Welcome to People.Power.Perspectives, the podcast where we talk to the people that are working to overcome system inequities to achieve just outcomes.
Hi, and welcome to this episode of People.Power.Perspectives. I'm Sue Watson.
And I'm Marcel Harris,.
And we're with CA4Health. We're excited to have Donna Hilliard the Executive Director of Code Tenderloin with us. And we're really looking forward to talking with you today about community health workers and what it looks like to build an ecosystem to support them. So to get us started, Donna, can you tell us a little bit about yourself and what brought you to work in the equity and justice space?
Yeah, absolutely. So my name is Donna Hilliard, I'm the Executive Director of Code Tenderloin. But I always like to tell people, most importantly, I'm a student. That's when I started in this work. I never thought by any chance was I going to get into this nonprofit, this space period. I spent a lot of years in corporate I spent a lot of years doing sales in tech. You never know what God has planned for you and the things that he has you go through in your life that actually are going to show up later. And when I was a youth when I was a juvenile, I was in a lot of trouble. I was in and out of incarceration. Actually, to the point where my 18th birthday, I was taken from juvie Hall to county jail, I was in foster homes group homes, I was selling drugs, I was gang banging, I was You name it, I was doing it to survive on the streets. I was on the streets at 13. So throughout my career, I always hide that about myself. And when I came into this nonprofit space, and really, I came to Code Tenderloin originally, I wanted to learn to code. But what I found was my passion, and that was helping people with untraditional backgrounds break into tech. But most importantly, understand that their past doesn't define them. And that my story has power. And I can help other people by telling that story versus hiding it. You know? Yeah, really excited to be here today with y'all.
Love that. Thank you for sharing all of that, as we move in and think about the topic for today. What do you want people to understand about community health workers, and even maybe broader workforce development.
The one thing if I have to say I want anyone to take anything from this is we have to really start taking people taking the skills that they have, no matter where they come from, and realizing the transferable skills that live within that. And I say that because as we train people to be community health workers, we're taking them we're saying, use your lived experience when you were homeless, maybe when you were struggling with substance use problems, take that experience of how you you learn resources, you're able to do all these multitasking things, like take those skills, and use them because they're valuable.
That's so important when we think about what people bring for any of us what we bring to what we do. And in that role of community health workers that much more valuable to be able to do that. So that's great. There's been this journey of community health workers and what they are and how people use them and what their training is. And it's really heated up again recently and become a hot topic today. Are there things that you see that makes working in that space, working with building teams of community health workers, that is unique in 2023.
Yeah, absolutely. And I guess I'll talk a little bit about the pandemic, because for Code Tenderloin, we really started a lot of this work during the pandemic, when everything happened, everyone was shutting their doors, nonprofits, businesses, we decided to keep ours open, because we knew in the Tenderloin area, people needed us. There's so many unhoused folks right here in this area, there was no way we could shut our doors. So as we opened our doors, I leaned on my team, and we said, okay, what can we do, we started walking the streets. So what we found is that people really felt comfortable and trusted us. That was the beginning when the light bulb kind of went off and was like, You know what, we have something here, we're actually able to talk to people get in their tent with them, we're able to have these real conversations, but bigger than that, we're actually able to be a role model for somebody that's on the street. I can tell you that weighs so much more than coming with the degree but actually saying I was where you're at right now. I got out of it. And you can to very powerful work.
Wonderful. And when I think about public health, that so many things are connected. And while community health workers, I think the way the conversation is now it really puts it in this workforce development space. Do you have thoughts on how does this or can it really connect to broader movements for social justice or racial equity? Even if we're talking about community health workers?
Definitely. I mean, this work for a lot of folks is just one step to get to that next level. When people start this journey to be peer to peer counselors, community health workers, case managers, they're trained to be substance use counselors, they're crisis relief coverage, COVID-19 workers, but it opens up a whole nother door, you actually have a space in the health sector. But also with that, how can you empower the people? How are your people like knowing about all the black disparities in the community, understanding those things that really raises the awareness. We have two teams that go out every week on a Thursday and a Saturday. And what we're doing is we're actually giving flu shots, Mpox, and COVID-19. But bigger than that, we're walking through these communities. And we're helping break down all those disbeliefs. So we're able to to have real conversations with people to say like, this is safe. And this is why, but also like, if you're not comfortable with this voice that you may not be comfortable today. But guess what, maybe two weeks down the line when you see us, and it has happened. We just did a pop up last Thursday on one of our new locations on Mission Street. And in two hours. We did 26 vaccinations and two of those were first doses. Like think about it in the pandemic. Yeah, people that have that resistance getting vaccinated, but because we had it community style, we had a barbecue. We're just there on the ground like, Okay, what else do you need? Okay, maybe you don't need this. But what else can we find you people were more open to that.
That's wonderful. I'm anything, it creates that bridge and not just for the people who find themselves as community health workers, but for the communities that they're serving. It's bridging people to resources, maybe direction for themselves, as well as employing people who may have come from the situations which we all know that that has wide ranging impacts for individuals, families, communities. I love that story. And I'm so glad to hear some people are still getting their first COVID shots.
Yeah, a lot of flu shots right now, too. Yeah, experienced that. But everyone's catching the flu. So get your flu shot. But it's pretty amazing. You touched on something about how this creating jobs and I think a lot of people don't see that side of it. How awesome is it to have someone who was just living in a tent now working. But guess what, they have two paychecks now we can get them moved into their own apartment. People are always talking about how do we solve homelessness? How do we solve homelessness? Guess what? Let's get folks working. Let's get folks trained. Huge.
Yeah, that's great. Marcel, you want to jump in here?
Loving the conversation, Donna and Sue. And you know, I'm all about utilizing that lived experiences and wish we had more systems that really valued that unique peer perspective. So I'm curious, you know, what challenges do you experience with bringing in people with various lived experiences into employment opportunities?
Well, I'll tell you, especially in the community health worker, field, you know, you're working sometimes along with doctors, and interned students who don't have that lived experience and may not understand what communities you're in. And the talk is a little different. It's not someone's not sitting there taking notes for things. And so it's that thing you don't know what you don't know. And so it's educating, right. It's educating the people you're working with, and educating the people to do the work. But I think the biggest challenge is making people understand that every piece of this is important. So for the community health workers to understand that, hey, this person, the doctor, whoever is bringing the interns bringing this other piece that you can learn from as well. But also, you're important, and what you're bringing is just as equal on the table, and how do you communicate with each other so that you can make sure that the person that community is getting the services they deserve?
That's so interesting, I wish there was more of that partnership, collaboration, rather than competition, or deaming folks less value just because of no degree. I really appreciate you touching on that. What are some lessons learned around building that ecosystem that welcomes and prepares people for roles like community health workers?
I think the biggest lesson learned is that we have to support the people who are doing the hardest job and who are on the ground. And what we have to appreciate them for the work they join. But also set up systems that let them know if too much is too much. That is okay to say that it's too much. For us, we try to make sure folks are working on a salary so that they don't have to take their lunch at a particular time or if they want to take a longer break. We tell our folks all the time, you need to go have a quick one on one with one of your mentors. You need to go to a NA meeting whatever that looks like you need to go do yoga. We have a lot of folks were encouraging, go get out their workout, do something, go do some meditation, it's okay. And that's okay. You know, a lot of times, especially in our culture, We're surviving and working so hard. And we think we can't take that time for ourselves. And we can, you know, and we deserve it. Definitely one of the biggest learnings.
That's amazing supporting that wellness and modeling that as well. Not enough employees support that, especially with when you can take your lunch and when you can't. And so that's amazing. I appreciate you sharing that. What are some other success stories or successful models for running community health worker programs, and preparing community members and the various public health sectors.
When you say success story, it looks so different for so many different people. But I would say being able to expose people to this whole pathway and careers is the biggest success. There's people who didn't even realize that this is a job. This is a career, I should say career not a job. You can make living wage salary you can provide for your families, and do what you love to do. There's a lot of people who maybe grew up in the church, maybe they gave out food, and they love that. But they never thought, hey, I could actually do this full time. And you can get paid.
Why not find your passion? Why not do something you really love? No one wants to go to work and be miserable. Go do something you'd love to do.
That opportunity? Yep. Looking at the broader vision, if decision makers, we could say local officials, state decision makers invested more into health equity and racial justice, what would that look like? What types of projects would we see?
A lot of the problems and issues we tried to tackle if we brought more people with the lived experience, who are actually living through that we'd have new ideas to the table. Because obviously what we're doing right now, it's not working, we have to do something different. But where does that come from? That comes from our youth. And that comes from the people who are actually experiencing this. And so if we can broaden our mind to that, I think it would be a much better place. And if not, why are we not at least trying?
I appreciate that inclusive decision making, I really appreciate you shedding light on that. I'm thinking of so many examples of where we can do that. At times, we wonder why the outcome is the way it is, we could have just included those that are closest to the issue with shaping, you know, whatever it is that we're working on, rather than deciding for those that are not connected to the issue. And I'm gonna go ahead and bring Sue back in here. I know that we have a couple more questions.
I was wondering, as we talked about a little bit earlier with community health workers and that care professional class being a hot topic right now, which means that they're federal funding and state funding and to build that out, which may get in the certifications and accrediting programs and things like that. Do you have any thoughts or concerns about maybe the structures now being laid over or connecting to this type of employment lane? The community health worker stuff?
No, that's actually a really good point. It's interesting, because I just had a student who was saying, like, I want to go this path all the way, go, Okay, I've taken this community health worker class with Code Tenderloin. Now, I want to take the next step. We're like, Okay, well, let's get you registered for school. And then they're just like, whoa, what do you mean, I have to do all this schooling. And I have, this is someone who just got their GED while they were in jail. So we need more community programs to set the foundation. So when people are ready to make those next leaps, they understand what they're getting into, and understand and have the support along the way. Can't say, everyone's got to go get this four year degree to do this work now, because that's not realistic. We got to do some out of the box thinking because I will tell you some of the best community health workers I've ever had, don't even have a GED or high school diploma, how do we nurture that person to get them where they need to be so that they meet all the qualifications? And I'll tell you, there's so many different certification training, right? Why not laced them with all of that, and then have them go out there and do the work? I think we just have to be mindful of that with anything right? Start putting too many restrictions on it gets a little one sided?
Yeah, do we start to lose what you were talking about at the top that people with lived experience, all kinds of lived experience, and what they bring to this, and if we put too many controls on it, we may make it so that those folks it's another pathway that they get that gets shut off to them. And it just kind of leads me to if you think about the year ahead, and maybe plans that you all have at Code tenderloin around this work, or even just about some of these potential policy shifts, are there important points of action that you might identify, to advance this work or to make sure that the way you're approaching this and training community health workers that that remains in focus, and those opportunities aren't shut out.
I think it's just really important that people open their doors to this. So like internship opportunities for community health workers to come and work at USF or those type of Institute's kind of finding entry level jobs where people can take Those jobs and then build their skills, and then keep going. Those things are all super important. But I think the other piece to this is, this is just not the end for most folks. Some people want to be community health workers, but this is just the beginning. Because once they get to taste of this, then whatever they're really, really into, like, if they're into elder care, we got to set make sure that they have a pathway to that, for instance, people who only want to deal with seniors, like that's what they love to do. We need more people to take care of our elders. So why are we not nurturing that we need to say, okay, great, now you've been exposed to this, let's get you the training, and everything to get you to that space where you can actually do this, or even become an entrepreneur in that space. This is 2023, folks aren't rushing to go work at someone's company anymore. Like entrepreneur, I really what it is, there's folks who we have in this community health worker program, who have taken some of our tech classes, guess what they want to build technology and apps around community health care, that's awesome. And that's, you know, future forward, and we should be thinking about those things. AI, robotics, all these things, people can incorporate all this with technology. And so I think just thinking future Foward is like, we have to be mindful of that. And let's not stop here. Let's make sure that people are exposed to those things, medical billing, these are all jobs that our people can do.
Yeah. So once we get people in, how do we keep them hooked? And I hope that you and maybe others at Code Tenderloin, find seats at the table when these conversations are occurring? Because I think you have really, really valuable perspective and voice for these conversations. And I think probably some of the decisions that may get made in the coming years. So around this new emphasis.
Absolutely. Our hopes too!
Yeah, well, Donna, it's been great learning more about code tenderloin and working with you all during the pandemic, and really hearing your perspectives today. And we're really grateful that you took the time to share your insights and your experience on these issues. So thank you for joining us today. And thank you all for listening to another episode from CA4Health's People.Power. Perspectives. Podcast.
