I just amazed at how it has evolved even beyond what I put on paper, so I’m proud of it and I’m ready to see it grow and blossom into what it truly can and will become.”
To learn more about the work of ABC2 and CEO Chester Williams, visit https://www.abc-2.net/
In North Carolina, Care Share Health Alliance and Community Food Strategies are partnering to strengthen the relationships between Collaborative Networks and Food Councils to address food as a social determinant of health with the ultimate goal to improve the health and quality of life for North Carolinians.
State-Level Partners
Care Share’s mission is collaborating for health equity. The core work is to support Collaborative Networks across the state. Community Food Strategies works to empower local food councils and networks to create community-led collaboration and equitable policy change at the local, state, and national level. The ultimate vision is an equitable food system that is community driven and improves the quality of life for all.
Community-Level Partners
A Collaborative network is an entity comprised of multiple state or local partners who integrate medical, preventative, community, social, and economic resources to achieve collective outcomes through a coordinated system of care. The purpose of the networks is to bring healthcare resources to those who don’t have access to healthcare with the overall vision to improve the health of the underserved.
Food councils are community-based coalitions, often but not always organized by county, that help promote more resilient food systems. Councils build connections across stakeholders and collaborate to improve health, food access, natural resource protection, economic development, and production agriculture for all its community’s residents. Using this cross-sector approach, food councils solve broad food system issues and give communities more control over the food they consume.
There are 19 collaborative networks serving 45 counties and over 30 food councils across NC. The map below illustrates where collaborative networks and food councils exist. There are many opportunities for collaborative networks and food councils to support each other especially in the counties where both are existing.
Understanding Food as a Component of Health
Food is an essential component of health for all people. Nutrition and unhealthy diet are risk factors for several chronic diseases including heart disease, hypertension, and diabetes. In North Carolina diseases of the heart are the second leading cause of death and diabetes is the 7th. Almost 829,000 adults report having been diagnosed with diabetes by a health care professional (NC State Center for Health Statistics, 2015).
Food insecurity is a major public health problem that impacts many people in our country and state. Food insecurity is not having access or affordability to food on a regular basis. Frequently used words to describe food insecurity include hunger, malnutrition, and food deserts. According to the 2016 fact sheet Hunger in the Tarheel State, North Carolina has the 8th highest rate of food insecurity in the nation. 81% of people receiving food assistance don’t know where their next meal is coming from. 73% of people receiving food assistance have had to choose between paying for food or health care or medicine (Hunger in North Carolina). There are many opportunities to create a better food system to improve the health and quality of life for people in North Carolina.
Opportunities for Partnerships to Improve Health between Collaborative Networks and Food Councils
Encourage partnerships to address food security.
Encourage education to prevent and control chronic diseases.
Encourage access to local, fresh foods.
Encourage policy initiatives to make healthy foods an easy choice.
This is a (non-exhaustive) list of policies that support food and health.
To learn about local examples, contact Megan Bolejack at mbolejack@caresharehealth.org. To learn more about Care Share Health Alliance and Collaborative Networks visit www.caresharehealth.org. To learn about Community Food Strategies and Local Food Councils visit www.communityfoodstrategies.com
This resource explores social driver of health community partners to consider when partnering to improve the health of residents. It gives tips to consider when building relationships with partners. Download the resource in the resource section of our website.
