Applications for the Medicaid Expansion Outreach & Education Coordinator are currently closed.
During the Public Health Emergency (PHE) due to COVID-19, states had to follow federal requirements around the “Medicaid Continuous Enrollment Condition”, and were therefore not allowed to remove individuals from their Medicaid programs. However, in March, 2023 the Consolidated Appropriations Act unlinked the continuous enrollment condition from the PHE, which allowed states to begin redetermining Medicaid recipients’ eligibility, and potentially removing them from the program. North Carolina began our redetermination process on April 1, 2023; this is called the “Continuous Coverage Unwinding” or “Medicaid Unwinding”.
Unfortunately, more North Carolinians than expected have lost Medicaid coverage during the Continuous Coverage Unwinding due to “procedural terminations”. This means that these individuals may still be eligible for Medicaid, but just need to update certain information with their local DSS.
Some may have received “Medical Assistance Renewal Notice” or “Request for More Information” letters from their local DSS and not known what to do about them. Others may not have received anything, because their DSS does not have their up-to-date mailing address.
There’s also concern that some people who received termination letters from Medicaid won’t try to re-enroll because they feel they’re healthy and don’t need coverage. We highly encourage all individuals to maintain the health coverage that is available to them so they don’t have to seek coverage in a crisis, and have access to the care they need and deserve.
Community Based Organizations can help their clients and community members understand how to maintain their Medicaid coverage, or seek other affordable coverage several ways:
Inform Them the “Unwinding” Is Happening
Many people still don’t know the Continuous Coverage/Medicaid Unwinding is happening, or that it affects them. You can help spread the word about the Unwinding with pre-made materials from NC DHHS & CMS:
- NC DHHS CCU Unwinding Toolkit
- NC Medicaid Recertification Video – 15s
- NC Medicaid Recertification Video – 30s
- NC Medicaid Recertification Video – 60s
- All Hands-on-Deck: Keeping People Covered As States Restart Routine Medicaid Renewals
- Medicaid and CHIP Eligibility Renewals: A Communications Toolkit
Make Sure Medicaid Recipients in Your Community Know 3 Key Messages:
- Update their current contact information with their local DSS
- Check their mail and open all letters from DSS
- Sign Up For an Enhanced EPASS Account – This lets you update your contact and other Medicaid information online without having to call your local DSS.
Let Them Know There are Options if their Medicaid has Been Terminated
You can help community members know what steps to take if their Medicaid has been terminated by directing them to FREE resources, like the ones below:
Who to Contact if…
I received a letter from Medicaid/DSS that I don’t understand
- Your Local DSS – Find Your Local DSS Number
- NCMedHelp.org / NCMedHelp.com
- NC Medicaid Ombudsman
My Medicaid was terminated, but I think I should be eligible:
I don’t qualify for Medicaid, but might qualify for financial help through the Health Insurance Marketplace:
- Get Covered Connector – Find local help understanding your options through the Marketplace
I don’t qualify for Medicaid, but I may qualify for Medicare:
Seniors’ Health Insurance Information Program – Find a local SHIIP Counselor to help you understand your Medicare options
I don’t qualify for any affordable health insurance options:
- Find a Health Center – Find a local Federally Qualified Health Center that could offer low cost sliding-scale payment options
- NC Association of Free & Charitable Clinics
- NC Networks of Care for Low-Income, Uninsured
What About Medicaid Expansion?
Eligible individuals will be able to enroll in NC’s “expanded” Medicaid program starting December 1, 2023.
NC DHHS Resources
- NC Medicaid Recertification Page
- NC Medicaid Beneficiary Webpage
- NC Medicaid Beneficiary Help Center
- Sample Medical Assistance Renewal Notice | Spanish
- Sample Request for More Information | Spanish
- CMS Resources
- Partner Education on Medicaid and CHIP Continuous Enrollment Unwinding Webinars
- HHS Announcement of State Flexibilities to Minimize Coverage Loss
Protecting Immigrant Families
If you have questions about how your CBO can help your community understand the Medicaid/Continuous Coverage Unwinding, Marketplace and other low cost healthcare options, contact Erin Storie at: firstname.lastname@example.org
As Thanksgiving day quickly approaches, we’d like to take this time to reflect on the things our organization is thankful for.
This year, we’ve been happy to announce new additions to our Care Share staff, including our Virtual Assistant, Kyndal Dodd, and Medicaid Expansion Outreach & Education Coordinator, Hollis Smith. Hollis is leading Care Share’s collaborative work with the NC Community Health Center Association and NC Navigator Consortium to promote Medicaid Expansion in North Carolina, which begins Dec. 1, 2023. This work is generously supported by combined funding from the Kate B. Reynolds Charitable Trust, the Duke Endowment, Dogwood Health Trust, the Cone Health Foundation and the John Rex Endowment. We are so grateful to have these – and other – important partners working together to make sure Medicaid Expansion is a success in our state!
In addition to staff, Care Share is deeply appreciative to welcome five new members to our board of directors. Thank you to Dr. Carrie Rosario, Honey Yang Estrada, Jamilla Pinder, Dr. Meredith Gringle and Yesenia Cuello for being willing to dedicate your time and expertise to our mission!
We also want to extend our thanks to all of the guests who were part of the first season of the Equity+ Podcast. Without your willingness to share your knowledge, passion and lived experience, in the service of uplifting your community’s voice, our podcast wouldn’t have been such a success!
And, although bittersweet, we are thankful for the work that our past Director of Community Engagement, Shaunessy Lofton, and Director of Innovation and Capacity Building, Jalah Clayton, have done, and the lasting impact they have made on Care Share as an organization. We wish them all the best in their new professional endeavors.
Finally, we are thankful for you, our partners, who work hard every day to make your communities healthy and more equitable. We hope that this week you are able to take time for yourself, to connect with friends and family, and have the chance to truly feel appreciated for all that you are and what you do. Have a wonderful holiday!
Episode 8: Creating Equitable Internships | Listen Here
In this episode, we’ll hear a conversation between our Director of Innovation and Capacity Building, Jalah Clayton, our former Director of Community Engagement, Shaunessy Lofton and the inaugural interns of our Equitable Health Leadership Pathways Program, Jasmine Riddle and Claire Hopkins about their experiences with both being mentors and mentees while at Care Share Health Alliance.
In this episode we’ll hear a conversation between our Director of Innovation and Capacity Building, Jalah Clayton, and Kenya Joseph of Heart and Hands Food Pantry, located in Mecklenburg County, about the unique approach the organization takes to addressing food insecurity in their community.
You can support Hearts & Hands Food Pantry via their Amazon Wishlist.
Care Share Health Alliance is excited to welcome Hollis Smith as our new Medicaid Expansion Outreach & Education Coordinator.
As the Medicaid Expansion O&E Coordinator, Smith will lead Care Share’s work promoting Medicaid Expansion in North Carolina to primarily underserved communities, educating enrollment assisters and community partners on new eligibility guidelines, and supporting their efforts to inform their communities about opportunities to enroll.
This work is in collaboration with our partners at the NC Navigator Consortium and the NC Community Health Center Association, made possible by combined funding from the Kate B. Reynolds Charitable Trust, the Duke Endowment, Dogwood Health Trust, the Cone Health Foundation and the John Rex Endowment.
“We are thrilled to see North Carolina take this historic step to expanding access to affordable health coverage,” says Care Share Board Chair, Alice Pollard. “With partners, Care Share has led collaborative efforts in North Carolina to promote health insurance coverage since we opened our doors. We’re grateful to have funding and support from partners to continue this work.”
Beginning Dec. 1, 2023, Medicaid eligible income will increase, so North Carolinians may be able to get healthcare insurance through Medicaid even if they didn’t qualify before. Most people will be able to get healthcare coverage through Medicaid if they live in North Carolina, are age 19 through 64, are a citizen or qualified non-U.S. citizen, and have a household income that is below 138% of the federal poverty level.
“The passing of Medicaid Expansion in North Carolina marks the beginning of a new era where we are able to provide eligible North Carolinians with the healthcare coverage and services they need,” says Weyling White, Care Share’s Executive Director. “I am grateful for our funders that have made it possible for Care Share Health Alliance, in collaboration with the Navigator Consortium and the NC Community Health Center Association, to provide education, community preparedness and support of Medicaid Expansion efforts to communities across North Carolina. Our newest addition to the Care Share team, Hollis Smith, has hit the ground running, and I look forward to future community engagements and healthier community members as we embark on this momentous opportunity for health in our state”.
Smith has lived in the Carolinas all of her life. She holds a Bachelor’s degree in Linguistics with minors in Spanish and Social and Economic Justice from the University of North Carolina at Chapel Hill.
Smith is passionate about a systems-level approach to achieve equity. In her previous position, she served as a Health Insurance Marketplace Navigator as part of the NC Navigator Consortium, where she performed outreach and enrollment efforts to uninsured and underinsured individuals in the High Country Region. She believes that healthcare is a human right and understands the power of the Affordable Care Act and Medicaid Expansion in creating a healthier, more equitable North Carolina.
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.
Reports to: Executive Director
Type: Full Time (40 hours per week)
This is a full-time position, 40 hours per week, requires some travel and evenings and weekends.
The primary responsibility of the Director of Innovation and Capacity Building is to direct all aspects of the NC Collaborative on Medicaid Transformation. This includes supporting the collaboration and alignment of interests and priorities between partners impacted by Medicaid Transformation and the shift towards value-based care across the state. Shared learning and further engagement will be achieved by facilitating and expanding the NCCOMeT (North Carolina Collaborative on Medicaid Transformation) convening and other convenings supporting the link between healthcare and social drivers of health, also known as the Healthy Opportunities Pilot, as part of NC DHHS’ Medicaid Transformation; providing onsite and/or virtual technical assistance for the delivery of effective strategies and services; and the development, sharing and implementation of promising practices.
Program Expansion and Management of NCCOMeT and Medicaid-related convenings (50%)
• Design, plan, and implement convenings to support the connection between healthcare and social drivers of health with a focus on housing, food, transportation, and interpersonal safety in collaboration with Care Share team members.
• Serve as an advocate and voice for historically marginalized populations, including rural communities and populations who experience health, social and economic barriers, Black, Indigenous, People of Color, LGBTQIA+, low-income, disabled, women, etc.
• Gather, create, and compile best practices, tools, and strategies for the Equity+ Network, including the identification and development of new technical assistance services for Community Based Organizations across the state.
• Review program contracts and grant reports regularly with appropriate staff; provide reports to Executive Director, funders, and partners as appropriate.
• Responsible for developing and maintaining relationships with all partners including philanthropy, NC DHHS, state, and community-based organizations.
• Facilitate peer-to-peer learning by convening in-person and virtual meetings.
• Lead internal/external multi-disciplinary partnerships to establish, implement and monitor strategy, standards, and initiatives.
• Work to achieve specific outcomes by collaborating with a variety of partners including Care Share team members, funders, Care Share board of directors, existing and new partners.
• Ensure compliance with all grant requirements.
Technical Assistance (30%):
• Provide direction and management for the implementation of technical assistance services,
including tracking services provided, dissemination and implementation of best practices,
measuring progress towards outcomes.
• Identify and develop new technical assistance services for Humans Service Organizations
support delivering services to the NC DHHS Healthy Opportunity Pilots regions.
• Work collaboratively with Care Share staff for promising practices development and
Thought Leadership (20%):
• Evaluate quantitative & qualitative data while performing high-level strategic thinking and facilitation of initiatives.
• Contribute to long-term team project planning, including identifying future activities and searching and applying for additional funding to support their designated specialty area of work.
Required & Desirable Skills:
• The ideal candidate will have experience in and be a passionate advocate of health focused on racial equity and social justice who will creatively and boldly drive organizational, and community-level public health systems change. They will have a firm understanding of public health, including the drivers of inequity and social injustice, have a successful track record leading projects and teams, and have strong presentation, writing, and facilitation skills.
• Commitment to advancing health equity, including an understanding of institutional and structural racism and implicit bias and their impact on historically marginalized communities in NC and their health.
• Strategic thinker, team and network builder, and thought leader.
• Strong ability to present to racially, ethnically, culturally, and socioeconomically diverse people and communities.
• Bachelor’s degree or equivalent combination education and lived experience.
• Minimum of 3 – 5 years leadership experience in healthcare and/or nonprofits.
• Strong facilitation and partner engagement skills.
• Master’s degree in public health, health administration, public policy, organizational
development, or other related field
• Grants management experience
• Collaborative learner who has community engagement skills.
• Bi/multi-lingual and experience working directly with racially, ethnically, culturally, and socioeconomically diverse people and communities.
• Performs other tasks and duties as assigned.
Salary & Benefits:
Salary Range: $70,000 – $80,000
Benefits include: Health, Dental and Vision, 401K with Employer Match, Life & Disability Insurance, Flexible Spending Account, Paid Time Off & Holidays
Process & Required Documents: To apply, candidates should send a cover letter and resume to email@example.com
As an equal opportunity employer, Care Share is committed to building a diverse, inclusive culture with a commitment to our values and mission. Care Share strongly encourages applicants from people of color and other diverse backgrounds.
In this episode, CSHA Executive Director, Weyling White, talks about what it’s like to be “The Only One in the Room” as Black man in public health and healthcare with our guests Brandon Allison, a Licensed Mental Health Counselor, Cornell P. Wright, owner of Wrightway Equity Solutions, and Omari Richins, Program Officer for Health Improvement in North Carolina at the Kate B. Reynolds Charitable Trust.
Note: Cornell is a member of Care Share’s board of directors.
Care Share is excited to offer this opportunity, in collaboration with Non-Profit Finance Fund, to our Equity+ Network CBOs! Want to become one? NC Community Based Organizations can join the Equity+ Network by adding your org to the Community Resource Map!
Care Share Health Alliance is pleased to partner with Nonprofit Finance Fund (NFF) to offer a virtual, introductory workshop on the financial implications of Medicaid contracting, Tuesday, October 17, 2023 from 1:30pm-3:00pm. This workshop is intended for Equity+ Network community-based organization members like you!
NFF believes that the CBOs in the Equity+ Network best understand their communities’ aspirations and challenges and have the clearest insights about how to drive healthier outcomes. We see the greatest potential for advancing health equity and the success of Medicaid Expansion in North Carolina by delivering services in a manner that follows the lead of those closest to the work in their communities.
To support Equity+ Network members’ engagement in these efforts, NFF will facilitate a 90-minute workshop which aims to have participants leave with:
- An understanding the challenges of operating and achieving financial strength in the nonprofit sector
- A greater awareness of the major ways in which partnering with healthcare could impact their organization’s financial situation
- Knowledge of resources, tools and consulting available from NFF to support organizations’ continued consideration of and planning for Medicaid contracting
Following the workshop, participating organizations can opt into a one-on-one follow-up call with NFF staff to discuss follow-up questions, their organizational priorities and potential interest in engaging in financial management coaching and consulting from NFF in the future.
NFF supports community wealth and well-being through our lending, consulting, and our work to positively influence how money flows to nonprofits. We contribute to a more equitable world by helping mission-driven organizations adapt, thrive, and drive positive change. Learn more at nff.org.
Episode 5 of the Equity+ Podcast is live! This episode features an interview with Yesenia Cuello who shares what is was like for her to grow up in rural Eastern North Carolina while working in tobacco fields with her mother and sisters, and how that inspires the work she does today advocating for farmworkers and their families as the Executive Director of NC FIELD.
It is our sincere pleasure to share that North Carolina Medicaid Expansion will launch December 1, 2023!
Although we know Medicaid Expansion in our state is long overdue, we are grateful that the over 600,000 North Carolinians eligible for coverage will finally have the opportunity to access the care they need and deserve.
We are grateful to Governor Cooper and members of the NC General Assembly for working together to reach a bipartisan solution that will benefit the health of all North Carolinians.
And, of course, we thank all of you who have continued to advocate for expansion – no matter how unlikely it seemed! Please know that the work you have done will go on to profoundly change the lives of hundreds of thousands of people in our state.
We hope that you are able to take some time to celebrate this substantial victory for healthcare justice in North Carolina before we begin the much anticipated work of helping individuals enroll into “expanded” Medicaid!
More information about NC Medicaid Expansion can be found at:
Spring 2024 Internship Program – Request for Applications
Application Deadline: September 22, 2023
Care Share Health Alliance is pleased to announce our Spring 2024 Internship Program for students at the University of North Carolina at Greensboro Public Health Education Department. We are seeking dedicated and motivated individuals to join our team and contribute to our mission of improving healthcare access and quality for underserved communities. This internship offers a unique opportunity to gain hands-on experience in the health nonprofit industry while making a meaningful impact.
Care Share Health Alliance is dedicated to collaborating for health equity and our vision is that communities are healthy and committed to healthy equity for all. Internships at Care Share Health Alliance are designed to mentor and embolden the next generation of healthcare leaders. We aim to create an environment of institutional support, structural empathy, and systemic accountability for students pursuing experiences that are transferable to their endeavors in the health professions.
Position: Program Coordination Intern
Duration: Spring 2024 semester; minimum 240 hours
Compensation: $1,800 stipend
Hours: Part-time; 20-25 hours/week
Start Date: January 8, 2024
End Date: April 19, 2024
– Currently enrolled as an undergraduate student in UNCG’s Public Health Education program
– Strong communication and interpersonal skills
– Ability to work autonomously and collaboratively
– Willingness to learn new skills
– Commitment to advancing health equity and healthy communities
– Proficient with Microsoft Outlook, Excel, Word, Office 365, Zoom and Teams (or similar file sharing platform like Dropbox, Google Drive, etc.)
– Bonus: Relevant work experience and/or related educational background in administration, non-profit operations, or healthcare settings
Internship Focus Areas:
– Professional Development
– Relationship Building and Community Engagement
– Capacity Building and Technical Assistance
– Community Health and Healthcare Access
– Nonprofit Organizational Administration
Major Duties and Responsibilities
– Attend staff, board, and other meetings
– Identify and foster strategic organizational partnerships & sponsors
– Partner with board and staff members to support health equity convenings and conference planning
– Notetaking (staff meetings, board meetings, NC Collaborative on Medicaid Transformation meetings, NC Get Covered meetings and trainings, Equity+ Network webinars, meetings and convenings), agenda development, and notes transcription
– Prepare communications such as emails, reports, presentations and other correspondence
– Write and edit documents such as white papers, reports, or instructional documents as resources for our community-based organization resource hub
– Collects and responds to collaboration inquiry requests from our community-based organization resource hub and network
*This is not an exhaustive list of duties and responsibilities that may be required of an intern. Internship preceptors will determine a specific work plan with interns upon onboarding.
1. Interested candidates should submit the following documents to firstname.lastname@example.org AND email@example.com:
– Cover Letter
2. Applications must be received by September 22, 2023, to be considered.
– Applications will be reviewed by the Care Share Health Alliance selection committee
– Selected candidates will be invited for an interview, if application is not selected, applicants will be notified
For more information about Care Share Health Alliance, visit our website: https://www.caresharehealth.org/internships/
The North Carolina Department of Health and Human Services has announced that Medicaid Expansion will no longer launch on October 1st, as the North Carolina General Assembly failed to take needed action to meet that date. The department is confident that legislators will not sign a budget this month, nor pass separate legislation giving the final authorization to provide health coverage to more than 600,000 North Carolinians. A new date will be announced following needed legislative action, but it will not be Oct. 1
Read More: https://www.ncdhhs.gov/press-releases
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.
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.
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.
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.
Join Care Share and our featured guests Dr. Sue Ledford of Four Square Community Action, Charis Blackmon of West Side Community Land Trust, and S.J. Hightower and Hope Williams of Legal Aid of North Carolina for our a discussion on the different ways their organizations approach their work to help individuals and communities get and remain in affordable housing.
Care Share Health Alliance is excited to welcome five new members to our board of directors: Dr. Carrie Rosario, Honey Yang Estrada, Jamilla Pinder, Dr. Meredith Gringle and Yesenia Cuello.
“Care Share is fortunate to have a strong board of directors that is dedicated to our mission of collaborating for health equity.” says Care Share Board Chair, Alice Pollard. “I am excited to work with the new board members, who will bring new insight and experience, helping us further our bold strategic plan and path forward.”
Carrie Rosario, DrPH, MPH is a health equity advocate, public health leader, and strategist with 15 years of experience in varied health settings. She is currently faculty in the Department of Public Health Education at UNC Greensboro, where she has served in executive leadership roles as Director of Undergraduate Study and Associate Chair of the Department.
Dr. Rosario holds a DrPH in Health Education from Loma Linda University and MPH in Community Health Education from UNC Greensboro. Her research focuses on advancing place-based public health and health equity, with an emphasis on tobacco control. Dr. Rosario is a respected leader in the academic public health community and member of the Society for Research on Nicotine and Tobacco (SRNT), American Public Health Association (APHA), and NC Institute of Medicine (NCIOM).
In 2020, Dr. Rosario was appointed by Governor Cooper to the North Carolina Institute of Medicine (NCIOM) Board of Directors, where she currently serves as Chairperson. Her deep commitment to a healthier North Carolina has also led her to serve on the Healthy North Carolina 2030 Task Force, the Community Advisory Board for the UNCG Center for Housing and Community Studies, and the North Carolina State Health Improvement Plan Community Council.
Honey Yang Estrada is the President of the North Carolina Community Health Worker Association. She was born in Fresno, California and moved to North Carolina when she was 11 years old. The eldest daughter of Hmong refugees who sought refuge in the United States during times of war, Honey understands the struggles families face in navigating various societal systems and the existing barriers that inhibits them from achieving positive outcomes.
A proud Community Health Worker, Honey has worked in healthcare and public health for over 20 years. Her experience is rooted in community health and advocacy. Throughout her career, Honey continues to serve as a catalyst for change where she champions racial and health equity.
She holds a Masters in Public Health and currently lives in Newton, NC with her family and teaches Zumba at the local library.
Over the past 20 years, Jamilla Pinder has dedicated herself to advancing health care access. As a healthcare professional, she has extensive experience serving uninsured and underinsured patients in Guilford and Rockingham counties. Jamilla obtained a Bachelor of Science from North Carolina A&T State University for Agricultural and Environmental Systems (Agribusiness and Food Industry Management). She uses her education and experience to build and support local coalitions. Her work involves strategic partnerships with community-based organizations, healthcare systems, and faith-based communities to address access to healthcare and social determinants of health. Jamilla takes a grassroots approach to improving public health by tackling issues at the block level. As the Psalmist says, “Truth’s shining light guides me to make good choices and decisions; your word makes my pathway clear.” Jamila’s drive and self-confidence are both shaped by this passage.
Dr. Meredith Gringle earned her BA in Political Science and English Literature at McGill University and my MPH and PhD in Community Health Education at UNC Greensboro (UNCG). Dr. Gringle taught her first university course as a first-year doctoral student and fell in love with the ways that teaching and learning together helps create caring, incisive, and equitable community. Soon after receiving her PhD, Dr. Gringle joined the UNCG Public Health Education faculty, serving most recently as Assistant Professor and Undergraduate Internship Coordinator. In the fall of 2023, Dr. Gringle will begin her new role as Assistant Professor of Public Health at North Carolina Wesleyan University. She has extensive experience advising, mentoring, and learning with “traditional” and adult undergraduate and graduate students. Her research interests and scholarly focus areas include stigma and health disparities, reproductive health equity, and qualitative methodologies. Her current interdisciplinary research focuses on perinatal substance use and care-provision.
Yesenia Cuello was born in Los Angeles, CA but moved to NC with her mother and younger siblings when she was 5 years old. Spanish is her first language. Yesenia’s mother is from Morelos Cuernavaca, Mexico and her father is from Santo Domingo, República Dominicana. In NC, she graduated from Lenoir County Early College Highschool and became the first generation high school and college graduate in her family. She received a Nonprofit Management certificate from Duke University in 2019. Yesenia is a former child tobacco worker, became co-founder of a nonprofit organization called NC FIELD in 2009, and in 2019 was voted into her current role of Executive Director of NC FIELD, an organization created by farmworkers for farmworkers.
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 on our About page.
Episode 3: Connecting Communities to Health w/ Honey Yang Estrada | Listen Here
In this episode, we talk to Honey Yang Estrada, President of the NC Community Health Worker Association (NCCHWA). We discuss her background and what brought her to CHW work, how CHWs help bridge the gap between their community members and healthcare systems, and how the NCCHWA truly centers equity in the support they provide their members.
Episode 2: Dr. Dawn Baldwin Gibson | Listen Here
Note: This episode deals with the loss of a child.
In this episode, we share an interview with Dr. Dawn Baldwin Gibson, originally recorded as part of NC BIPOC Leaders series published last year on our blog. Dr. Gibson shares how her life experiences have informed and inspired the incredible work she does at Peletah Ministries, the ministry she founded with her husband, Anthony, which has included mental health support, disaster relief and a trauma informed k-12 school.
Hello! My name is Jalah Clayton and I serve as the Director of Innovation and Capacity Building here at Care Share. The second Friday of the month are some of my favorite days as I get to come together with our group of partners in the NC Collaborative for Medicaid Transformation meetings, an initiative that I support organizing at Care Share.
After a little over a year with the organization, one thing I can say I appreciate about serving a statewide nonprofit is that working remotely allows our organization to have a broad reach across the state and gives me the opportunity to work in a location that is close to my family and loved ones. Charlotte, North Carolina is my hometown, so I’m grateful to be near family and many of the communities that raised me.
7:30 am – My alarm goes off and I start my morning with a 5-10 minute mindfulness meditation on gratitude, and prayer. I do some light stretches to wake up my body and mind for the day.
8:30 am – After answering any quick emails from my phone while I get breakfast ready (today breakfast is ginger tea, a clementine, a bagel with cream cheese and a protein shake), I get set up at my work spot.
10:00 am – It’s time to begin the NC COMeT meeting! In today’s meeting, we’re hearing from Quantified Ventures. We’re excited to learn from this group and discover if there are ways that our partners can collaborate!
11:30 am – Start the process of uploading the meeting recording, notes and highlights from the discussion on our website, where we have a designated page for NC COMeT. I also then send a thank you and follow up email to our guests before quickly jumping onto an introduction call with a CBO.
12:00 pm – The call went great and I’m excited to explore ways to support our new CBO partners’ ability to serve their community through our Equity+ Network. Now it’s time for lunch!
Usually I try to cook something quick for a midday mindfulness and screen break. This allows me to be more present when I’m returning from lunch. Today it’s Friday though so I had lunch while I caught an episode of a show on Netflix. I bring my brain back to get ready for the next meeting with a brisk 5 minute walk outside.
1:00 pm – I join the NC Get Covered meeting. The presenter, Charlotte Center for Legal Advocacy, talked about improper Medicaid terminations, so it’s helpful information to make sure I’m aware of to direct our partners to the right resources.
2:30 pm – I join our internal strategic plan check-in meeting. Our organization developed a new strategic plan last year and since we’ve officially adopted it this year, we check in on our measures to see how we’re reaching our targets and adjust if necessary.
3:30 pm – I use my tablet to tune in to the live stream for the hooding ceremony of one of my sorority sisters, while I work on a one-pager document to accompany a program proposal for a future initiative of Care Share.
4:30 pm – Off to the weekend! I’m kicking it off with a run since it’s sunny and warm outside.
Want to hear more from Jalah? Listen to the first episode of our Equity+ Podcast, where she and the rest of our staff discuss about how our lived experiences with equitable healthcare and White supremacy culture affects our work.
North Carolina Department of Health and Human Services will delay the implementation of the NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans. The launch was scheduled for April 1 and is now targeted for Oct. 1, 2023. Read More: https://www.ncdhhs.gov/press-releases
At Care Share Health Alliance we approach this statement with intense sadness for the loss of life of Tyre Nichols and with the deepest sympathy for his family to have lost a loved one in such a horrific way.
We also approach the statement almost with trepidation – because we again must address the murder of a Black man at the hands of police in America. These murders continue to happen over and over, many of them never acknowledged by the media, but enough so that we fear our nation is becoming desensitized. This should be a wakeup call.
It’s well past the time to ask why this continues happening, and face the hard truth that it is because our criminal justice system has origins in the racial persecution of Black Americans and intentional dehumanization of Black men. It allows for the abuse of power and lack of accountability which have been the hallmark of these terrible events.
It’s tempting to think that because the officers who murdered Tyre Nichols were also Black that means racism can’t be a motivator. But when we work within systems that are built around a racist structure, and take advantage of their inequities, we are complicit in their abuses.
Unfortunately, the majority of American social and political systems are built on a culture of White Supremacy which, more often than not, goes unacknowledged. This lends to the desensitization we feel when we are confronted with the news of another terrible tragedy like what happened in Memphis. When entire social structures are built upon intentional injustice, we become desensitized because we feel like there’s nothing we can do to make change.
In that light, we’d like to share ways to help Tyre’s family and to donate your time or money to organizations working toward police reform:
The GoFundMe started by the family of Tyre Nichols:
If you are an organizational leader, you are probably also wondering how you can help your staff and colleagues process their responses to these events. We suggest the following:
- Encourage open conversation on the impact of recent events and structural racism with your staff
- Encourage use of EAP, if available
- Give employees time and space to work through their emotions
- Recognize that employees may be re-experiencing trauma from times that have felt unsafe with law enforcement
Care Share Health Alliance hopes to never have to publish another statement like this. We do not want to see any more lives lost to police brutality. However, for that to be a reality, our country must be brave enough to face hard truths about the racist heritage of our law enforcement system and make changes that holds itself accountable for the safety of all Americans.
“Of all forms of discrimination and inequalities, injustice in health is the most shocking and inhuman.”
This quote from Dr. Martin Luther King, Jr. is often cited by those of us involved with healthcare at any capacity. Today, as we honor the legacy of Dr. King’s civil rights activism, the inherent truth of his words remind us of the work that still needs to be done for all Americans to have access to equitable care.
To provide a little context, the quote comes from a 1966 press conference, where Dr. King spoke out against hospitals across the country that were illegally denying care to Black Americans, and medical societies refusing admittance to qualified Black doctors or turning a blind eye to the racism of their own members.
Since then, our country has made significant progress in addressing racial injustices across all sectors of society, including medical care. Unfortunately, however, it doesn’t take a hard look at our current healthcare system to recognize that our own modern versions of the injustices Dr. King fought are still affecting the way Black and Brown Americans receive care.
A 2021 UCLA study discovered that only 5% of American doctors were Black. In 2019, 5.8% were Hispanic, and less than half of 1% were American Indian or Alaska native. Another 2021 study showed that Black patients are more likely than White patients to be in hospitals with worse patient safety conditions. In 2019, research found that emergency room providers were less likely to order blood tests, CT scans, or X-rays for Black, Hispanic, or Asian children compared to White children.
A final portion of Dr. King’s quote adds, “Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.”
The consequences of inequitable healthcare are not merely an issue of morality or even well-being, but one of life or death. We see this evidenced in the reports from the CDC of shorter life expectancy for Black men in the US. The fact that Black, American Indian, and Alaska Native women are three times more likely to die from pregnancy-related causes than White women. The significantly higher infections and death rates experienced by Black, Hispanic and AIAN Americans during the COVID-19 pandemic.
That is why, when strive to make changes to our healthcare system, we must keep equity at the forefront of all the work we do. We must continue to center the voices of those who are experiencing the injustices of our current systems, and be willing to acknowledge that many of our systems were built on white supremacy models that were intentionally unjust.
The work can be difficult, and often the data we see is depressing and alarming. Many of us may have expected to see more change in the 54 years since Dr. King’s words, but to reference another frequently cited and beautiful quote, “The arc of the moral universe is long, but it bends toward justice.”
Care Share will continue to work for a more just healthcare system through our partnerships with communities. By providing support and creating opportunities for collaboration, we strive to help them make the changes they want to see to become healthier and more equitable for all.
Rev. Dr. Dawn Baldwin Gibson still remembers when she was only four years old sitting at a nurse’s station in the hospital, while her mother was visiting with Gibson’s father, who was dying of pancreatic cancer.
“So much of the work that I do around health equity comes from that very early knowledge of how important healthcare access is.” Says Gibson.
Her father had been with DuPont in Wilmington, NC for many years, but when he got too sick to work, he was fired, and with that lost his health insurance. He died within months of his diagnosis, at just twenty-nine years old.
Gibson believes her father did not receive the kind of care he should have to help fight his disease.
“They said it was the flu. I don’t know that they really even took it really seriously,” she says.
It was a stark contrast to the care received by her mother, who was diagnosed with ovarian cancer years later in the 90s, and had access to health insurance.
“She had the ability to get that good care. And so now she’s been cancer free for 20 plus years,” says Gibson. “I think that those are the early memories that stay with you, of how important healthcare is, how important early detection is, all of those things. All of those memories still remain with me.”
Gibson has gone on to use those memories to inform the work in the organizations she’s founded with her husband, Pastor Anthony Gibson: Peletah Ministries, Peletah Institute for Building Resilient Communities, and Peletah Academic Center for Excellence, all located in New Bern, North Carolina.
“New Bern is as much home as home can be for me,” she says. It’s where her mother’s family is from, and Pamlico County where she and her mother settled after her mother worked on master’s degree at then Atlanta University in Atlanta, Georgia.
“We actually live on the farm that my grandfather purchased after his service in World War I. So my grandfather was born in 1891, and my mom is one of the folks that are still walking around who can say that her grandparents were actually enslaved.”
Although Gibson was born many years after her great-grandparents had passed away, she still heard stories about their experiences from her grandparents.
“The stories that my grandfather and my grandmother shared – they were just so impactful. The house that my mother lives in, my great-grandmother lived in that house. So there are these very significant connections that we have to the history of the land and the history of the community in which we live.”
As Gibson grew up, she went on to attain her BA in Liberal Studies from Shaw University, where her parents met. She continued her education at East Carolina University, where she received an MA in English, and later started working on a doctorate in higher education administration at George Washington University.
“And halfway through my program, I said, you know what? I think I want to be a Christian counselor.” So Gibson took the unusual step of changing her doctorate, and completed her PhD at Christian Leadership University in Christian counseling. There, her focus was on trauma and Adverse Childhood Experiences (ACEs) in children of color.
She shares that part of what influenced her to make such a major change had to do with a tragic experience she had while working as an instructor at Lenoir Community College, where one of her students was killed in what she describes as, “just a senseless act of violence”,
“I really felt like there were things that I wanted to give my time to, and that administration in that sense might not be where my passion was,” she recalls. “I think that particular situation of violence really began to change my focus.”
Gibson also credits another, this time positive, experience with changing the trajectory of her work. At the time, she was working as a Community Response Coordinator with Easter Seals UCP, which sent her to a conference where one of the speakers was Dr. Vincent J. Felitti.
Felitti originated the research showing certain traumatic experiences and environments in early life, known as Adverse Childhood Events (ACEs) can have lasting, negative effects on a person’s health, well-being, and life opportunities, such as education and job potential.
Gibson – who admits she had attended the conference essentially because that’s just where her job sent her – recalls standing against the back wall of the packed ballroom where Dr. Felitti spoke, “That day, it changed my life and it changed the focus of my work in a way I could never have anticipated.”
The extensive work Dr. Gibson now helps lead at Peletah Ministries is sensitive to trauma in all areas. “Peletah is a Hebrew word for great deliverance,” she explains,” It’s holistic; not in just one area, it’s in every part of your life.“
This also involves early childhood intervention, through the Peletah Academic Center for Excellence, where Dr. Gibson, who has over 25 years of teaching experience, serves as Superintendent. PACE is a culturally competent, trauma-informed, grief-sensitive Pre-K-12 school that provides both academic and social-emotional learning, as well as wraparound services for students’ families, such as access to a social worker and case managers if additional support is needed.
“I was always really interested in this area of education and how children, especially children of color, show up in classrooms, and the importance of education, the importance of the community, and the importance of these wraparound services,” says Gibson, “My Master’s degree concentration was technical and professional communications, but I did my thesis work around culturally responsive pedagogy as it relates to African American males as a learning discourse community.”
At P.A.C.E. Mondays through Wednesdays are strict academic days, Thursdays are dedicated to health and wellness and Fridays to place-based education.
“It is really about giving our scholars opportunities to create, develop, and thrive, on these health and wellness days,” Gibson says. “We have a dietician, we have a social worker, we have a clinician, and they are all doing different projects on Thursdays and Fridays for our scholars.”
As part of her work as Executive Pastor at Peletah Ministries, Dr. Gibson has also written a trauma-informed worship for her church, part of which includes keeping worship services private. Often, people say they can’t find Peletah’s church services aired on social media, but Gibson says that’s intentional. She makes a comparison to HIPAA, a law healthcare providers must follow to protect patients’ privacy when receiving medical services:
“Is there not a spiritual HIPAA, that we have an obligation to protect people’s information unless it’s going to hurt them or hurt someone else?” Gibson asks. She talks about “toxic resiliency”, where individuals, especially in the Black community, are taught “what goes on in the house stays in the house”, and to put on a smile in public regardless of what they’re been through, or are going through.
Gibson also references Post Traumatic Slave Syndrome, a theory that the experience of slavery in the United States and the continued discrimination and oppression endured by Black Americans creates intergenerational psychological trauma.
“So much of the work for my doctorate I did around post-traumatic slave syndrome,” she says, “When we think about trauma and its impact – the brain is constantly either in this fight, flight or freeze posture, then you see high blood pressure, you see more incidents of heart palpitations and heart problems and diabetes. All of that is impacted by issues of underlying and ongoing trauma and toxic stress. Then you add in these different areas of poverty and the lack of health access. All of these are compounding factors that when people show up in a worship setting, they bring all that with them.”
Peletah also connects ministry with mental health services. “We’ve prayed for people at the altar and still made a referral to Crossroads psychiatric care facility,” says Gibson, “We’ve said ‘there are some other things that are going on here and we need to help you connect to a clinician.’”
Gibson is intimately familiar with how important access to mental health services is. In 2016, she suffered a tragic miscarriage at five months into her pregnancy with her daughter, Hannah Elizabeth. Her loss was only amplified by the treatment she received when she sought medical care.
During her pregnancy, Gibson suffered from uterine fibroids, which are more likely to occur in Black women like herself. The fibroids were so severe that at 5 months pregnant, Gibson’s abdominal circumference measured the same as if she had been nine months. Her daughter was literally being pushed out by the fibroids, causing Gibson to go into premature labor.
However, when she went for help at the ER, she was discharged while still in active labor, although she didn’t know it. Later that night she was rushed back to the hospital by paramedics after she had given birth to her daughter at home.
“Hannah died probably about 45 minutes after her birth.” Remembers Gibson, “I had a vaginal birth and they sent me home within an hour.”
She and her husband went home that morning and planned Hannah’s burial. Two weeks later Gibson attempted suicide.
Thankfully, she survived and was able to receive mental health services to help her deal with her loss at Crossroads Psychiatric Care Facility in New Bern, the same organization where she will now refer members of her congregation.
“That is the reason why I am probably one of their biggest advocates,” she says, “ Because I understand that when your serotonin level is off, it is off.”
She also describes the hesitancy many people in her community have toward addressing mental health issues, as opposed to seeking other healthcare services, “When my mother was diagnosed with ovarian cancer, people said, ‘you gotta get over to the Leo Jenkins Cancer Center in Greenville.’ We actively did it. But when people talk about mental health struggles, that something chemically is happening in the brain, we kind of, well – we can’t do that.”
That mindset, and Gibson’s own experience, has helped inform Peletah’s SHELL program, which helps other African American clergy in eastern North Carolina access culturally appropriate mental health counseling. It was developed by Gibson and her husband, Anthony – who has extensive experience in the mental health field – as a response to the emotional toll the COVID-19 pandemic was taking on pastors and lay leaders in Black churches.
“We are serious about changing how our communities have thought about mental health services.” She says. “We’re continuing to do that work because of the impact that Covid has had on our communities, on our mental health, on our ability to process effectively what grief is, what loss is. It is something that is going to be with us for decades, and we are going to have to really look at how this is impacting our health and our wellbeing.”
The Peletah Institute, where Dr. Gibson serves as Executive Director, could be considered something of an expert on how to support communities through the effects of COVID-19. In fact, in the beginning days of the pandemic, they were in the very unique position of actually knowing what to do.
While institutions from the federal government to local clinics were struggling with how to reach everyday Americans with accurate information and, eventually, the vaccine, Peletah utilized a framework and network of connections they’d had in place from shortly after their church had opened, which happened to be just six weeks before hurricane Irene hit North Carolina.
“So very quickly we were doing disaster work,” Gibson recalls, “We were going around after Hurricane Irene and we saw all of this need. And what we now say is that whatever is in the community at the time of the disaster is only amplified by the disaster.”
In response, Gibson says they put together what they call their own “FEMAA” approach to help communities be resilient after disaster. Peletah Institute’s version of FEMAA stands for Food Access, Educational Recovery, Mental Health Support Resources, Affordable Health Care and Affordable Housing.
“And in the meantime, we ended up connecting with 300 plus churches across eastern North Carolina; that’s now grown above 500 churches that we’ve connected with so that when things are happening, we can get resources and information to them.”
“When Covid happened, we just did the same thing. We started up with those same churches just like it was a disaster; because it really was.”
She recalls during hurricane Florence, her community didn’t have internet access for weeks, so they relied on free conference call phone numbers to spread needed information.
“When Covid happened and people needed information, we just went back to those free conference calls. But the thing that we were able to do was that everybody had gotten these phones where they could see Facebook.”
So Peletah partnered with their local hospital to host “Vaccine 101” Facebook Lives.
“The first one we did was with State Health Director Betsy Tilson and some of the staff at the NC Department of Health and Human Services. They said, well, you get a hundred or 200 people to come on, and that will be great.”
But 200 people didn’t come – 12,000 did. Eventually, Gibson says, they ended up reaching hundreds of thousands of people through Facebook and other social media platforms, such as Instagram and TikTok.
Some of the platforms were not familiar to Gibson, but she put her trust in her staff to figure them out. “The staff just did such an amazing job,” she says. “There were so many different things they kept learning how to do and how to develop to reach different populations. It was all about making sure that people were getting factual information, and so we were really fortunate to continue to expand in that way.”
Peletah’s work providing accurate information and access to vaccines for African American seniors in their community even earned a shout-out from Surgeon General Dr. Vivek H. Murthy, as part of a White House COVID-19 Press Briefing in 2021.
“I still don’t know how it happened.” Gibson says, as no one had informed her that her organization would be mentioned by the Surgeon General, “But what we realized was that was the way to connect to people and make sure they were getting information.”
So, what was it that made Peletah so effective when so many other organizations struggled at the time? Gibson credits their success in both disaster relief and addressing COVID-19 to the fact Peletah Institute’s work is a direct response to the needs expressed by her community.
“It’s something about being in community, not assuming, not hearing part of what I want to hear, but hearing the whole matter,” Gibson explains. She describes a call she had with a mentor, who helped her understand the importance of community voice.
“One time I called her and I said, ‘we need to make all these changes and the people, they need this, this, this, this, this.’” The mentor allowed Gibson to say her piece, and then asked, “But what did the people say?”
“She said, ‘the wisdom is in the room’.” Gibson recalls, “And now I’ve kind of expanded what she taught me and say, the wisdom is in the community.”
Pelatah’s approach is not to assume what a community needs, but instead, Gibson explains, “We let them tell us what they need, and then figure out how we partner to support the infrastructure being built strong in this community.”
“We don’t need little Peletahs everywhere.” She says, “We need the people who have always been doing the work to be supported in a way where they can get the resources, they can get the funding, they can get the opportunities that they need for the communities where they’ve been doing this all along.”
That work is done partly through the Eastern North Carolina Regional Church and Community Resiliency Collaboratives hosted by Peletah, which originated in the SHELL Program. SHELL stands for Safety, Hope, Efficacy, Lasting, and Linkage. Specifically, “Lasting, sustainable systems for building resilient communities” and ”Links to community partners.”
As a part of helping create sustainable systems and linking to community partners, Peletah organized a meeting of local pastors to share community needs. “Now we thought we probably have about 25 pastors show up, which was great for a Monday.” Recalls Gibson, “We had 154 show up.”
The attendees were appreciative of the information provided but wanted to communicate directly with governmental organizations that Gibson and her staff were working with. So Peletah brought together those organizations for the first ENC Church and Community Resiliency Collaborative in March of 2022.
As part of the event, a listening session with government officials was held, including the Director of Community Partnerships and Faith-Based partnerships for FEMA, the Director of the NC Office of Recovery and Resiliency, and NC Department of Health and Human Services Assistant Secretary for Equity and Inclusion.
There was also a “health equity room” where visitors could get COVID-19 vaccines, blood pressure checks, anxiety and depression screenings, and could talk to representatives from Medicaid managed care plan providers. Next door was an “intake room” with other services like housing assistance, clothing for job interviews, Legal Aid, Land Loss Prevention, and social service providers, in addition to 30 vendors sharing their services with the community. They also gave out over 300 boxes of groceries and fresh produce in partnership with Conetoe Family Life Center.
Gibson was expecting to have around 200 attendees, but, again, what was expected to be a relatively small event turned into something much more when nearly 700 people showed up. Due to the overwhelmingly positive response, the Resiliency Collaboratives have become a regular occurrence.
“We have another one coming up,” Gibson shares. The ENC Regional Church and Community Holiday Resiliency Collaborative will take place on Monday, December 12, 2022 at the New Bern Riverfront Convention Center.
“We have more than 80 vendors. We’re excited that the hospital will be doing COVID-19 vaccines. We’ll have ACA open enrollment opportunities,” says Gibson, “All of our Medicaid managed care providers will be on site. We’ll have lots of free health screenings. We’ll have 500 food boxes, and Toys for Tots ( which requires pre-registration.)”
With everything her organization is doing, and all of the roles Dr. Gibson has at Peletah, one wonders how she has time to sleep. However, she says that she makes self-care a priority, both for herself and those she leads.
“Our staff come with a lot of their own knowledge, skills, and education to this work. It is a lot that they carry and it’s a lot that we’re doing. We recognize how important it is, but we also recognize how important it is to get rest for self-care.”
“Self-care is not being selfish,” says Gibson, “It is being mindful of how important it is to care for yourself. You cannot pour from an empty cup.”“Let’s refocus from wrong to strong.“
For more information on Peletah’s work, including the upcoming NC Regional Church and Community Holiday Resiliency Collaborative you can visit peletah.org or follow their social media:
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/