From Peace Corps to Organizing Community Health Workers During Covid
Education
My background is quite varied. I come from Indianapolis, Indiana, and earned a B.S. in nursing at Indiana State University.
Jobs Prior to CDC
For 4 years after college, I worked as a floor nurse on a Medical-Surgical Unit, and in pediatric home healthcare. In 2006, I joined the Peace Corps and, until 2008, I served in South Africa where I became more aware of the potential of public health and more interested in the field.
In 2010, I applied for a CDC Public Health Fellowship and was selected. During that 2-year training program, I gained experience in interviewing, contact tracing and case management for HIV/STI and TB.
After the fellowship, I signed a 6-month contract with CDC to help eliminate Guinea Worm in South Sudan. Then I spent 4 years with the Texas State Health Department as part of its HIV Surveillance team.
First CDC Job
I returned to CDC as a contractor supporting workforce development, and for the next 4 years, helped maintain and improve the fellowship program that originally brought me to the agency. I also coordinated that program’s mentorship program.
Later CDC Job
When COVID struck the US, Congress allocated emergency funds to CDC to help combat the epidemic. That time-limited funding allowed me and others to be hired for 3 years as project officers for grants to states and localities. The grants supported community health workers in conducting outreach, education, testing and other covid-relevant services on the ground across the country. In that role, I gained experience administering and providing oversight and technical assistance to CDC grantees like State and Territorial health departments and community-based organizations.
Final CDC Job
This past August (2024), I got a permanent FTE in CDC’s Injury unit and became part of a multi-agency, multi-year response to the opioid epidemic called the Drug-Free Communities Program (DCP). It was authorized by the 2016 Comprehensive Addition and Recovery Act (CARA) and is administered by the White House Office of National Drug Control Policy (ONDCP). The DCP is a network of 750 local coalitions that span the nation and its territories. There is a big focus on rural and frontier communities, but there are many urban and suburban coalitions too. Addressing aspects of the problem that range from law enforcement to safe disposal of prescription drugs, the overall aims of the DCP are to facilitate collaboration among local partners and to create local prevention infrastructure.
As specified in the CARA, CDC’s role is to award modest additional grants (most recently $125,000) to a subset (now around 70) of the ONDCP-funded coalitions. They must match these “enhancement” grants with local funds and use the money for overdose prevention efforts aimed at youth. Specifically, the enhancement activities must be designed to prevent illicit opioid and methamphetamine use and the misuse of prescription drugs among young people. I was project officer for 37 of the enhancement grants.
I helped to write the Notice of Funding Opportunity for the program, and my other duties included:
answering questions from grantees
sharing information about prevention activities that had worked in similar communities (e.g., placing Narcan anti-overdose nasal spray in vending machines in communities where confidentiality is an issue, holding unused prescription medication ”take-back days” in collaboration with local law enforcement, organizing positive youth activities that reduce risk factors and increase protective factors, and other approaches summarized in: Drug-Free Communities Program Successes | Overdose Prevention | CDC)
collaborating on coalition training activities with an ONDCP-funded nonprofit partner, Community Anti-Drug Coalitions of America [CADCA]) Customized Trainings & Services | CADCA
remote and on-site coalition activity monitoring for purposes of accountability
technical assistance concerning administrative matters such as reporting requirements
reviewing and providing feedback on grant deliverables, including reporting requirements
Proudest Achievement
I was involved from the very beginning in helping to stand up the Covid Response in Resilient Communities program. This was a program funded by emergency grants and supplementary cooperative agreements. I helped think through how the program would function, focusing on systems for monitoring awards and for communicating with local grantees. Also, drawing on my experience in health departments and the Peace Corps, I helped expand the role of Community Health Workers hired with the emergency funds. These trusted community members went door-to-door in hard-hit neighborhoods to deliver critical information about the virus, how to minimize its spread, how to access testing and vaccination when they became available, and where to get reliable information updates. As the epidemic evolved, the health workers added educational information that helped address vaccine hesitancy and manage non-clinical aspects of long covid.
The Impact of the Work
The overdose prevention work was incredibly important. We were “thought partners” with local coalitions and that connection to the field keeps Atlanta CDC headquarters staff engaged and realistic. The coalitions were so creative with their limited financial resources! Through direct communication and trainings like CADCA’s Overdose-to-Action program, we could drive the coalitions towards evidence-based interventions that saved lives.
Leaving CDC
I was out of town on leave the Friday of Valentine’s weekend, and I got calls from my branch chief and deputy branch chief late in the morning and again at 3 pm. They told me that I was on the list of those being terminated.
I was given no notice, although a couple of weeks before that, word had gotten out that HHS was asking leadership for a list of probationary staff. I understand that CDC leadership was not involved in the final decision at all.
I was one of 5 project officers terminated, and there were already 2 vacancies, which was about a 30% cut in staff altogether. The DCP has had to restructure its work because there are now too few people to respond to queries from individual coalition representatives directly. This means that coalitions may not be able to get specific information about how to fulfill their contracts, and staff likely can’t review deliverables in a timely manner or conduct site visits.
The reason given for the termination was that my performance didn’t justify retention in my probationary status. This was inconsistent with my performance review which concluded that I had achieved greater-than-expected results and was eligible for a merit bonus.
I have administrative leave pay so I’m alright for now, and I hope that unemployment insurance officials will understand the situation. That may be less true when I apply for future jobs, especially in the public sector, so I got a letter of recommendation from my branch chief.
Future Plans
I’m applying for jobs. If the courts reinstate me, I would come back to CDC and do the work happily, but not comfortably. I would assume that they would fire me again, but legally this time, so I’d have to keep applying elsewhere.
Other Comments
I understand that senior CDC leadership has not been involved at all in planning for the most recent reduction in force which is cutting 2,400 people—that HHS is making all the decisions, without much rhyme or reason expected. Right now, people who still have their CDC positions are walking on eggshells, keeping their heads down. My only solace is that I’m in good company.