BHT's Equity Journey

/

Since the inception of the Medicaid Waiver, BHT saw the importance of integrating health equity into this transformative work. In the early years of the Waiver, we were frustrated with the way the HCA kept telling us health equity was a priority but then treating it separately from the rest of the Waiver work. We were frequently asked “how are you applying an equity lens to waiver work?” without ever having a conversation about what health equity really meant in the context of this work. Then we realized we were doing the same things to our partners. This realization launched our organizational journey to explore what we mean by “health equity” and how we could make this actionable. The Board and staff felt strongly that we couldn’t fake our way through this—if we were going to ask partners to stretch, we needed to as well.

In 2017, we started new hiring practices as we were building up our staff infrastructure. In our recruiting, we emphasize lived experience and diversity. We set our definition of diversity to include race/ethnicity, disability, sexual orientation, gender, and veteran status. 

By the start of 2018, we had about 40% of our staff meeting this definition. However, we were unsuccessful in retaining a few of our diverse staff members. After feedback and reflection, we attributed this turnover to a lack of awareness in our organizational structure on how to support and retain diverse teams, and the need to have leadership in the organization more grounded in the principles of inclusion. 

In 2019, the Board and leadership team launched some critical activities for BHT:

  • Board members committed to participating in an equity retreat and evaluating their efforts to grow in their equity journey

  • BHT leadership doubled down on our commitment to creating a diverse workforce

  • We launched a voluntary, staff Equity workgroup

This was a great set of first steps for BHT. And it was hard work. Especially on the staff side, as each of us had to come to terms with feelings, emotions, and challenges to our perspectives. More than once last year, staff members were in tears due to trauma-triggering topics and the realization of how white privilege had afforded some of us advantages denied to others, that we thought we’d earned. I was so proud of the team for hanging in there, and appreciative of our Board for embracing our teams’ journey.

During our staff workgroup, we explored a number of concepts, including intersectionality implicit bias, and white supremacy culture. Additionally, we built our own working set of definitions. (You can view our evolving slide deck here.)

There were a couple of additional moments for me as the leader that have stood out. During our discussion on dismantling white supremacy culture, I was struck by a couple of the characteristics- “perfectionism” and “sense of urgency”. I have no doubt I have succeeded in my professional leadership endeavors because I could perform well with these tenants, sometimes at personal cost and without a doubt at staff costs. This was hard to reconcile when I believe the work I’ve done has helped the community I served. But I had to ask myself, at what cost? 

BHT continues to think about how we support and nurture a high performing staff. Around this same time, we were defining high-performance standards for our team. We realized in that process that we needed to challenge ourselves to look at how we might be (unintentionally) building perfection and urgency into our standards at a cost to the overall wellness of our team. As we did this, we’ve worked to more intentionally build in planning time (so we don’t create a false sense of urgency) and worked to create an environment of learning. We don’t expect our team to be perfect, but we do expect a lot of communication and teamwork. We must provide supportive environments for all of our teams to thrive. I spend more of my leadership time focused on this than ever before. This work won’t matter if we harm the folks charged with making the change.

Each of us is on a personal journey, and there is no denying it’s hard. Each day that I come home exhausted by the work, I focus my thoughts on our friends who face overt racism and discrimination daily and remind myself not to act on my privilege and opt out but instead lean in.