Attack of the Three-Headed Hydras

Introduction

Elevator pitch: The blockbuster movie of the year

Earth in peril. Lizards. Capes.

Here’s our elevator pitch to movie producers to secure 100 million dollars for a film:

Imagine the future and a global pandemic that turns into a surreal apocalypse as the economy collapses and the world is revealed to be run by overlords who are giant three-headed hydras in business suits.

Think Contagion meets Walking Dead with Avengers and a dash of I, Robot with giant mutant lizards.

With superpowers combined, we win.

Trapped in a direct-to-streaming movie

What you’re holding in your hand could be an outline for a new Netflix series on post-pandemic America, but instead it’s a plan out of this train wreck we are living through—a perfect storm of colliding (and mostly man-made) crises: a tardy, uncoordinated national response to a pandemic hits an economic disruption and reaches the breaking point with centuries old disparities and social injustices thrown in. And three-headed hydras! (Yes, we’ll explain.)

Attack of the Three-Headed Hydras could represent a big delete button, meaning a way to say goodbye to a very dysfunctional past—a part of US history that shows how badly so many misguided leaders went wrong. And while some share more blame than others, we all had, and have, a role in this mess.

We still have a chance to turn things around by applying very important lessons learned from a painful past as we forge a new future. This requires a radically simple plan of action. Creating a human society, city by city, where 100% of us get a chance to survive and thrive.

Reading Notes

This book can be read in any order. Reading from front to back is how we intended it, but from back to front works well too. Skip to stories you find interesting (but don’t skip “Star Trek vs Walking Dead,” ”The Story of the River and the Bridge” and “Are you a Watcher, Hero or Three-headed Hydra”—our favorites). In our 60+ entries, there is plenty to ponder and talk about. Consider starting a Three-Headed Hydra book club to really dive into the issues and solutions. Invite the kids to color in the illustrations as you explain that hydras, not the boogeyman, are what you should be afraid of.

Some of the text is adapted from our book 100% Community: Ensuring 10 vital services for surviving and thriving. We use the term “we” in almost every article but sometimes an “I” slips in. If so, we attempted to make a note explaining which of us was sharing a story. And as for the illustrations, any resemblance to an actual human or three-headed hydra you may know is pure coincidence.

Tales from the Battlefield

These are fictionalized accounts of real stories. Some of them happened to us, some of them happened to our county champions, some of them happened to colleagues from distant lands. The point of these stories is so that you can learn from them. Think of these as lessons you can use to defeat the hydras that come across your path. Any resemblance to real places and people is 100% coincidence. The tales are presented in the form of reports from both of us or “Katherine’s Report” or “Dom’s Report,” plus a few from “Anonymous” entries which are stories from those heroes out in the field working undercover.

Bottom line?

(The 30 second overview for those with no time to read)

In the field of communication, there is a clunky sixteen-word sentence made up of six questions that poses everything needed for effective messaging: Who says what to whom, through which channel, for what reason and with what results?

Because we have no time for misunderstandings, we will use this sentence’s framework to briefly explain what Attack of the Three-Headed Hydra is all about.

Who?

Two humans (us, the co-authors) fighting with the three-headed hydras while mobilizing heroic change agents

Says what?

Calling out the three-headed hydras and retire/remove/work around them

To Whom?

To all those who believe in social justice and the capacity for creating a far more caring and socially-engaged society

Through which channel?

Through the power of every form of media known to humans

For what reason?

To fix predictable and preventable social challenges, making all fifty states places where 100% of residents can be safe, respected and empowered

With what results?

The jury is out on this one and much will depend on your actions

Said another way

Three-headed hydras are out to maintain a totally dysfunctional status quo. To explain, we need to take a step back and see the big picture. On earth, there are about 200+ societies called countries. They have governments run by caring humans and uncaring three-headed hydras. Those run by a majority of caring humans ensure that all of their residents have access to the vital services for surviving and thriving so that when crises (like pandemics and financial downturns) happen, everyone gets by with dignity, resources, food, shelter and health care. The societies run by a majority of three-headed hydras couldn’t care less about you and everyone. In these times of chaos and change, the hydras believe that all humans are on their own, alone to fix themselves with or without support.

This book is about bringing an end to what we think future historians will one day call “the era of three-headed hydras.”

Fun Fact: When you see this special superhero, it means there’s an important question to consider. these questions can also serve as book club conversation starters

Episode 1

Waking up on the planet of three-headed hydras

Waking up to a very new reality.

No one can explain how it happened but here you are, waking up to life on a planet where three-headed hydras in tailored suits run almost everything. You aren’t sure if it’s a nightmare, an extended hallucination or some quirky time travel/parallel universe situation seen in your favorite sci-fi movies. But, the reality is that everything is the same in your world except that nobody seems to find anything unusual about eight-foot-tall, three-headed hydras existing among us. Suddenly you can see them but other humans can’t or just don’t care.

And when we say that they run almost everything, we mean every-thing. Giant hydras appear to be in charge of Fortune 500 companies, city hall, the police department and your news streams. When your eyes were first opened to them, you were, naturally, shocked by the hydras as much as by the total normality in which everyone went about life in deference to them. If this were a Netflix series, it would have taken three episodes into the ten-episode season for the hero to realize that:

Humans believe that the three headed hydras have always been with us.
Humans believe that the hydras have always run most things.
The hydras have three distinct personalities (and names), one for each of their three heads: Apathy, Envy and Fear.

Hydras are everywhere.

Figuring out the hydras

It didn’t take long for you to figure out the modes of operation for each of the three heads.

Head #1 is called Apathy, always well groomed, polite, smooth talking and completely disingenuous—all the traits of a sociopath. The status quo is working great for them, and they have no interest in changing it.

Head #2 is known as Envy and has the qualities of a viper, rarely speaks but watches every detail closely with penetrating x-ray-like eyes. Envy assesses everyone and needs you to be cowed at all times. Hell hath no fury like Envy discovering someone’s hot tub is bigger than his. Or worse, someone else getting credit or kudos for good work.

Head #3 is known as Fear, a toxic presence with a bloated face, resembling everyone’s least favorite boss and can, if provoked, get pretty dangerous—ranting, screaming and occasionally vomiting up bile. Fear is completely irrational yet somehow manages to hold it together thanks to the telepathic support of Apathy and Envy. Fear has managed to build a system of homeostasis, and anything that might disrupt their perfect system must be stopped.

The three heads work collectively and do their best to keep society rolling and the humans doing their jobs, spending money and accepting orders without question. At any encounter with a hydra, listening to three heads spinning tales of half-truths and outright lies, one always leaves disoriented, disempowered and destabilized. Hydra-form is also contagious. Spend too much time around them, and you might turn into one yourself.

Q: Should people be afraid of their leaders (hydras), or should hydras (leaders) be afraid of people?

But then…

Just when you were almost used to the hydras and accepting of the fact that they were essentially our overlords, there was a cataclysmic event in the form of a global pandemic. A deadly virus was hopping all over the world. Government leaders, following prudent public health policy,told everyone to work from home. This worked for those lucky enough to have jobs where that was possible. Others depended on government subsidies and the kindness of friends and families.

A few months into this new way of living, kids, teens, parents, grandparents and everyone else started to go a little stir crazy. Then government subsidies ended and desperation grew. School morphed into something not quite school while other educational services, like colleges, had no clue how to operate effectively and what jobs they were now supposed to be training people for since the pandemic tossed everything up in the air.

Meanwhile, advances in artificial intelligence and robotics suddenly looked even more attractive to hydra CEOs. After all, robots don’t get sick. This meant that the conversion of jobs once done by humans (from call center staff, to therapists, to educators) into automated computerized systems went into overdrive. Suddenly, calling almost any business meant a chat with a chipper, all-knowing machine. This only added to the growing fear of permanent massive layoffs in once reliable jobs throughout the private and public sectors.

Suddenly, people started talking to their neighbors and through social media about how badly everything was being run. With everything falling apart around them, many began questioning why those in charge were in those positions, regardless of whether they could see their true hydra forms or not. This was, quite literally, revolutionary.

And so, here you are. Stuck on planet earth with three-headed hydras desperately clinging to power, an unpredictable virus still spreading, a nationwide lack of medical care and an unshakable fear of more viruses and upheavals to come. Jobs and businesses disappearing, many never to return, and an absence of any economic development plans. Services to help people survive and thrive are spotty at best.

More and more streaming news shows and vlogs, produced by newly-awakened humans, create viral news stories with headlines like “hydra exposed by whistleblower,” finding that calling out hydras exposes their true form to others. Soon, the majority realizes they are overrun with hydras in charge of everything that is broken. Brave humans call for resistance, branding the fight as: “Heroes vs Hydras.” Some even look to a bright future, predicting that the hydras will soon go the way of the dinosaurs.

Anything is possible

Yet, anything can happen in a world where three-headed hydras, when threatened, use their considerable power to influence every part of business, governments, the tech world, and the infotainment industrial complex. Will they win? Will they lose? Or, will they pretend to lose while surreptitiously keeping control?

Yes, the future is uncertain. But, hydras are easy to spot once you know what to look for. Defeating them will take resistance, resilience and coordination. We know how to make it happen. Read on...

Tales from the Battlefield: Katherine and Dom’s Report

We were invited to one of those “let’s get out of here” quick latte breaks by what we thought was another human, a new colleague in a new organization we were collaborating with. As she over-shared about her troubled teen years that fueled her desire to do better than the “losers” (her term) and allowed her to fund a McMansion remodeling, a hot tub and her husband’s collection of antiques, something inside our heads clicked: “Get ready, right as your lattes arrive she will sprout three heads, ruining a tasty treat.” You know the feeling. There was something off about this person with a smile far too wide for a human face. She would soon emerge as our nemesis, the uber-hydra with writhing heads of Apathy, Envy and Fear unmatched by any we had ever encountered before. It would take every ounce of courage, cunning and creativity to overcome her and her far-reaching scaly and oozing appendages. Ultimately, we did win the battle, but not without huge costs and scars. This corrupt hydra’s weakness was her total incompetence.

Episode 3

We fix the pandemic and disruption one county at a time.

The three-headed hydra of Apathy, Envy and Fear has news for you.

Our world is one where our phones, tablets, laptops and desktops all scream for attention, asking us to save humans around the world. One “like” is all any site wants (along with a donation). There’s another way.

Our hope for surviving this pandemic, economic disruption and “societal reset” rests on getting change agents within one tiny geographic area on the planet — just one county, your county — to focus on raising everyone up. It is as simple as possessing a shared vision.

You may live in a nice place near a city center with food and wine delivery available 24/7, but if you look at the data focused on your county’s residents, a third of your families may lack access to medical care, food and other survival services. Even if your entire county is a shining light of abundance, the next one over is most likely not.

We first survive, then thrive.

You might be asking, why focus on ensuring all county residents have access to survival services? Why not just focus on a city, or work within one community at a time? Across these fragmented states of America, many counties are either rural or have vastly under-resourced urban areas. Both possess punishing disparities and all the problems that come with lack of resources. And that was in “normal” times. Mix in a pandemic, add an economic free fall with a splash of uncertainty and we have a recipe for disaster.

One city within a county might be doing well (during this upheaval) and have a larger economic base from which to fund solutions. City-county partnerships should be the goal, once you get off Netflix and connect with your local survival services. Just ask, “What can I do to help?” Better yet, ask your local elected leaders in bold emails, “How do we ensure every family and community member has food, safe shelter and timely access to medical care?”

As you most likely think, fixing decades of health disparities and all the problems attached to accessing related services may sound, to be candid, impossible. In your county, you may find that it will take a majority of your city council, county commissions and school boards. That may sound like a lot, but that’s fewer than 100 people who control all the priorities and budgets of key services for surviving and thriving. It’s fewer people than many middle class people invite to their weddings.

If networked and mobilized with a shared vision, the power of all cities within a county’s borders can raise up every community. Everyone. Everywhere. We like to think that this vision is quite pragmatic. If we get all 3000+ counties working in the US, we reinvent this troubled nation and make vital services available to all.

We have so much to gain by sharing a vision and collaborating to create a society where 100% can thrive. The alternative is something so dark we don’t wish to consider it.

Tales from the Battlefield: Katherine’s Report

“1% of our budget? Are you out of your minds?” screamed the three-headed hydra—with the head of Fear taking center stage.

(5 minutes earlier.)

As Dom and I sat in the waiting room, we thought we had come up with a pretty simple funding formula to create the local program to ensure our most vulnerable families’ safety. Our idea (and slogan) was “1% for 100%.” If city and county governments, working in partnership, dedicated 1% of their budget to fund a continuous quality improvement process to ensure that 100% of residents had access to ten vital services for surviving, real change could happen in communities. Our local partners agreed that this was a formula that seemed to make sense. That is, until it was time to actually talk to the mayors, city councilors and county commissioners.

Once inside the conference room, a tangible sense of fear permeated the air. The hydra’s head of Fear, was explaining (mansplaining? hydrasplaining?) how local government ran and how in times of crisis no percentage of a locality’s budget would be earmarked to ensure vital services. We were lectured that even in calmer times, it was not the job of city or county government to ensure vital services.

I tried to explain that it was precisely during a crisis that the local government had to take a leadership role and commit whatever it took to keep families, and all vulnerable residents, safe as the economy collapsed and small businesses and jobs disappeared. The hydra ushered us out the door with the classic line of “good luck with your mission” that translated into “get lost.”

Q: Amid all the distraction from across the globe, why should we focus our attention locally?

Episode 4

The three-headed hydra invites you to do nothing.

The three-headed hydra of Apathy, Envy and Fear has a gift for you.

Your capacity to do something profoundly important in this era of rapid change is within reach, which is why you’re reading this book.

Despite torrents of information, advances in technology and best intentions, we have yet to ensure that all residents have access to the services for surviving and thriving. You don’t have to dig into the data to know how dire things can be for many. We know that fixing this predictable and preventable state of affairs is the right thing to do. We know how to do it.

Whether during so-called “normal times” or episodes of crisis and instability within a pandemic and economic disruption, there are key local services that keep us healthy, safe and resilient.

Timely action is required.

There is a strategy for all local leaders (your city council and county commissioners who all live near you) for ensuring that the services for surviving and thriving are in place for all residents in your city and county. As we often say, you don’t have to save the nation or world, just your neighborhoods within your county’s borders.

First we survive

Developing the list for what we call “survival” services has been known for a long time, at least since the days of Maslow (if this doesn’t ring a bell, Google “maslow’s hierarchy of needs”). People need to be confident that they will survive before they can thrive. We all require stable shelter, a secure food system, medical care, behavioral health care and transportation to the vital services. All it took was one public health crisis to show us just how important these services are and, equally important, where gaps in these services existed in both urban and rural areas.

Then we thrive

Our list of five “thriving” services came together as we took a close look at which services empower children and parents. These give all family members the resources to succeed in school, job readiness and community life, which in turn make them even better prepared to handle crises. These services include parent supports, early childhood learning programs, fully-resourced community schools with health clinics, youth mentors and job training.

Talk to any health care provider or first responder and it is clear that our focus on ten vital services could have a significant impact on reducing a host of social challenges, including lack of readiness for a public health crisis and economic free fall.

For example, with robust communities equipped with ten accessible and user-friendly services, everyone could access timely and effective medical care so that outbreaks like COVID-19 would be quickly contained and neutralized through organized accessible testing and treatment. We would also expect to see a reduction in every costly public health and education challenge: substance misuse, depression, suicidal ideation, untreated mental health challenges, low school achievement and school dropout, bullying and school violence, domestic violence, sexual assault, low birth weight babies, teen pregnancy, poor nutrition, and lack of job readiness.

We have the recipe for making your county fully prepared to handle times of unexpected challenges and crises. It’s simply awaiting implementation. All we need now is you (yes, you the change agent reading this) to contact your local elected leaders and draw their attention to a public blueprint for establishing and updating a system of services that ensure all our families and community members survive and, equally important, thrive.

No more tinkering

If you just want to tinker around the edges of the problems with our lives and yours in the balance, then a bold, data-driven plan of action is not for you. If you are looking for the next social Mars-shot-level initiative designed to fix everything that’s wrong with how the fifty “united” states treat their most vulnerable residents, please keep reading. (Remember! During a crisis, we are all vulnerable.)

A plan, not a miracle

Let’s be very clear. Solving problems related to health care access and all the services we require will take courageous efforts in state capital buildings, city halls, county offices, school board meeting rooms, community centers and university presidents’ offices.

We all must recognize that it’s up to each of our fifty states and their own counties to customize a strategy for ensuring ten vital services. No easy fixes, no miracle app, just one radically simple strategy to implement county-by-county. It’s a process that can be started by you with one email sent to each of your county legislators, the mayor and city council members.

100%

Let us revisit our favorite percentage: 100%. We’re all in this situation together — and we need to keep working until 100% of us are safe and secure.

Ask any socially-engaged, caring person about the status of this troubled nation and you will most likely learn that, deep in their gut, they know that there’s something very wrong with this country. There is a nagging feeling, especially when you have ample resources and a comfortable life, that — for a country that prides itself on compassion — we are not living in the American culture we were supposed to grow into. Somehow, we strayed from the ideal symbolized by a huge statue in New York Harbor welcoming the most vulnerable families on the planet. This is made clear every time we have a public health and man-made economic crisis.

Our future depends fully on you and the elected leaders who guide states, counties and cities. Is this an easy mission? Far from it. The three-headed hydra of Apathy, Envy and Fear will attempt to block you every step of the way. The hydra hopes when you’re done reading this article you take no action. We want you to disappoint it.

Tales from the Battlefield: Dom’s Report

It is my worst nightmare, having to sit with potential funders through a lunch meeting. As I look at the two people across the table from me—funders with more millions than they know what to do with—I feel as though I am in a movie with Johnny Depp in his “bar with reptiles” scene from Fear and Loathing in Las Vegas. As the two hosts/funders, who have suddenly transformed into giant mutant three-headed hydras with chopsticks, continue to make insipid comments on the quality of the Sushi, I look at Katherine for a sign we can end this apparently useless meeting—a convening called by the hydra hosts. But because it’s a meal, we are forced to follow certain social niceties. I do my best to steer the conversation to our mission but we end up back with the hydras sharing insights like, “It’s just so difficult to get good chicken teriyaki in Santa Fe, don’t you think?”

Episode 5

In a

pandemic, physical distancing is not social distancing

The three-headed hydra of Apathy, Envy and Fear wants you isolated.

Where were you when it happened? We all have our stories. Dominic shares his:

It felt like a movie when Sara, the manager of the hotel said, “They say they are closing the border so you might not get out.” I was near the end of my week-long writing retreat in Mexico. My brain was racing, “Will they really do that? Do I change my ticket? Can I get through to the airlines? Do I wait it out here for a week? What if it turns into weeks or months?” I returned to Santa Fe the day before the border was closed to non-essential personnel.

Stay? For how long?

Sitting at home, in self-imposed isolation for 14 days, I had lots of time to reflect on what this public health crisis meant, or could mean. I thought back to living in Manhattan and standing in the Hudson River Park looking down twenty blocks to the Twin Towers on 9/11. The planes had hit earlier and now, as crowds gathered, the towers collapsed. Soon the military arrived to take control. The next day, still in a state of trauma, I was on the Today Show sharing recommendations from my new book on family communication about violence. It was surreal. I remember having to pass a checkpoint, showing ID to a soldier to get in and out of my neighborhood. Like everyone, I wondered what could happen next.

I thought back to another public health crisis I had lived through. That one more slow-moving but deadly to many in my city of San Francisco during the 1980s. I was working on a public health project for UC Berkeley as very angry and fearful AIDS advocates, who had lost many friends very quickly to the infection, called on the Federal government to help the infected. “Silence = Death” was their slogan.

And then there were three

Now it’s three public health crises. Three very different eras pre- and post-internet: AIDS, 9/11, COVID-19. Ironic, to say the least, as my job is working to ensure that everyone in New Mexico has timely access to medical care, food security, stable housing, mental health care, transport and five other vital services. The mission to identify gaps in services and fix them across 33 counties has never been more urgent. I can’t help thinking, “Where will this pandemic lead? To long-term hoarding or helping?” From my streaming feeds, emails and links, the one phrase I keep seeing repeated is, “We’re all in this together.”

A sign we are on the right track is that all my meetings with community mobilizers—those dedicated New Mexicans surveying families to measure gaps in health care and other key services, and why those gaps exist—were not cancelled. Instead, I find myself in video conference meetings throughout the day. I see twenty earnest faces on my desktop, representing the leaders in city and county government, along with stakeholders in medical care, higher education, law enforcement and the nonprofit sector. The work to ensure the safety and health of families and all community members is not going to miss a beat. Together, we can confront the three-headed hydra of Apathy, Envy and Fear (in the form of power brokers who control resources, in this case).

What’s very clear is that physical distancing is not social distancing. Far from being slowed down, problem-solvers are more motivated and productive than ever. Groundbreaking work awaits all of us as this societal reset button is being pressed. Our role in this pandemic and economic disruption is clear.

Mobilize!

Tales from the Battlefield: Anonymous Report

What I found fascinating, as we were told to take unprecedented actions and to stay indoors, was how we were given no inspirational talks on how to use this unique situation to build a sense of shared purpose with the community. As we adhered to prudent public health policy, to all our collective benefit, imagine if our leaders had said:

“While staying at home, all of us can use this opportunity to examine our biggest social challenges—including an alarming lack of accessible and fully-resourced health care systems. Let us commit to educating ourselves on how best to move forward state by state, city by city.”

Instead we got, “Await further instructions.”

Q: How do we turn physical distancing into an advantage against hydras?

(hint: a lot can be accomplished online!)

Episode 6

The three-headed hydra wants you to think small. So think huge.

The three-headed hydra of Apathy, Envy and Fear has left you a message.

When confronting the consequences of the pandemic and economic disruption, should we prioritize workshops on “adjusting to the new normal” or commit to creating timely access to medical care and other vital services for survival?

While to some this may sound out of reach, our experience is that implementing a countywide system of care, that includes access to ten vital services for surviving and thriving, is entirely possible and worth mobilizing around. Yes, it will take a level of collaboration heretofore unseen with most state, county, city, school, higher ed and nonprofit organizations. And yet, we have the technology to make this collaborative effort entirely transparent and easy to engage, all while tracking progress.

We have an incredible and historic opportunity to rethink government on every level and to re-prioritize. It’s all about collaboration, data and technology. And pulling it all together, is a shared vision.

What we knew

Pre-COVID-19, there were surveys taken by families that revealed how many people in a county struggled to access five “surviving services” of housing, food, transport, behavioral health care and medical care. We learned that as many as a third of county residents might be struggling to access health care. This is not good news in a pandemic.

Surveys also revealed to what degree parents needed, but could not easily access, the five “thriving services” of parent supports, early childhood learning programs, community schools with school-based medical and mental health care, youth mentors, and job training. Survey respondents told anyone who would read the survey results why services may be hard to access. Barriers to services vary widely, including reasons related to cost, quality of services, meeting guidelines, ease of access, transportation and language issues.

What we need to know

Today, survey results might look different. It all depends which way things go with infection rates and the mystical forces that impact the job market. More middle class moms might report concerns about getting in to see a health care provider and worry about the local supermarket limiting hours and purchases. Older residents might express concerns about accessing everything if they are told it is prudent public health policy to never leave their homes. As for services like job training, survey takers of high school and college age may wonder what types of formal education will align with the future workforce (as though anyone really knows what the brave new world of jobs looks like).

A really big and bold vision

What we can learn through surveys is how vulnerable we all feel. Trust us, if you don’t feel vulnerable you are not paying attention. To address our collective insecurities, we require a groundbreaking and ambitious vision. We need progress toward a solution to any public health crisis and economic free fall.

There is a vision that is radically simple. Ten services can change how we live, work and care for each other in normal times and crisis.

We know the gaps in key services that doom families to costly health challenges. These disparities have been hurting many of our families for decades. Now gaps and potential chasms can impact the majority of the population. We know which ten services can empower families and all community members and have the evidence to prove it. We also know the steps needed to empower state, county and city lawmakers to collaborate and change “business as usual” into a new way of governing and providing for every child and adult in the aftermath of the pandemic.

Big ideas are feasible because you’re reading this

We know which skills, capacity, relationships and experience are needed to make a local plan for ensuring the services for surviving and thriving a success. We know the funding implications for state, county, city and school budgets and stand by our belief that what we propose saves us all money in the end. Not to mention that it’s plain fair and will save lives, which are both proud American qualities.

It’s time to change the trajectory of local government to solve public health problems and economic instability. It’s time to generate robust public and private sector partnerships. Those partnerships are vital to create a pathway for addressing the root causes of everything we know that we need to eradicate, especially vulnerability to pandemics and economic upheaval. Along with way, we can also greatly reduce substance misuse, violence, abuse, trauma, school dropout, underemployment and lack of self-sufficiency.

The hydra lacks and fears a bold vision

The three-headed hydra of Apathy, Envy and Fear, sitting in positions of power in your city (and screaming for attention on your mobile), would like you to think small. You can do the opposite and develop a proposal that advances a clear, cogent and compelling vision for the future — one where every child is a priority, every parent is healthy, every student is empowered, every entrepreneur is encouraged, every elder is respected, and every community member is well-resourced and inspired to succeed with family life, work life, economic development and community engagement.

Quite simply, if we have the vision and technology to create a society where 100% of us have the resources to learn, work hard and thrive, why on earth would we settle for anything less?

Report from the Battlefield: Dom’s Report

Katherine is calling me and she is the most angry I have ever heard her. She has just had a meeting with two wealthy old guys who have access to all the funding one would want to ensure that all Santa Fe County’s families have the resources to survive and thrive. As she shared our proposed initiative and vision to make ten vital services accessible for the most vulnerable families, the two guys, now fully-morphed into drooling three-headed hydras in bolo ties and cowboy hats, felt the need to mansplain a few things to her. Of course, it was the head of Apathy who spoke first, “Listen, little lady, you really should set your sights on a much smaller goal. You can’t take on big challenges like what you’re describing.”

Episode 7

Apathy suggests you not worry. History suggests you do.

Meet Apathy, the most charming head of the three-headed hydra.

Everything we’ve done so far has led us to this status quo of colliding crises.

It’s time to explore the root causes of why our nation has done so very little to prepare us for a pandemic that requires we stay at home until we require hospitalization at an overcrowded facility regardless of how much insurance we have, and an economic disruption that may mean the end of many of our jobs and challenge our capacity to thrive. If that sentence sounds dire, it’s meant to be a wakeup call for you, everyone you will communicate with or ever vote for.

For those of us with decades of work in both field and central offices within state government, we theorize that there are a wide variety of reasons for each of our fifty states not addressing long-standing public health and economic disparity challenges that make this pandemic tough to face.

Hunches, not data

A lot of work to strengthen systems of emergency readiness, crisis response, public health and education in the public sector is not data-driven. You would be shocked to learn how many projects are funded based on the hunches of the three-headed hydra of Apathy, Envy and Fear. There are noble exceptions and we hope you live in a state and city guided by a data-driven process to attain measurable and meaningful results as the pandemic and economic disruption unfold.

Lack of alignment

Government agencies and nonprofits serving the same population might not coordinate their efforts but, instead, work isolated in their own separate silos. Ask your city councilors how much work is being done in alignment with your county commissioners related to ensuring ten vital services for surviving. Yes, there are models of exceptional collaboration to learn from but they are not the norm. They should be.

No root cause analysis

Most work in the public sector, even that which has private sector support, is not focused on the root causes of problems. We look at symptoms of problems like why first responders don’t have enough protective gear. We need to ask, “Who in the county has the job of ensuring a stockpile of vital medical supplies?” We see hungry kids. We fail to ask, “Why does hunger exist in my town?”

We tinker

Public sector organizations, think tanks and foundations might only have the capacity to tinker around the edges of a challenge like COVID-19. We can easily go back a few decades to identify that many families in most of our 3000+ counties may lack access to timely health care. Given the millions upon millions of dollars floating around philanthropy that is focused on family health, why do predictable and preventable health disparities exist in 2020?

Unsustainable solutions

Few projects supported by the federal government or foundations have a realistic sustainability plan. Once funding ends, so do the innovations. With COVID-19 and an economic free fall, watch closely to see how long projects designed to help the vulnerable (that would be all of us) exist.

Isolated academics

Some academics become isolated from the communities in which they are based. In our universities, we don’t lack for brilliant minds with a deep understanding of the social determinants of health calling for social justice and research-based solutions. We do lack the voices of reason being loud enough to counter the commanding voices of the three-headed hydras in positions of power.

Few developed systems

Parts of the US are, in many respects, more like a developing country than a developed one. It only takes one public health crisis to show everyone how lacking we are in medical care facilities, supplies and food banks. We all should be painfully aware that neighboring communities lack access to timely health care. We know that some of our families live without electricity and water in one of the wealthiest nations on earth.

Social norms

We have a social norm in many communities that says people don’t inherently deserve help — especially people different from ourselves. Attend a government committee meeting or a public forum and you will hear, “People should fix themselves without help. I did.” In a global pandemic, that attitude will not work out so well for all of us.

Not connecting dots

Coalitions focused on a particular health issue may fail to have measurable and meaningful goals guiding the work. To some coalitions, just meeting to discuss the problem is enough; passing policies to ensure survival services is not part of the program. Groups, filled with good-hearted people, may be too focused on one specific program or issue, and aren’t looking at the interconnectedness of a variety of challenges that clearly intersect. We have to connect the dots today. A pandemic leads to economic disruption, lost jobs and an urgent need to ensure the ten vital services for surviving and thriving.

Questioning the hydra

No one wants to risk being marginalized for speaking very inconvenient truths about disparities and crisis-readiness programs that fail to achieve results. The three-headed hydra leads a lot of meetings and discussions. Will you be brave enough to question a powerful hydra guided by Apathy, Envy and Fear?

Now the good news

There is good news. There are shining examples of government leaders, medical directors and organization managers doing things right. Models for taking care of 100% of us exist and are guiding heroic efforts in some counties. These are the individuals and entities you need to connect with and emulate. Today.

While we can use blogging platforms like Medium to debate the root causes of the health disparities and social adversity we find ourselves facing, we know such analysis can only take us so far in creating a master plan. We need to focus on the end game: creating a countywide system (in your county), guided by champions (you), where every resident (your family, friends and those kids on the other side of town) can access ten vital services easily in what we call “normal times” and those periods today that are chaotic.

The three-headed hydra’s calming head of apathy suggests you not worry about a thing. History suggests you do.

Tales from the Battlefield: Dom’s Report

I am in a meeting with a government official and my expectations are high as this guy is very well-educated. It has been a tough month, doing my best to explain to dozens of leaders how all the costly social challenges that children face are predictable and preventable. Sadly, all meetings ending with their eyes glazing over. I think this meeting will go well until the guy at the head of the table morphed into hydra. The swirling head of Fear took the center stage, while Apathy and Envy barely raised an eyebrow. It was Fear that filled the room, fear of taking a bold stand and risking disapproval from voters. Instead of leaving the office with a commitment to move forward, I am left with these words reverberating in my mind, “You just don’t understand…” Again, another lecture of civics in the US on how things work in government.

When I was told, “We cannot take responsibility for our residents having access to health care and all those other services.”

I countered, “I understand perfectly well how the government works today… What I am pitching is a new way for the government to work. You know? In that concept we call “the future.”

Draw your own hydra in the space above. Remember! Fat-headed hydras have three heads and often pretend to be human!

Episode 8

Bored in a pandemic? Binge the best new show: Hydras vs. Heroes.

Hydras vs. heroes. Who will win?

Most of you reading this don’t see what we see every day. As you do your best to make the day pass without a tense altercation with the boss, the kids, the spouse, the co-parent, the grandma or the “friends” on social media, the fight of the century is going on.

We must unite to win.

Three-headed Hydras vs. the Heroes of Planet Earth

You can’t find it on Netflix. Yet. It’s playing out in video conferencing calls between your elected leaders and those who run the state and local institutions of public health, higher education, workforce development and other government agencies you may only have passing knowledge of. The fight between those in power makes Godzilla look like Mary Poppins.

In one corner we have the hydras guided by Apathy, Envy and Fear. In another corner we have the heroes, committed to compassion, creativity and courage. The battle, like any good Terminator movie, is over the future of humankind. The stakes are real and about as high as they can get in a global pandemic and economic disruption.

The battle is all about our health and safety. Important decisions are being made on state and local levels. Usually, a senator wants one thing while a mayor wants another, and, as one medical director says, “This is how we move forward together.” Those controlling million-dollar agencies are on a virtual battlefield, and with all the explosive conflict at all levels, it gets hard to see which side they are on.

As we sit in on meetings of local heroes and engage in surreal email debates with hydras, it is obvious that some of our three-headed monsters just want the whole mess to go away. Their unrealistic plan is to return to the pre-epidemic status quo when their superpowers were at their strongest. (Note: Three-headed Hydras vs. the Heroes of Planet Earth has no time travel and no hydras get to return to the past.)

What’s clear to anyone paying attention is that three-headed hydras hate change, which to them represents loss of control and privilege. Their strategy is to obstruct all innovation for as long as they can. Meanwhile, heroes in every city work tirelessly to solve problems and take care of the vulnerable (that’s all of us).

What the hell is happening?

If this were a superhero movie, this is the part where the scientists watching the raging battle over giant view screens explain to the audience what’s happening. Rotten Tomato’s reviewers would say this part of the show was “too talky.”

SCIENTIST ONE

Why do the hydras fight us, doesn’t everyone deserve access to medical care?

 Scientist One takes off his Mission Impossible-like mask, revealing three heads of a hydra. Scientist One reacts in horror.

SCIENTIST TWO – FEAR HEAD

Deserve access to medical care? You fool, this isn’t about that. If people find out that not everyone can access medical care, it might make me look bad! Then I might lose my funding, or worse, my job!”

SCIENTIST TWO – ENVY HEAD

Plus if we point this out and Milagro Medical Clinics step up and provide access, they will be the heroes! Not me! I alone am the hero!

 Scientist One runs for the door as Scientist Two – Envy Head hisses.

Reality vs. Fantasy

If Three-headed Hydras vs. the Heroes of Planet Earth was being pitched as a new Netflix series, we doubt the money guys would fund it. Captain America battles the Smurfs might sound more realistic and binge-worthy. Of course the reality is, we are all in this movie whether we like it or not. Not only is the ending far from being written, but you are being offered a speaking role. We’re casting for heroes.

Q: If our reality were a Netlix series, what role will you play?

Episode 9

City Hall in a Pandemic: 3 actions to avoid 3 really terrible outcomes

How can City Hall protect us?

What we need from city hall is a commitment to assess how all residents are doing. We require a department that has the capacity to use data to identify where gaps in vital services exist. This is easily done by asking residents of all ages, “Can you access the services for surviving and thriving? If not, why not?” With data, city hall can take the lead in fixing gaps and creating a seamless system of health, safety and empowerment.

To avoid three terrible outcomes

What if hospital beds fill up?

1. No hospital beds

We don’t want ambulances with sick people waiting outside hospitals for hours because there are no beds available or infected patients on gurneys pushed against the walls of busy hallways, all because we did not enforce prudent prevention efforts and build the capacity of health care providers.

What if food pantries are foodless?

2. No food security

We don’t want long lines for food pantries and shelters because we did not address the growing food insecurity issues as business closures and joblessness increased.

What if shelters are full?

3. No housing security

We don’t want our public parks turned into tent cities (as they did in the crash of 2008) because we didn’t have a plan to support our most vulnerable residents. Many will become homeless and a high proportion will have untreated mental health challenges.

Take three actions

City’s leaders require experts.

1. Empower leadership in vital sectors

We do want our city’s leaders in daily communication with the City Directors of Housing Security, Food Security, Medical Care, Mental Health, Education, Child Safety, Jobs and Community Policing all engaged in ensuring vital services during the pandemic and economic turmoil.

City leaders can align all actions.

2. Align actions to ensure care

We do want our city’s leaders in daily communication with the City Manager, County Manager, the Governor’s Office and State Public Health to ensure all work is being done in alignment, with data-driven strategies, to create a system of safety and care that serves all city and county residents.

Cty leaders can connect.

3. Communicate and invite dialogue

We do want our city’s leaders in weekly communication with the public to provide updates on progress being made to ensure all residents have the vital services for surviving and thriving—as colliding crises unfold.

Can it be done in your community?

If you wonder how a government ensures the safety and health of its people know that there are many societies and government that do have a plan and make people’s health a priority. Your job is to make your society one of them.

Tales from the Battlefield: Katherine and Dom’s Report

We get to engage with the most inspiring people on earth. Amid three-headed hydras who do their best to derail, disempower and dissuade, our community partners (heroes) are unstoppable. They all have one thing in common: a vision. They have the capacity to see a future when everyone thrives and they work daily to get to that future. Time spent with these folks is synergy that inspires and we developed what we call “The 100% Power Hour” to connect with each county team once a week with video conferencing. We tackle the question of the day, exploring a local challenge. We are part of a collective process whose members fully understand that we are in for the long haul. With 100% Community we are taking on a groundbreaking project that has never been accomplished in the nation. Until now.

Q: How will you engage your city hall in hydra prevention?

Episode 10

Your elevator ride with the mayor, Bill Gates and Oprah

Get your elevator pitch ready.

We don’t know how it happened, but you have just found yourself in an elevator with your local mayor and philanthropists Bill Gates and Oprah Winfrey. You have three minutes to pitch your brilliant idea focused on addressing the pandemic and economic disruption. To impress them with your bold idea for saving your city (and state, nation and planet), remember this very long sentence that describes basic communication in six components.

We pitch solutions

Who says what to whom, for what reason, through which process, with what results?

Just to reiterate, what this 14-word sentence details is everything you need to know about communicating with those leaders and stakeholders who hold the success of your (or any) brilliant project in their hands. As you contemplate connecting with Mayor Albert, Mr. Gates and Ms. Winfrey, be very clear about the following:

Who?

The “who” is you, or more accurately, who is doing the reaching out. When you begin to reach out to the trio, be very aware of what we call your “public face” and who you represent.

Says what?

What is your message? You may have many things to say during the 3-minute elevator pitch, but focus on the top three most important issues. You may wish to share that, 1) You have a brilliant idea. 2) Based on research, there is a significant need for your brilliant idea. 3) Support can make the brilliant idea a reality.

To Whom?

Be very clear about whom you need to connect with and why the relationships matter. If your idea is related to city food security policy to ensure that every family has access to food pantries, focus on Mayor Albert. If your idea involves technology to improve health outcomes in a pandemic, turn to Bill Gates (as he and his wife fund innovation through the Bill and Melinda Gates Foundation). If you seek philanthropy to develop the model for ending the digital divide and ensuring that every child in your state has access to state-of-the-art web-based education, talk directly to Oprah (and use eye-contact, she likes that).

For what reason?

Be very clear about why you are pitching an idea to these people. You need to convince them in minutes that your brilliant idea is needed, doable, measurable and meaningful.

Through which process?

You, like billions of people, want the ear of Bill Gates and Oprah Winfrey. You not only wish to be heard, you want them as a partner to support your brilliant idea. It’s all about personal style so just follow the golden rule: be polite. Be prepared with a one-pager that clearly describes your project and why it’s important. (Mr. Gates might prefer a 60 second Powerpoint presentation.) Have reliable data to make a point. Listen closely to what your potential investors and/or collaborators say. Your mission, in a first meeting crowded in the elevator, is not about getting a “yes” — it’s about exploring a connection.

With what results?

The goal of any meeting, even a quick elevator ride, with persons of influence should be to make that magical connection, share vital information and explore mutual interest in a brilliant project. (By the way, with folks like Mr. Gates, Ms. Winfrey and the mayor, it’s their “people” who may become your biggest supporter, so never be dismissive of the support staff who often wield great power.) After your elevator ride you should assess what took place — or at least what you think took place. Follow up with a thank you note, flowers and chocolate. (Mayor Albert loves those thin mints.) If you pitched your brilliant project with clarity, earnestness and intelligence, you might hear from the trio again. If not, get back into that elevator with the classy ridership.

The world needs your brilliant idea funded.

Tales from the Battlefield: Katherine’s Report

Dom and I enter the room and so far, the seven people at the table look human. This was one of those meetings with people who claimed to love what we are doing and want to help. We give our pitch and heads nod and smiles broaden. When “the ask” finally comes, the guy who had been dripping compliments for weeks via emails and calls, turns from glad-handing beaurocrat to three-headed hydra. Dom and I stared at one another—this was far from our first rodeo with hydras—as the three heads of Apathy, Envy and Fear were all talking at the same time. As the almost indecipherable babbling went on with three snakelike heads, everyone at the table continued smiling and nodding. Such as it was, and is, in the meetings of people of power. We all sit and indulge the hydra. We have to. They control the purse strings. In this situation, Dom and I were caught off guard, as who we thought was a trusted colleague turned into a hydra, with not only a list of reasons why funding for local communities would not be coming, but a thinly veiled threat to take us down if we question him or his minions.

Episode 11

Awake! Breaking the hypnotic spell of the three-headed hydra

The hydra says, “Relax.”

Two realities exist. There’s the reality we live in, and then there’s the one that’s broadcast to your television, radio, social media and mobile devices. It’s best not to confuse the two.

When it comes to any insights provided by the mass media into the root causes of our public health challenges, including being warned far in advance of impending viral infections, we report a big failure.

So where does that leave those of us who want to use the mass media and global technology to engage residents in mobilizing around access to surviving and thriving services, and the prevention and treatment of health challenges during a public health crisis?

You are feeling very sleepy.

An endless stream of clutter

We would venture to guess that of all the content coming at you on your various devices, 90% is just noise. And, that’s not news to you. The biggest problem is the content that claims to be doing “something” — promoting organizations or individuals that purport to be involved in addressing social challenges but, sadly, producing few documented results. For this reason, we must be critical consumers and always seek data that indicate measurable and meaningful change.

The only way to know if problems are real, or solutions are actually helping your community, is to identify reliable data and, quite honestly, go see for yourself. The real work of helping each child, parent and grandparent is county-based for a number of important reasons, and one is that you can simply drive to most communities to see how people are doing and what services exist.

You have what you need to proceed with the work on ensuring ten vital services for surviving and thriving. You don’t require any content from news and media agencies to explain how your local world works.

You feel calm and rested.

We interrupt this article with breaking news

“This just in,” says the newscaster. “We’re living in a giant convoluted and mostly mindless world of media. Your mobile devices invite you to swim in a sea of distracting clutter during this era of colliding crises.”

Where to begin

Many of us guided by social justice and the belief that we are all in this pandemic together, are doing our best to keep up and make a difference. So why is it so difficult to create a national (or state or community) sustained dialogue about improving systems of care?

Why can’t our so-called progressive shows engage in sustained commentary on the collapse of a safety net for our most vulnerable families. Why don’t we see local news outlets publishing to-do lists on how to fix communities where parents report a lack of access to medical care, food and stable shelter? Why don’t national publishing companies publish books that inspire us to invent state systems to ensure safety and stability when economies collapse, instead of self-help books asking families to fix themselves without resources?

And as for movers, shakers and innovators, why don’t entities like TED (or any conference on health, safety and education) promote ideas that take on systemic challenges, instead of talks that tackle only a nicely-packaged sliver of a problem? We don’t doubt the good intentions of most folks in the media profession (except the three-headed hydras at the top who control most of the media corporations), we just need them to embrace what we call “systems thinking” that leads to positive results.

Speaking of hydras and their hypnotic spells, we are living in an unprecedented time on earth when many are opening their eyes to stark challenges. If you are reading this , you have the power to find synergy with colleagues and friends. We can force multiply our problem-solving powers. The solutions to every problem that the pandemic and future crises presents are staring us in the face.

Consume but with caution

Are we saying you should not keep up with current affairs? No. You should. But, do your research using reliable sources and read with a critical eye. Even when you read an article about health policy on COVID-19 or an evidence-based program to increase health care, you have to scrutinize every paragraph, check all data sources and find similar articles to compare and contrast.

Being informed is difficult, time-consuming work. The alternative is living under the hypnotic spell of the hydras and being asleep during one of the biggest disruptions on earth.

Tales from the Battlefield: Katherine’s Report

I am watching a news segment on medical care challenges with a panel of four leaders in health care. A very earnest-looking reporter is introducing the talks and, like something out of a David Cronenberg horror film, in mid-sentence her entire body splits open like a giant banana being peeled to reveal a three-headed hydra. Yet the panelists don’t seem to notice anything and the talk continues without a word about centuries of health disparities in the US, the fact that in some counties, a third of the population seeking care can’t get to it. There is no context in this conversation. No explanation of how we got to this place where timely medical care is a luxury for only those who can afford it.

Episode 12

The three-headed hydra has a Plan A. We propose Plan B.

The hydra has a plan for you.

We all watched a global pandemic unfold using all forms of technology that were pure science fiction only decades ago. The book you’re currently reading wouldn’t exist without modern technology, so yes, we embrace it as a friend.

We always have a Plan B.

Plan A

The three-headed hydra of Apathy, Envy and Fear loves the newest technology and is delivering his “Pandemic Recovery Plan” to your mobile devices. The hydra, a power broker in government and mass media, says that you will love the plan. And it’s under twenty words.

“Trust us. Everything’s going to be fine. HBO has an amazing new show to binge watch. Great stuff ahead. Keep spending money.”

Plan B

If you would prefer another path, read on.

New Mexico’s entire 100% Community initiative, designed to ensure that all residents have access to the ten vital services for surviving and thriving, is only possible because of the power of modern technology. We are grateful for that.

But what impact does technology have on capacity to address a public health challenge coupled with economic disruption? The business models of Amazon and its top competitors’ show that it is possible to deliver vital resources rapidly. The ubiquity and power of smart phones means we can share crucial information across town and the planet instantaneously. Online conferencing technology allows us to offer virtual training sessions from the comfort of our homes as well as check in with the most vulnerable members of remote communities, without a three hour drive. And, rolling out solutions inspired by TripAdvisor’s review model means we can identify and rate the quality and accessibility of vital services like a health clinic or food bank then work to fix those with the lowest rankings.

The 100% Community initiative is a continuous experiment exploring how we use technology to launch and maintain a movement to ensure the health, safety and resilience of all residents, county by county.

Evolving technologies can provide community change agents with incredible power if local stakeholders are ready to take advantage of new software and the way it reorganizes public sector and private sector work. Here is a list of how we are using that technology for the 100% Community initiative being piloted in the New Mexico counties of San Miguel, Doña Ana, Socorro and Rio Arriba.

Click. Inspire. Solve.

Thanks to Amazon’s self-publishing tools and distribution network, we were able to publish the 100% Community book series, including textbooks for courses, online and in print with lightning speed.

Thanks to online collaboration software, we were able to combine the talents of individuals across the country (and in some cases, the world) in real time to create additional resources, check facts and brainstorm innovative solutions.

Thanks to email and newsletter management software providers, we were able to create and send weekly messages to state lawmakers and other stakeholders. One was State Senator Bill Soules who became our co-sponsor (with representative Gail Armstrong) of a senate bill to fund the organization that sponsors the 100% Community initiative.

Thanks to Facebook advertising, a city councilor in Las Cruces, NM took notice of our book, ordered and read it, becoming a leader in piloting some of its key policies and organizing ten action teams focused on ensuring surviving and thriving services.

Online radio streaming and podcasting allowed our radio show to be sent to state lawmakers and stakeholders who became champions of our mission.

Online learning management systems allowed us to create the 100% Community course to educate and empower community members everywhere, with links to effective innovations and problem solving strategies.

Thanks to collaborative databases and analysis software, we are able to track all our work in the public sector and use our 100% Community survey to identify what percentage of our county residents need resources (our ten “surviving” and “thriving” services), collecting data on why they are blocked from currently accessing support. We can also use the software to track our innovations and measure to what degree they are making the vital ten sectors more accessible and of higher quality.

We use mapping software to take that data and visualize local services, gaps in services, progress toward solutions and alignment of all county stakeholder’s work.

Widely available software allows us to show the future in the form of innovation prototypes and create mini-documentaries and animated stories to demonstrate that if we do A (for example, invest in a school-based health clinic) we get B (more students, family members, and school staff having access to vital medical services).

We use all our devices to take an inspiring idea (how to create a local system for ensuring students and the elderly get lunches), and go viral with it (friends telling friends tell friends x 1000), share our vision, to be transparent with our goals and activities and proposed outcomes, and gather support for our mission.

Tech, human ingenuity and results

At first glance we see technology as a key component of our work. What you don’t see are the literal years it took to write books, design courses, present at forums (driving four hours to share our story), attend government committee meetings, and engage with countless people to inspire them to help the books and our ideas go viral.

Clearly, the entire process of ensuring a county’s surviving and thriving services, cannot be packaged neatly into one app but how about an app to help organize community mobilizers and services across a county, neighborhood by neighborhood? Would that move the meter? (Ask San Miguel County folks about their new online directory of vital services, noting any changes in services due to the pandemic, developed within weeks.)

One question we ponder often: how can we engage our mobile device-carrying, tech-comfortable residents in our movement to strengthen health and safety systems? We know we can use technology to assist with creating a reality where local communities can ensure that everyone is okay. This is the goal of the 100% Community initiative.

We do know that humans already spend hours (totaling up, we might say “years”) staring at screens, clicking buttons that indicate support or dislike of something or someone, and self-producing vanity projects (podcasts, YouTube videos, etc). Perhaps they would do the same to locate, engage with and rate local resources in the ten thriving and surviving services.

Amid a population glued to their mobile devices, we can use that same obsession to help us keep track of how bad things are for our neighbors — across the street or across town. We can see if trends in maltreatment and all forms of social adversity are rising or falling, then coordinate our solutions accordingly.

Tech’s power and the plan of action

The private sector’s successes are most often driven by taking advantage of the latest technology wave. The public sector, twenty years after mobile phones became affordable to the masses, is still catching up. It might surprise readers to discover how much work in government and nonprofits still requires paper, pens and (until the pandemic) people to drive hours for meetings when online conferencing is free and widely accessible.

100% Community is two initiatives in one — with technology vital at both the state level and the county level. On the state level, we must collaborate with state lawmakers and state cabinet secretaries to improve all systems of health, safety, education and economic development. And our county focus means that we treat each county like a sovereign country, with its own systems of care, safety and learning. The real work is local. And we have a plan of action for you to consider.

Don’t forget. For every data-driven, results-targeted plan we have, the three-headed hydra of Apathy, Envy and Fear has a plan for you, too.

Superheroes Bill and Kasandra connect

Q: What technology will help you defeat the hydras?

Episode 13

Beware the seductive charm of the three-headed hydra

Can you feel the hydra’s love?

We have urgent work to do in a pandemic and you will be slowed down, misdirected and blocked by hydras.

It took the collision of a pandemic, economic disruption and physical isolation across our cities for many of us to come face to face with a stark reality. Our vulnerable families (that would be almost every family) are struggling to varying degrees, wondering what’s happening to health care, school, jobs and what feels like a derailed future.

We know how to fix this. We also know there are some people in power who would prefer we do nothing.

Hydras are cowards.

The Hydra Removal Project

As champions focused on building systems of care emerge, so do the hydras. Some wield great power and we need to identify them, call them out and get them out of the way.

But why do hydras have so much power?

Hydras, especially those who have managed to achieve very high-level positions, tend to manipulate others, often with incredible charm. The capacity to ooze charm, when saying all the right things, is one of the hydra’s greatest superpowers. Giving the appearance of caring, without actually doing anything is one of the hydra’s greatest tools to maintain power. Ultimately that is all the powerful hydra cares about. Remember, hydra’s aren’t necessarily always evil, they just care more about maintaining the status quo and their comfortable lives.

Their superpower charm is used to manipulate others for personal gain or professional and political power. Skilled hydras are very good at hiding their arrogance and a sense of superiority. They say everything you want to hear but lack true empathy for others. They also lack remorse about harming others through their actions or inactions. Many hydras who cross our paths and attempt to sabotage our work fail to consider the negative consequences of their behaviors.

We can’t run, not anymore.

We don’t have the luxury, in a pandemic and economic free fall, to indulge the hydras. They have their weaknesses. At the end of the day, they are ruled by fear. They are cowards and being called out for the damaged and frightened people they are is their kryptonite.

If we can keep their claws off our work, we must do so. If they have the power to derail our projects that represent a lifeline to families, we have to devote some energy to disempowering them. We have to report their negative behaviors to their bosses and boards. We have to remove them from any position where they might have control over you or any organization. But it is also worth noting that many hydras operate from a place of fear. Once they are assured that innovations will make them look good and are not a threat to their livelihood, they might actually turn back into a human.

Devoting energy to defanging three-headed hydras is not what any of us wish to do with our days. Yet, it is part of the work and knowing that this is something you will face can help you prepare.

Q: How will you confront the sociopathic behavior of the hydras?

Episode 14

Is YOUR city hall run by hydras?

The three-headed hydra wants your vote.

We can completely rethink how to leverage the power of cities to make vast improvements to health care, crisis response and our long, winding economic recovery.

City mayors and council members actually have the power to increase or decrease the quality of your life in significant ways. They could, if they were so inclined, be at the forefront of ensuring that the ten services for surviving and thriving are available to everyone in your community. If you are lucky, you have a thoughtful mayor who can clearly explain how the city is addressing the pandemic in chaotic times, but most cities just get deafening silence.

Hydras wreck our cities.

As we went through many months of physical distancing, People started to go a little crazy. Some acted out and defied public health protocols. Many more retreated into ennui, that truly dismal feeling of listlessness and dissatisfaction. What kept us focused and engaged were ongoing calls, emails and video conferences with our elected leaders and stakeholders. While so many folks were shutting down and retreating into Netflix binge watching, we found ourselves ramping up and asking: “What’s the plan forward and how do we ensure all city and county residents are truly in this recovery process together?”

The Plan

We are cautiously optimistic that with the right amount of educating, mobilizing and technology-enhancement, city and county governments can be transformed together into an engine for reinvention and community resilience. We must look to, and collaborate with, our local elected leaders as we lurch toward economic health. We require a new, bold collective vision, goals and measurable activities. We need THE PLAN FORWARD.

We recommend that you put considerable energy into connecting with your local leaders. Our biggest challenge might be getting city hall to see itself as the local power that makes sure all city residents of all income levels have access to the services that matter most. We need one centralized entity that can oversee the quality and accessibility of vital sectors that include medical care, behavioral health care, stable housing and job training to help all of us transition into the post-pandemic/economic free fall world. City hall is positioned perfectly for that role for non-rural residents.

City leaders agree with the hypothesis that if city residents have access to vital services like health care, food, transportation and state-of-the-art education that aligns with the future job market, they have a chance at a successful future. It’s just that up to now, just like county governments, city governments in the US weren’t designed to ensure the availability of such services. As waiters often say in overcrowded bistros with hungry people waiting, “That’s not my table.”

Ten Areas To Innovate

We are reminded of the film The Martian and the line by the stranded astronaut, “I’m going to have to science the sh-t out of this.” Humans have solved problems far more complex than ensuring every person has access to food and shelter. We just need the motivation to do it.

So it is with city hall and problem-solving. We need a level of innovation never seen before. Let’s look at the ten services at the core of empowering families and all city residents to see what role city government has or could have in their capacity to serve all residents, while working with their partners in county government, the schools and higher education.

Behavioral health care

Today, that’s handled mostly by the private sector with some funding for local agencies by the city, county, state and foundations. Tomorrow, cities could take an active role in meeting these needs through the funding of community and school-based behavioral health care centers. Add in telehealth models and we have a citywide system of mental health care (once we ensure everyone has access to the internet).

Medical and dental care

Today, just as with behavioral health, this is addressed by a private sector solution that only people with health insurance or Medicaid can access. Cities and counties might help fund a clinic with a sliding fee scale, but it’s not their job to ensure access to medical care. Tomorrow, city leaders could assess the need, identify gaps in medical and dental care, and push for innovation and partnership to ensure care for all residents. And like mental health care, tele-health models will revolutionize care.

Housing

Today, cities can and do get involved with zoning, building permits and inspections, but they don’t ensure every child and parent has a safe place to live. Housing comes from developers and the private sector. Tomorrow, housing could be guided with care by city leaders, pushing for green homes built locally to serve varied populations: young folks wanting tiny homes, vets with PTSD needing housing with special support, low-income families, people fleeing domestic violence and those with chronic mental health challenges needing subsidized housing so they don’t end up homeless. City counselors can work on statutes and laws that make creating additional dwelling units easier to build and rent — radically increasing local housing options.

Transportation

Today, the city will take responsibility for a bus line, if a line exists. Tomorrow, city leaders could choose to assess the need for public transport and seek out alternatives that will work in both urban and rural settings. Subsidized vans akin to Uber cars might be the answer. Or, perhaps cities convene transport experts to identify best practices from what’s working really well elsewhere on planet earth.

Family-centered community schools

Today, city leaders and school district superintendents (who are sometimes at the county level) do a little political dance, understanding that they represent two distinct groups that must work together in order for residents to learn and get good paying jobs. This means important conversations about how today’s education aligns with the rapidly changing job market.

Early childhood learning programs

Usually a patchwork of funders, from nonprofits and foundations to state agencies, make such programming available to some but not all who need it. Tomorrow, city leaders can make creating a seamless system a reality by leveraging their power and relationships.

Parent supports

Also usually funded by assorted players, programs like home visitation are typically offered scattershot throughout the city and county. Tomorrow, city leaders can be main players in a strategic plan to ensure all city residents have the parent support services that they say they need, as established by a yearly survey of families administered by the city.

Youth mentors

Today, city government might award small grants to a group like Big Brothers/Big Sisters. Tomorrow, city leaders can support a seamless system of mentorship partnered with the county that’s easy for parents to access, with models that are both face-to-face and online (offering mentors with expertise in both “hanging out” and job readiness).

Job training and placement

Today, city leaders look to higher education and assorted vocational education programs to meet the needs of residents as they train for jobs. Tomorrow, city leaders can prioritize supporting education that leads to the jobs of the near-future — those that pay well, include benefits and promotion prospects. If there was ever a priority for city hall then post-pandemic job readiness is a poster child of a candidate.

As you can see, city leaders can be actively involved in assessing the status of vital services, identifying gaps and using their clout to leverage improvements. Note that this is not necessarily an ask for bigger budgets. All of this might be able to be done within existing city budgets with some of it spread out to include the county budget. But, it does ask mayors and city council members to radically rethink what a city does to protect and empower 100% of its residents.

Elected leaders are just like you except…

We have met (and by “met” it might be a long collaboration or a handshake and a one-minute exchange) with many elected leaders, from school board members to city council members, mayors, county commissioners, state lawmakers, congress people and Lt. Governors. If you didn’t know their titles (and that they control the funding that can make or break groundbreaking projects), you might perceive them as your basic nice businessperson with a spouse, kids, mortgage and hopes for keeping the public healthy and safe during good and bad times.

These folks are civil servants and doing important work. They did not sign up for global pandemic/economic disruption recovery. Regardless of which side of the aisle they may sit, they have chosen the public sector to focus their energies in the hopes of helping. How they wish to help is for you to discover. Amid unprecedented change, we believe that the slogan “we’re all in this together” is one most elected officials at City Hall are embracing these days.

Tales from the Battlefield: Anonymous Report

Hydras tend to make appearances at unexpected times, but even the bravest heroes can get caught off guard when the Fear head shows up to block progress. We were in a meeting in a tiny rural community with several high level city, county and school employees. Everyone agreed with our model for ensuring ten services, presented in our powerpoint and the books we had provided. I was in the middle of explaining how access to vital services should be a priority, when things went sideways. Suddenly, a colleague sitting next to me morphed into a hydra and her Fear head said, “I have way too many meetings, I can’t possibly take any more on.” At this point, hydra heads were swirling all around us.

An Apathy head added, in a matter of fact tone, “I think there are actually already task forces that address most of these services.”

“Oh, yes,” chimed in three hydras, which meant nine heads singing in chorus. “We have committees for everything.”

Keeping composed amid the lunacy, I suggested that a good first step might be to list all of those task forces and committees to determine whether they would be helpful in this effort to use a data-driven process to assess access to services. Yet more hydras appeared and another Apathy head stated, “We’d have to schedule another meeting to discuss how we might compile that list.”

Another agreed, “I’d have to check my files and find out when they meet, and I won’t have time to do that for months.” The hydras had once again successfully slowed progress to a crawl.

Episode 15

When we

invest wisely

in systems

of change,

hydras

shudder

The hydra says, “Invest small.”

Three-headed hydras would prefer that philanthropists and all foundations think tiny, only funding small, short-term projects. Luckily, hydras (those power brokers who treasure the status quo) are not the bosses of all foundations and there’s nothing like a global pandemic and economic free fall to inspire big picture thinking among those big givers in the world of philanthropy.

We are measurable and meaningful.

A Billionaire’s Story: Fantasy or Reality?

Imagine if a major mover and shaker/titan of industry, who we’ll call Jake Maker, is a billionaire philanthropist and the owner of global tech firm. Now imagine he wanted to invest his philanthropic dollars in a COVID-19 Recovery Project with a focus on student health and achievement.

Now imagine he sits at his desk and thinks about the Jake Maker Family Foundation and its mission: Our vision is that all young people are prepared to achieve their full potential and make a meaningful contribution to society.

Somehow, amid his emails, he discovers a proposal for a groundbreaking initiative that promises to create learning environments where students have the best chance to succeed. He can see that this groundbreaking initiative provides a model for a data-driven strategy to vastly improve the health and education of students and families. It’s an innovative model that once funded, tested and evaluated, could be replicated in almost any city in the nation.

Mr. Maker, a very smart businessman, understands all about the root causes of the challenges many students face. He knows that if we as a nation do not invest in resourced communities to ensure the health, safety and early education of children, older students won’t thrive. He knows that students don’t exist in a vacuum, and that to enrich the lives of students one must create local community systems to enrich the lives of student’s parents.

Investing in systems of empowerment

In our fantasy world, we can see a thoughtful Jake Maker thinking about investing a tiny percentage of his billions in a data-driven, cross-sector and tech-empowered initiative designed to ensure access to services for surviving and thriving. He’s intrigued with the plan that promises to set up ten pilot sites in ten counties in one state for only $20 million a year, a total of $100 million over five years. The goals of the proposal are clearly laid out with data and research informing the initiative’s hypothesis, inputs, activities, outputs, and short, intermediate and long-term measurable goals.

When Jake Maker calls his foundation director, he says, “Imagine if such a small investment could actually create a new countywide system of health, safety and resilience, and a plan for crisis preparedness, for all families. Just think how such a plan of action could support our mission to empower all students.”

Jake Maker reads the foundation’s mission on the website: Jake Maker Family Foundation supports rigorous, data-driven, result-focused learning environments for young people, from birth to career, to put their education into action. Through investments in research, public awareness and programs, the foundation works to elevate the field of education and improve life outcomes for all students.

Jake Maker stares at the words “birth to career” and it becomes clear that his foundation’s mission will only be achieved by investing in a model that ensures, in addition to fully-resourced community schools, countywide systems of accessible medical care, mental health care, housing and food security programs and job training that is in alignment with future job markets.

Anything is possible with a vision

That imaginative scenario above may not be probable, but it’s not impossible. The point is that we must create well-conceived proposals to share our vision with foundation leaders. And, our “ask” of $20 million a year to reach the majority of a state’s population with an evidence-driven process of community capacity-building and crisis-readiness is, in the scheme of things, quite small. There are cities that spend more than that on keeping their parks tidy.

Each state has a network of independent, self-governing foundations with the resources to do big picture work. There is a movement, supported by technology, that is helping all foundations in a state work collectively to eradicate our most pressing health, safety and education challenges — through collaborative work. That’s a future we are looking forward to.

For many decades, foundations of all sizes have said they are working to improve the lives of children. According to the National Center for Charitable Statistics (NCCS), more than 1.5 million nonprofit organizations are registered in the US. This number includes public charities, private foundations, and other types of nonprofit organizations, including: chambers of commerce, fraternal organizations and civic leagues.

So how can the foundation world empower states, city and counties, strengthening their capacity to confront and recover from a public health crisis and economic disruption? They can fund our/your proposals to do groundbreaking work designed to achieve measurable and meaningful results.

Have the proposal ready

It’s up to each of us to share our vision for a post-pandemic world where all us thrive. Toddlers. Students. Parents. Grandparents. Public sector. Private sector. Everyone. Everywhere. Go grab a cup of joe and start writing those proposals articulating bold plans for a future when 100% are empowered to succeed. Mr. Jake Maker or some philanthropist just like him is waiting.

Tales from the Battlefield: Anonymous Report

I am reading yet another email from a foundation, sharing what they want to fund. This philanthropy wishes to fund research and innovative strategies in order to support communities in achieving health, safety and education goals. Twenty years ago, that was wonderful to see. Decades later, we fully understand why we have health and education disparities. An hour of online searching would overwhelm a foundation program officer with published and respected research on the social determinants of health, the ecological model for health, health disparities and historical disparities and trauma a direct result of social injustice.

Bottom line: We know the problems. We know the solutions.

And it’s not about a foundation providing funding (though we love that they do). We, those working in under-resourced communities, should not have to compete for a multi-million dollar prize from a foundation to make health equity, or providing food to families, a reality. Our health status should not be at the whim of a foundation’s proposal review committee.

Episode 16

Watch your cares and pounds melt away with

the hydra

workout

The hydra has the workout you need.

Feeling fit and fabulous is easy with the right workout plan but be careful! The plan you choose will impact your mental health and your entire community.

The “Three-Headed Hydra” Workout

Why be fearful when you can feel fabulous? The three-headed hydra of Apathy, Envy and Fear has the perfect workout for you. Watch those extra pounds and pesky worries about humanity melt away. Get ready to feel the burn!

Hydras say books are for dumbbells.

Step 1: The Book Burn Twirl

In each hand, hold a copy of the 2.9 pound book 100% Community: Ensuring the ten vital services for surviving and thriving. Do NOT open the books (or ANY book), ever. Instead, step to the right and wave the books in a small circle for one minute. Feel a sense of accomplishment knowing that book twirling, as opposed to reading, is burning away the calories and brain cells.

Careful not to let your eyes move from the screen.

Step 2: The Net Numbing Nod

Hold in one hand your mobile and the other your laptop. Move to the left then stare at the mobile for ten minutes. Make sure it shows talking heads on your favorite “news” show, while streaming your dance tunes. Now look at your laptop for 30 minutes, showing your favorite HBO series. Feel a sense of calm as your screens fill your mind with disconnected clutter, rather than being used to connect you with health equity and social justice activities.

Hydras say, “Things get better with apathy.”

Step 3: The Banana Pudding Posture

Hold a spoon in one hand and the pudding in the other. (Recommended: Magnolia Bakery Banana Pudding* from NYC.) Every 30 seconds bring the spoon to the pudding, then to mouth. Savor the taste. With each swallow, know that without changing anything in your life, the world gets better. At least your world.

The hydra’s workout is all about you focusing exclusively on you. And stopping there.

* Allergic to bananas and whipped cream? Substitute vanilla pudding with white wine.

The “100% Community” Workout

As you may know, the three-headed hydra workout has been around for decades, as some call it a national pastime. If you care to try something fresh to create a new lemon-scented lifestyle, we recommend the 100% COMMUNITY WORKOUT. Far from easy, it’s the ultimate exercise to push your limits and transform you and your community. Ready to take on the 100% challenge and give it your all? We hope so.

Note: This article is not intended as expert health advice. Please consult your local health care provider for the right exercise program (if such a provider is accessible without high costs and/or long waiting times). Ask if the three-headed hydra workout, with pudding, is right for you. If yes, visit: www.magnoliabakery.com.

Episode 18

Your future: four fantastic innovations in medical care

Mrs. Drew gets a health assessment.

Pandemic recovery means different things to different leaders. In our book, it means we work, county by county, to ensure that everyone has access to the health care and other vital services they need. It means all clinics are well-resourced and our local public health systems can track infections effectively with contract tracing. It also means we use technology, including artificial intelligence, to make all forms of health care as user-friendly, cost-effective and efficient as possible.

Sandra finds affordable care.

Innovation 1: Sandra can review her health care options

Sandra can identify all the clinics in her region, explore their offerings, staff profiles, and read their ratings and client comments related to quality of service. This directory also shows where gaps in local services exist.

Mr. Joe gets self-care advice.

Innovation 2: Screening Mr. Joe’s (constant) requests for care

Folks like Mr. Joe call into the clinic quite a bit. We can screen those calls and address many of his concerns without him coming into the clinic.

Technology knows what help Juan needs.

Innovation 3: Getting to Juan’s emergency fast

When it’s urgent, we can screen medical problems within seconds and get emergency services to folks like Juan in minutes.

Technology supports a seamless care system.

Innovation 4: Creating a countywide system of quality care

Medical director Sam, leading the countywide action team on medical care, can communicate daily with all his colleagues in 20 (or 200) clinics, ensuring that timely quality care exists for every county resident. Technology, collaboration and communication increases alignment of services, reduces gaps, promotes cost-effectiveness and establishes a local system of continuous quality improvement.

Tales from the Battlefield: Anonymous Report

Imagine how happy I was to finally get to the US version of a universal care system called medicare. I felt as though I scored the golden ticket when I hit 65 years young. Then I tried to use it. First came months of waiting to get an appointment. Then learning not all services are covered. Then the complex world of co-pays hit. It was then I pondered briefly if it was too late to marry a Canadian to get into their universal care system. Then I thought, “How many pandemics showing just how vulnerable we all are will it take until each state finally commits to creating their own version of medicare-for-all.”

Episode 19

Behavioral health care is

innovating to help us survive and thrive

We’re overwhelmed. Technology can help.

Recovery from a pandemic and economic disruption means different things to different leaders. In our book, it means we work, county by county, to ensure that everyone has access to the behavioral health care and the other vital services they need. It also means we use technology, including artificial intelligence, to make all forms of mental health support services as user-friendly, cost-effective and efficient as possible.

Tech+Compassion=Solution

Innovation 1: Dan can review his counseling options

Dan can identify all the mental health care providers in his city (and across the globe), explore their offerings, costs, staff profiles, and read their ratings and client comments related to quality of service. This directory also shows where gaps in local services exist.

Technology helps care reach us.

Innovation 2: Bringing counseling to teen Eddy wherever he is

Counselor Albert (who works from home) can talk with Eddy in the environments the teen likes, from his room or the skateboard park. Eddy’s mom (and dad who lives in another state) can also join in when appropriate.

Technology connects the system of care.

Innovation 3: Providing Teresa with the support she needs to survive and thrive

Counselor Dr. Mary knows Teresa’s local resources thanks to a state-of-the-art directory. Counselor and client have a productive partnership that helps Teresa navigate a chaotic post-pandemic world to achieve her goals.

Technology connects us so we can fix gaps.

Innovation 4: Creating a countywide system of quality care

Counselor Sara, leading the countywide action team on behavioral health care care, can communicate daily with all her colleagues in 20 (or 200) clinics, ensuring that timely quality care exists for every county resident. Technology, collaboration and communication increases alignment of services, reduces gaps, promotes cost-effectiveness and establishes a local system of continuous quality improvement. In this time of unprecedented change, the need for a seamless system of care is a priority.

Tales from the Battlefield: Dom’s Report

I think back decades ago, in more troubled times in my life, to how fortunate I was to have a job that afforded me the opportunity to access mental health care. I was eager to get started and solve some problems related to my emotional and financial health. I was pretty sure they were connected and it turned out I was right. On my second visit to my counselor, after sharing my early childhood stories with her, I asked, “How long does this therapy process take?”

She said, “Well, it has a lot to do with how much damage was done in your childhood.”

I responded, “OK, so given that you know my family story, how long might I be here?”

She paused for a long moment, then said with a slight grin, “I think you might be on the five-year plan.”

It might not have taken quite five years, but I found great value in having a weekly counselor who also served as a mentor and navigator to a wide variety of helpful services. Scoring a 5 out of 10 on the Adverse Childhood Experience Survey, without therapy, I might have turned into a three-headed hydra and be lost in depression, delusion and self-medication.

Episode 20

Mother Earth interview: Talks “human extinction,” and “red and green chile”

Mother Earth shares a message.

Mother earth grants a rare interview with us to discuss what’s on her mind, plus music, the wonders of extinction and Oprah.

Hydras are really messing with Mom Earth.

Why have you agreed to this interview?

What was the name of that lovely band from the 60s? Wait, gimme a minute. The Doors! Yes. Loved them and they really capture the moment we face today with the lyrics of their song The End.

This is the end, beautiful friend

This is the end, my only friend*

Did you have a role in the pandemic?

Viruses? Like atoms and rainbows, all part of the big plan. How you humans identify, track and prevent viral pandemics is up to you. Since you were gifted with the power of choice, you get to decide if you fund systems of universal health care or the luxury cruise line industries. I don’t want to sound preachy, but so many of you have turned greed into what appears to be some sort of religion. You worship material possessions and leave the vulnerable to fix themselves without any help. I’m reminded of that Broadway play Rent. Hated the movie. But those lyrics to “What you own” often play over and over in my mind at times like this.

And when you’re living in America. At the end of the millenium. You’re what you own.**

Love that last line. Prophetic in 2000 and even more so in 2020. Greed is clearly not very helpful on a planet where pandemics and man-made economic free falls can become commonplace.

How have humans disappointed you?

Wait, we said this interview would be three minutes, not three hours. Don’t get me going, though I do keep a list. It starts with Apathy, Envy and Fear.

What do you want to see happen?

As you know, I have the power to see what you humans call the past and the future for all time and all at the same time. At this moment you humans are at what will be branded “Earth’s Tipping Point.” The t-shirts were a big seller in 2022. This entire global sh-t show has nothing to do with what I want. It’s about what you want. And trust me, you really want to be paying attention right now.

Are you suggesting that humans might go the way of the dinosaurs?

I think most reasonable people would agree it’s clearly time for a course correction on earth. There’s a long line of species ready to take over from humans with far more compassion and capacity for critical thinking. I’m thinking dolphins but am still in talks with the baboons and the ants.

What can one person do?

Stop sleepwalking. Unite with a common cause to take care of everyone. Alone, a human is like a leaf in the wind. You’re fragile and prone to Netflix addiction. Collectively you might still have a chance. I was hopeful your experiments in democracy would work but you allowed the billionaires to wreck that concept.

How did we score this interview when Oprah really wanted it?

I love Oprah… but this is the only place on earth that does that enchanting green and red chile ritual with a burrito. I suppose I thought your readership might not only understand my words of warning, but act on them because you have that “100%-Community-we-are-all-in-this-together” concept. And if humanity has any chance, they’ll embrace it like there’s no tomorrow.

But we do get a tomorrow, right?

(Sound of Mother Earth disappearing into a golden beam of light)

*The Door lyrics are just being quoted for discussion. We don’t own them.

**Rent lyrics are also being quoted for discussion. We don’t own them either.

Q: What are the lessons mother earth is trying to teach us (and how will you get people to listen)?

Episode 22

We interrupt this public health crisis to share another one

May we please have your attention?

When the pandemic hit, all we could focus on was the immediate threat. It’s time to ask, “How are our kids doing?”

COVID-19 grabbed the headlines in the US a few months ago and because the viral pandemic first hit older adults, we focused on that population. This made sense. We saw news images of elders in nursing homes and hospitals gasping for air. We immediately worried about everyone over 60 and rightfully so. We did this because this segment of the population was at risk for severe illness or death due to COVID-19.

How child-friendly are we?

The first time children were mentioned in frantic emails passing back and forth about COVID-19 was focused on the closing of schools. OK. That made good sense if we were to be prudent. Of course, for the vast majority of parents who work outside the home, this meant a major disruption. Then work went remote (for those who had jobs that still existed and that could accommodate the option of working from home). A few days later across our desktops were filled with emails that were bringing up the issue of feeding students who depended on school breakfasts and lunches. Kids were part of the emergency preparedness equation and that was good to see.

Eventually, the inevitable happened and some children were exposed to COVID-19. We got a call from a health clinic medical director who was concerned that in his county, there were a lot of unanswered questions about services for families and students. He sent us a list of twelve:

Do school leaders know how they can best reach students and their families, via phone and/or online?
Have all educators and school staff helped parents and students identify a health care provider who they can access easily?
In case of crisis, do parents and students know where to go for medical help?
Who can contact the county’s network of school educators and staff during a public health crisis?
Have school directors been trained on how and when to keep in contact with staff during a public health crisis?
Do school food banks have enough supplies for an extended period during a public health crisis?
Do school-based health centers have staff trained to operate during a public health crisis?
What supplies might they need to serve school staff, students and families?
Who is in charge of food and how do schools keep food services going for students?
Are school-based health care providers trained to offer services and support during a public health crisis? What supplies might they need?
How can all schools be prepared to serve as a shelter if need be?
Is there a number that students can call for support if they face challenges at home but do not wish to involve child welfare?

These were excellent questions that every school district working on readiness with county and city leaders needed to get answers to. The word of the day was “alignment” with no duplication of services or activities in a time of crisis.

Who is there to call?

It was the last question on the list that caught our eye, about students having a number to call if they felt unsafe at home, but didn’t want to call child protective services. This is where we depart from focusing on one public health crisis, a new pandemic, and turn to a very long-standing one called childhood trauma.

In so-called normal times, if youth face abuse or neglect at home, we don’t give them many choices. If they tell anyone working for the school, child protective services must be called immediately and kids know this. But as businesses close, parents lose jobs, a sense of panic fills the web, stressed parents get desperate, and children and youth get scared to be at home. Do we file “child abuse and neglect” under “Very important, but we’ll get to that after we deal with this current giant crisis”?

Many of our kids were not safe before the pandemic and economic disruption hit, and it’s most likely worse for them now. Are they dying quickly? No, but that’s not the point.

Of course we need to marshal resources into helping those in immediate medical peril. It goes without saying. And as days and weeks pass, we need to broaden our lens to ensure that the status of our kids, as in 100% of them, are in clear view.

The irony here is that years ago in the book Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment, we advocated for ten vital surviving and thriving services as the way to prevent abuse and neglect. We made a plea to all who would listen, that if we provide to our most vulnerable families the resources to be healthy and safe (medical and behavioral health care at the top of the list, with food, shelter and transport right behind), we get to end epidemic rates of adverse childhood experiences (ACEs), which describe the abuse and neglect many of our children endure and are currently enduring as you read this.

We now find ourselves in the middle of a global public health crisis colliding with an economic free fall and the best prevention and treatment calls for timely access to well-resourced health care providers. As things get really stressful and desperate for our most vulnerable families, ten vital services for surviving and thriving will also become part of the prescription for keeping all of us healthy and safe.

Forward or Backward? You decide.

If COVID-19 recovery means we finally provide all families with the resources they need to be healthy, we will see childhood trauma decrease. If we go back to the way it was, we have epidemic rates of childhood adversity, abuse and neglect that will be ignored. A future where childhood adversity is considered by the public “sad” but a part of life, is one we work tirelessly to prevent.

For those of you who have the bandwidth to absorb a quick course in childhood trauma and how to ensure safe childhoods, the book Anna, Age Eight will let you know what social workers have known for decades: our kids from all social classes, from McMansions to housing projects, need our attention and their parents desperately need help before a totally overburdened police force and child welfare system are called in.

Tales from the Battlefield: Dom’s Report

I am presenting to a community group, filled with mostly parents of school-age children. I am doing my “ten services” speech and the group of 70 appear quite attentive when I finish. I ask for comments and a dad stands up to say, “I really like this idea of ensuring vital services for parents… but we need to make sure that only those parents who deserve services get them.

Another attendee, a large green mutant with three heads stood up. The Envy head stated, “I didn’t get anything handed to me so why should anyone else?”

Then a true hero, a woman who identified herself as school staff stood up, unfurled her red cape, and flew around the auditorium. She said with a sense of deep conviction for all to hear, “Our goal is to do whatever it takes to keep our students healthy and ready to learn. Our kids require basic services and we don’t deny them those because we might feel their parents are undeserving.”

Q: How do we get adult leaders to care about children’s health safety and education?

Episode 23

Star Trek

vs. The

Walking Dead. Which future is ours?

Mr. Spock or Joe a flesh-eating zombie.

Two earths exist. One is called the private sector, populated with those engaged in commerce and focused on accumulating wealth, while the other is called the public sector, focused on addressing health, education and opportunity disparities. They do speak the same language but in reality, they rarely understand each other.

This is a problem to be remedied if we hope to make COVID-19 recovery a statewide strategic plan to strengthen the lives of all residents, not just the wealthy. Note that we said “statewide” plan, as each state will have to create its own way out of this pandemic and economic free fall. There will be no comprehensive federal plan to help your state to ensure that a future beyond a Mad Max apocalypse-inspired reality exists.

Who is supposed to fix all this?

What future will you fight for?

The work of ensuring your quality of life will involve both your state and local government and business leaders. The private sector, with their share of brilliant minds, are key players in ensuring that we survive and thrive in the post-pandemic world, even if they don’t yet know it.

At forums on designing community systems of health and safety, often a participant will stand up and say “What about the private sector? What’s the role of business in all this?”

This is a great question. This public health crisis and economic disruption is impacting families, education, work readiness, workplaces and small businesses. This challenge certainly requires the participation and creative thinking of the business community. Government bureaucrats, who are afraid to rock the boat, won’t be fully up to the task in this time of unprecedented change.

Across every state, there are entire communities, cities and counties that can’t get businesses to thrive because of factors related to the lack of training that aligns with the current and future job markets. And this was before COVID-19. Consider what economically depressed cities and counties are like today, with mayors and council members trying to create meaningful strategic plans that address unemployment without any support.

Entrepreneurial thinking welcome

We can connect the dots from COVID-19, to our financial downturn that is crushing local businesses, to the economic recovery of our communities. How best to respond is a question the private sector needs to be engaged with.

We need business leaders in each of our 3000+ counties across the nation to invest in the public good. This means private sector leaders collaborating with those in the public sector to improve the quality and quantity of vital services like medical care, behavioral health care, housing security, food security, transportation and fully-resourced community schools and colleges. Since well-resourced communities produce employable and entrepreneurial people, let’s make sure 100% of our communities are set up with the services needed to succeed.

As we transition to post-pandemic times, millions of jobs will never return due to bankruptcies and downsizing. Many more will disappear because a robot can do it cheaper and don’t get sick. The lucky breadwinners will be working from home, sheltered from the cyclical rise and fall of quarantine rules. The less-fortunate, but still employed will scrape by delivering meatball sandwiches to them, while Amazon drones buzz overhead, delivering the best in self-medication.

Star Trek vs. The Walking Dead

There is a way forward that’s more explore-brave-new-worlds Star Trek than the zombie-infested-survival-of-the-fittest-universe of The Walking Dead.

If caring and brilliant minds come together to create cities that ensure the services for surviving and thriving, we all get through this economic free fall together without hitting the pavement and be ready to face down the next one. If we retreat into silos, this will not end well for most of us.

In an era when nanotechnology and artificial intelligence are radically reinventing every product and service on the planet, now is the time for innovative, socially-engaged business thinking. It’s no longer business vs. public good. We can’t afford to play that game any longer. Instead, we must combine entrepreneurial thinking and technology-utilization to vastly improve everyone’s quality of life. We just need to be vigilant about the “everyone” part of the equation.

Pull up a chair

We need everyone at the table as city halls convene smart folks from all sectors to come up with THE PLAN FORWARD. When you are done reading this book, you need to grab a chair and add your insights to the local brainstorming. If your mayor is not convening public and private sector folks to guide all residents into the brave new future, you need to do it. And soon, before the era of machete-wielding, zombie-protection gangs begins.

Tales from the Battlefield: Dom’s Report

I remember as a kid loving that classic Star Trek episode called Assignment: Earth where our heroes on the starship Enterprise go back in time to observe an era around the late 1960s, seeking to understand how earth survived the cold war without blowing up the planet.

As I sit here after reading the daily news, a mish-mash of mostly eye-catching headlines with articles that paint a picture of a society gone mad, I have to wonder how folks living decades from now will view us. I suspect they will be completely baffled by the United State’s response to the pandemic and resulting economic free fall.

In yet another Star Trek reboot, the scene in a newly reimagined Assignment: Pandemic 2020 will go like this. Captain Kirk will ask Mr. Spock, “Why on earth didn’t each country create a health care system where contract tracing was made effective? Why didn’t everyone follow such simple procedures as wearing a mask and keeping a safe physical distance?

Mr. Spock would explain, “These were primitive times on much of the planet. While there were civilized societies with efficient medical systems, some had yet to build infrastructure to ensure the health of all their residents. The area once called the USA was fascinating in many respects. It had more material wealth than most countries, yet many lived without survival services. Of course that was before the Humans vs. Hydras War.”

Episode 24

Are you a

Hydra, a Hero or a Watcher? (Choose one.)

A Hydra, a Hero and a Watcher walk into a bar...

There is a short book about your childhood most people won’t read. Here’s why.

Reading a book about childhood trauma is, in many ways, like waking up from a bad dream. The fog that once obscured this tragic corner of life slowly clears and, the more you learn, the more you see children at risk all over the place. Turning the pages of a book on childhood challenges, you may well experience feelings of overwhelming sadness, anger, frustration and hopelessness. You may feel powerless, as though you are single-handedly facing some monstrous thing far too big to confront.

These words come from the preface of the book Anna, Age Eight, that shares the story of a little girl who would not reach her ninth birthday due to abuse. Anna’s story could have been yours. It’s a cautionary tale that lets us all know we navigate a world of trauma every day. We may have grown up in loving homes yet we still interact with traumatized people who didn’t.

And that brings us to where we are today, living in a traumatized country, waiting out a pandemic as the economy goes into free fall. Not unlike reading a book about trauma and a veil being lifted to reveal childhood adversity, reading an article about COVID-19’s impact on our lives can trigger all sorts of feelings. If you’re like most people, ourselves included, those feelings would be a combination of confusion and fear, mixed with a strong desire to binge watch Mystery Science Theater 3000 from under a blanket.

A Survey

As much as we don’t like putting people into boxes, please allow us to do so in a little experiment. Over the last two months of physical isolation, it feels as though the people have fallen into three distinct categories. These categories are based on pure observation of our colleagues in person, online and on social media.

Category One: The Watcher

Watchers appear to be the vast majority of people. They watch. As an unprecedented worldwide event takes place, with far-reaching implications on almost every aspect of daily life, the Watcher observes from the sidelines. They watch the news, social media and anything of entertainment they can stream. They like to be informed. They seek escape. The Watchers are, for the most part, a caring people. They work hard, wish well for others, and as long as their life is stable, being a Watcher is satisfying. The Watchers are happy there are heroes in the world and hate that three-headed hydras ruin everything. When asked if they would consider devoting eight hours a week (the equivalent of watching four superhero movies) to social engagement that could be part of meaningful positive change in a time of upheaval, they reply with earnest, “That work is so important. Thank you for all you do, but I can’t.” Then they retreat to watching. It’s what brings them a sense of security. Watching provides the fog to obscure the magnitude of what’s going. We can relate to the Watcher. It’s really scary out there.

Category Two: The Hero

The Hero is awake and taking action.

In our line of work, building local systems to ensure everyone has access to the ten vital services for surviving and thriving, we connect with heroes every day. When they do swoop down, we are filled with hope, joy and admiration.

The Hero is a person who woke up from the bad dream, marched through the fog and is filled with an insatiable appetite for social justice and plain old fairness.

The Hero can’t help but act when confronted with the corruption and incompetence brought on by the three-headed hydra of Apathy, Envy and Fear. When the pandemic hit and we were told to stay home, physical isolation did not mean social isolation. The Hero was on video conferencing, reaching out to other heroes and forming collectives focused on the health and safety of their community. Books were read and strategies formulated. Plans were made and actions taken.

If we navigate, county by county, our way out of this surreal post-pandemic phase where jobs and community services are evaporating daily, it will be because of the Hero. To you heroes reading this, thank you.

Category Three: The Three-Headed Hydra

The Hero is awake and taking action.

While we have not done a study, it appears that for every hero we meet, there is a three-headed hydra doing it’s best to block innovation, problem-solving and any attempt to change the status quo. We know the Hydra acts primarily out of fear and we do our best to be forgiving. The problem is that we don’t have the luxury to indulge the Hydras of the world, especially those who run the organizations that can help. In government, non-governmental agencies, philanthropy, business and the media, the Hydra is holding on with a death grip to maintain a sense of control. This is not easy in a pandemic where economic disruptions shift funding and influence daily.

In an unstable environment like today, the Hydra acts as a cornered animal and lashes out to protect itself. Like any capable sociopath, the Hydra will attempt to continue on into the new normal with oozing charm. The fog that once obscured the tragic corners of life, including the selfish motivations of the Hydra, is lifting. The Hydras in your world are being exposed.

The Hero, Watcher and Hydra. Who are you?

One can learn a lot by watching Mystery Science Theater 3000. We‘ve been introduced to the entire line of Godzilla movies, with the franchise starting in 1954. What strikes us is how all the films appear to mirror life today. A heroic monster versus a hydra-like beast battling for the fate of the earth as the frightened residents watch in terror.

While current times have the feeling of a sci-fi film, we are not living in a movie where a giant moth guided by tiny psychic twin sisters will save the day.

Where we are is a place none of us have been before. There are, however, a few thoughtful actions to consider. We can use data to identify who is hurting or going to be harmed as a result of the pandemic and economic disruptions. We can use the collective impact model to create a shared vision of how to create systems of care in all our communities. We can face the fog, move toward the light and commit to measurable and meaningful activities.

It all starts with a choice. We can choose any role we wish in this grand experiment. Which one feels right to you?

Q: If you are certain you aren’t a hydra, which category do you fit in?

Episode 26

Hydras

create

the social

adversity that can crush us

Social adversity is outside your door.

Concept 1: Social Adversity

Most of us have hit some walls in our lifetime. Pandemics and economic disruptions are two more to drive around or climb. While we can say that a force of nature is responsible for some challenges, the truth is that most of the social adversity we face is the result of the actions or inactions of people in positions of power — the three-headed hydras of the world.

How might we define social adversity?

Let’s get on the same page with a definition of social adversity, as an online search offers about 209,000 results. Here’s a selection.

Adversity [ad-vur-si-tee]

noun, plural ad·ver·si·ties for 2 or more

adverse or unfavorable fortune or fate; a condition marked by misfortune, calamity, or distress: Friends will show their true colors in times of adversity; an adverse or unfortunate event or circumstance: You will meet many adversities in life.

Adversity: hardships, challenges or misfortune. An example of adversity is poverty.

Adversity: a state of wretchedness or misfortune; poverty and trouble

Social adversities: These are accepted as critical factors in the development of psychological problems in young people, but the precise mechanisms of this relationship are unknown. Evidence to date suggests there is no simple relationship between adverse life events and the subsequent emergence of psychological problems.

Adversity: a difficult or unfortunate event or circumstance. As humans, we all experience adversity at some point in our lives. Unfortunately, some of us experience more than others. However, for something so critical to our development as humans, we don’t talk about it enough.

Childhood Adversity: Children exposed to social adversity — hardship as a result of social circumstances such as poverty or intergenerational trauma — are at increased risk of poor outcomes across the life course.

Who designs social adversity?

Interesting. There was no mention above of three-headed hydras, persons of power who obstruct progress while holding tight to a broken status quo, in any definition of social adversity. It appears that social adversity is like the wind. It just exists. Join us for a little thought exercise.

Do you see much difference between the following definitions?

Adversity: hardships or challenges experienced in society

Adversity: hardships or challenges experienced in society, the result of the actions or inactions of people in power.

If we are going to have a conversation about social adversity, we need to understand why adversity exists and who is behind the curtain pulling the switches to place adversity in one’s path.

Social adversity: one example

In one definition above, we saw that poverty is considered a social adversity. Let’s explore that. There are six main types of poverty according to Dr. Eric Jensen, who is a member of the Society for Neuroscience, the President’s Club at Salk Institute of Biological Studies, and the New York Academy of Sciences. From his study presented in Teaching with Poverty in Mind (2009), he lists these six types of poverty as situational, generational, absolute, relative, urban, and rural.

Situational: This particular type of poverty is usually temporary as it involves a crisis or loss occurring as a result of something like a divorce or a hurricane, or a pandemic.
Time out! Before we explore Dr. Jensen’s five other definitions, let’s take a moment to explore the 2020 pandemic colliding with economic disruption. When leaders told us that for our own safety, we must stay at home for what would be months, some made the transition to working from home, with full salary and benefits intact, easily. For those in the service industry, the gig economy, temps, freelancers and day workers, this meant no income. Yes, unemployment benefits existed for some, but not all and not for long. Social adversity hit folks like restaurant workers and contracting welders like a bucket of cold water. Will the adverse economic impact of physical distancing be situational? That remains to be seen.
As for the lives of your neighbors across town that were already punishing before a crisis, we can describe their type of adversity with the following definitions of poverty provided by Dr. Jensen.
Generational: This type of poverty involves the birth of two generations into poverty. Because they were born into this situation, they usually don’t have the tools to help get themselves out of it.
Absolute: People in absolute poverty don’t even have basic necessities like a roof over their head, food and water. Their only focus is on surviving each day as it comes.
Relative: This type of poverty is known as relative because it is relative to the average standard of living in that person’s society. What is considered high income in one country could be considered middle or low income in another. If a family’s income isn’t enough to meet the average standard of living, they are considered to be in relative poverty.
Urban: This particular type of poverty is only for metropolitan areas with populations over 50,000.
Rural: Like urban poverty above, rural poverty occurs only in specific area types. These areas are nonmetropolitan with populations below 50,000. The low population limits services available for people struggling financially, and a lack of job opportunities only compounds the problem.

Social Adversity vs. Adverse Childhood Experiences

Needless to say, one can write volumes on social adversity. One form, poverty, will take you to 280,000,000 results online. The point is to create a working definition of social adversity we can use in our conversations and campaigns to educate ourselves and the public.

Much of our work has been focused on preventing adverse childhood experiences (ACEs) that happen within the home, the result of traumatized and/or struggling parents who inflict abuse and neglect on their children. ACEs are a very specific form of adversity, with twenty years of research behind it.

To make a distinction between ACEs and social adversity, social adversity is what we encounter when we step outside our home’s doorway into society. We enter a world of desperation or one of community support. Please consider four questions.

As children, will we encounter adversity in the form of underfunded schools? Instead, might we engage with fully-resourced schools with empowered educators, meals, youth mentors, tutors and accessible medical, dental and behavioral health care?
As parents, will adversity come in the form of isolation with little support? Instead, will we have access to parent supports, childcare, early childhood development programs and timely health care?
As a member of the workforce, will adversity come in the form of being unemployed or woefully underemployed? Instead, will there be a statewide system of subsidized training to help us transition from jobs that no longer exist, to those that align with the future job market?
As county residents living in times of colliding crises, will we be on our own? Instead, might we have access to housing and food security programs, along with other services for surviving and thriving, until one can transition to a new livelihood?

Humans create adversity. We can end it.

In some societies, the vital services for surviving and thriving are already in place, accessible to all residents. In your county, they aren’t. Data tell us where vital services are needed and why. History tells us that many of those in power, whether because of apathy, envy or fear (it’s a long list), have no interest in creating a seamless system of care to ensure 100% of county residents have access to support services until they can become self-sustaining.

Social adversity, at the end of the day, is a three-headed hydra saying, “no.”

Report from the Battlefield: Katherine’s Report

The hydras were coming out en force and what was extra surprising was that they had entered the building as concerned community volunteers. “Well, those parents on the other side of town just don’t value education” said one Apathy head.

A Fear head chimed in “and they don’t even make sure their kids go to school, I can’t even walk my dog in the park anymore because there are so many gangsters there.”

Another Apathy head chimed in with, “I think we should cut funding for parent support programs, they only had two parents show up to the parent-teacher meeting last week.” The hydra’s non-stop bashing of parents was becoming overwhelming. Then I remembered that one of the most effective tools for fighting hydras is stories. I told them about the mom who had been unable to drive her kids to school because she couldn’t afford tires for her car, once she found help with transportation, the kids returned to school and everything was fine. I told them about Maria, the 15-year-old who had to stay home from school to take care of her 3-year-old brother while her mom worked, because mom couldn’t afford childcare. I told them about Marta, the mom who cried because despite her best efforts, she could not take off from work to drive across town to the parent-teacher conference.

Suddenly the hydras morphed back into humans. “Well, it sounds like we might need to have those meetings after work,” said one kind lady in her 70s who had just moments ago been a judgy hydra.

“And maybe we should find out what the childcare options in that neighborhood are,” said the man who had previously called the youth gangsters. The hydras and their swirling heads, in what was a rare occurrence, had gone away and now we were ready to work together as humans.

Episode 27

Why would a hydra oppose ensuring five survival

services? Reasons!

The hydra says, “Access denied.”

Concept 2: Five services for surviving

Survivor is described as “a television show that places a group of strangers in an isolated location, where they must provide food, fire, and shelter for themselves. The contestants compete in challenges for rewards and immunity from elimination.”

When did reality shows become our reality?

Today, a survivor might also be defined as a person who navigates an unstable environment in a pandemic and economic free fall to access the basics of survival. Collect them all!

In our world of community health, we describe the five services for surviving as: medical and dental care, behavioral health care, food security programs, housing security programs and transport to vital services.

For many reading this, accessing health care, at least up until now, was not viewed as an extreme sport. Health insurance, attached to a job, covered most care. Transport wasn’t a problem as even car-free people had Uber. As for shelter and food, those come with the middle class lifestyle a career provides.

Then the pandemic and life in isolation hit. And one of Dom’s favorite waiters, also a free-lance welder, was out of work and asking about cheap shelter, food banks and if he could borrow some cash. As we all saw, life can change dramatically without notice.

As for your neighbors on the other side of town, for a host of reasons, they have been struggling to access five services for surviving since they were born. In an era of colliding crises, life is now near impossible for them.

How might we define the five services for surviving?

Let’s describe each service and present solutions for ensuring that the services exist for all, even if three-headed hydras oppose such ideas.

Medical and dental care

This is what we need to address our physical challenges. Some societies ensure that 100% of residents have access to care—not tied to a job, insurance or capacity to pay. That would not be our US society.

To fix health disparities, we must engage collectively, county by county, with partners in the health care field to ensure that all county residents have timely access to the care they need. This includes assessing to what degree county residents have access to care and identifying gaps and their causes. Reasons for gaps may include prohibitive costs, long waiting lists, lack of personal or public transportation, poor services, and lack of awareness of services offered. Innovations in this area should include technology-based solutions such as using video-conferencing to “see” patients online for assessments and screening. (The Bill and Melinda Gates Foundation could be very helpful here as they have lots of experience working in other developing countries. Can some reader get Mr. Gates on the phone?)

We also have to end the digital divide, ensuring that all residents have access to technology capable of utilizing online health services.

Recommended reading: Medical and Dental Care@100%

Behavioral health care

In a county where untreated trauma due to adverse childhood experiences and historical trauma is almost a norm, mental health care serves a vital role in a time of crisis and change. In some societies, behavioral health care is part of the overall health care package one gets as a resident. The care is accessible to all, not based on one’s capacity to pay. In the US, that would not be the case, for the most part.

As with medical care we must mobilize county by county, working with partners in the behavioral health care field to reach all county residents with the timely care they need. This includes assessing to what degree county residents have access to behavioral health care. High costs, transport, poor quality service and lack of awareness of services create gaps. In many cases, promoting the widespread use of video conferencing to serve many clients is a good start.

Also, new forms of support groups, providing alternative ways of improving emotional health and addressing trauma, borrowed from a variety of cultures, can be developed to meet the unique needs of different populations. (Google loves to get into new ventures, so let’s contact them to explore GoogleTherapy.)

Recommended reading: Behavioral Health Care@100%

Food insecurity programs

Hunger has been alive and diminishing lives in each state since before they even were states. We may be told we have a right to life, liberty and the pursuit of happiness, but it appears freedom from hunger was not part of the deal. At least not yet.

We must work, county by county, to assess where gaps in food security services are and work to implement solutions. Gaps in services include lack of transport to services, lack of family-friendly hours, and lack of stable supplies.

Food security can be strengthened with food pantries and food banks in all community centers, schools and campuses — with support from new public-private sector partnerships and apps to organize distribution. (We could use some help from the brilliant minds behind Starbucks here, as they already have a system and software to support getting their food to shelter programs.)

Recommended reading: Job training@100%

First we survive. Then we thrive.

Think of each of the five services for surviving and five services for thriving like one piece of a ten-piece puzzle. When put together, they can form a complete picture. In this case, an image of a healthy person living in a well-resourced and supportive community.

Each one of the ten vital services in your county have their own complicated histories, research and political relationships associated with them. One thing is simple, without vital services people struggle. This has been illustrated most effectively through Maslow’s Hierarchy of Needs. Abraham Maslow introduced the concept in his 1943 paper “A Theory of Human Motivation” in Psychological Review. Fundamentally, according to Maslow, people must have their basic needs met before anything else. Education, enlightenment and actualization are entirely possible for all of us, but only if we have stable shelter, food and the basics.

Without basic services, a wide variety of problems emerge: substance misuse, mental health challenges, poor school achievement, lack of job readiness and adverse childhood experiences (ACES). Investing in vital services is both compassionate and very cost-effective.

Who gets to thrive depends on the actions of people like you.

There you have it. With the five services for thriving in place, we can be empowered during pandemics and economic disruptions (assuming the five services for surviving are accessible, too).

A county collective, working with a shared vision, goals and activities, can be leaders in innovation with the five services for thriving. We don’t lack ways to increase access to services and to improve the quality of their services. We have the resources to ensure 100% of the residents in our nation’s 3000+ counties can both survive and thrive. This revolution in thriving can start with you. What better person is there to guide a local initiative that gives you, your neighbors and those families across town, the best chance for success?

Report from the Battlefield: Katherine’s Report

We kept waiting for this person to turn into a hydra. She had given us no reason to not trust her but we had been burned by so many hydras in this particular region. In our first meeting she said, “I’ve been working in this community for a long time and I’m going to do what you said we need to do in Anna Age Eight.”

I shared, “We just want to make sure we’re on the same page. This initiative is a lot of work.” Instead of spouting three heads, the heroic community leader adjusted her newly revealed superhero cape as she said, “I know… but if it was easy someone would have done it by now. If not me, who?”

Episode 29

Do the social

determinants of health

dictate our

destiny? No.

The hydra is not taking questions.

Concept 4: social determinants of health

Social [so·cial]

adjective

relating to society or its organization.

“Alcoholism is recognized as a major social problem.”

Determinant [de·ter·mi·nant]

noun

a factor which decisively affects the nature or outcome of something.

“Pure force of will was the main determinant of his success.”

Health [helth]

noun

the state of being free from illness or injury.

“He was restored to health.”

How might we define the social determinants of health?

If you have a spare weekend, explore all the definitions of health. Searching the definition of health, about 174,000,000 results appear in 0.52 seconds. According to the World Health Organization’s website:

health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

We can go with that for now and follow up with asking what and who determines our health.

The answer can be found by exploring a concept called the social determinants of health.

The social determinants of health are elements (people, services, resources) that people have access to in childhood. It’s a fascinating and sometimes complex field of study that explores how a person’s community environment can impact his or her health and opportunities for learning, work and wealth. To translate many decades of research into one phrase, if we grow up with access to helpful services and resources, we do much better in life than if we don’t. As we delve into the social determinants we encounter concepts like health equity and health disparities.

To be less abstract, the social determinants of health could be considered the ten vital services for surviving and thriving. Through a survey of residents, we can determine to what degree their health improved because they had easy access to medical, dental and mental health care, along with stable food, secure housing (thanks to food and housing security programs) and transport to all vital services.

We should mention that there are those who would prefer you not think too deeply about what or who determines the health and safety of your neighbors or families on the other side of town. To defy the wishes of the three-headed hydras, read on.

10 social determinants of health: one definition

The World Health Organization has identified ten social determinants of health:

The social gradient
Stress
Early life
Social exclusion
Work
Unemployment
Social support
Addiction
Food
Transport

Of these ten, the single strongest predictor of our health and well-being is our position on the social gradient (or the ‘social ladder’). Whether measured by income, education, place of residence or occupation, those people at the top of the gradient have the most power and resources, and on average live longer and healthier lives. Those people at the bottom have the least power and usually run at least twice the risk of serious illness and premature death as those near the top.

Five Categories for the Social Determinants of Health: yet another definition

The US Centers for Disease Control and Preventions offers this:

Health is influenced by many factors, which may generally be organized into five broad categories known as determinants of health: genetics, behavior, environmental and physical influences, medical care and social factors. These five categories are interconnected. The fifth category (social factors or social determinants of health) encompasses economic and social conditions that influence the health of people and communities. All of these factors (social determinants) impact the health and well-being of people and the communities they interact with.

Six factors related to the social determinants of health and tied to services

We took a look at the CDC’s list of several factors related to health outcomes and did some edits and embellishments. See below a list of seven (and it could be a much longer list).

How a person develops during the first few years of life (access to early childhood development which can be greatly enhanced with access to home visiting and quality early childhood learning programs)
How much education a person obtains and the quality of that education (access to higher education and vocational education)
Being able to get and keep a job, what kind of work a person does and how much money a person earns (individual income and household income)
Having food or being able to get food (access to food security programs)
Having access to health services and the quality of those services (access to medical, dental and mental health care)
Living conditions such as housing status, public safety, clean water and pollution (access to housing security programs)

One factor (or social determinant of health) is tied to technology

Access to current and emerging technologies impacts our health, education and economic opportunities in many ways. Mobile devices, computers and the internet makes web-based education, online services, job training, placement and the capacity to work online from home possible. Without easy access to the net, you are on the punishing side of the digital divide.

Who determines the social determinants of health? (hint: heroes and hydras)

Not unlike the definitions of social adversity, one can read tons of definitions and never once read that it is people, humans in positions of power, who maintain the living environments that lack vital resources.

They, meaning the elected leaders of your county, determine to what degree county residents have access to the services and resources to be healthy.

While some communities are awash in accessible services, in others, we doom people to poor health outcomes with man-made strategies. It’s human ingenuity, compassion and a strong sense of social justice that will reverse this.

To be clear, through action or inaction on the part of elected leaders (and those who support them and work for them), we are either empowering people or diminishing them.

The social determinants of health are measurable and that is what we can do, county by county. The primary mission of a civilized society should be to ensure the survival of its residents, once that is secured, the society should ensure thriving. It is possible to survey residents to understand their access to services (and we do!) and then increase vital services so that 100% of residents may access them.

Saving your world

We can’t save the world or the nation alone, yet we all have the power to be engaged in a local process that ensures every community within one’s county borders is well-resourced. What determines the quality of life for our most vulnerable populations is determined by caring people like you. If you don’t step up, the three-headed hydras, who rejoice at keeping people down, will.

Recommended reading: 100% Community, Chapter 5: The Root Causes of a Host of Health Challenges

Report from the Battlefield: Anonymous Report

Yet another multi-zillion dollar foundation was reporting the finalists for the multi-million dollar, multi-year grant. And yet again, we saw potential funding going to projects that, while certainly worthy of support, did not connect the dots in any significant way to address the many complex and interconnected challenges facing society’s most vulnerable people. Hydras like it that way. Why think big picture when thinking small gets good press.

The philanthropies run by three-headed hydras refuse to understand what is needed to ensure that humans can survive and thrive. With all the billions of dollars that philanthropy has, we need the caring humans who work for foundations to get their hydra overlords out of the way.

Episode 30

Historical disparities and historical trauma must be addressed

Hydras create and sustain systems of injustice.

Concept 5: historical disparities and historical trauma

How might we begin to define historical disparities and historical trauma? Carefully and thoughtfully. What is provided is a very brief overview and a heartfelt invitation to learn more.

Historic [his·tor·ic]

adjective

famous or important in history, or potentially so.

“we are standing on a historic site”

Disparity [dis·par·i·ty]

noun, plural noun: disparities

a great difference.

“economic disparities between different regions of the country”

Historical trauma [his·tor·ic·al tra·ma]

The cumulative, multigenerational, collective experience of emotional and psychological injury in communities and in descendants.

Historic Trauma and Response

Another definition of historical trauma is provided by Dr. Maria Yellow Horse Brave Heart, a Native American social worker, associate professor and mental health expert, known for developing a model of historical trauma for the Lakota people.

“The collective emotional and psychological injury both over the life span and across generations, resulting from a cataclysmic history of genocide.”

“The cumulative emotional and psychological wounding,” states Dr. Yellow Horse Brave Heart, emanates from massive group trauma. The reaction to this wounding, which she calls the historical trauma response, often includes survivor guilt, depression, PTSD symptoms, physical symptoms, psychic numbing, anger, suicidal ideation and fixation to trauma, among other features and behaviors.

Historical trauma can be viewed as the result of the dominant culture perpetuating mass trauma on a population.

Reflecting

We ask that you take a long, quiet pause to reflect on the centuries long list of crises our diverse society has endured. While a public health crisis may disrupt our lives today, a long painful history of man-made challenges has diminished the lives of many residents for as long as we have been tracking crises. We live in a country that, for the most part, gave only lip service to social justice and equality by requiring this disclaimer in an organization’s policy guidelines for employees and clients:

Non-discrimination Statement and Policy

We do not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation or military status, in any of our activities or operations.

The above statement is only a first step in addressing disparities and requires hard work and vigilance to bring into reality. Our goal, through our 100% Community initiative, is to make sure these powerful words are far more than spin.

The citizens of these fifty “united” states that many would argue are more fractured than cohesive, have a long history of traumatizing each other. While we may focus on creating services to support community health, trauma has been a reality for many people across this continent for as long as this country has existed, and long before it became known as the United States.

Many identities, many disparities and traumas

People are complicated. We have many identities based on a host of factors: race, class, gender, age, sexual orientation and religion, to name only a few. While our differences and diversity are cause for celebration, they have also been (and continue to be) catalysts for conflict, leading to trauma and other challenges.

A quick Google search on racism alone reveals 135,000 articles. We don’t lack information on how differences have hurt us, and this painful history in the US goes back centuries. We do not always have a way to have difficult conversations about our hurts and what we need to heal.

We need to create a safe space for community members to discuss the many forms of trauma and their root causes. We need ground rules and guidelines so that our pasts and presents can be explored with candor and compassion. Let’s take a look at some of the historical and ongoing traumas your community might want to discuss here:

Colonists traumatizing the indigenous/native populations
Men traumatizing women
Rich traumatizing the poor
Adults traumatizing children and youth
One race traumatizing other races
Heterosexuals traumatizing homosexuals
Long-term residents traumatizing immigrants and newcomers
Religious majorities traumatizing religious minorities
The formally educated traumatizing those with less formal education
People without disabilities traumatizing those with disabilities

Each of these forms of trauma come with very complicated histories. Our roles have also changed dramatically, so exceptions and entire role reversals in power structures also exist in some circles. For example, it is entirely possible for a female to harass a male in both the personal and professional world. People with lower incomes can intimidate those with higher incomes. Unwelcome romantic advances can come from people with any sexual orientation. These are only a few of the many aspects of inequality, disparities and trauma that make any conversation complicated, difficult and very necessary.

The hydras have done a very good job of creating marginalized communities. Racism, disparities, lack of access to services, all collide to create struggling, traumatized populations. This leads to substance use, crime, and poor educational outcomes, which in turn lead to more discrimination and neglect from the hydras, which creates a viscous cycle. The good news is that the more attention we pay to the systems that reinforce inequities, the more we can do to disrupt these systems. Hydras don’t like that, but they also like staying in power so if you and your community members become loud enough, the hydras will come along, or even better new heroes like you will replace them.

Courageous conversations

What’s required for every initiative seeking to address public health, education and economic challenges is an acknowledgement of past injustices impacting present day injustices.

Historical disparities, like all forms of disparities, are not the result of the wind. They are manmade and require compassion, political will and an unwavering commitment to social justice to address.

Empowered to thrive

Though historical disparities and historical trauma can be difficult conversation topics and will make many people uncomfortable, the issues cannot be ignored if we want to prevent disparities and trauma—and support every community member living in environments where they feel respected, well-resourced, and empowered to thrive.

Report from the Battlefield: Katherine’s Report

I sat in horror as my friend described battling the three-headed hydras at his college, working in a summer intern program. He was explaining that there was an unspoken hiring practice for a major employer which was based on which high school youth attended. Kids from a certain marginalized community, which happened to have a majority Hispanic population, were automatically placed in the pile for “trade” jobs which involved cleaning, manual labor, working in the sun, etc. The kids from “good” schools were placed in the other pile. They got to work either desk jobs or with scientists. I was speechless. Even when kids tried to get their foot in the door with a summer job, they were automatically classified before anyone even looked at their application.

Q: How can you empower community leaders to discuss historical disparities and trauma?

Episode 31

Fight or flight, bears,

trauma, and childhood

adversity

We live in an epidemic of trauma.

Concept 6: adverse childhood experiences (ACEs)

Before we talk about adverse childhood experiences (ACEs), let’s talk about you in the forest with a giant bear. If you found yourself face to face with a bear in the woods your brain and entire body would respond with that is called “fight or flight.” This means that your brain is sending a message that you either must run away as fast as you can or stand and fight. You are feeling frightened, anxious and on alert. You know you’re in danger and this response is healthy and needed to escape harm. Once you get away from the bear you can calm down.

The “fight or flight” response is good for a crisis in the woods but we humans have not evolved to be in such an emotional and physical state 24/7. Yet, some children, youth and adults spend much of their time ready to flee. This can be the result of a traumatic home life.

Trauma can be the result of many things. In this article we are going to focus on ten types of family situations in the home that can be traumatic for a child. These “situations” are forms of abuse or neglect that impact children and youth. It is also important to understand how childhood trauma does not end in childhood.

About trauma

A doctor might describe “trauma” as only a serious injury to a person’s body. It can also be defined as “very difficult or unpleasant experiences that cause someone to have mental or emotional problems.” Lots of these problems end with the passage of a little time and a couple of heart-to-hearts with good friends or family members.

Routine romantic breakups in high school work like that. A troubling failure to make the football team can greatly upset a student but with good friends, the sadness can go away over time. All too often, more dramatic trauma causes problems that continue to hamper normal life, long after the trauma itself has ended. These experiences become stubborn emotional wounds, hampering a child’s ability to trust.

These wounds may stay with us for months, years or a lifetime, impacting our adult relationships in our homes, on campus, the workplace, and community. Wounds do many things, including having us seek out a way to numb the pain. We have easy access to alcohol, drugs and our mobile devices where we can spend hours online chatting, clicking “friend” or “unfriend” or staring at moving images from Entertainment, Inc.

Running from trauma? Not really an option.

Many forms of trauma can also lead to the “flight or fight” response we discussed earlier. A child may always fear that another attack is coming from an adult. For students with a history of traumatic events in the home, they never know when they return from school if a parent will be in a good mood, bad mood, sad, drunk or acting strangely. There may also be adult strangers in the home who act in a way that makes a child feel unsafe.Children with a history of abuse or neglect may find it difficult to attach emotionally to others. There is a great deal of research demonstrating that traumatic childhoods impact brain functioning in very real ways. This can impact their chance at a healthy and successful life. Like any other wound, leaving the business of healing to the passage of time only works in the least serious of situations.

ACEs are one of the biggest factors in poor student achievement yet you will be hard-pressed to find any school with an ACEs prevention policy. Bullying prevention policies? Yes. Policies to protect traumatized students and help their struggling parents? No. At least not yet. This is part of the work we must do, acknowledging the epidemic rates of student trauma that diminish their capacity for learning.

Defining Adverse Childhood Experiences

Trauma is so common in our society that it takes a survey just to identify the types of traumatic events children are experiencing. It’s called the Adverse Childhood Experiences (ACEs) survey. This survey may have already been used in a community or school near you. It is a checklist of potentially traumatic events, both large and less large. Some of the childhood experiences that the survey asks about may not seem to be so bad.

Some people have said that some difficult situations in a family are “normal.” Others have said that tough childhoods can make a person stronger. But for most of these childhood experiences, most everyone already agrees that they should not be part of childhood.

The Adverse Childhood Experiences survey was first written and used about twenty years ago, developed by Drs. Felitti and Anda. The doctors who invented the survey wanted to understand the connection between childhood trauma and adult health. The doctors discovered that there existed cycles of trauma that were passed from grandparent to parent to child. The doctors called for big changes to support families with services to reduce trauma. This call for action was met with deafening silence.

What are the 10 ACEs? How much adversity did you face?

What are the ten ACEs? The list includes, in no particular order: physical abuse, emotional abuse, physical neglect, emotional neglect, sexual abuse, witnessing domestic violence, living in a household with someone who is mentally ill, living in a household with someone who abuses alcohol and/or drugs (legal or not), having a family member sent to prison, and having parents who separated or divorced.

If we have healthy, positive relationships with parents, neighbors, family members, teachers, faith groups, sports leagues, we have a good chance of generally turning out pretty well. But if our relationship with parents and other adults are a series of hopelessly negative experiences, like that list of ACEs, we can be in trouble. Serious trouble.

This should not come as a surprise, but the levels of adverse childhood experiences, like those listed above, can predict to a degree all kinds of risky behavior later on in life. Put too many of them into a childhood, and pretty soon there are colliding problems with serious consequences.

Here are some problems that may arise due to a high ACEs score.

Depression
Suicide
Alcoholism
Substance misuse
Prescription drug misuse
Smoking
Severe obesity
Depression
Risky sexual behaviors
Sexually transmitted diseases

Two of the biggest challenges that may come with a high ACEs score are substance misuse and emotional health problems.

An ACEs Score does not predict your future. But it is a helpful warning to be careful.

An ACEs score is not destiny. By this we mean that a person can score a 9 on the survey and still have a good life. Possibly a great one. Another person might score a 1 yet be in a state of flight or fight or years or a lifetime. Another person may score a 0 but grow up in a community struggling with racism and marginalization. Everyone is different. We all respond to trauma and traumatized people differently. There are factors that help mitigate the effects of ACES, many of which are included in the 10 Vital services we’re always going on about.

People going through the trauma associated with adverse childhood experiences are more likely to struggle in school and have a harder time with job readiness and keeping a job.

As you can imagine, a feeling of trauma or fight or flight is not a good feeling. It makes sense that people would want to find a way to reduce feelings of anxiety, fear and sadness. This explains why people turn to alcohol and other substances to numb emotional pain.

For so many reasons all of us — from high school students and parents to health care providers, educators and elected officials — need to understand ACEs in order to prevent and treat problems related to trauma.

The ACEs Survey

The following ten questions from the ACEs survey can help you understand your childhood. It might also help you understand your parents who might have endured ACEs. If you are a parent or thinking of becoming one, it will give you insights to the impact of ACEs on all our children. These questions can also trigger difficult memories. Read with care.

ONE: Did a parent or other adult in the household often or very often push, grab, slap, or throw something at you? Or ever hit you so hard that you had marks or were injured?

TWO: Did a parent or other adult in the household often or very often swear at you, insult you, put you down, or humiliate you? Or act in a way that made you afraid that you might be physically hurt?

THREE: Did an adult or person at least five years older than you ever touch or fondle you or have you touch their body in a sexual way? Or attempt, or actually have, oral, anal, or vaginal intercourse with you?

FOUR: Did you often or very often feel that no one in your family loved you or thought you were important or special, or that your family didn’t look out for each other, feel close to each other, or support each other?

FIVE: Did you often or very often feel that you didn’t have enough to eat, had to wear dirty clothes, or had no one to protect you? Or your parents were too drunk or high to take care of you or take you to the doctor if you needed to go?

SIX: Did you live with anyone who was a problem drinker or alcoholic? Or who used street drugs?

SEVEN: Was your parent or stepparent often or very often pushed, grabbed, slapped or hit by a thrown object? Or sometimes, often, or very often, kicked, bitten, hit with a fist or hit with something hard? Or ever repeatedly hit for at least a few minutes or threatened with a gun or knife?

EIGHT: Was a household member depressed or mentally ill? Or did a household member attempt suicide?

NINE: Were your parents separated or divorced?

TEN: Did a household member go to prison?

ACEs are predictable and preventable

ACEs are predictable and preventable if leaders and stakeholders wish to make its prevention a priority. If you wanted to start a countywide prevention process, you have support. New Mexico has the first state-funded agency with the mission of providing all county leaders and stakeholders with a data-driven, cross-sector and technology-empowered strategy to prevent ACEs. The Institute’s process is guided by decades of research focused on the social determinants of health, health equity, historical trauma and the root causes of trauma. (More on the strategy later.)

States commit to ending ACEs. Or don’t.

Will the 49 other states in the US fund their own statewide strategic (and data-driven) plan for finally ending what can be called an epidemic of trauma? I certainly hope so, especially in our era of destabilizing pandemics and economic disruptions that only make rates of child adversity and maltreatment climb.

As you discuss preventing ACEs with leaders (heroes and the three headed hydras of Apathy, Envy and Fear), you will hear everyone agreeing that ACEs should be prevented. Will these leaders support a comprehensive countywide plan to address the root causes of ACEs? You won’t know until you ask.

Colliding crises

During a public health crisis or economic disruption, people with high ACEs scores may feel especially insecure and destabilized. Beaten down emotionally by trauma, those with high ACEs score may struggle to reach for help and may not have the stamina to make it through the hurdles (and hours of waiting on hold) required to access a particular service. We are talking about Herculean efforts and persistence that would wear anyone out.

Many crises. One solution.

The good news is that the same strategies to make all of us more secure during pandemics and economic disruptions, are the same ones required to reduce ACEs. By ensuring all families are supported in accessing the services for surviving and thriving (assuming these services exist), notably trauma-informed behavioral health care, we can address the root causes of ACEs.

The bottom line is that we need all caring adults to educate themselves about the magnitude of ACEs and the sea of untreated trauma that exists as a result of them today. We often write about colliding crises, and ACEs is one we must confront, prevent and heal. All it takes is one champion to start a local movement to ensure safe childhoods. Someone like you.

Recommended reading: 100% Community, Chapter 7: We Interrupt This Public Health Crisis to Share Another One; Anna, Age Eight: The data-driven prevention of childhood trauma

Report from the Battlefield: Katherine’s Report

Hydras have opinions which they confuse with facts. In one meeting I was discussing the importance of early childhood learning programs.

The hydra, seeking to start a fight, stated, “Wait a minute. Kids have done fine without these new childhood programs that you seem to think we should be funding.”

“It’s actually not my opinion, it’s based on research,”

The other participants in the meeting diverted their eyes, looking at the ceiling or their floor. A hydra in the room turns even caring people into passive zombies.

I responded knowing full well that this conversation was going to go nowhere fast. I learned long ago that trying to defend a position based on data and research was pointless with hydras.

Q: How do we ensure our city and county leaders commit to preventing ACEs?

Episode 32

Hydras want to distract your focus from local countywide projects

The hydra says,”Ignore local stuff.”

Concept 7: a county’s borders (and how they define our 100% Community initiative)

We have to make a choice. Do we become fixated on global disasters-of-the-day, filling our time with doom scrolling and frustrated with the actions of emotionally-challenged leaders in Washington, DC, or do we focus all our energy on fixing problems locally?

If people took that hour a day, reading so-called “NEWS,” and directed that time toward result-focused and data-driven projects in their hometown, we would be half-way toward securing the ten vital services for surviving and thriving for 100% of county residents.

We would all be feeling a lot more secure with accessible local vital services in this era of pandemics and turmoil since things are going to get a lot stranger and much worse before we find stability.

Why a county?

The vast majority of us in the US live within a geographic and political boundary called a county. There are about 3000+ in the nation, across 50 states. If we thought of them as countries rather than counties, some would operate with the efficiency of Singapore or Sweden. Others might operate with less user-friendliness like Moldova or Nicaragua. Some county governments, and the cities governments within each county’s borders, generate resources that they could spend wisely on the public good. Others not so much.

This leads us to the focus of the 100% Community initiative, ensuring the ten vital services for surviving and thriving within all the cities, towns and communities within a county’s borders. We chose the county model, in order to create a countywide system of care, for some very pragmatic, economic and political reasons.

Our formula for funding: County/City Partnerships

Each county, along with all the cities within its borders, need to work to be self-sustaining. County and city residents need local control. The solution for funding is found by visiting the websites of your county and city governments. Allow us to offer a local funding option, one to discuss with your local elected leaders.

In a typical county of 30,000 people, a county government’s budget may be around $30,000,000 (YES! That is 30 MILLION).

In a typical city, with a population of 12,000 residents, the city budget might be around $20,000,000.

This brings you to a total of $50,000,000.

We boldly propose that we earmark 1% of the combined county budget (and city budgets of all cities within the county’s borders) for a countywide 100% Community initiative.

At 1%, that would give this collaborative city/county initiative a budget of $500,000. For that investment, we get what’s called a countywide process to ensure that 100% of residents have access to ten vital services using continuous quality improvement in four phases (a model used to make businesses successful):

Assessment: identifying service gaps and why they exist
Planning: creating public-private sector partnership to fix gaps
Action: fueled by collaboration, innovation and technology, we ensure that ten services meet the needs of 100%, including creating the businesses and jobs
Evaluation: tracking the efficacy of all projects and what county residents report about those services

Consider the “1% for 100%” funding model and engage all county residents in the conversation about funding vital services. If survival services matter, then it’s time to make their accessibility a priority for local government.

Impossible! Until it’s not.

As you will read, fixing decades of health disparities and all the problems related to access to services may sound, to be candid, impossible. You will learn that it will take, in each county, only a majority of your city councils, county commissions and school boards—not all of them. That’s fewer than 100 people who control the priorities and budgets of key services.

As for focusing on only one community, we know within each county, certain areas have suffered historically. They should be prioritized. We again advocate for using our county model, as city, county, school and higher education budgets, along with non-profit organizations and foundations, — if combined and mobilized — can raise up every community within county borders.

Our vision is quite pragmatic. If we get all the counties in one state working well, we reinvent the entire state and make vital services available to all. We have so much to gain by sharing a vision and collaborating county by county. It starts with one or two county residents combining superpowers, networking and mobilizing.

Our colliding challenges will not be solved in Washington, DC, by a horde of three-headed hydras. Nor do problems get solved by watching talking heads on national news outlets. The heroes required to make your city and county as caring as possible are living down the block or a short drive away. The local champion we need now more than ever is you.

Recommended reading: 100% Community, Introduction to the Book, Course, Initiative and Movement

Tales from the battlefield: Dom’s Report

A long time ago I was explaining to my new boss that we have a treasure trove of data to analyse for improving our work and the services for domestic violence across the state. In each shelter, every activity that a shelter resident is engaged with is billed. This means we know when a domestic violence survivor sees a counselor or a substance misuse specialist. We know when residents come and go and return. I was surprised to discover that all this data on every client in every domestic violence shelter was ours to analyze. But, I was even more surprised when my boss told me, all three of her hydra heads swirling around my desk, that we would not be analysing that data. My boss shrieked, “That data is from an invoicing system and it can only be used that way.”

It was only my third day on the job so I had no idea if this was ignorance, incompetence or some form of corruption being used as an excuse to ignore the data that could vastly improve services. I took a chance and said, “We really could learn so much from this data, like a hotel chain does as it learns everything it can from its guests.”

The hydra was incensed, nearly knocking over my computer and coffee as it stormed out. There would be no data analysis and I would be seeking a transfer and gone within months.

Episode 33

Continuous quality

improvement sets us up for success

Hydras hate data-driven anything.

Concept 8: continuous quality improvement (CQI)

CQI is our favorite model for quality improvement when working in the public sector with the goal of getting to results. Many people have invented various forms of quality improvement but, if you scratch the service of most of them, you will see that improving a system or solving challenges comes down to four skills: assessing, planning, acting and evaluating. That’s CQI. Radically simple stuff.

How do we begin to define CQI?

CQI is the framework that is guiding all action teams in the 100% Community initiative to ensure the ten vital services for surviving and thriving. The initiative has one action team for each of the ten vital services (more on action teams in a bit). Every initiative participant on an action team should have a good understanding of the CQI framework. With some projects the problem identified may be a lack of quality on the part of a particular agency. If this is the case, the action teams may propose to the agency leadership that CQI may be used to address the agency’s challenges.

Action teams may discover in the assessment process that it’s not the quality (or lack of quality) of an organization that’s the problem, instead it may be that an organization to provide the service in a particular community does not yet exist. CQI can guide solutions in this case.

Four Key Components of CQI

The key components of the CQI cycle that we use are assess, plan, act and evaluate.

Assess

Using data, a change agent or action team will identify the magnitude of a challenge, the capacity of local organizations to address a challenge.

Plan

After analyzing data, a change agent or action team will build a measurable plan to address the identified challenge. This planning starts with researching evidence-informed solutions (to problems associated with lack of timely access to vital services or services lacking user-friendliness). We recommend using a planning tool called a logic model (discussed shortly) that identifies the goal, inputs/partners needed, activities and measurable outcomes.

Act

Implement plan, working with strategic partnerships, with measurable short term, intermediate and long-term outcomes.

Evaluate

Monitor progress with all stakeholders.

Each of these four components of CQI, or phases, comes with a set of questions to ensure that the change agent or action team is using data to support the improvement process every step of the way.

CQI is a Team Process

CQI cannot operate in a vacuum. Objectives, goals, and implementation are shared responsibilities and activities. When the team shares an understanding of the process, the team can move forward as one. When an action team works together, CQI is fully supported.

Quality Data and the CQI process

We need quality data that is accurate and timely in order to assess a challenge. Data need to be current and analyzed with care to support the entire CQI process. Our action teams focused on the surviving and thriving services will be in contact with a wide variety of agencies providing specific services. Data will need to guide all attempts at improvement.

Who Wants CQI and Who Doesn’t

State and local stakeholders, including elected leaders, have a wide range of reactions to both CQI and a data-driven process. Data, used correctly, will show where systems aren’t working or don’t exist where they should. Many people want this information in the fields of health, safety, education and economic development — and across the public sector. There are also those who prefer to use hunches or opinions to guide work, rather than data.

Positive responses to CQI

Opens up all aspects of work to possible improvement
Frees up ways of thinking about work (we’ve never done it that way before)
Reframes the idea of failure and turns it into an experiment
Makes it a process of discovery and adaptation
Allows for growth and encourages growth
Helps to keep priorities upfront
Can change the culture of the office/organization
Improves organizational accountability
Refines service delivery process
Supports flexibility when services need to change
Enhances information management, client tracking and documentation
Lends itself to design of new programs and program components
Allows creative/innovative solutions

Negative and disruptive responses to CQI (hydras often appear here)

People may feel threatened by CQI and use of data to assess their work, leading to fears of being judged.
People feel a sense of loss as the old way of making decisions (by hunch, or ideas from higher up the food chain) is traded in for a data-driven process.
It spotlights processes, services or products that aren’t working, and this may shine light on ineffective investments and investors.
It may show how certain populations are experiencing social adversity, injustices and health, education and opportunity disparities.

A hunch-free zone

CQI will set all your projects up for success. The alternative is following hunches, guesswork or some three-headed hydra’s whim. We don’t have the luxury to follow whims in an era of pandemics and economic disruptions. Not when services for survival are needed.

Recommended reading: 100% Community, Chapter 29: Continuous Quality Improvement Guides Us with Data

Episode 34

Collective impact—not Apathy, Envy and Fear

Hydras have a shared vision.

Concept 9: collective impact model

A shared vision is required for any successful social movement . The 100% Community initiative, designed to ensure ten vital services for surviving and thriving, is as much a movement as it is a mobilizing strategy. One vital component of our project is a guiding philosophy and process called collective impact.

Solving challenges together

Before we define collective impact, let’s talk about the type of challenges it can solve. As our national leaders argue over how to address pandemics and economic disruptions, we can take a moment to reflect on how some strategies were used in the last few decades to address some public health challenges. Our nation and state leaders learned to mobilize around two costly health and safety challenges: we reduced motor vehicle injury by nudging (through laws, design modifications and public education) the wearing of seat belts and we reduced respiratory problems and cancer by ending smoking on planes and in shared work and public buildings. Brilliant!

We were even pretty “Johnny on the spot” when we thought Ebola might enter the US. We as a nation knew exactly how to focus on our collective attention and millions of dollars on that particular health threat and solve it. Fast.

What is baffling to many health advocates is that after four decades of health crises, from AIDS to COVID-19, our national leaders have not worked to ensure that all residents have access to medical care and other services for surviving. We have not worked collectively, as a nation or as states, to ensure vital services to protect us during pandemics and economic disruptions. Until now.

Committing to collaboration

Local leaders engaged with the 100% Community initiative are committed to everyone surviving and thriving. They are doing the data-driven and collaborative work of setting up ten action teams (each team focused on a surviving and thriving service) in each county to do both small-scale and large-scale, long-term projects.

The 100% Community initiative is building the capacity to increase the services of health clinics, food banks, housing security agencies and other vital organizations. Initiative action teams are working to support the development of full service community schools with health care for students and families. This community mobilizing work benefits greatly from a framework shown to move people toward a shared goal and vision. That would be collective impact.

Defining Collective Impact: a strategy for change

This process of sharing a vision has been packaged as a process called collective impact. It has decades of research behind it, and many meaningful projects have been completed by following its guidelines.

In the article “Collective Impact,” written by John Kania and Mark Kramer and published in the Stanford Social Innovation Review, developers of the collective impact model, discuss how large-scale social change requires broad cross-sector coordination and the importance of social sector focused collaboration instead of the isolated intervention of individual organizations. They describe how successful collective impact initiatives typically have five conditions that together produce true alignment and lead to powerful results:

A common agenda
Shared measurement systems
Mutually reinforcing activities
Continuous communication
Backbone support organization

The 100% Community initiative uses the collective impact model because it focuses on the power of strong leadership working in collaboration to get results through a shared vision and goals. The philosophy of collective impact can be applied to many large scale projects, such as creating a system of mental health services across the county to reduce childhood trauma, so we empower our 100% Community action teams with the collective impact model, along with the other tools in our toolbox.

As you mobilize around an innovation (assuming that we have convinced you), you will find the collective impact model essential. Like so many of the frameworks that guide our 100% Community initiative, the best ones are the simplest. And, what could be simpler (and more powerful) than sharing a vision?

10 Visions within a One Shared Vision

The 100% Community initiative, as you well know by now, envisions a county where all residents have access to ten vital services. Within that process are a thousand different moving parts. Some of those components of the initiative are the ten action teams, each focused on one of the ten vital services for surviving and thriving. The action teams function, in some ways, as ten county coalitions within one mothership coalition.

Within each of the ten action teams, members are developing innovations to increase services. These innovations have one purpose: ensure access to quality services for all county residents. The goal, supported by the collective impact process, is to ensure that all activities within the initiative are in alignment with one another.

The choice is yours as the era of pandemics and economic disruptions unfolds. Create a shared vision to solve our most costly challenges or work in isolation and hope for the best. I believe the former will get you to the results you seek.

Recommended reading: 100% Community, Chapter 31: Sharing the Vision to Achieve Collective Impact

Report from the Battlefield: Katherine’s Report

In the local community meeting, all of a sudden I was surrounded by hydras. Each one’s Fear head assuring me that they were “doing collective impact.”

I tried to explain that collective impact has specific criteria they have to meet in order to be a true collective impact project.

“Criteria?” Apathy said.

“Yes,” I responded, “if your citywide project has a stable economic base and shares data, goals, a vision and strategies for interrelated and measurable activities with all the organizations engaged in your work, then you have collective impact.”

Hydras do not like to share. Anything. Collective impact is not a model they would ever endorse.

Episode 35

Is it a

technical

or an

adaptive

challenge?

Hydras fear change and loss of power.

Concept 10: adaptive leadership

This era of pandemics and economic disruptions brings out the best and worst in people. If you told someone that you were working on a county initiative to ensure that all residents had access to ten vital services for surviving and thriving, expect two types of reactions.

Person A: “Tell me more.”

Person B: “That’s crazy talk.”

Defining adaptive leadership

For the Person B-types of the world, we have a framework guiding our initiative, and all projects within, called Adaptive Leadership. This is a way of thinking about identifying and solving complex and political challenges. In a nutshell, it asks all of us to look at community or organizational problems as either technical challenges or adaptive challenges. Technical ones have an agreed upon path to follow for problem-solving while adaptive ones have no agreed upon path forward and you’re in uncharted waters. Trust us, you don’t want to confuse a technical challenge with an adaptive one. Most of the challenges encountered as an initiative and with project development will be adaptive challenges.

Loss vs. Change

Loss versus change is a concept that is fundamental to our work with 100% Community, but you really, really need to read yet another book to fully understand why. To understand why, let’s talk about Dennis, who did not read Adaptive Leadership* and suffered a huge professional defeat.

*If you can’t wait for the full reveal on the next page, the actual title is: Heifetz, Ronald A., Marty Linsky, and Alexander Grashow. The Practice of Adaptive Leadership: Tools and Tactics for Changing Your Organization and the World. Harvard Business Press, 2009.

Meet Dennis: change agent

Picture young, bright and energetic Dennis, who is an avid bike enthusiast. He works for a local government, and he’s been given the go-ahead and budget to implement a dream project: implementing bike paths throughout the city. He’s done his homework on all the technical aspects of the project, and researched studies on how other cities have achieved this same objective. Key staff are on board to begin creating barriers between the car lanes and new bike lanes on the main street downtown. For Dennis and his colleagues, this means there’s less room for polluting cars and a delineated path for the city’s environmentally-conscious bike community. What’s not to love?

See Dennis in trouble

Well, as the construction begins, some very well-connected business people based downtown start placing angry calls to the mayor’s office. Turns out that the “review” process was so badly publicized and attended that few of the stakeholders downtown along the proposed bike paths had heard about this project and what it would do for their businesses. To them, bike paths meant losing customer parking. Long story short, some wealthy, well-connected people got the mayor and city council to halt the project for an undefined cooling-off period to allow time for further community input.

See Dennis confuse a technical challenge with an adaptive one

So what happened here? Dennis had the technical part of the proposed project down perfectly, from the cooperation of the contractors and city workers to the budget, timeline and even environmentally safe road paint. However, he failed to understand that bike paths meant change and loss for those next to them. Business owners feared losing business due to less parking, and, just as important, they and local residents felt as though they had lost control of their neighborhood. Their tiny part of planet Earth had been destabilized by the Death Star. To them, it was all happening too fast, and nobody had bothered to explain the positive effects of bike paths, like bringing new clients into their neighborhood. The ultimate goal should be to create a neighborhood people wanted to visit and linger in — designed for people, not cars.

One book: changing your views on change

The entire process of change is summed up expertly in a book with the inspiring full title The Practice of Adaptive Leadership: Tools and Tactics for Changing Your Organization and World by Ronald Heifetz, Alexander Grashow and Marty Linsky. Its main thesis is that there are two types of challenges: one type is “technical,” like how Dennis had his plans and paints in line, while the other is “adaptive” and focuses on how humans fear loss and must be convinced to buy into change in a very thoughtful way, lest they push back as they did to unprepared Dennis.

Trust us, you’ll really want to know this stuff

Before we can proceed with our bold plans for the 100% Community initiative, which in many ways represents a huge change from the status quo, we need to pause. We’re talking about redesigning communities, cities and counties so they have ten vital user-friendly services to provide vital care in times both calm and chaotic.

You may be thinking, “Who wouldn’t love our vision and plans?” or “Who doesn’t want to support surviving and thriving services?” but, unless we explain why we’re doing what we’re doing, lots of people won’t feel the love.

Instead, they’ll ask:

“Who’s paying for this?”

“Do all residents really deserve services?”

“Don’t you know we’re already doing all this?”

“Why spend time, energy and money on this when most folks are OK?”

“Why revitalize our downtown when people probably won’t visit anyway?”

“Who’s gonna make money off any of this?”

“If this project gets funding, then won’t that mean less funding for my agency?”

Lastly, “I just don’t understand how this is even possible?”

People are ruled by fear

Change, to many people, is just plain loss, which can be scary. We already live in a culture that tells us at every possible opportunity that the world is falling apart. For people over 60, who happen to represent a huge voting bloc, as well as people in positions of local and state power, things are moving far too fast to keep up.

The field of study that focuses on change, called Adaptive Leadership, is one we all would greatly benefit from, even if we just had a basic understanding of the difference between a technical challenge and an adaptive one. Confusing the two can set projects back , sometimes indefinitely.

It’s adaptive challenges that cause leadership and supporters to retreat from (and at times actively fight against) change, unless there is a process to help them see the benefits. If you only read two books this year, might we humbly suggest Adaptive Leadership (and that 100% Community book you might have heard about).

The benefits of Adaptive Leadership

Some things we promise you’ll be gratified to learn and/or have reinforced by reading Adaptive Leadership:

Understanding the root causes of the challenge you seek to solve.
Reflecting on why your agency or community hasn’t been able to move the needle on the challenge for decades or forever.
Identifying those in power on the city council, county commission, school board or chamber of commerce who could be allies, as well as who may initially attempt to block your progress.
Assessing your own personal, professional and political power, and how you might leverage it.
Designing what we call a change initiative, innovation or experiment to test out a new protocol, program or policy to improve the quality of a service or expand services.
Adapt to changing political, cultural and commercial landscapes and focus on building trusting relationships.
Using push-back and resistance as teachable moments, moving forward with compassion and understanding.

The “balcony”

One key element of Adaptive Leadership is the idea of “getting on the balcony,” i.e. stepping back from a challenge to get the big picture. Assessing the history of the problem is vital. Understanding the active players on both sides of an issue related to your project, and everyone who might be impacted directly or indirectly by your proposed changes will be invaluable when you’re trying to determine what to do next. Trust us, the authors really know their stuff, and there’s an entire industry built around Adaptive Leadership, one which we fully support. You can even order audio versions of the book and supplemental resources with Kate Winslet narrating.

Qualities to aspire to

Out of respect for the authors of Adaptive Leadership (also copyright law and plain common decency), we can’t reproduce all their brilliance in this article, but let us end by reflecting on qualities related to being an adaptive leader. Adaptive leaders are self-aware and committed to understanding others. They speak truth — often uncomfortable truths — but always with respect, so those being guided feel valued. They’re transparent and lead by example. Proponents of Adaptive Leadership are lifelong learners and support that same quality in those they lead.

Before you stand in front of your colleagues at work, leaders at city hall or delegates at the United Nations asking for support, do yourself a huge favor. Immerse yourself in the process of Adaptive Leadership and then go change (and save) the world.

Report from the Battlefield: Katherine’s Report

My heart sank. We were hearing from the grapevine that people we considered colleagues had transitioned into hydras. One hydra started going around a local community stating that they had been ensuring vital services for years, and didn’t need a new model. Neither Dom nor I had the energy for gossip games. At the next community meeting, Dom pulled the gossiping hydra aside, and calmly told it, “It’s great stakeholders in the county have it all figured out, and we’d love to see the documentation that shows what you’re claiming, that all residents have access to vital services.”

Of course, that documentation was never produced. In the meantime though, we got on the balcony and assessed the readiness of that hydra’s community. First, it was obvious that the town was overrun with hydras, with Apathy, Fear and Envy making progress almost impossible. This was going to be one of our biggest adaptive challenges.

Episode 36

The

readiness and

capacity

assessment reality check

Assessment reveals where hydras roam.

Concept 11: readiness and capacity assessment

In the era of pandemics and economic disruptions, our best line of defense is ensuring that all county residents have access to the ten vital services for surviving and thriving. This is the grand experiment currently unfolding in New Mexico, mobilizing community leaders and stakeholders around one question and answer.

Question: What percentage of county residents should have access to medical care and other basic services to navigate a chaotic world?

Answer: 100%

100% is a noble goal and worth striving toward

Each county committed to 100% will be doing a readiness and capacity assessment, learning to what degree local leaders and stakeholders are committed to improving the ten surviving and thriving services. This process is done through information interviews, surveys and other tools to answer the question, “Are county residents and their leaders ready for change?”

Readiness is a tricky business. On the one hand, those of us working in the public sector have been taught that before launching any significant initiative, you need to follow a long assessment process to ensure that community leaders, and those who follow them, are ready for change. We agree — and there is an entire field of study called Adaptive Leadership (concept 10) that teaches people how to assess for readiness and measure if an agency, community, city, county or state has the capacity to move in a different direction.

Yet we must also accept that sometimes readiness is about a person being inspired with a virtual lightning bolt — call it an epiphany. Suddenly, it becomes clear that immediate change is necessary and it’s time to start mobilizing today, the official assessment process can catch up later.

Not every community is ready. Yet.

Through an assessment process it may also become painfully clear that a county, city or community does not yet have the capacity for significant change. That is one of the most disappointing and frustrating aspects of the work. It doesn’t mean important work can’t be done. It does mean you are navigating a little society controlled by three-headed hydras who will do everything in their power to block your efforts. It’s here you must be on special alert for the hydra head of Apathy, oozing charm while he allows the heads of Envy and Fear to obstruct.

Ready to do what’s needed, not what’s easy

100% Community is focusing on improving systems, which will require taking on some big infrastructure projects and building the foundation of key services that allows all our systems of care, safety and learning to work for our communities. We are not here to tinker around the edges of health disparities and lack of vital services. What we propose is only possible because of extraordinary collaboration and a commitment to a shared vision and goals.

Is your county ready? We have the tools to answer that. The most important question is... are you ready?

Recommended reading: 100% Community, Chapter 9: Readiness and Radically Altering Course

Q: How will you help make sure your community is ready?

Episode 37

We save time and resources by working in alignment

Combine superpowers and align work.

Concept 12: working in alignment

Let’s first talk about pie. Scarcity mentality refers to people seeing life as one pie. Just one. And there won’t be another one. So we better hoard what we have. We limit our vision of what’s possible. Scarcity mentality is the opposite of abundance mentality.

In times of economic free fall, scarcity thinking is rampant. When it comes to budgets for local governments to ponder, the leaders may only see one tiny pie. State lawmakers, city councilors and county commissioners get very nervous and rightly so. Questions abound. What is our revenue? Our expenses? Can we survive the year with our current pie? Could we ever bake a bigger pie?

There are other questions about state and local government to ask. What is the priority of the government? Where does access to services for surviving, like medical care, fit in? Is an investment in services for thriving, like job training, prudent?

Lastly, government leaders can ask about alignment between city and county services, and the state agencies and nongovernmental organizations working on the local level. To what degree do we duplicate efforts? How aligned is the workforce in all our sectors, from mental health care to education? Can we assess what each government department and staff member actually do in a day and how those activities get us to our goal of serving the public in measurable and meaningful ways?

Bottom line: if we align the work of government and nongovernmental organizations, we save money, time and energy in ways that add up to millions of dollars.

Alignment saves money and energy.

All our work with the 100% Community initiative is designed to be working in alignment with all existing data-driven local efforts. As we work to increase access to ten vital services, we seek to combine our forces with those county residents already working on such a process in each of the ten sectors for surviving and thriving.

In alignment (always)

One of the first things we usually hear when we convene a group of government agency leaders to discuss services needed to strengthen families is “we are already doing that.” And in some communities, that’s true: committees exist, task forces meet regularly and progress is being made. In other communities and agencies, people meet, talk, update, network and eat. But there is no progress made toward problem-solving. You won’t know if a task force is focused on convening and the illusion of doing something or data-driven, result-focused action until you check for yourself.

As you will discover when you engage with the 100% Community initiative, one of the first things participants do is complete an assessment of everything their county is currently doing to serve residents in our ten vital sectors. This process brings good news and bad news.

Good news first

The good news is that you will discover hard working people doing important work in a wide variety of sectors. Most city and county governments have staff that work in vital services like law enforcement, fire and parks. Some will have community services that can include all sorts of programs for kids and the elderly. School districts may have a health department of some sort, possibly with a trained psychologist. And there may be, depending on the size and location of your county, hundreds of nonprofit organizations (called NGOs in some circles) working on a wide variety of community projects, some of which are related to health, safety and education.

The bad news

The bad news is that most of these people won’t know what the others are really doing, even though they serve the same populations in a handful of zip codes. It is not uncommon for a county government staff person overseeing mental health services with absolutely no idea what the city government staff person overseeing mental health services is doing. No alignment. No sharing of strategic plans, even though they serve the same people. We have lots of ideas about why people like their silos and fear sharing any information about the local work but, suffice it to say, that era is over for two reasons.

One: Software is forcing everyone in government to be transparent and many old-time employees are being dragged into the information age kicking and screaming.

Two: Economic collapse dictates that we cannot afford to duplicate and waste.

Back to good news

The good news is that the 100% Community initiative links every human taking part in the mission of ensuring that ten vital services reach all residents. This is done with both good old-fashioned face-to-face meeting and communication technology. We never want to reinvent the wheel or duplicate current efforts that work well. We do, however, wish to evaluate all the work currently in play to assess its effectiveness. We have the technology to create a seamless countywide system of communication between organizations and within the organization so that we know, 24/7, who is working on a given program and what the expected outcome is.

When we align, combing our superhero powers, we make measurable progress every day. Will it be easy to move a work culture that has worked out of alignment since it was invented? This gets right back to concept 10: adaptive leadership and resistance to change. We must allow for push back, fear and confusion.

We must also make it very clear to all involved that in an era of pandemics and economic collapse, we’re all in this together, so it’s not a question of if we align to commit to collaboration, but how soon.

Recommended reading: 100% Community, Chapter 37: When Epidemics Collide, It’s Time for People to Collaborate Ready to do what’s needed, not what’s easy

Episode 38

We ask

residents

if they can

access vital survival

services

Surveys reveal huge gaps in services.

Concept 13: 100% Community survey

In the era of uncertainty, our community services that support our surviving and thriving may be struggling to keep their doors open. Then there are the neighborhoods across town that have never had such services.

To understand to what degree county residents do or don’t have access to the ten vital services, we ask them if they need such services, and if so, do they know where they exist. This is done through a variety of tools including our 100% Community survey. The survey also asks why services might be difficult to access. As action teams in each of the ten sectors focus on increasing access to services, they also focus on analyzing the reasons why access is difficult.

Ten vital service for surviving and thriving

We ask to what degree residents have access to the five services for surviving:

Medical/dental care
Behavioral health care
Housing security programs
Food security programs
Transport

We ask to what degree residents have access to the five services for thriving:

Parent supports
Early childhood learning programs
Fully-resourced community schools with health centers
Youth mentors
Job training aligned with the job market (of today and tomorrow)

Survey results guide solutions

Armed with data on where services are tough to get and why, 100% Community action teams can focus on using continuous quality improvement to address gaps. It’s not brain surgery but it does take matching why gaps exist and evidence-informed strategies to address them.

Some solutions are easy, just change service delivery hours to ones that residents say will work better for them. Other solutions may require fixing the digital divide so residents can access services online. Technology may, in some surviving and thriving service areas like behavioral health care, parents supports, youth mentors and job training, be incredibly helpful. We live in a world where many helpful services can beam in through a mobile device.

But we won’t know where and how to innovate until we know why accessing services is a challenge. And challenges for a single mom of two may be very different from the challenges a teen or grandparent face, and can even depend on where in the county they reside. With a completed countywide survey, we don’t have to guess where the glitches in a seamless countywide system of care exist and why.

Survey results guide solutions

What survey results and reports can and can’t do

Survey results can be a catalyst for change. Heroic leaders will want to use the data to push for funding and problem-solving. Three-headed hydras will ignore or dismiss the data, hoping any concern to address disparities will fade away. (See concept 10: adaptive leadership to address the three-headed hydra’s less than supportive responses).

Today, every county can have easy access to a survey and assessment process to provide all county and city leaders with the information they need to direct planning, spending, innovating and problem-solving. All that’s missing is the hero to start the process of discovery.

Recommended reading: 100% Community, Chapter What Percentage of our Nation Should Be Able to Access Survival Services?

Report from the Battlefield: Katherine’s Report

There were many Hydras in the meeting room. As I presented the results of the county’s 100% Community survey, something magical started to happen. Suddenly these hydras who had loudly and viciously declared our work unnecessary started turning back into humans. They had entered the room with their swirling heads of Fear in prominence, worrying that the survey results were going to demonstrate their ineffectiveness. What they saw instead in my presentation were real opportunities to close gaps. The data laid out clearly that while there were gaps, many of them were easy fixes and they began to see roles for themselves in fixing these gaps. Suddenly several people who had only moments ago been vicious hydras were brainstorming ideas for how to increase service delivery. Concrete data can be, if you’re lucky, a very useful tool for turning hydras into humans.

Episode 39

A logic

model can science the sh*t out of challenges

Hydras hate planning and logic.

Concept 14: logic model

Imagine you determine, amid a pandemic, that increasing access to health care could be done quite efficiently by turning your public school into a fully-resourced community school with school-based medical and mental health care for students and their families.

This is a big project, and instead of guessing your way through the development process, you can create a plan to share with all community and school stakeholders for buy-in.

One key planning tool we use to design projects, focused on increasing access to ten vital services for surviving and thriving (including community schools), is a logic model. This is a one-page document with a visual representation of a plan to guide a project that includes the project’s hypothesis, goal, purpose, inputs, activities, outputs and outcomes.

Can we be logical about this? Absolutely!

The more carefully thought out a plan, the better chance for conducting a successful local innovation. And the more detailed the logic model can be — like a good map with clear markings — the better chance of getting buy-in for projects, as well as having a shared vision, goals and objectives. Take a look at our 100% Community initiative logic model components (you can find the graphic representation in the book’s appendices). The entire logic model fits on one page, easily copied and emailed to every county stakeholder. Not only is the logic model used to guide the entire initiative, it’s used by action team leaders to develop each of their projects.

There are many ways to design a logic model, with a variety of sections. We use the following format:

Hypothesis (research-based assumption guiding the project)
Purpose
Goals
Inputs/Partners
Activities
Evaluation (measuring the impact of each activity)
Short-term outcomes
Intermediate-term outcomes
Long-term outcomes

Let’s take a look at each of the components of a logic model. In this example, let us imagine you wish to launch a county coalition dedicated to ensuring ten vital services for surviving and thriving for all residents.

Hypothesis

A logic model is our plan of action.

If city, county, and community stakeholders come together to provide access for all county residents, we increase their capacity for good health and positive outcomes from birth to work to retirement, including school achievement, job readiness and self-sufficiency.

Purpose

Build the capacity of each community within a county’s borders to create a seamlessly networked countywide system of care, safety, emergency preparedness and education for 100% of residents. Ensure that each community has the resources and structure for emergency management.

Goals

Educate elected leaders and stakeholders on the need for and benefits of ensuring that all residents have access to the ten services for surviving and thriving. Develop a hub for competency-based online learning for county leaders in ten vital surviving and thriving service sectors. Use continuous quality improvement (CQI — Assess, Plan, Act, Evaluate) to improve quality of and access to ten vital services shown to strengthen families. Finally, evaluate progress.

Inputs/Partners

State lawmakers who serve the county
Mayors, council members and city managers
County commissioners and county managers
School board members and school superintendents
University and college leadership based in the county
Leadership from agencies in the ten surviving and thriving service sectors: behavioral health care, medical/dental care, transportation, housing, food security, parent supports, early childhood learning, youth mentors, family-centered schools, job training and placement
Experts in continuous quality improvement, collective impact and adaptive leadership
Emergency management specialists
Economic development experts and social entrepreneurs
Historians and historical trauma experts
Information technology and infrastructure
100% Community developers
Community stakeholders of all ages
Data systems

Activities (Each of these activities is measurable.)

Identify co-organizers and ten action team leaders to use collective impact model to guide initiative
Support ongoing surveying of county’s families and community members to assess gaps in ten service areas
Recruit action team members from ten sectors.
Facilitate 100% Community course for all initiative participants, with 100% Community as course textbook
Implement local innovations and projects to address gaps in services in ten sectors
Create a history and cultures task force to educate public on health disparity root causes, trauma and social adversity
Track all innovations and projects and share measurable progress with all residents
Create public and private partnerships to support innovations
Create economic base to institutionalize work in each county

Evaluation

Measure satisfaction and user experience of those taking course and engaging with the initiative
Measure knowledge and behaviors changes of initiative participants related to their understanding of CQI, data-driven work and reaching goal of 100% accessibility.
Measure changes in agency leadership and increased use of CQI, collective impact and adaptive leadership
Track alignment of the initiative with current local work
Measure increases in quality of services and accessibility to services (in each of the ten sectors)
Track the increase of public awareness of root causes of health disparities, trauma and social adversity
Track increase in effective use of technology to increase agency user-friendliness and accessibility
Track increases in buy-in from elected leaders related to serving 100% of residents within the ten sectors

Short-term Outcomes

(In normal times, these activities could take a year. In times of crisis, we need to respond rapidly to establish governance, communication and awareness of gaps in services.)

Establish effective and transparent governance of 100% Community initiative with governmental or non-governmental organizations, securing evaluation processes.
Increase knowledge and skills of 100% Community initiative participants (government/agency leaders) to:
Use data to identify local challenges in ten sectors
Mine (dig deep) and analyze data
Assess agency workflow challenges and successes
Research evidence-based or evidence-informed solutions
Implement continuous quality improvement (CQI) to improve services
Increase use of CQI, Collective Impact and Adaptive Leadership among agency leadership
Improve communication between elected officials and their staff on the state, city, county, school board and tribal levels
Increase awareness of gaps in vital services
Increase use of structured innovations to address gaps in services with measurable activities
Increase knowledge of the root causes of health challenges, health disparities, trauma and social adversity among public and leaders

Intermediate Outcomes

(Under normal circumstances, these activities could take 2–4 years. During a crisis, we need to respond rapidly to increase access to vital services.)

Increased access to ten vital surviving and thriving services
Increased local funding of programs and services related to preventing health disparities and social adversity
Increased leadership awareness of social costs of lack of access to ten vital services, health disparities, trauma and social adversity
Agencies in ten sectors have data-driven plan to serve 100% of residents

Long-term Outcomes

(Depending on the level of urgency, and commitment to funding from heroic leaders, the timeline could be measured in months or years.)

Increase access for all county residents to ten surviving and thriving services
Increased school/college attendance, performance and graduation; increased job readiness
Increased accessibility of vital services
Increased use of technology to strengthen access to ten services
100% Community initiative institutionalized within local government
Increased public/private partnerships ensuring 100% of residents have access to the ten vital services for surviving and thriving

A million reasons to use a logic model exist. Here’s ours.

A logic model helps 100% Community initiative action teams (and partners who include elected city, county and state leaders) focus on each projected outcome they want to achieve with a project. Their desired outcomes are a direct result of their activities, mapped out in the process of designing a logic model with colleagues. Logic models work best when they clearly illustrate (in graphics and text) what the 100% Community initiative (as a whole) and each action team is trying to accomplish. For example, increasing timely access to medical care.

Planning quickly yet calmly in times of crisis

There’s a funny scene from the movie The Martian in which an astronaut stranded on Mars and facing death says, “So, in the face of overwhelming odds, I’m left with only one option: I’m going to have to science the sh*t out of this.” That is where many of us may find ourselves as we plan to address a public health crisis. And yes, with focused research, the astronaut survives. Similarly, using the frameworks of continuous quality improvement and collective impact, we can science our way to a collective vision of 100% access to ten vital services. Logic models can serve as the map we use to get there.

Recommended reading: 100% Community, Chapter 38: The Logic of the 100% Community

Q: Why are logic models a useful tool for hydra prevention?

Episode 40

Increasing

services with

evidence-

informed

strategies

Heroes gather evidence to solve.

Concept 15: evidence-informed strategies

As we seek to improve the quality of family services and their accessibility, we will research evidence-informed strategies. We will find that many of the solutions to our local challenges have already been tested and evaluated in other localities, meaning we don’t need to reinvent wheels. In hard times, we do need to implement the strategies shown to increase access to vital services with a sense of urgency.

evidence [ev·i·dence]

Noun

the available body of facts or information indicating whether a belief or proposition is true or valid.

Verb

be or show evidence of.

Scientific evidence

Scientific evidence consists of observations and experimental results that serve to support, refute, or modify a scientific hypothesis or theory. For example, the 100% Community initiative’s hypothesis is:

If we ensure that 100% of county residents have access to timely health care and nine other services for surviving and thriving, residents will be healthier.

To gather evidence to support this hypothesis, we can survey county residents to learn about their health and their access to services as the initiative grows year after year.

Research, not hunches, guesswork and whims

Evidence-informed practice is used to design systems, programs and activities using information about what works. It means using evidence to identify the potential benefits, harms and costs of any intervention and also acknowledging that what works in one context may not be appropriate or feasible in another. Evidence-informed practice brings together local experience and expertise with the best available evidence from research.

There are two ways evidence-informed practice should influence our work to increase services to increase health and safety outcomes.

First, we should consider evidence when we are in the planning stages of an intervention or program.

Second, the program should be evaluated and the findings disseminated, helping build the evidence base.

Evidence requires data

Seek evidence of success, not guesses.

The evidence we use could be about the links between a new program and respected theory. It could be about components of the program or an approach we are taking, or it could be about the overall effectiveness of the program.

Evidence can be numerical information analyzed statistically (quantitative data) or can be descriptive information gathered from interviews or open-ended questions (qualitative data). For it to be evidence, it needs to be collected in a systematic manner and it needs to be informed by research and/or evaluation.

Evidence used in the health, education and economic development promotion context can come from a range of sources. For example, we could use evidence from our own services if we have run the program before and collected evidence to show it works; evidence could come from the evaluation of a program run by a similar organization; or it could come from the broad research base.

Program work

We are working to increase the quality of individual organizations that provide services within one of ten sectors, for example the Food Sector. This is called program development and we use continuous quality improvement to assess challenges within a program like a downtown food pantry. We can then move to planning, action and evaluation to improve overall quality and performance of the food pantry (or any food security-related organization). This is collaborative work between the 100% Community action team and each agency.

Systems work

We are also working to create a countywide system for a particular sector, such as the Food Sector. In this work, we are linking, via technology and collaboration on the part of organizations leadership, to design a seamless network. This would mean, to end food insecurity, all the county’s organizations that provide food are in constant communication with each other, with a data system that tracks supply and demand. The end result of this work would be the creation of the “County X Coalition of Food Security” or the “Food@100% County Network.” This is collaborative work between the 100% action team and all the service providers (and funders of providers) working in the county.

Whether we are improving programs or designing countywide systems (made up of programs), we are using evidence to support our practices.

If there is a gap in the evidence base we can innovate and develop an approach based on available evidence. We can develop a pilot, collect evidence and evaluate it - we just need to demonstrate there is a gap in the evidence and that the pilot is building the basis for further research.

What we need to know about evidence

To practice in an evidence-informed way requires us to know about:

The health, education or economic issue being addressed
What the evidence tells us works to bring about desired outcomes
How to put what works into practice effectively
Who to involve and how to involve them, including partners, communities and key stakeholders
Why action is needed
The size, duration and sophistication of the intervention

Moving the needle

As we work in ten inter-connected sectors, each county will be developing innovative projects to increase user-friendliness and access. Each project we take on is using a data-driven process of assessment, planning, action and evaluation. This is a process that seeks to acquire evidence of effectiveness.

We are on a path to yield practical and concrete results. At the end of the day we must ask, to what degree do our county residents have access to the ten services for surviving and thriving? As a result of our work over the months and years, did we move the needle and increase action and availability? As a result of access to ten vital services, are 100% of our county residents healthier, safer and more self-sufficient?

With evidence, we can answer those questions.

Recommended reading: 100% Community, Chapter 40: First We Survive, Then We Can Thrive

Report from the Battlefield: Anonymous Report

We were working on an improvement plan for a state agency that had to be submitted to the higher ups. One county had tried an innovative practice, and there was evidence that it was improving outcomes. Several of us at a planning meeting advocated to include that practice in the report, however the person in charge of submitting the report suddenly turned into a hydra, and the Envy head came spewing forth. They couldn’t make a coherent argument against the practice, but it was clear that the hydra had a problem with the person who had implemented the practice. It kept spewing nonsense about how just because the practice worked there doesn’t mean it would work everywhere. My colleagues and I tried to argue that it was better to implement something with some evidence behind it rather than something someone had a hunch about. My argument didn’t matter. The Hydra had made up its mind, and an innovative practice with evidence behind it was not included in the plan.

Q: How will you encourage your city and county leaders to prioritize evidence based strategies?

Episode 41

Technology transforms the public sector

(and exposes

hydras)

Tech exposes the Hydra’s corruption

Concept 16: Technology

In our rush to connect everyone on the planet, we forgot to encourage people to use technology to make our societies fairer and kinder for everyone. We can remedy that today.

In this article we do our humble best to show how technology can be used to support groundbreaking projects to ensure the ten vital services for surviving and thriving. This ranges from websites to artificial intelligence. This topic also brings up the challenge of the digital divide that must be addressed in each county, ensuring all county residents have access to tech and wifi to access web-based services, learning, job placement and the capacity to work from home.

The tricky part is harnessing the power of the latest tech to reach people and project goals while avoiding distracting and disempowering clutter.

Tech is us

Only a quick search on Google is needed to find these “facts” about the Internet (this changes daily, but it’s a good starting point for a list of fun facts):

Number of websites: approximately 1.7 billion
Number of email accounts: about 4 billion
Emails sent in a day: more than 200 billion
Number of users on YouTube: 1.3 billion
Number of video hours uploaded to YouTube every minute: 300

While we hesitate to overwhelm you with long lists, consider that we are a planet of 8 billion people where almost 5 billion YouTube videos are watched every single day.

In an average month, eight out of ten 18–49 year-olds watch YouTube
Six out of ten people prefer online video platforms to cable TV
More than half a million podcasts with 29 million episodes
3.2 billion use social media every day (42% of the world’s population)
Over 90% of millennials and over 77% of generation X use social media
Social media users average over 2 hours and 22 minutes of engagement per day
90% of social media users access via a mobile device

Tech’s power

The private sector’s successes are most often driven by taking advantage of the latest technology wave. The public sector, twenty years after mobile phones became affordable to the masses, is still catching up. It might surprise readers to discover how much work in government and nonprofits is done with paper, pens and decisions based on hunches, not data. Until just a few months ago (pre-pandemic), people drove hours and hours for meetings when online conferencing has been free and widely accessible for some time.

We have gathered together a few accessible technology recommendations for managing the 100% Community initiative to help you quickly and efficiently move from success to success. And, thanks to a colleague’s research, we also give you a little peek into the future.

Huge potential (if used for good and not evil)

We watched a global pandemic unfold using all forms of technology that were pure science fiction only decades ago. The book you’re currently reading wouldn’t exist without modern technology, so yes, embrace it as a friend. This entire 100% Community initiative is only possible because of the power of modern technology, and for that we are grateful.

But what impact does technology have on capacity to address a public health challenge like a pandemic or economic free fall? Amazon’s highly-efficient model shows that it is possible to deliver vital resources rapidly. The ubiquity and power of smart phones means we can share vital information across town and the planet instantaneously. Online conferencing technology allows us to offer virtual training sessions from the comfort of our homes as well as check in the most vulnerable members of remote communities, providing advice and services without a three hour drive or plane ride. And, rolling out solutions inspired by TripAdvisor’s review model (focused on hotels) means we can identify and rate the quality and accessibility of vital services like a health clinic or food bank and work to fix those with the lowest rankings.

How tech can work for you

We already provided a taste of the opportunities that evolving technologies can provide to a community ready to take advantage of them. Here is a list of how we are using that technology for 100% Community. Remember only twenty years ago this tech would have been considered the stuff of Star Trek.

Publishing software

Thanks to Amazon’s self-publishing tools and distribution network, we were able to publish the 100% Community book series online and in print with lightning speed.

Video Conferencing

Thanks to online collaboration software, we were able to combine the talents of individuals across the state and country (and in some cases, the world) in realtime to create additional resources, check facts and brainstorm innovative solutions.

Thanks to email and newsletter management software providers, we were able to create and send weekly messages to state lawmakers and other stakeholders. One was a state senator who became our co-sponsor (with a state representative) of a senate bill to fund the Institute that sponsors the 100% Community initiative.

Social networking

Thanks to Facebook advertising, a heroic city councilor in Las Cruces, NM took notice of our book, ordered and read it, becoming a leader in piloting some of its key policies and organizing ten action teams focused on ensuring surviving and thriving services.

Online radio streaming and podcasting

These allowed our radio show appearances to be sent to state lawmakers and stakeholders who became champions of our mission.

Online learning management systems

These allowed us to create the 100% Community course to educate and empower community members everywhere, with links to effective innovations and problem solving strategies.

Survey software

Thanks to collaborative databases and analysis software, we are able to track all our work in the public sector and use our 100% Community survey to identify what percentage of county residents need resources (our ten “surviving” and “thriving” services) and why theyhave trouble accessing support. We can also use the software to track our innovations and measure to what degree they are making the vital ten sectors more accessible and of higher quality.

Mapping software

We use mapping software to take that data and visualize local services, gaps in services, progress toward solutions and alignment of all county stakeholder’s work.

Visualization software

We use widely available software to show the future in the form of innovation prototypes and create mini-documentaries and animated stories to demonstrate that if we do A (for example, invest in a school-based health clinic) we get B (more students, family members, and school staff having access to vital medical services).

Mobiles and more

Artificial intelligence (AI)

The effectiveness of the tech listed here can be enhanced by AI and AI is transforming all the ways we can deliver our ten vital services for surviving and thriving.

Tech makes 12,345 moving parts of the initiative work in alignment

100% Community is two initiatives in one — with technology vital at both the state and county level.

State Level

On the state level, we must communicate and collaborate with state lawmakers and state cabinet secretaries of all major state agencies to improve all systems of health, safety, education and economic development. Each state must ensure ongoing dialogue with every state lawmaker to pitch PLAN A: ensuring 100% of residents have access to ten vital services for surviving and thriving. We can also share that if there’s no PLAN A, there is a PLAN B that might evolve on its own. (See: History of desperate actions of scared people during pandemics and economic disruptions.) PLAN A, please.

County Level

Our county focus with the 100% Community initiative means that we treat each county like a sovereign country (The People’s Republic of San Miguel, etc.), with its own systems of care, safety, learning and economic development. This is where a community itself decides to either support 100% of their residents (PLAN A) or leave them to fix themselves without services in times of crisis (PLAN B).

Once a county is engaged with the 100% Community initiative, there are three goals, all supported by the latest technological advances:

Improving Individual Organizations: Strengthening individual service organizations (within the ten surviving and thriving service sectors) to increase efficiency, user-friendliness and reach. Technology will play a huge role here as many services evolve to become web-based and those that remain face-to-face are tracked by state-of-the-software to provide clients with opportunities for feedback to improve services.
Creating a Seamless Countywide Network: Networking all service organizations (in all ten sectors) with one another, using technology and a collaborative spirit established by agency leadership, to create a seamless countywide system working in alignment.
Local Investing in 100%: Ensuring sustainability by establishing funding streams through county and city government. This could be accomplished through a process one could describe as “1% for 100%”, meaning that 1% of the combined budgets of the county and cities within the county’s borders, are earmarked to fund a local countywide 100% Community initiative. Even in a small county of 30,000, that could equal a yearly operating budget of $500,000 (far less than some cities spend on maintaining their parks). Technology will be used to track every component of the initiative, making every aspect of the work transparent, ensuring funds and energy are spent as efficiently as possible to achieve measurable and meaningful results.

Tech + Caring Humans = Progress

As you can see, much work awaits us and technology, coupled with collaboration and compassion, makes it all possible.

Recommended reading: 100% Community, Chapter 36: Connecting, Improving, Surfing and Muting: Adventures in Tech

Tomas accesses care online.

Marie accesses job training online.

Q: How will you address the digital divide in your county?

Even with a technology gap there are still solutions.

Episode 42

Partnerships and 100% collaboration required to survive and thrive

Combined superpowers defeat hydras.

Concept 17: Partnerships

To get anything of significance accomplished, we must build relationships and partnerships with the leaders and stakeholders working in government on the county and city levels. We need to collaborate with those working in school districts, higher education, nongovernmental organizations, foundations and all elected officials who control the budgets and priorities of counties and cities.

18 Heart-breaking Challenges

We can list the various problems that our thousands of public sector employees and nonprofit members are focusing on (in just one county). We find that their prevention efforts, pre-COVID-19, covered the noble goal of addressing the following costly challenges:

Substance misuse
DWIs
Food insecurity
Teen pregnancy
Housing insecurity
Bullying and harassment
Adverse childhood experiences and trauma
School drop out
Suicidal ideation
Untreated mental health challenges
Domestic violence
Obesity
Systemic racism
Youth crime
Human trafficking
Juvenile Justice involvement
Child Protective Services involvement
Sexual assault
Add 2 more challenges to make it an even 20
Today, as we wonder how long the era of pandemics and economic disruptions will last, we add to the above “to do” list two vital tasks:
Viral infection prevention
Employment and small business development during economic downturns

Many problems. One solution.

What these 20 challenges (and that list can be quite a bit longer) have in common is that most of them could be significantly reduced if everyone in one county, working in the arenas of public health, safety, education and youth development, worked to create a coordinated countywide system. Imagine all that work done in alignment.

Now imagine that one (1) strategy could reduce those 20 challenges, including pandemics and economic disruption.

That strategy is the radically simple idea of ensuring that every county resident has timely access to ten vital services for surviving and thriving. Take a minute to let that sink in. If ten vital services are accessible in all the communities within your county’s border, you significantly reduce the 20 challenges that are the priority.

What are those ten vital services? Let’s review.

5 SERVICES FOR SURVIVING

Medical and dental care
Behavioral health care
Food security programs
Housing security programs
Transportation to vital services

5 SERVICES FOR THRIVING

Parent supports including child care
Early childhood learning programs
Fully-resourced community schools with health clinics
Youth mentors
Job training aligned with the future job markets

But wait, how does it work?

How does access to ten vital services help my clients while supporting my particular prevention project?

How does ensuring those kids and parents (and caregiving grandparents) access to ten vital services like health care, housing and food security and transportation end substance misuse? Or school drop out? Or suicide? The answer to that excellent question comes from decades of research focused on root causes, health disparities and the social determinants of health. It would take a 650-page book to explain it. And we invite you to read it free-of-charge (linked below).

And, to make things very clear, workshops and connecting to families are a vital part of the process, we just make sure those folks we connect with have all the vital services they need.

Imagine a future when…

Imagine if everyone in your county worked to reduce these 20 challenges gathered on one really big video conference call and decided to coordinate all their activities focused on ensuring the ten vital services. Imagine using the collective impact model (also known as having a shared vision, goals, activities, shared understanding of how data is used, etc).

Imagine if everyone on that call (including their work colleagues and agency directors) also committed to using the data-driven framework of continuous quality improvement we discussed earlier.

Imagine that everyone working in the public sector had a firm understanding of health equity and social justice in order to end a host of disparities facing all county residents, including the most vulnerable.

Imagine, in each county, tracking and measuring all activities focused on increasing access to vital services.

What would countywide collaboration focused on ending twenty challenges by ensuring ten vital services look like? It looks a lot like the 100% Community initiative.

Vital local partnerships: linked online and in spirit

The work of the 100% Community initiative, guided by the book 100% Community: Ensuring 10 vital services for surviving and thriving offers one strategy. It is a new data-driven, cross-sector and tech-empowered strategy.

It is only through trusting relationships and partnerships that we will end the 20 challenges. Without trust, we remain in our deeply troubling status quo.

The Choice

We can make a choice. In each county, all those thousands of people working to end 20 challenges can work in isolation. (The three-headed hydras absolutely love this option called “divide and diminish.”)

Or we commit to a series of 100% goals: 100% alignment, 100% collaboration and 100% countywide communication, to end 20 challenges with a shared vision. We commit to the strategy to build user-friendly services in ten interrelated sectors across the county for 100% of residents. Everyone. Everywhere. This is the work of heroes combining their superpower.

Interested? Get the book and more info at www.100nm.org.

Recommended reading: 100% Community, Chapter 11: Courageous Champions vs. Keepers of the Status Quo

Heroes unite to defeat the hydras.

Q: How can you make sure potential partners are not hydras in disguise?

Episode 43

The

public sector requires the experience of the private sector

Big thinkers have some big ideas.

Concept 18: Private sector partnerships

The 100% Community initiative will be developing and launching innovations and projects focused on ensuring ten vital services for surviving and thriving. Many of these projects will be public and private sector partnerships. This requires for many of us, expanding our networks, developing new relationships with business people and entrepreneurs. The private sector has a very different mind set from those of us working in the public sector. Positive attributes of business people, like a drive to reach measurable results, is one we admire.

Everyone has a role

By now, we can connect the dots from a public health crisis like the COVID-19 pandemic to an economic downturn that is crushing for local businesses—and destabilizing for workers, whether they work for big box stores or ma and pa shops. What the future holds for the US in terms of jobs, along with social justice and access to timely health care, is up for grabs.

How best to navigate the colliding crises is a question the private sector needs to be engaged with. This entire chaotic reality we face in our homes, on our mobile devices and outside our front door will not be solved by government leaders alone.

Setting a big table

We need a big table where everyone can sit side by side and pitch solutions focused on how we can revolutionize service delivery, starting with the vital services for surviving in an era of pandemics and economic meltdowns. We need big thinkers like Elon Musk to share outside-the-box thinking with all fifty governors.

We need business leaders in each of our 3000+ counties to help leaders in city and county government to improve the quality of services and increase the quantity of ten vital services for surviving and thriving. As we say over and over (forgive us for repeating this mantra but we will keep at it until it sinks in with local leadership): In a time when technology and artificial intelligence is radically reinventing every product and service on the planet, now is the time for innovative socially-engaged business thinking combined with pragmatic public sector planning.

100%

We need business people to help invent everything from drive-thru family medical services and web-based job training with job placement services to app-ordered mental health/life skills coaching and youth mentorship. We need to make these services accessible to all residents—everyone, everywhere, across every urban and rural community in our county.

Invitations should go out now

There are countless ways to make accessible the ten vital services to improve family and community life for everyone in every part of your county. (High on the list is ending the digital divide.) Some of that brilliant outside-the-box thinking will come from your socially-engaged local business leaders. Set the table (or schedule the video conference with your chamber of commerce leadership) and they will come.

Recommended reading: 100% Community, Chapter 27: The Chamber of Commerce and Private Sector Must be Full Partners in Ensuring Surviving and Thriving Services

Report from the Battlefield: Dom’s Report

It’s good to understand your enemy. I have learned that when I say sentence one (see below), three-headed hydras hear sentence two.

Sentence one: “30% of those seeking medical care and 50% of those seeking mental health care can’t easily access it.”

Sentence two: “Gibo tan nal swig, plau po nadi igno lavnig dsssss flaytorn and bla bla bla bla and blah.”

With this realization, I keep my conversations to a minimum with any entity with three heads and save my energy for those who speak my language.

Big brains required.

Q: How will you engage the private sector in hydra prevention?

Episode 44

The 100%

Community initiative is radically simple and unique

Hydras truly don’t care.

Concept 19: 100% Community initiative

100% Community is a book, an initiative and a movement. It is promoting one radically simple idea that can be summed up in one question and answer. This question is for all of us, but especially our elected officials.

Question: What percentage of people should have access to the ten vital services for surviving and thriving?

Answer: If your answer is 100%, then 100% Community is what you’ve been waiting for.

Which ten services are we talking about?

As you are now reading “Concept 19” of the 20-concept series, we hope you are up to speed on the ten vital services the 100% Community initiative is focused on. If not, you only need to go back to “Concept 17” for a refresher.

How 100% Community happens: one story

100% Community ensures the safety of your community during normal and difficult times. We provide our step-by-step process, with the understanding that each county may wish to customize it to meet their unique needs. You may be wondering, “Is my county ready for the 100% Community initiative?”

To help answer this, we offer an inspiring story from months before the pandemic hit New Mexico. In one county, a medical director of twenty clinics in northern New Mexico named Matt Probst reached out to us pretty much out of the blue. He had heard about the book 100% Community through a mutual friend.

Matt asked what the first step was for launching the 100% Community initiative. We said reading the 600-plus page 100% Community book was a good start.

Within a week he had read it and emailed, “What’s next?”

We responded, “Can you identify two community organizers and ten action team leaders, each one representing one of our ten surviving and thriving services? Will all of them be willing to read the book and commit eight hours a week of community service time to the 100% Community initiative?”

Two weeks later an email arrived from Matt, one heck of a highly-motivated hero (already working 60 hours a week in his day job), with bios of the twelve person team, all committing to the book and eight hours a week.

Matt asked, “Now what?”

We replied, “How about getting all your team members to read and discuss the book guiding the initiative?”

Suddenly a series of book club meetings were scheduled by Matt and started at the local university. Then COVID-19 hit. Matt, not one to let a pandemic or economic meltdown hamper a new initiative, transformed the book club from face-to-face to video conference mode.

The rest is history as he works tirelessly, with his action team leaders and ever growing community of 100% Community collaborators and supporters (including the sheriff, mayor and representatives from higher education, emergency management and economic development).

Honestly, keeping up with Matt and his county coalition is a challenge we look forward to every single day.

Different counties. Different timelines.

Other counties exploring the 100% Community initiative are evolving at different paces and that’s perfectly understandable. What matters most is that we start a dialogue with all county champions about the goals of the initiative and include as many potential change agents as possible. From there, everything falls into place.

Not tinkering around the edges

The 100% Community is not business as usual, which should be clear by now. Launched before the pandemic and economic crisis, our mission is more urgent now than ever. We are all vulnerable and having access to the ten vital services for surviving and thriving can bring us peace of mind in difficult times.

Our initiative is unlike most other ventures that seek to ensure healthy, safe and resilient lives of all residents, because:

This is not a short term fix: instead, this is a process that will change how all your local government and nonprofit agencies view their role of serving all residents.
The goal is to create solutions and wide support from both the public and private sectors, harnessing human and technological ingenuity.
This is, by the nature of the work and philosophy, a movement to ensure vital health services for all residents, joining a long list of collective action movements to ensure equity and end health disparities.

Through relationship-building, community mobilization and communication, you will be able to do three things:

Engage: Dialogue with leaders and the public to share the importance of having access to the vital services that keep 100% healthy.
Mobilize: Invite county residents to become involved in promoting health, safety and resilience for all residents.
Solve: Empower and activate the change agents through the 100% Community process. Through research focused on the social determinants of health, innovations in every family and student-serving sector, and advances in technology, we address our long-standing health and safety challenges.

Our destination

This twenty-part series was intended to serve as an introduction to the twenty key concepts (or terms) guiding the 100% Community initiative. The initiative is designed to be a blueprint for taking a county from a place of health disparities and social adversity to one of health access, resilience and opportunity.

Ultimately, our work in ten sectors leads to buy-in from city governments, county governments and school government so that elected leaders can quickly see the cost-benefit of ensuring ten “surviving and thriving” community services.

Who’s funding what?

As discussed in an earlier article “Concept 7: a county’s borders,” funding the health of county residents should be the responsibility of local government. Let’s briefly review a few key concepts.

First, it’s important to note that the 100% Community initiative does not require localities to raise money to fund it. It might sound to some like a Marshall Plan or mission to mars program involving millions directed to each county. It’s not. It does mean reprioritizing where current city and county funds go: to a line item called “survival.”

The initiative was designed to be “staffed” by people who are already employed in the ten services areas, as well as higher education and all areas of government. That does not mean each county initiative, a county/city partnership, does not require stable funding. It does, just like any public serving organization working to ensure vital services in a rapidly evolving pandemic as the national economy goes over a cliff.

Remember, our formula for funding is radically simple.

We can’t think the feds, state or some foundation will commit to prioritizing the ten vital services in a county, to serve 100% of residents. Each county has to be self-sustaining. Each county needs to take local control. The solution is staring us in the face, especially if we are looking at our laptops, visiting the websites of our county and city governments. Recall that a typical county of 30,000 people usually has a budget around $30 million and a 12,000 resident city typically has a budget around $20 million. Together that’s $50 million!

We boldly propose that we earmark 1% of the combined county budget (and city budgets of all cities within the county’s borders)for a countywide 100% Community initiative. ONE PERCENT, that’s it. When we put it like that, we don’t think it’s a very tough “ask.”

To save you doing the math or going back a lot of pages, that’s a city/county initiative budget of $500,000. For that investment, your county can implement a countywide process of continuous quality improvement in the four phases of assessment, planning, action and evaluation (see “Concept 7: a county’s borders” for a full review).

What 100% Community does not do. And does.

Does not

The initiative does NOT ask the city or county to fund ten services. That’s not possible. We fully understand that the ten vital services are delivered by a collection of disconnected organizations and businesses in the public and private sector. Some are funded, in part and/or sporadically, by local and state government, some by foundations (for a limited time), and others are entirely pay as you go services, courtesy private enterprises.

Does

What 100% Community does do, as stated above, is identify gaps in services and then identify ways to fix gaps. We are thrilled private sector leaders have great services to fill gaps. And in most counties, many people can afford those services. Our job, with 100% Community, is to make sure lack of money does not mean lack of access to services for surviving. We also commit to ensuring services for thriving because that’s what civilized societies do. With partnerships with local governments, our city and county leaders can gently nudge all sorts of service providers to find creative ways to ensure access in some sort of sliding fee scale scenario or with creatively developed subsidies. We envision lots of imaginatively designed public-private sector partnerships.

1% for 100%

Every county faces stark challenges and decisions and without a coordinated plan, we are far too vulnerable to viruses and hopelessness. We have the plan with the 100% Community. We have the local funding if we believe an investment of 1% is a prudent one.

Institutionalizing the initiative

“What does institutionalizing all this look like?” is a question we hear a lot. The answer is: a future where any youth, student, parent or grandparent can visit the website of the city or county in which they live to find a “Department of Family and Community Resilience” or “Dept. of Surviving and Thriving.” These sites will be providing links to user-friendly services within the county’s borders (as well as options online that show evidence of success). This future “department” will assess yearly to what level families and all community members have access to ten services. Then this department will support, with data, collaboration, technology and political will, evidence-informed strategies to reduce all disparities. Simply put, the department will ensure that all ten sectors are able to meet the needs of 100% of county residents.

A public health crisis colliding into economic free fall shows how fragile we all are, especially in regards to timely health care. Our goal is to harness ingenuity and our concern for our neighbors, then focus it on creating a seamless system of solutions.

If not you, who?

Who should engage with the 100% Community? That’s easy to answer. You. In this unprecedented collision of at least seven crises (yes, we keep a list), we need every caring human we can find. As for 1,567 moving parts of the initiative, those details await you in a short hour read (if you read 100% Community an hour a night for seven nights). We hope you do.

And we now come full circle, with a question for you. What percentage of your neighbors, living across the county, should be able to access the ten vital services for surviving and thriving? In a pandemic and economic upheaval?

We eagerly await your answer.

Recommended reading: 100% Community, Chapter 32: Getting to the 100% Community Goal, Step-by-Step

Report from the Battlefield: Dom’s Report

I have finally scored a meeting with a guy I will call Bernard, the department head in charge of what might be referred to as “community services.” This a big umbrella department that means very different things to different local government leaders. I never really know where a department leader is at, with their commitment to problem-solving, until we talk. I was greatly encouraged when on Bernard’s office white board I saw the words “every resident should have every service they need to keep healthy.” Ten minutes into our talk I realized two things.

One: Bernard really did believe what he wrote on the wall. He was not a three-headed hydra.

Two: Bernard was so overwhelmed with bureaucratic duties that he could not envision making time for a new project that would actually help him achieve his stated goal. Essentially his department was so busy putting out daily fires that he would never have the chance to make things fireproof.

Because of Bernard’s work environment he was at risk for evolving into a hydra.

Matt the hero (not drawn to scale).

Q: What support do you need to clear out the hydras in your community?

Episode 45

Join the

evolution and revolution. Self-care

required.

Healed people heal people.

We self-care. We care.

Concept 20: self-care

First, congratulations on making it through the 20-part “Terms of Survival” series.

Why self-care matters

Never underestimate the importance of the relationship you have with yourself. We focus on the role of self-care while working on the 100% Community initiative. It’s going to be a long process to transform all the under-resourced communities within a county’s borders to create a countywide system of care and empowerment. We must ensure that our own physical and emotional health is ready for what will be an endurance tempered by a sense of great accomplishment.

Cautious optimism and gratitude

One never knows who is reading our books. Some readers are curious, dipping their toe into an issue, while others have been at this work for decades, working with their communities to create the vital services that have been shown to promote health, safety and resilience. To all we say, carve out time to rejuvenate and replenish.

The work of community-building requires us to be as physically and emotionally healthy as possible. If you take the time to be calm and centered each morning, expressing gratitude for having another day to engage with the world, you are in a stronger place to be a collaborator.

We all have our own rituals. That’s how we find the strength to do the vital work ahead.

How to stop worrying and embrace the chaos

We humbly offer ten tips for getting through the day in a nation lurching from crisis to crisis.

REFRAMING: Instead of thinking, “I did not sign up for this mess,” start asking, “What’s my role in the era of unprecedented change?”
DECLUTTERING: Minimize any contact with the so-called “news,” asking friends to inform you of anything time-sensitive—the earth-shattering “updates” that one truly has to know to function (you’ll find that those updates of significance are few and far between).
READING: Increase your reading of books on how societies successfully address public health crises, economic disruptions and manmade challenges. Including audio books in your day is a great way to do this also. (Consider starting Bruce Mau’s 24 principles for designing Massive Change in your life and work.)
SEEING: Look outside your window, armed with data on how your neighbors within a 50 mile radius are suffering, and focus energies on addressing the local problems hurting children, families and all the most vulnerable residents.
ADJUSTING: Meditate daily and reflect on your capacity to be a change agent in this strange turn of global events. Make adjustments as needed, to your lifestyle and living arrangement, so that you are better equipped to empower others.
ACTING: With a new sense of clarity, see that this stark moment in US history is our opportunity to join together and take measurable and meaningful action to address a very, very long list of social wrongs, disparities and injustices.
CONNECTING: Invest in synergy, keeping in constant communication and forming collaborations with like-minded folks who are also rising to the challenges.
MOVING: Take a long stroll each day. In the quiet moments, the sunrise and sunset continue to inspire.
TREATING: Order your favorite dessert or food, or whatever floats your boat, delivered quarterly as part of your self-care process.
ACKNOWLEDGING: Accept with grace the fact that earth has plans for us, working in ways one can never fully understand. Mortality reminds us that we were always guests on a brief stay.

Forward we go. Together.

Despite the horror shows now streaming on your mobiles, without any context or mention of root causes, we have seen successes as heroes do the hard work of social justice. We know a countdown to ensuring that every community is a fully-resourced “100% Community” is possible because the clock has already started.

Yes, things are very complicated on this tiny planet and the work in all fifty states represents a unique challenge. As stated repeatedly, we can’t save the world or the nation. We can absolutely work together to heal our county. So we start there, focused on community.

We start with taking care of ourselves. We take time off. This includes time off from distracting and disempowering media pushing itself into our lives.

From a rested place, with time for weekly reflection, we show compassion to our family and friends. Then to our co-workers and collaborators. Ideally, we find a way to expand the process of care to our neighbors, then to all the neighbors who make up the county we live in. This is what our 100% Community initiative is depending on.

With cautious optimism, let’s keep moving forward, as backwards isn’t really a viable option. To that end, please consider sharing the twenty key concepts presented in this “Terms of Survival” series with your friends and colleagues to increase the dialogue about a groundbreaking model for community-wide empowerment. A process to heal and protect 100%. Everyone. Everywhere. Starting with you.

Recommended reading: 100% Community, Chapter 39: Faith

Report from the Battlefield: Katherine’s Report

Our partners inspire us every single day. One ally offered up one brilliant idea. During our weekly video conference meetings, she asked if we could devote the first 5 to 10 minutes of the meeting to a self-care exercise? It might be taking three long breaths or any type of activity to ground us and give us a little “centering time” before diving into all the challenges. We tried it out, and we were surprised by how many of the people in the group reported that this was the only time they’ve been able to sit still and reflect in weeks. Some even got a little bit emotional because they were so grateful they had the opportunity to use that time. This is now a practice we encourage all of our teams to utilize. Self-care not only keeps the hydras away, it gives us the strength we need to fight them when they do appear.

Episode 46

Ten apps to survive and thrive

10 apps to ensure surviving and thriving

To navigate a world of pandemics, economic disruptions, social injustice, trauma, health disparities and three-headed hydras of Apathy, Envy and Fear, we (meaning 100% of the population), require:

Five services for surviving

Medical and dental care

Behavioral health care

Food security programs

Housing security programs

Transportation

Five services for thriving

Parent supports (including child care)

Early childhood learning programs

Fully-resourced community schools with health care centers

Youth mentors

Job training aligned to future job markets

How do these 10 apps appear on my phone? (And how do the services the apps lead me to come to be?)

We will secure the ten vital services, county by county, through county/city partnerships. With 1% of the combined budgets of a county government (and all city governments within it), we can create a local program with the sole mission of ensuring the ten services through a collaborative, data-driven and tech-empowered process called continuous quality improvement.

Problem identified

Ten services working for 100% of county residents—in your county. How hard does that need to be? We can survey residents so you see where gaps in vital services are. The survey also tells you why it’s hard for folks to access services. Problem identified.

As for solutions, that comes down to political will, technology and smarts. Our plan is for the 100% Community initiative to launch, in each of our 3000+ counties, public and private sector partnerships to address all gaps in services. The only things stopping a revolution in innovation are the three-headed hydras.

A time portal reveals the future.

Through a portal to the (possible) future

Imagine there is a magic portal that takes you to the future. You stroll through and things seem to be going so well. Your future self finally got a promotion at work, you had booked a quick spring getaway with your partner to a remote sunny beach and the inlaws agreed to babysit the kids so you could turn it into a pseudo-honeymoon since you couldn’t afford one back when you originally married. Then people started getting sick and everything shut down. You went from promoted to laid off almost overnight. The travel package company cancelled the beach getaway but wouldn’t refund your money, handing out credit toward a future trip instead. Your partner was furloughed too so money is suddenly very tight. You can’t leave the house and the kids are climbing the walls and bickering all day, every day.

Slowly everything somehow got so bad that you began to drink a little too much as a way to cope and the first drink started earlier and earlier in the day. Your mood turned dark. Thoughts of suicide began to creep in. Then yesterday, someone you follow on Twitter recommended an app that had helped them. It was $20. You almost didn’t download it because money was so tight. But in the end you did, willing to try anything to stop the descent into the abyss.

The app seemed simple enough. It asks questions and you answer them. Sometimes there’s a drawing that you are supposed to interpret. Sometimes there’s a short story followed by music and more questions. The app seems to be adjusting the questions based on your past answers and at some point you realize that the Q&A session morphed into a full conversation. You aren’t sure when it happened but slowly it became a discussion about you. Responding to the questions felt good, like a massive weight being lifted from you, one piece at a time. From time to time you had to pause the app to deal with the kids or feed the cat, but you immediately went back to chat some more.

Whoever was on the other end was very good at coming up with just the right thing to say at just the right moment. How long you stayed on, you aren’t sure. It was so late when you tired of holding up your end of the conversation that you went right to bed – more relaxed than you had felt in months. For the first time since the quarantine started, you hadn’t mixed a drink all evening.

The next morning, your phone had a message on the screen. The therapist on the other end of the app was asking how things were going. You instantly logged in and responded. The follow up questions turned into a long conversation about career goals, grand plans and the kids. After a while you realized that this therapist must not have any other clients because you were monopolizing all of their time. You chatted with them all day off and on. Sometimes there were suggested videos on coping with fear and uncertainty that you watched then got back on the chat to discuss.

Services must exist in order to link to them.

As the kids needed more attention and chores piled up, you’d thank the counselor on the other end and sign off. Hours would go by, but when you logged in again, the counselor was there, ready to chat some more. It was amazing. You’d never felt more positive about a difficult situation before. It was the best $20 you had ever spent. Then you began wondering how this counseling service could keep going. $20 was too little to pay for endless counseling. Private counseling services were very expensive.

Out of curiosity, you Googled the service to find out more and were shocked to find out that you had just spent the last day and a half talking to a virtual counselor. Virtual as in artificial. Artificial Intelligence. You learned that it was a system that had been trained on billions of conversations between real people with a bunch of rules and target outcomes programmed in. For the briefest of moments you felt duped, but then the desire to get back on the app and talk with the “counselor” easily overcame that negative reaction. For the first time in your life someone was really listening. And it was helping.

As you can see from our visit to the future, things can get better. But it takes heroes to defeat the hydras and ensure progress.

Tales from the Battlefield: Dom’s Report

I love technology and enjoy how tech folks think through problems. Often pragmatic and stoic, many techies from well-resourced families find it hard to comprehend that all folks dont have wifi and laptops. I have to explain that while developing apps to connect people to resources is brilliant, if those local resources don’t exist, we don’t solve the problem. Designing apps is easy compared to funding a health clinic or bringing electricity and water to communities.

Q: Hydra prevention. Is there an app for that?

Episode 48

What a global pandemic has failed to teach us so far

Being awake and aware takes courage.

On earth, we don’t get a global pandemic coupled with social distancing leading to an economic collapse every day. What we did get everyday in the United States, right up until COVID-19 was found menacing, was a society with a long history of social injustice, with wide gaps in access to vital services for surviving and thriving. We also lived with epidemic rates of childhood trauma, abuse and neglect—most flying under the radar of child welfare and, while known to school staff, accepted as a truly sad but inevitable part of many students’ lives.

Months and months into full alert with face masks in place, what have we learned about our nation and the city we live in? Are we willing to challenge some of our assumptions about just how fair and caring our society is? Deadly viruses and mortality have a way of giving us pause to reflect, lifting a veil to reveal some harsh realities. If you choose to take a sober look, read on.

Fantasy vs. Reality

Consider how things are, rather than how we assume they might be based on wishful thinking.

The COVID-19 pandemic

A viral pandemic is still revealing its magnitude and severity. What we know is that we were woefully unprepared for this one, and there doesn’t seem to be a plan for the next one.

Local economic disruption

Entire industries froze as we entered into prudent social distancing, creating an economic downturn of unknown proportions. What we know is that when unemployment benefits end, large percentages of the populations will be without a livelihood in a marketplace where jobs don’t exist. Closing schools followed by inconsistent movement to online education created an almost impossible situation for parents who cannot work from home. So, just like we get daily weather reports, we need up-to-the-minute local data on business closures and how many people need jobs (not vague estimates from the feds).

Lack of capacity

Lack of government and non-governmental infrastructure impact capacity to address the growing demand for assistance in services for surviving like medical care, mental health care, food, housing and transport to services. We know from our countywide surveys that significant percentages of our parents can’t access vital services for a variety of reasons. If you wonder why families struggle daily and how woefully under-resourced your county is, we have a useful survey for you to implement.

Existing challenges increase

Long-standing health and safety challenges are increased by the health and economic disruption, including adverse childhood experiences, trauma, maltreatment, domestic violence and substance misuse—all requiring local community services. Here we arrive back to where we were before COVID-19, with historical disparities, injustices, and our children enduring various forms of abuse and neglect as their parents struggle without help.

Digital divide

Large segments of populations are without access to online resources: telemedicine, options for working remotely, and online education and training options. We know we are a two-class society in regards to tech, with those who can and those who can’t access vital information, help and resources online.

Emergency response requires alignment

County, city and community agencies, including emergency management, struggle to coordinate in times of emergency to meet the urgent needs of residents. What we know is that when the next public health crisis (or crises) hits—possibly something bigger and more lethal—our coordinated emergency response, from state to county to city government, won’t be ready to ensure everyone’s safety and stability.

Local leaders facing unprecedented problems

Elected leaders in city, county and school government face unprecedented challenges. Government, across the board, is lacking a data-driven coordinated process of problem-solving. Hunches and political whim, not data and research, guide many multi-million dollar state and local government policies and initiatives. In an era of colliding crises that won’t be going away, we need local leadership to use data and science to identify and solve challenges, amid the urgent need for both a short-term response and long-term recovery.

Woke

The bottom line is that while the well-resourced class spent the last two decades enjoying tech advances and creating comfortable middle and upper class lives, we forgot that we left so many behind to struggle daily. While some of us certainly cared, we didn’t demand that local governments ensure the vital services for surviving and thriving for everyone. Our long standing cultural norm is that people should fix themselves, with or without services and supports. Anyone with even cursory awareness of the social determinants of health, health disparities, centuries of racism and classism, and the way childhood trauma diminishes us, knows we have stacked the deck against many.

Yesterday’s elected leaders were not elected to create a seamless system of care to empower 100% of the population in their cities and rural towns. Tomorrow’s leaders could be.

If we learn, we thrive. If not, we fail.

Wishing

We hear people wishing we can just all get back to normal. If your normal life was filled with resources, safety and respect, that makes sense. You had better just hope nothing more deadly, virus-wise, arrives at your home, workplace, school, grocery store or plane ride. Hope you stay healthy. Hope that you get to keep your job. Hope the schools function.

We don’t have to be a nation living on hope. We can instead be a nation that finally builds the services that keep us stable in times of uncertainty. And this is what we can do city by city, as no president of any party is going to be fixing the mess we’re in.

The colliding challenges listed above are not going away, at least not without mobilizing, advocacy and incessant demands for social justice and timely access to medical care, food, housing, and an education system that produces literate and job-ready graduates. This is work each of us can commit to on the local level with our neighbors and those who work at city hall.

What we require are visionary mayors, council members and county commissioners to commit to doing the infrastructure-building to make the services for surviving and thriving for all residents the measurable and meaningful goal of government. If you are wondering how this could be done, we have the model and framework to do this in your county and in each of the 3000+ counties across the nation.

We have, collectively, had cold water thrown on our faces. A pandemic and economic free fall are staring us right in the eyes. Do we have the political will and commitment to social justice to guide us toward a fairer future when 100% thrive? Or will we just go back to the normal that was failing a large portion of our residents?

Tales from the Battlefield: Katherine and Dom’s Report

After years and years of advocating for the safety and health of children and their families, one can get discouraged. And then you get a text that reads, “I am starting the 100% Community project whether you want me to or not.” This witty message was from a high energy socially-engaged entrepreneur. She had been watching us try, against what seemed insurmountable odds, to get our initiative going in one of the state’s most traumatized and economically depressed regions. When we talked with her, she had already formulated an innovative plan and was reaching out to stakeholders we hadn’t met yet.

The same day a call came in from another region from a stakeholder who wanted to engage with our initiative in more significant ways, setting up weekly strategy sessions, while yet another email came from a neighboring county that had been working (far under our radar) on plans to develop a 100% Community center—all plans we had no idea were in the works with university partners. To top it all off, a colleague called to say he had introduced our book and initiative to a contact with a federal agency and they wanted to to set up a call to discuss if the initiative was a replicable model. Four updates in one day that brought hope. There are heroes out there that no one knows about. Maybe you’re one of them.

What do you

wish for?

(in fewer than 20 words...)

Episode 49

We haven’t met… yet.

(A call to action and an invitation to connect)

Let’s go!

We don’t know who you are. That should matter as the rule of good writing is know your audience. If you made it this far you are what we refer to as a “connect-the-dots human” —a change agent with the capacity to see how everything is connected. You don’t need to be convinced that investing in safe childhoods means more empowered students and families. You can also see that if our local governments ensured ten vital services as part of their mission to serve all residents, everyone would have a much better chance of surviving and thriving amid colliding crises.

Those who have connected with us in the past give us a clue about our readers—namely you. You might be in the city or in a farming community. You’re in high school or college, living at home with your parents or a grad student living on coffee and power drinks in a dorm room. Since the economic disruption you may likely be sharing a rental home with four friends, each one scrambling for gigs to pay bills just to get by.

Based on our previous work, you could be a university professor, a medical clinic director, a school superintendent, a city councilperson, a blogger who writes on neighborhood quality of life, or a state lawmaker. You might be a parent. Maybe you’re child-free and, given the state of affairs, committed to staying that way. Ironically, you may be a huge fan of our mission, working for a NYC based publishing company run by hydras who would never in a million years publish a book like this since, “the market for this kind of stuff is way too small.” (Thank you, self-publishing software.)

Still standing

What we all have in common is critical thinking and the capacity to see that things are not right in so many parts of life within these fifty fragmented states. You also have, somehow, maintained a strong sense of social justice and a burning commitment to fix what’s completely broken. As tempting as it is to retreat into a world of daily distractions (with drink, drugs, gaming, doomscrolling, obsessive binge watching and 100 other ways to disengage) you have instead decided to stand up and be counted, even if there is only a small chance of saving humans from themselves.

We offer our solution in the form of the 100% Community initiative—designed to transform, county by county, the world you and your neighbors inhabit. There are other solutions all around you, as well. Coalitions with important goals can be easily found with an online search. The trick is scratching the surface of each proposed endeavor or collective action to make sure that the mission, vision, goals and activities make sense and align so that you have the best chance at making measurable and meaningful progress. We recommend that you look at an organization’s list of demands or goals and see how they align with your values. Then look at their strategies for achieving those goals. We often find organizations with the noblest of demands lacking a clear path to achieving them on a local, state or federal level. You may have noticed by now that we favor focusing your efforts at the local level so that you can meet eye-to-eye with those in power—both fellow champions and hydras.

The hydras won’t win.

Beware that three-headed hydras run many noble sounding organizations where slick websites and lofty slogans are a dime a dozen. We are both bemused and horrified when we find a nonprofit claiming to end child abuse by selling pinwheels for your lawn or proposing baby showers to address the ravages of multi-generational poverty. Fighting against the clutter that claims to help is one of the more disheartening parts of this work. We expect bold faced lies from the business world (The CEOs of major airlines send us emails wishing us well in their new lemon-scented, virus-free cabins that they wouldn’t dare take a flight in), but must we have the public and not-for-profit sectors polluted with half-truths and meaningless feel-good activities, too? Those hydras just never give up.

Whatever you choose, choose wisely

Wherever you choose to invest your time, energy and insights, make sure it’s a hydra-free endeavor. That said, we welcome you to a very new phase in the small part of the planet earth known as the United States, with all its complexities, success stories and disasters. There is as much hope as horror, as much compassion as corruption. Bottom line, the critical work of reinventing society is waiting for you and all of us. Time to get to it, hero.

Q: How will your city look when the hydras leave town?

Episode 50

Turning

outrage into action!

(Yes, there will be an app for that.)

N.E.W.S. (Nothing Even Worth Seeing)

Your websites and news sources won’t tell you just how difficult it is to get the services in your city needed to survive in an era of colliding crises. Wonder why?

If you are waiting for the news to come streaming to your phone informing you about our most pressing challenges, you may be waiting a long time.

10 Headlines: Engaging or Distracting?

If you were to scan the first page of the US version of The Guardian, you might these headlines:

Protests: Tensions Rise as Federal Forces Use Flash-Bangs against Protesters
China: Hacker Sought to Steal Coronavirus Vaccine Research Says US
Opinion: Shaming People Who Refuse to Wear Masks Isn’t a Good Look
The proof is in the sewage: Hundreds of Yosemite Visitors May Have Coronavirus
Embracing change: Pandemic Forces Professional Cuddlers to Get Creative
Sing into the funnel: Inside the Lab Hoping to Declare Singing Safe
California: Two Firefighters Injured as Wildfires Prompt Evacuations
Jeff Bezos: The World’s Richest Man Add Billions to His Fortune in One Day
Travel: Stunning Latin American Photography
Ukraine: Hostage Siege Ends after Ukranian President Orders Joaquin Phoenix Film on Animal Rights

We are sure that each article above is a fascinating read, but we think the following headlines that require action, that is, if the hydras would ever let these see the light of day.

10 Headlines Hydras Veto

Medical Care? Access Denied: Up to 30% of parents who report needing medical and dental care have difficulty accessing it. In a pandemic, this must be addressed with a sense of urgency.
Mental Health Out of Reach: Almost 50% of parents who report needing behavioral health care services have difficulty accessing it. With the stresses and strains individuals and family members are experiencing with the pandemic, social isolation and financial downturn, along with high rates of adverse childhood experiences, counseling is a vital service.
Hunger Can’t Be Helped Here: About one-third of parents who report needing food security programs have difficulty accessing it. With the financial downturn, food insecurity will grow.
No Shelter in the Storm: Two-thirds of parents who report needing housing security programs have difficulty accessing it. With the financial downturn, housing insecurity and homelessness will grow so get ready to start seeing the tent cities popping up in public parks.
You Can’t Get There: Over half of parents who report needing transportation to vital services have difficulty accessing it. With the financial downturn, transportation insecurity will grow, impacting our capacity to get to vital services such as medical and mental health care.
Parents Fend for Themselves: Between 30% and 50% of parents who report needing various forms of parents supports, including home visiting, child care and parenting classes, have difficulty accessing them.
What Happened to Early Childhood Programs?: More than one-third of parents who report needing early childhood learning programs have difficulty accessing it.
Schools Can’t Provide Care: About 24% of parents who seek school-based medical care for their children, and 48% who seek school-based mental health care for their children, have difficulty accessing it.
Youth Lost Without Mentors: Many parents report needing a wide variety of youth mentoring programs, as well as afterschool and out-of-school activities.
Getting a Job: Not for Half of Us: Almost 50% of parents who reported needing job training have difficulty accessing it. With the economic downturn, business closures and joblessness, job training for all working age adults is vital, aligned with the future job markets.

The fictional article headlines above reveal very real data about gaps in vital services that matter—certainly to the residents of Rio Arriba County, with a population of roughly 40,000 people, a short drive north from Santa Fe, New Mexico. The survey (done in late 2019/Early 2020 as the pandemic was being identified in the US) is one any county can and should do soon if they truly want to create the headline news that matters.

Turning your outrage into action

Our point is that a billion websites scream for your attention. We know some are helpful while others give a welcome break from the day’s stresses. If the survey data above makes you wonder what percentage of your city and county’s residents are struggling to get help, we have your next step. And it’s all about local actions you can start today.

Tales from the Battlefield: Dom’s Report

I’ve seen lots of US presidents come and go. To be sure, having an articulate and intelligent communicator in the White House offers a sense of stability, calm and a feeling that things can get better. However, we need to face one reality about how local change occurs (that for some reason was not taught with gusto in school.) The truth is that no matter who is running the federal government, our most vulnerable communities, towns and cities can remain under-resourced and desolate environments. Yes, let the best human win the presidency by all means, but know that our work is local. Until the majority of our mayors, city counselors, county commissioners and school board members are believers in fairness and social justice, backed up by policy and funding, our work is not done. Far from it. The good news is that you’re holding the plan to make your part of planet earth an empowered place for 100%.

Episode 51

Us, you, monsters and the plan

Every community needs a plan.

Who is “Us”?

On this tiny spinning planet in the vast universe there is a large landmass that you may be familiar with. When we talk about “us” we are referring to the humans residing in the USofA—a uniquely troubled society amid hundreds of others on our tiny planet. What makes the United States unique is the fact that it has vast stores of material wealth spread across fifty states yet fails to guarantee anyone other than prisoners the basic necessities of food, shelter and medical care. But, we still like to call ourselves the land of opportunity.

The United States also has managed, up until now, to project an image of modernity and development when, in fact, much of it operates as a developing country with families living without water, electricity and wifi in an environment of food and housing scarcity.

The pronoun “us” is much like the pronoun “we” in the phrase “We’re all in this together.” Think of the Titanic and all those onboard, going down—together—except split into first, second and third class. And we all knew which class got the first seats on the lifeboats.

As we like to remind our local folks working on the 100% Community initiative, our most pressing injustices dooming people to lives of despair are not caused by acts of nature. As should be clear by reading this book, the complete mess we are in is man-made, requiring human ingenuity, compassion and courage to fix.

Unless

We think you can tell that we did not write this book just to curse out incompetence and corruption. We are what you call “glass half full people.” We see the potential for things to go well if stars align and people mobilize with a shared vision.

We were, back in 2015, two people working in a basement government office, two floors down with bad lighting, who saw a huge wrong in the form of government agencies failing kids in life and death scenarios. We wrote the book Anna, Age Eight to expose incompetence and unpreparedness—to fix the systems, including child welfare, public health and public education. As with all actions worth taking, this one came with risk to our future employment. Whistleblowers rarely get rewarded.

From there, we tirelessly advocated for strengthening systems of care for the most vulnerable (which today, includes most of us). We wrote a second book—100% Community—our plan of action to guide people forward to a future where well-resourced communities could help everyone. Everywhere.

We were, to our amazement, rewarded by state lawmakers believing in our vision, goals and strategies to save the country, well, actually, one state out of fifty, and within it, one community at a time. With this support, we found funding to form a collective based in Santa Fe, New Mexico, from which to support change agents.

And here we are. You have nearly finished a book filled with mutant lizards, with calls for justice along with innovation.

Being Woke

The economic free fall resulting from the pandemic was not an unstoppable force of nature. The leadership of the nation and all fifty states had decades to prepare for such a crisis and plenty of opportunities while dealing with natural disasters and terrorist activities in order to test and perfect their strategies. Each state could have been like New Zealand, Norway or Singapore or a host of other developed societies that have systems of health and support to ensure all residents endure with grace life’s unpredictable events.

For many of us, the failure of the national, state and local response to the pandemic ended all sleepwalking and lifted the veil to expose some very unsettling truths which we have listed below. We caution against using this list to make gross generalizations. Not every institution is doomed nor every leader misguided. That said, consider the following Alice in Wonderland reality we inhabit where up is down and insanity is the theme:

Government agencies designed to help us, may instead hurt us and/or ignore us.
Education systems funded to teach, may be set up to fail.
Law enforcement who should protect us, may harm us.
Big business is all in on artificial intelligence and robotics in order to squeeze every penny out of every working hour but, in the absence of a plan and funding for retraining and relocating, large segments of the population will become permanently unemployed.
Behavioral health care professionals, feeling powerless and out of options, advise us to “adapt” to the new, deranged societal norms.
Our health care system turns out to be unorganized, inaccessible, and profit-focused instead of care and solution-focused, leaving us all woefully unprepared if a more lethal viral pandemic arrives.
Talking heads, digital influencers and social bots spouting “the news” and “the truth” turn out to be lying, distorting and misdirecting through the very same digital devices that could be used to solve so many of society’s issues.
Food and housing insecurity, all preventable serious social adversities, continues to haunt every city and town.
People wait for elected officials to come along and fix everything, yet keep voting for those who lack the desire to help, lack the political will to initiate change, and lack any understanding of how problems are solved at the local level.

Yep, it’s a troubling list and it only scratches the surface. Lest you think we are only focused on what’s wrong, rest assured we get through our days focused on the positive as we work with passionate local champions who inspire us. For every crumbling organization, there’s a new system waiting to emerge that is far more accessible, efficient and fair. For every hydra, there’s a hero.

There is a plan.

You’re holding a plan of action in your hands.

We hope you have found in Attack of the Three-Headed Hydras a roadmap to a better future and practical strategies to get there. We also hope that our mix satire and sci-fi painted a picture of the way forward and actual steps you can take now.

We wrote this book as both encouragement and as a warning. You will hit your own three-headed hydras and they will be hateful, horrible and damaged creatures. By being prepared, you will find a way around each of them and the doomed fiefdoms they rule over. Hydras, those people who screwed everything up running corporations, institutions and the entertainment industrial complex without a care for humanity, are dinosaurs to be sure, but they also act like trapped animals who will lash out to survive.

Our words are designed to empower you and, if you have the calling, to engage with the 100% Community initiative. You’re needed. Each person counts in this race to fix all the man-made problems that got us into this precarious point in history. While it may be tempting to resign yourself to what feels like civilization heading off a cliff, we offer an alternative reality where three-headed hydras, and the disasters they have caused and are causing in your community, are history. Hold tight, the world is turning upside down as you read this. Once it feels a bit more stable, our vital work continues.

www.100nm.org

Episode 52

Founders of the Hydra

Prevention Project:

Origin Stories

Building the project.

Katherine grew up in Española, New Mexico and Dom grew up in Costa Mesa, California. Through a series of cataclysmic events, they met and knew they had to combine their superpowers to defeat the three-headed hydras.

Our stories

Katherine Ortega Courtney, PhD and Dominic Cappello are New Mexico-based advocates for turning crises into opportunities for improving systems, solving challenges using data, technology and collaboration. They know why systems that should protect us, can fail us—and teach leadership development and data-driven problem-solving. Dr. Courtney’s expertise in data analysis, continuous quality improvement, collective impact and experimental psychology guides communities and organizations through turbulent and timely change. Cappello is a health systems strategist and New York Times bestseller author, whose Ten Talks book series on family safety reached a national audience when his innovative work was featured on The Oprah Winfrey Show. He was also the writer and director of the animated social satire Not Brain Surgery.

Courtney and Cappello collaborated on writing Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment to awaken the nation to epidemic rates of childhood adversity, abuse, neglect and trauma, resulting in untreated trauma among the adult population, including parents and politicians.

Their follow up book 100% Community: Ensuring 10 vital services for surviving and thriving guides the 100% Community initiative, a groundbreaking county-based process for mobilizing leaders in ten sectors, identifying gaps in vital services and creating city-county partnerships to fix them. The initiative addresses, state-by state, centuries of disparities, injustices and trauma. The initiative is a framework that guides local stakeholders in ensuring every household has access to vital services as well as stable shelter, secure food, clear water, electricity, transport and wifi.

100% Community supports a process of reinventing local government, creating a new norm where city and county leadership are committed to 100% of their resident’s health, safety and resilience. To provide stability to all in an era of crises, the authors ask readers to imagine a future when every community has a Department of Surviving and Thriving, considered as vital as the Departments of Fire, Police and Parks.

Disneyland prepared Dom for anything.

The illustrations

Dominic Cappello claims that his years working at Disneyland, strolling the park as the cartoon character Cap’t Hook, inspired him to sketch. This would come in handy with work and activism. Decades ago, amid another public health crisis called AIDS, Cappello was asked by the Seattle-King County Department of Public Health to invent a cartoon series on characters staying healthy and safe during the epidemic. Then with funding from the Centers for Disease Control and Prevention, the National Education Association asked Cappello to create an illustrated workbook, animated video series, and parent workshop series, to teach parents how to discuss with their children the AIDS epidemic. It seems both fitting and ironic that Cappello’s illustrations would help to guide a very different generation, more than a quarter of a century later, through a new era of colliding crises that includes a global pandemic.

Books By the Authors

Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment

Ana, de 8 años: Prevención del trauma y el maltrato enfantil en base a datos

100% Community: Ensuring 10 vital services for surviving and thriving

Special Editions: Excerpts from the 100% Community designed for local action teams

Medical and Dental Care@100%

Behavioral Health Care@100%

Food@100%

Housing@100%

Transportation @100%

Parent Supports@100%

Early Childhood Learning@100%

Community Schools@100%

Youth Mentors@100%

Job Training@100%

Leadership@100%

Assessment@100%

Thanks

First we thank Gregory Sherrow, a three-headed hydra attack survivor, who unfurls his big red cape whenever needed. Thanks again to the hydra-fighting heroes who inspire us every day: Leticia Bernal, Noel Chaves, Dr. Esther Devall, Richard Eeds, Kasandra Gandara, David Greenberg, Dr. Melissa Hardin, Rollin Jones, Diego Lopez, Jennifer Manzanares, Bram Meehan, Jerrett Perry, Matt Probst, Dr. Sharon Sessions, David Sherman, Dr. Bill Soules, Colleen Tagle, JC Trujillo, Aurora Valdez and Mary Nell Wegner.

Ready to roll?

Your next stop is www.100nm.org.

Get the books at www.annaageeight.org and www.100nm.org!

“Nothing makes me more nervous than people who say, ‘It can’t happen here.’ Anything can happen anywhere, given the right circumstances.”

―Margaret Atwood, author of The Handmaid’s Tale

PART ONE: THE HYDRAS AMONG US	1
Yes, they’re everywhere. And it’s time for heroes to step in to defeat them.
A TIME TO PAUSE AND LOOK OUTSIDE
Time to stop everything you’re doing. Take a deep breath. Assess how close the hydras and their trail of damage, diversions and distraction are.
PART TWO: TERMS FOR SURVIVAL
The following twenty chapters introduce you to twenty key terms used in the local mobilizing and capacity-building process called 100% Community (aka The Hydra Prevention Project), a local initiative that you and your community will need to implement in order to survive and thrive during the era of roaming hydras and colliding crises.
PART THREE: THE HYDRA-FREE SOCIETY
Your assignment, should you choose to accept it, awaits here. Details provided.
PART FOUR: MISSION POWERUPS
Yes. It’s just like in a video game but even more important.