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Section 18. PACE EH: Protocol for Assessing Community Excellence in Environmental Health

Example: Julianne Price, West Wabasso, FL

In 2004, Julianne Price took a job administering a new grant for the Environmental Health division of the Indian River County Department of Health in Florida. The grant, from the Centers for Disease Control, was for a PACE EH project in West Wabasso, a small community a couple of miles away. West Wabasso is a suburb of Vero Beach, a city that occupies one of the most affluent zip codes in the state. Price drove the short distance north through acres of golf courses and past the manicured lawns of million-dollar houses. When she came to West Wabasso, however, she found herself in a different world.

“It was like something out of a developing country. There were tiny houses, most – but not all – with electricity, but many without running water. The streets were dirt, there were no sidewalks. There was a park, but it wasn’t in great shape. There was just nothing there…and we were a mile from a wealthy neighborhood of huge homes.”

West Wabasso was a traditionally African-American community that had essentially remained unchanged from the days of legal segregation in the 1960’s. There were no city services, no public transportation, no sewage system. Water for most houses came from hand-dug wells or from an antiquated water system that produced brown water…not discolored, not with traces of iron in it, but brown. Septic systems were hand-made tanks (and totally illegal – they had no bottoms.) Price, then in her late 20’s, had never seen anything like it. She set out to get to know the community.

“It was really hard to get people to open up; no one wanted to talk to me. The Health Department had been there before, and had made promises that were never kept. They’d taken information, and then used it to get funding for other projects. People were justifiably suspicious. They just didn’t trust government to do anything to help their situation. Besides, they were afraid I was there to get them in trouble. In their experience, when the government came around, you wanted to be somewhere else, or you’d be cited for something.

“The key was face-to-face time. I just went there every day and talked to people, anyone who’d talk to me. I talked to community leaders and to people out in front of their houses. I went to the churches, to the school, to community events. I was just there all the time, building relationships one person at a time. Eventually, they got the idea I wasn’t going to go away like the others had, and they started telling me what they needed.”

What they needed was what Price wanted to find out, so that she could start putting together a CEHA (Community Environmental Health Assessment) team. It took several months, but she eventually managed to get on the agenda at a meeting of the West Wabasso Civic Progressive League to introduce the PACE EH project and ask for help.

“I stood up to talk, and people just started yelling. They weren’t really yelling at me, but they had so much anger and frustration about the way they’d been treated in the past that they just had to get it out.”

At that first meeting, however, Price did manage to survey the crowd, and found that the number one item on their wish list was streetlights. It stunned her: why streetlights, when they had no clean water and no effective sewage disposal? In talking to people, she found the answer to her question: there were abandoned buildings in town that had been turned into crack houses, and a notorious drug lord lived in the community as well. Residents, many of them elderly, were afraid to go out at night in their own community.

Besides the survey, there were two major consequences of that first meeting: “The Civic League invited me to take over their meetings for several months, to work on the PACE process. And we grabbed the low-hanging fruit: we got the street lights, which was fairly easy. Within seven months, streetlights were in place, and the people were involved in the process. They started believing that something might really happen.”

About five months after coming to West Wabasso, Price was able to put together a Steering Committee (the CEHA team). She emphasizes that it’s important to identify issues before assembling a team, so that you’ll know who you need. “It was obvious that water was an issue, so I got the Director of the County Utilities Department involved. I brought him to a meeting at a church where a man stood up and talked about how embarrassed he was that he and his family had to wash in brown water, how it gave them sores and stained their clothes so that they couldn’t look respectable no matter what they did. The Utilities guy was practically in tears, and I knew we’d get a water system.”

It took time to get to that point, however. From the beginning, Price started calling various county and state agencies, trying to get them involved. “I’d call and explain the situation, and then I wouldn’t ever get called back. I knew how the folks in Wabasso felt.”

Price used the media to help get agencies involved. “I contacted a reporter who came to Wabasso and saw the situation. The issues were so apparent, he latched right on, and wrote a bunch of stories about how the community was ignored. Agencies started coming around at that point.” Price also cultivated personal relationships with people at agencies she worked with. People are much more likely to return phone calls when they know the person on the other end of the line as a human being, rather than as a proverbial faceless bureaucrat.

In addition, the community was becoming empowered. They were learning how to contact their legislators to pressure agency administrators, and how to find their way through the labyrinth of county bureaucracy to reach someone who could get them results.

As agencies became involved, Price conducted tours of West Wabasso for adminstrators that included interviews with residents, demonstrations of the water that came out of their taps, and drives by notorious crack houses. Bringing legislators or their aides along markedly improved attendance by agency administrators.

With the multi-pronged demonstration of need, help was soon forthcoming. West Wabasso, in addition to streetlights and a water system, got sidewalks, park improvements (including a walking trail), and grants for septic system upgrades and home improvements. For a $30,000.00 investment in the PACE EH project by the Health Department, the community received about $1.3 million in services and improvements.

Another positive result of the process was that those crack houses that made residents hesitant to leave their houses at night were knocked down, and three new houses built (each in one day, for residents who had lost homes to weather or decay) with volunteer labor by contractors and donations of building materials by local businesses. Both the knockdowns and the construction were coordinated by the sheriff, who himself had grown up and still lived in West Wabasso. During the first construction day, a man came up to him and said that he had seen the positive changes in the community and wanted to do something to help. It turned out that he was one of the drug lord’s henchmen. He went undercover and helped the sheriff take down his boss, who is now in jail for the next 20 years or so. Thus, an unexpected result of the PACE EH process was that 15 abandoned houses were demolished and hauled away, and a serious crime problem was eliminated.

Julianne Price mentions that 90% of PACE communities around the state have identified substandard and abandoned houses as a serious issue. West Wabasso was clearly not alone in its concerns.

Price is convinced that PACE really does what it’s intended to do. It makes possible developing relationships with community leaders, and facilitates collaboration among agencies. Most important, it makes government an ally, rather than an adversary, of communities in need. “We as government need a vehicle for getting things done in communities that the communities want and need. Without PACE, you have to use enforcement to get things changed. If you cite poor people for illegal septic systems, it doesn’t change anything – they don’t have the money to fix the problem, and the Health Department can’t force anyone… But with PACE, the community can show the problems, and enlist government to help.”

Furthermore, involvement in PACE both taught community members political skills – learning to use the system, establishing relationships with legislators and agency administrators – and developed their administrative and planning capacity as well. PACE funding is long gone from Wabasso, but the West Wabasso Civic Progressive League has taken over its function: it has a five-year development plan, and the community is sustaining its improvements and moving forward without help from the Health Department.

Price still administers local PACE projects directly – three at the moment – but she’s also now the state coordinator for PACE, overseeing more than 45 projects statewide. She’s acutely aware of the need to quantify PACE’s results, and states with pride that the total of $800,000.00 invested in PACE has brought a return of $21 million worth of improvements to Florida communities. That’s about a 2,300% return on investment – somewhat better than Wall St. can promise.

For Julianne Price, the personal rewards of her involvement have been great as well. She still spends time in West Wabasso, because she has people to see there. The minister from one of the churches that helped in the PACE process officiated at her wedding, and she describes the sheriff as her best friend. When a tree fell on her house during a hurricane, five men from West Wabasso were there the next morning with chain saws to repair the damage. It’s clear that the West Wabasso community regards her as family. For someone who cares about community building, it doesn’t get much better than that.