About This Episode

Dr. Sarah Mitchell started her career as a rural family physician. When a personal health crisis forced her to step away, she saw firsthand how broken the communication systems were for patients trying to navigate care in underserved communities.

That experience led her to found Community Health Partners, which has grown from a single clinic to a network serving 43,000 patients annually across rural America. In this conversation, she shares the communication infrastructure changes that made the biggest difference.

Key moments

  • 2:15 – What “hitting rock bottom” looked like for Dr. Mitchell
  • 8:30 – The communication gaps she discovered as a patient
  • 15:45 – Building the first clinic with SMS-first engagement
  • 23:10 – How automated texting reduced no-shows by 34%
  • 31:00 – Scaling to 43,000 patients: what broke and what held
  • 38:20 – Advice for leaders in mission-driven organizations
Episode Transcript

0:01 [Music]
0:16 Welcome back to another episode here on the Heart and Hustle Podcast. Our next guest says, "My mom was a single parent, a survivor, and had nothing except the
0:23 unshakable belief that education could change everything. And that's why we start with parents. That's why we start
0:29 at birth. Dr. Teresa, thank you so much for joining us. Thank you for having me. I'm excited to
0:34 have a conversation with you today. Abs. Absolutely. I love that you say that. A conversation exactly what it is. People like to say interview. I'm like,
0:40 no, we're just having a conversation, right? Two humans just talking about life um in this space that we're talking
0:45 about Dr. Teresa's life and and her upbringing. We can just kind of um talk about it. You said your mother is is
0:51 your why. What did she model for you that still shows up in how you lead every day?
0:57 uh first and foremost strength. It takes a lot for uh a woman to recognize that
1:04 she's not in a healthy place and more than anything it's like first the first steps awareness and then the action. And
1:11 so my mom you didn't have an education. She she did complete um high school but
1:17 didn't have a college education and she had to make a choice and she was you
1:22 know in an abusive relationship and um ultimately she made that choice to leave
1:29 because of us right she and and she'll she'll tell you it was largely because
1:34 of me I was the youngest right I had two older brothers um and when the moment
1:40 came when I witnessed some of the the abuse that was happening.
1:46 That was that was it. That was her that was her line in the sand that she was like, I will not have my daughter grow
1:53 up in a household where she thinks that this is the norm and this is okay. And so she packed us up and we left. Um
2:01 so strong woman. I actually re this past weekend I was in Boston or this past
2:06 week I was in Boston and um I have a brother that obviously we've been brothers our whole
2:12 life but I met him seven years ago you know so it's really still learning each other in a sense
2:17 but I love hiking and every time I go up to Boston he takes me to New Hampshire we go hiking and this time we just kind of sat there and appreciate the view but
2:25 also asked the questions like out of all the brothers and sisters and we have 10 plus it's like why us like what was so
2:33 special about us that God has blessed us with these opportunities or how do we cuz someone recently asked me that question like out of all these brothers
2:39 and sisters what makes you different that you were able to overcome right what makes your mom different that she had to overcome
2:46 and um it is the strength it is having people in your corner it is having the
2:52 we all have choices you know and and of course we have to be surrounded by good people to also make those right choices
2:58 because my mom that adopted me same thing she no college degree, right? Became a mom
3:04 at 16, 17 years old. She left home. She had four of her own kids, adopted three,
3:09 so single mom at seven. She decided to leave Boston because she didn't want that type of life for us anymore, you
3:15 know, and it's kind of like what your mom says. She that's not the life that she wanted you guys to grow up with. And maybe at the moment I didn't see it, you
3:22 know, but now I'm like so grateful that she took us out of that environment because I realize that if I look back
3:27 and I look at some of the people that's still there, what their lives look like, right? Do do you ever kind of think and
3:33 be and grateful for just kind of looking back and say, "Wow, my mom did this and even though she did the best she knew
3:39 with what she had?" Absolutely. Absolutely. And it's interesting that you say that because um
3:45 I think I people always say I'm an old soul like so this will date back to even
3:50 when I was little and I don't remember this conversation that I had with my mom but she did tell me cuz she held a lot of guilt. She felt guilty like oh you
3:57 know I've I've ruined my children's lives because I've you know removed them from their father. And um when I was
4:05 little, she I don't know if she had said something, but but apparently I came to her at like 8 and I just, you know, I
4:13 told her like I was I was happy that we were in the space we were in because she
4:18 wasn't sad anymore. She wasn't crying anymore. And so even at a very young age and I think this is really important and
4:24 it comes full circle to the work that we do with early childhood but at a very young age children can pick up
4:30 on things and they understand things and and sometimes we don't give them the credit right that they they can understand things but at a very young
4:36 age I think I I picked up on that and you know every step of the way it's so
4:43 interesting like you know I went to grad school when no one else in my family had gone to pursue a PhD and there were many
4:49 moments where I was like I'm out of here like this is not our family. My people don't do this. Like we don't do this. I
4:56 don't know what I'm doing here. I'm out of here. And my mom, you know, again, that strength would would come in and
5:02 and she would she would kind of just give me that you can do hard things. She
5:09 was always she always told me like it'll happen. It'll get done. You'll get it done. You always have like you can do
5:15 hard things. And um I think that that strength that she showed me also she she
5:24 said it and showed it. Um and it's just totally you know I look back like I wouldn't be the woman that I am today. I
5:30 wouldn't I and some say it's a little much, right? Like I've taken that strength to like a whole another level.
5:37 Um, but I do I hold a high level of um
5:42 high expectations for for the way that I get treated, right? And the way that I
5:49 show up in people's lives and the way that people show up for my life. And I think it's because of her. Expectations is such a
5:56 could be a challenging word and a challenging time, right? you have a high
6:02 expectation and you do anything less, you feel like you're not successful or or you didn't you didn't win. You ever
6:08 feel like those moments? Oh yeah, all the time. All the time. Um,
6:13 and it's funny because, um, I actually did a recently, not recently, a couple, I think it was like six months ago, I
6:19 did another podcast and it was around confidence and they they selected me to have this conversation about confidence
6:25 and I was like, what? Why? Um, I don't
6:30 necessarily I don't I'm not a self proclaimed confident person, but ever it's come up so much in my life. Like,
6:36 you're just so confident. You enter our space, you take up the room, like you you're so confident. Um, and I think about that
6:45 because every day I'm questioning like, oh my gosh, did I make the right decision? Is that like, you know, and
6:51 I'm very self-aware and self-reflective. And I think that that comes in all the time. And so I'm constantly questioning
6:58 like, did I do that right? Is this, you know, is it going to be successful? Um,
7:03 am I the right person to be doing this? Like, you know, I'm leading this massive early childhood organization.
7:10 Um, and there are so many moments where I'm like, I you know, I don't I don't
7:16 know, maybe maybe maybe there's someone else that could probably do a better job. And I, you know, I think that um
7:22 that humility, that's what I talk about. like my humble beginnings and where I grew up
7:28 and how I grew up has provided such humility
7:33 that no matter title schmidle no matter what my degrees are no matter what my
7:38 title is no matter how much I get paid no matter you know all of that like I'm still a person that says that questions
7:45 things and questions myself and always wants to strive to do better and be better
7:50 their imposter syndrome like so you're still dealing with it even at the head of the Oh, and it's Yes. Yes. And
7:58 it's so real. It's so real because it's been, you know, just this this um streamline through my through my life.
8:05 But recently um so I'm in the Aspen Ascend fellows program this year and shout out to my fellows because they're
8:12 brilliant. We were sitting in a room together and I brought this up and one
8:18 of them said like I'm so sick of that term. We are not sick. Just because we
8:24 question like whether we did the right thing or we're the right person to be
8:30 sitting in the seat or what doesn't mean we're have a syndrome or a disease. It means that we're humble and we're
8:36 self-reflective and we have strength and you know so it was really beautiful to see that kind of flipped and I've been
8:42 trying ever since to kind of take that in to be like yeah what is this in
8:47 imposter syndrome thing but it's hard it doesn't stop the feelings from coming through. It doesn't stop that like
8:52 natural reaction to happen. Yeah. No, it it's hard. I would tell you even this past week like I went on a on
8:58 a trip uh work trip, but I still felt a little selfish. I still felt like what
9:04 am I doing? I felt like what's next? Like I hit a place where I I envisioned,
9:09 right, and and I prayed for and then it's like what's next? We talked about expectations. I had this high
9:15 expectations and everyone's like, "Man, the audio is good." And I'm like, "Yeah, but when I hold myself to a certain standard and the audio failed me, like,
9:22 yes, you hear audio, but it's not the audio that I meant to record, um, it it does eat at you." And then as
9:27 you continue to grow, you're like, "Okay, I'm here now. Now what?" I can only imagine when you got into the seat
9:32 of CEO. Okay, I'm here now. Now what? Like, what's next? And you got to continue to move forward. You got to
9:39 really be strong at times. You're talking about the voices is still going to come, right? All that. How do you
9:46 overcome that when you do hear those voices when you are feeling some type of way? You know, I always say it is okay
9:52 as humans to feel that just don't dwell in it, right? But how do we not dwell in it?
9:58 Yeah, absolutely. So, I tend to have um
10:03 a bench of people that I know that are my cheerleaders, right? Like you, it's
10:09 one of those things that you know, you're never going to be successful alone. whoever write rewrites history to
10:15 be like oh yeah I did this all myself like you know there's like a whole cadre of people that help them along the way
10:21 whether they give them credit for it or not. So I have a very large bench that I
10:26 and I know who to call for what right? So if I'm in the moment where I'm struggling like I'm having a little
10:32 self-doubt or you know just needing that boost like I have my cheerleaders to call that I know that are going to give
10:38 me that and then there's moments where I need the hard truth. I'm going to call, you know, the friends that are just like, I'm going to give it to you
10:43 straight and you may not like it. Um, so I think that's one thing is just having that strong network and really leaning
10:49 on them when you you need support and knowing who to go to for what. Um, you
10:54 know, I I often think of my roots and my ancestors and that really grounds me to
11:00 say like my family didn't work that hard to get here for me for me to have this
11:08 life and then for me to throw it all away or me to give up. Like that is not what I'm here to do. And the other thing
11:15 about it too is like, you know, being a Latina in this seat,
11:21 which is very rare, like I feel a obligation to continue to pave and to
11:29 push to ensure that more Latinas are in these seats in the future. And so I'm
11:34 always thinking about the pipeline and, you know, how do we lift up the next generation and the next, you know, set
11:39 of leaders. Um, in fact, we're building a leadership academy within Avante right now for that reason. Um, but yeah, I
11:48 always, so there's like, you know, there's both. You have your current network, but then I always hold on to my ancestors and the fight that they had to
11:54 get, you know, to get here. Hey, real quick. Have you enjoying the podcast? We first want to say thank you.
12:01 And we also just want to give you a little insight of what we're up to at Francis. Some don't even realize that we're working with organizations to help
12:07 them use AI to create that real human communication experiences. Whether
12:12 that's actually supporting your your families, those patients or the entire community, we're actually creating tech
12:19 that connects. Check it out. Francis.ai. I love it. Do you think there's extra
12:25 pressure being a woman and a woman of color? My gosh. Yeah, absolutely. And a a
12:32 mother now. like I that's another added, you know, pressure that I've just um started to experience. And so, yeah,
12:39 I I the expectation it it's interesting, right? Because I I've had these
12:45 experiences where um I will approach something in a very
12:50 direct manner and it come the feedback that I get is like it comes off a
12:55 certain way and you know, it's just so hard for people to hear and some that. I'm like, if a man were to do that,
13:01 especially if a white man, cuz I experience it all the time where white men are talking to me in a certain way
13:07 and saying really inappropriate off-the-wall things, nobody questions
13:12 it. No one. There's no no one's giving any feedback. But because I'm a woman, a
13:17 Latina, I've actually been in a room where someone said to me once I revealed cuz I I am I'm white passing, right?
13:22 People don't look at me and say, "Oh, you're Latina." And especially if I'm wearing a suit, there's a whole lot of
13:28 perceptions, right, of what a Latina should look like. And I actually was sitting in a room one time full of 400
13:34 people. And this woman said to me that once I like we got cuz we kind of got
13:39 into it cuz she thought, oh, she was like, "Oh, I thought you were just a a funer, a white woman with power." And
13:45 you know, even though I had introduced myself, I'm the Grano. I'm the CEO at the time. I was with Ki Madre. And I I
13:52 started to kind of, you know, stand up for myself. And she goes, "Oh, okay. I
13:59 see it now. I can feel your fire, your fiery nature. I wanted to pick up a
14:04 chair." I was like, "You are just continuing to like dig a hole of stereotypes. Like this is so
14:11 ridiculous." Um, so yeah. No, it's it's a lot. It's uh ignorance, right? A lot of it.
14:17 Um, I've been that person that I am very work ethic is on point. I love what I
14:23 do. I'm always going to give 110%. But it's as soon as we decide to speak up
14:28 and have a voice, we automatically become something else. Oh, yeah. Right. They loved you until you spoke up
14:35 because you're no longer just a a yes man. Yep. Uh or yes woman, right? In the sense
14:41 or you're no longer fitting their stereotypes that they've created for you, right? And now they don't know what
14:47 to do with you because you're outside that and they're in a space of like, you know, I oh I don't know how to act. I
14:53 don't know how to how do I navigate this. Like their uncomfortability becomes your problem. You know, it's
14:59 like oh great I I don't need to own that too. Thank you. I I had a supervisor say it's not what
15:04 you said, it's how you said it. I said there's no other way to say it. Actually, like I had to say it because
15:10 you guys weren't listening any other way. I've been saying this for a long time and so what do you want me to do?
15:16 Be fake about it? Like like I can't that's just not in me, right? So I can imagine it's happening to you as well.
15:22 And you know that's where I had to sometimes see my own valley and realize you know what this is not the room I should be in. How
15:29 about that? This is not the company I should be working for. If I can't be authentically me, if we can't have a
15:34 conversation, if we can't grow together, then why am I here? And I can imagine, Teresa, you've as a woman, as a Latin
15:41 woman, you've experienced that, you know, especially as a Latin woman, you now, especially when they find out
15:46 you're Latin woman, everything changes. Everything changes. Their minds like are blown, you know, and um Yeah. And and to
15:54 your point, like I really that whole that comment you just made about like then this is not a place for
16:01 me. It's so interesting because what we it's been a real intentional effort on
16:06 my part at Avon to make sure that it is a place for learning and growing
16:11 together. Like I constantly say that we we do a lot of work, you know, internally with with our ops and, you
16:17 know, operations teams and stuff to make sure that that is so present for
16:22 everybody because so right because of the experiences that we've all had in different places where we're not able to
16:28 speak up and when we do, we're labeled that fiery oh, you know, speaking out
16:34 type of it's like, you know, or or somebody tells you this is what you this is what your path should be. Well, why
16:40 can't I decide what my path should be? Thank you. I have autonomy and I'm a human being anyway. So, yeah. I mean, I
16:45 think we're right. It's and and it's such a privilege. It's such a privilege to be able to take
16:52 experiences and then create an environment that wish we had had, you
16:58 know, and then now try to create that environment for other people so that they don't have to experience those
17:04 with everything you've seen your mom have to go through and who she become.
17:10 everything that you've experienced now as a leader, as a woman in this space and everything you've, you know, had to
17:16 overcome as well to become. Um, what are some of the things that you want your daughter to take as a a woman in this
17:23 world? I mean, it's only getting to me sometime. I feel a little bit more challenging, not a little easier, but what are some of the things that you
17:28 hope that she takes from who you are and and how you show up?
17:34 Yeah. Wow. Um the the image that came to my mind when you asked me that was when she's five,
17:41 maybe she was six. So she came into my office, you know, a spinny chair. What kid doesn't like a spinning chair? So
17:47 she's in the spinny chair and I'm, you know, I can see her and watch her from the other room and she's saying as she's
17:54 spinning, she's saying, "I'm the boss. I'm the boss." And I was like, "Yes."
18:01 Um, so, you know, I really want her to believe that she has everything that it
18:07 that she needs to lead and that she doesn't and that she can use her voice,
18:12 be respectful. We don't need to, you know, be using profanities and doing all
18:18 that, but that she can use her voice and speak up for herself and that she can lead and that she I know it sounds cliche, but
18:24 that she can be anything she wants to be. You know, she there's time she's like, I want to be an astronaut. I'm
18:29 like, great, let's do that. You know, like I lean into all the things that she's excited about. Um, but more than
18:36 anything, like I just want her to feel confident in her own skin and be able to speak her truth and use her voice. Um
18:43 because so often I feel that women are put in a place where we are silenced and we are told that like we are not to
18:49 speak up and that we are you know even in I' I've gotten coaching from like doing presentations
18:56 and I learned that and I don't I don't know if you know this or you probably do or have seen it but women tend to on
19:02 stage cross their legs while they're standing cross their legs and it is an
19:08 attempt to feel smaller to make themselves smaller in a space Right. And
19:13 my coach that was teaching me, she was like, "Wid take a wide stance on that stage. Take up as much space. Put your
19:20 arms out as far as you can. Take up as much space as you can." And ever since then, I've been watching. I watch women
19:27 all the time. No man is standing on a stage crossing his legs. You've never seen that. I've never seen that.
19:33 You take a look out for it. But anyway, just again, take your space, use your
19:38 voice, like, you know, stand firm in in what you believe in and and don't let
19:43 anybody tell you any different. I was in an event yesterday and maybe we can touch it kind of where we're at now
19:49 is this woman. She has she's actually an actor, been on shows of all that and
19:54 Zach and Cody and she's been having to really take care of her family almost since she was 13 years old, right?
20:00 Because she was kind of the bread winner in a sense. So, she felt like she always had to hit live this strong hard life.
20:06 And now she's in her 40s. She just got divorced. She's a mom. And she was like,
20:12 um, I'm in this new season of just being the softer version of myself. That it is okay to be softer. That I
20:18 don't have to always play on this hard macho. Like, what do you think about that, Teresa, when you hear someone
20:23 says, "I can be soft. I don't have to sit here and be this hard person." I love that. And I think that, you know,
20:30 that's something that I'm starting to embrace as I have a, you know, I have a two-year-old son.
20:36 Um, it is hard though. It's hard to
20:42 be soft, particularly in public, when for so long
20:48 you've been put in a place where you've had to be tough. Like you've had to be strong and not let anybody see any of
20:55 the weaknesses cuz you're afraid that like once they see that little thread, they'll pull it and everything just unravels, right? I spent so much time so
21:02 much of my life um I would I'm not saying to say protecting
21:08 but just like covering up right where I came from and all the dirt and stories
21:13 and all of that. Um and I think it's it is important to show that we can
21:19 we can be both, right? Like and there's a time and a place for all of it, but I
21:25 think it's really hard. I know that I struggle with it a lot. So, let's talk there's so much to uncover. I can't believe we we haven't
21:30 even gotten to what it is that you do in the organization. Tell tell us tell us the organization that you represent
21:36 today and your title. Yeah. So, um I am the CEO at Avante. We
21:43 are a national nonprofit that focuses on early childhood education, but we're unique in that we really focus on the
21:51 parenting side of early childhood education. So, we're a twogen organization. We work with both parents
21:57 and children simultaneously, particularly parents with children under the age of five. We ensure that the
22:04 young children have everything that they need to be successful in education and in life. And the way we do that is we
22:11 support parents to be the best versions of themselves and to provide everything that their children's their children
22:18 needs. also to have some own their own goals and like know that it's okay to pursue things for
22:26 themselves, right? And and it's not doesn't always have to be it is about the family and it is about the children,
22:32 but if you're not taking care of yourself and you're not put setting goals for yourself and continuing to to
22:38 evolve, um that's a that will reflect right on your family and your children.
22:44 And and what are some of the ways people take care of themselves? You say therapy? Is it finding a hobby? Like
22:49 what are some of the things you I mean it could be any number of things. I think that that's defined by the person. But I think that one of the one
22:56 of the things that we find so often, particularly when you're talking about parents with children under the age of
23:01 five is they're so speaking as a parent children under so
23:08 consumed by the child and the family and everything that that everyone else needs
23:15 to be successful and to be, you know, hate, healthy, safe, all those things
23:20 that there the parent and often times Mom is last. And it's that whole idea on
23:27 the airplane, right? Put your oxygen mask on first, then put your children because if you if mom is not great, if
23:34 dad is not great, if mom and dad aren't great together, that's the foundation, right? And so we
23:42 we do, you know, support parents and actually having a social network, right?
23:47 Social capital is so critical. So, at Devante, one of our core programs, the parent child education program, we
23:53 actually designed it to be cohort-based. So, it's not a one-on-one. It's not like we have a coach that works with one
24:00 parent. We do it in a cohort of of parents. We serve, you know, each classroom is roughly 25 parents. And
24:08 it's intentional to ensure that they are creating a network of support from one another. They're all going through the
24:14 similar situation, right? um and ensuring that they have other parents to
24:22 talk to and bounce ideas off of and learn from. Um I always say that avant is just the conduit to which this
24:28 happens, right? But um that having a social network is so critical for especially for parents with
24:36 young ones because it can be so isolating. And you're so right about just um it
24:41 being those woman uh mothers usually that kind of feel this. I actually asked
24:47 my wife recently. She's been a stay at home mom now for almost 5 years. And it is never turning off, right? This is
24:53 247. This is as you mentioned, she always says, "I feel like I'm last. like sometimes I need a break, you know, and
24:59 having to hear those things come out of her mouth is is I have to take action, right? Because how can she be present if
25:07 she doesn't feel present? Um, how can she be uh 100% with the kids if she
25:13 doesn't feel 100% with the kids, right? There's no sick days. So, it's that it's having to really in a
25:19 relationship having to hear those things and having to remember that while yeah, I am we're both making our own
25:25 sacrifices ideally, right? like I have to sit here, make my sacrifice while she makes hers is never forgetting that we
25:30 got to be there for each other. Um, so I I love that you guys in the space. What What brought you to this organization?
25:36 Was it just someone called or you just really felt the need and really felt I wanted to be a part of this? Like what
25:43 brought you to the organization? It's a mixture of both. So I did get a phone call. um they were look the
25:49 organization was looking for a CEO and I got a phone call and at the time you
25:55 know I was with another organization and I was like I'm I'm not looking. So thank
26:01 you for for the call. I really appreciate it. Um and then you know the
26:07 like the seed was planted all right and I started thinking about it more and more and and the
26:13 organization that I was with previously again a twogen organization working with both children and parents simultaneously
26:21 but it was focused on young Latinas starting in sixth grade and really working on ensuring that these young
26:28 Latinos had the opportunity and all the skills and resources that they need to pursue um post-secary education.
26:35 amazing organization to this day. Love it. Um it's it's a really great mission,
26:40 but starts at sixth grade, you know, and there's a lot that you can do, but the
26:49 research shows that, you know, when you invest in early early childhood,
26:55 that is it has the biggest return on investment and you have the opportunity. It's it's no longer an intervention.
27:02 it's a prevention program. And so, um, they called again months later
27:10 and just said, "Will you just put your application in?" So, I did. Um, and you know, I really
27:19 thought, you know what? I'm going to make a shift. I want to make a shift to
27:24 not serving the problem, but solving the problem. And if we start at birth, we
27:30 have a better chance of solving it. And so, um, also just, you know, personally,
27:37 like if my mom had a Volante, I feel like she probably would have been in a a different spot. And, um, you know, just
27:45 the mission is just beautiful and calls to me both on a personal and professional level. You You realize it wasn't chasing
27:52 paychecks, it was chasing purpose, passion, right? Absolutely. Uh, I love it. And I love that it kept
27:59 calling back. Sometime we say no and then it comes back. You're like, "Wait a minute, why did it come back and you
28:04 really got to start to think about it?" Like there's a reason that this shows up to my front door again. Um, but I can imagine even you getting
28:12 this call, it's like, damn, I'm doing something right. Was that like a know your worth moment for you to get that call and and
28:18 someone's actually calling you to come be a part of their organization because they see how good you're doing on the outside?
28:24 Yeah. You know, that was one of those like imposttor syndrome moments where I was like,
28:30 you know, like why why me? Like I, you know, here I am just minding my own business, doing my thing. Um, and so it
28:38 is a moment of reflection, right? And I I think those are those moments like you said, you have to take when it happens
28:44 more than once, you have to take stock and be like, okay, I must be doing something right here. Um, and so, you
28:50 know, I also feel like, again, I'm going to go back to my network, like relationships are matter. Relationships
28:57 are so critical. And so, you know, h taking care of my relationships. I think that helps
29:04 because how did they get my name? They got my name from someone else, right? They didn't, it wasn't the organization
29:09 themselves knew me off the bat. They had contacted somebody who knew me. Um, and
29:15 so, you know, I just, yeah, but but to your point about like it keeps knocking,
29:21 it keeps calling. There is, you know, and I'm a data person, so I'm always like, you know,
29:26 give me the data. Give me the data. It's like, well, how can I ignore this data, right? It it I said no once and it came back. Um,
29:33 yeah. So, yeah. You you've been C CEO now for years. What have you learned about leading with both
29:38 heart and strategy? um that it's really hard.
29:45 It is really really hard to balance the two and that it's so the most the most critical
29:54 part and for me the reason that I say that I or the organization can be
29:59 successful is because of the team. build knowing for me it's like
30:06 knowing where I'm not knowing my weaknesses knowing where I'm not as strong and then building a team around
30:14 that right to say like okay well if I'm not as strong here I'm going to build like this team's got to be really strong in that and I'm going to trust them
30:20 right um but I think
30:26 being authentically me in every setting no matter which team member I'm talking
30:31 to what you know I'm always authentically me. I don't try to be
30:36 somebody I'm not. And I think that that the team knows that, right? They know um and they know that my heart is in
30:43 this and and no matter what decision we have um a guiding principles for
30:49 decision-m at our organization and like they everybody knows about it. We repeat it all the time. And so everybody knows
30:55 that when decisions are made, when tough decisions are made, they weren't made lightly, right? they went through a process and um we're you know being very
31:03 transparent and here's the thing like you know I have a coach I have an executive coach I love her she's amazing and she always talks about like creating
31:09 a space that allows me to be me because when I am able to be authentically me that is when like everybody's going to
31:16 get the best of me right um and I think that that is something that if
31:24 you I'm conscious of not just for myself but for others like I need also will create a space that everybody else can
31:30 be authentically them and show up in that way because that's the way we're going to get the best of them too and they're going to feel valued, right?
31:37 They're going to be able to bring their value and feel valued. Um, but I think
31:42 again I'll go back to I I don't think I could be the leader
31:47 that I am with that kind of mindset had I not had humble beginnings, had I not had struggles and and had to,
31:55 you know, if I had been someone who kind of inherited success,
32:02 um, I don't think that I would show up the way that I do today. I want to tap into that executive leadership coach. like so many people
32:09 need it and like me being in the coaching space I see so many people that need it and they would always give you
32:15 that well I don't have any money but you see them spending money on different places or um I don't see the value right
32:22 I don't see the ROI in a coach what is your your process to those that have
32:28 that kind of stigma on coaching itself so here's the thing about coaching that I I think that I think those answers I'm
32:36 going be real honest I think those answers are excuses. I think that deep down underneath the iceberg on that one
32:43 is fear. If I get a coach, that means I'm not
32:48 good enough or I'm not doing a good job, right? Or if I get a coach, that means I'm going to have to question and like
32:55 do some self-reflection. And, you know, I think that it's more about the fear of
33:02 people thinking that they're they don't have it all together. And for me, I've always said, and I
33:09 anybody on our team that wants a coach, I'm like, "Yes, let's get you a coach." Um, they're a thought partner. They are
33:16 an unbiased um mirror and, you know, a wall to
33:22 bounce the ball off of. And it is so valuable. And and if you're
33:28 authentic and you come in and you're like, "Hey, you know what? Maybe I could I want to test this out, right?" Like so
33:33 my coach, she did this EQI um exam, you know, test and
33:39 came back with some stuff and you know I just we we were working on reality testing all sorts of really really great
33:46 things and nobody you know it wasn't like my board said hey you need an executive coach or like your your
33:51 performance is low here you you need no for me I was like look I'm about to go through a big transition
33:58 I just had a baby um our organization we just did a a unification process is like a recentralization process. We're
34:05 growing rapidly. Lots of change is coming which I know is going to require
34:11 change for me and I want to make sure that I show up as the best leader that I can show up at this time. And that means
34:17 I need to have somebody to walk alongside me in that process and that journey. Somebody who has outside
34:23 perspective, who has maybe worked with many different people, who has read all
34:28 the leadership books, right? with someone else who has a different perspective that can help reality test
34:34 for me, right? Can help guide me as I'm walking through this journey. So, I am just I'm a huge huge
34:41 fan. Um coaching is so critical no matter what stage you're in. No. And for those who have a little
34:47 hesitation for whatever reason that they they say because you can find the money you can you know um that's a moment of
34:55 of self-reflection like am I is it really that I don't have money or am I just a little bit afraid of what what
35:00 this means right what this means for me or what it's going to look like to others.
35:06 That's usually it. it is that um as you mentioned a little scared of the unknown, right?
35:11 Um not wanting to be called out on your BS because a lot of times you know and you kind of mentioned about your your
35:17 your bench of people. I have one friend that if I sat here and started giving what he would call excuses he would
35:23 automatically say yeah sound like a whole bunch of excuses he fra and I'm like you know what
35:29 maybe it is those are the best friends to have. I I don't like we talked about a little earlier that just the yesmen like be
35:36 real with me you know that's the only way that we grow is that you have to be real if you're just telling me everything is good and reality is not
35:42 good how do I supposed to grow as a person as a leader so I love you know those coaches
35:47 they're going to let you know and and let you know yes this is good or or no I don't know what in the world were you
35:52 thinking but this is not what you can do you had those moments I can imagine that's really cool
35:58 um government cuts man they're hitting How do you protect the mission when the money's tight?
36:04 Oh, we've had to do so much and this is like um so our organization
36:12 um last year we served 18 over 18,000 individuals throughout our network. Um a
36:21 large portion of those individuals we serve are through Head Start Early Head Start.
36:27 And if you're watching the news at all, you know that Head Start, Early Head Start initially was not even in the
36:33 budget for this year, which was a huge scare for us. Eventually, it did come back in,
36:39 but it was flat, which is the first time in ever, you know, very long time that it's been flat, but we're grateful to
36:45 still have it. Um, you know, but we're we're always, you know, on eggshells about that like the next, you know,
36:52 well, obviously right now with, you know, budgets not being passed and, you know, we just never know, um, when the
36:59 the plug is going to be pulled on Head Start, early Head Start and that's a huge concern for us because of the size
37:06 um, you know, of our budget that is dependent on that. But I will tell you
37:12 what I've done with our team, again, this is whole like strategy. you've got to be strategic and you always have to
37:17 be thinking five steps ahead. Um, we did some scenario planning and said, "Okay,
37:23 if Head Start, Early Head Start were to, you know, not have any funding, we
37:29 wouldn't be able to serve as many because no one can replace federal dollars, but what could we still do, right?" And
37:36 so, we did a and all of we had um three different locations that we did this exercise in. And it was really um
37:43 affirming. I heard from our executive directors in those locations that like although it's not fun, you never want to
37:50 be in that situation. They felt confident. They were like, "If something happens, I now have a plan. I know that
37:57 I can still serve children and and families and I can still employ people, not at the degree that I was before, but
38:02 that I'm not completely um leaving my community out to dry." And so um it's
38:09 been obviously a roller coaster on so many levels. the funding,
38:14 immigration stuff, everything. Like, it's just so much to take right now. And for leaders, especially, you know,
38:21 leading organizations that are kind of in the crosshairs of all of this, it is not for the faint of heart. Like you are
38:27 just constantly, you know, um try and I, you know, trying to hold space, both
38:34 being strategic and trying to figure out your like how do we move forward, but also hold space for people and their
38:39 their feelings, right, their emotions about this. And so you asked me about like the strategy and the heart like
38:45 that. Those are the two things like I'm constantly trying to hold like okay we still have a business to run. We still
38:51 have people to serve and I have staff and families
38:56 that have hearts and and needs and you know communities to take care of and and
39:02 we how do we make sure that that the heart is taken care of? Yeah. Human is taken care of in addition. So,
39:10 I don't know if this has anything to do with your space. Maybe, maybe not. But what I'm seeing here in Central Florida,
39:17 and we have one of the biggest districts in the state of Florida and probably one of the top 10 in the country, that our
39:23 elementary schools are empty. Are they're they're cutting teachers, they're cutting class sizes. Is that
39:29 going to be an impact to what your organization has to deal with? Yes. So, what we've seen so far is um a
39:38 decline in our Head Start enrollment for sure. Um where these children are going,
39:44 we do see them going to the school districts. We've also seen them going to charter schools. Um so that's that's
39:51 going to be a huge hit. Um the the other side of this which is a benefit for us
39:57 is that because we serve children from birth there is there is actually no
40:04 formal for better or for worse there's no formal early childhood system.
40:11 So there's no dismantling of a system because it doesn't exist. So we are kind
40:16 of what I tell my team is like we're fortunate in the sense that our services will continue to be needed and even more
40:24 so now than ever. Um the issue that we're going to see and what we have seen
40:29 is that we often operate some of our programs on school district campuses so
40:36 that we're introducing families to the school system early and that when those
40:42 families do transition into the school system that it's a seamless transition
40:48 because they've already been there and they've been there in a way that's less scary because they're not yet enrolled.
40:55 So they're kind of watching on the periphery and they're getting introduced slowly, right? They're getting little bites and pieces. Um so that will have
41:03 an impact, right? Um if we're not able to operate on school district campuses because they're shutting down campuses,
41:10 shutting down buildings. Um, but you know, we have, again, we've seen
41:15 the the decline in Head Start enrollment and then we have an opportunity right now and that's what I keep telling our
41:21 team is to like now it will require philanthropy because we know we're not getting any more federal dollars.
41:26 Yeah. So, it's going to require a stronger philanthropic support for us to
41:32 strengthen and grow the work that we're doing, but I think it's more important
41:38 now than ever, right? And if we can do our work right on our end. So I always
41:43 say you know the the a child 90% of a child's brain is developed by the age of
41:49 five. We have we are brain architects and we have a lot of really important work to
41:56 do. But if we do our work right on this side supporting parents and supporting children
42:03 we're like whatever elementary school they go to charter school whatever like they're going to be good. they're going
42:08 to be okay. Especially if the parents have the foundation of educational
42:13 support that they need to provide their children, not just in early childhood, but for the long haul.
42:20 They're going to be okay. I love this. I love that you're in this
42:25 space and just talking to you, it's just so relaxing. You're just like you said, authentically you you can definitely
42:31 tell. Um what's the vision? What's the vision? Last time we spoke, you mentioned growth in a space where people
42:38 are looking to decline, right? We just talked about even the school system, but there's expansion happening. What is
42:43 that vision look like and how can people listening support that growth? Yeah. And we are we we've done some
42:49 landscape analysis across the nation um to look at different states and communities where there is a higher
42:57 percentage of Latino families and communities um and there may not be as
43:04 many resources for early childhood. And so we are really targeting those communities because and here's the
43:12 biggest thing. What we want to do in terms of when you say growth, Avon is not interested in going into a community
43:17 and setting up a brick and mortar. No, communities across the nation have rich
43:23 amazing organizations and resources in their own community. What we want to do is partner. We want to partner with
43:30 those organizations to be able to provide our curriculum and our programs so that the community can serve
43:36 themselves. Right? I don't know if that makes sense, but just we believe that those who are closest to the community
43:42 are best suited to serve their community. And so we want to find those partners, provide our curriculum and our
43:48 resources and training and and technical assistance and let them do what they do best in serving their own community and
43:54 and because they have the trust. They they know where the people are and they know, you know, what their people need. And so if we can be a resource and and
44:02 be a support in their journey, that's where we really want to focus our energy. So we are um we're looking at
44:09 Miami right now. So speaking of Florida, that Miami is as an area and we're looking into New Mexico. We've just
44:15 expanded to two um two cities in New Mexico and we're also looking in
44:20 California. we we have some locations um of expansion in Northern California, but now we're looking more in, you know, the
44:27 the southern part of the state as well. Um so, we're really excited about that. And if folks are interested in learning
44:34 more about our growth, our strategic plan, visit our website and um there is actually an an email address you can
44:40 actually just send an email to. It's info@avansce.org. Um, there's a donate now button on the
44:47 website if you feel so inclined to to contribute. Any amount matters. Um, I
44:52 know folks often say like, "Well, I can't give $500." Give five. We every amount difference.
44:58 It does. It makes a difference. Um, you you've just mentioned the social the uh the website. Is there any socials
45:05 that you guys are on? People want to go see some some nice photos, videos, education.
45:10 We're on Instagram, Facebook, and LinkedIn. So you can find us um on you
45:17 know any one of those those platforms um Avante Inc. And yeah, follow us. We
45:23 we're very big right now on storytelling. We celebrated um we're 52 years old this year. So you can imagine
45:31 after 52 years of operating the amount of stories and success stories that we have particularly I mean we've got
45:36 lawyers and engineers and all these you know wildly successful people who were babies when they started with our
45:43 program. Um so we love to we love to share those stories. I love it. Listen, we have to stop wrapping this up but I'll leave you with
45:48 one last question. Yes. you built this career fighting to give families um a better start. What's
45:54 one moment where you needed a reset and how did you get back yourself back to that center?
46:03 Goodness. Um there's so many moments to to choose from, but I will say that um
46:14 just this most recently in in January, I I really had to take a step back and
46:21 so much was going on in the world and you know when you're someone who cares so much about your community, you always
46:26 are asking, can I do more, right? What more can I do? How can I help? Um and so
46:33 there there was a moment where I was like what you know what more can I do and I realized that like what I need to
46:41 do was to get really clear about our work at Avon and to not let external
46:50 stories external forces take us off course and my coach helped
46:58 me with that. I really leaned in to my coach and said, "Hey, I'm having a moment. Like, I need support here and like I I need to
47:05 work this out." Um, and then my my team, I'm very honest with them. Um, and we we
47:15 have each other's back. And so we we said, "Hey, look, this the way that we're going, we need to take a new
47:22 approach. We have to take a new approach." And so together we have been strategizing and we created a new
47:29 approach and we launched that um in in July August and so you know we're we're
47:36 really we're pushing hard. We've got a new we invested in advocacy. We have a whole department that's really focused
47:42 on advocacy right now and really pushing forward on that. And so I think you know
47:47 in moments where it's not always clear right what the next step is or there's
47:53 some doubt creeping in or just you're tired right as a leader I think it's so
47:58 important to to step back take that put that oxygen mask on whatever form that
48:04 takes um I'm a runner so I literally will put my shoes on and I'll go leave it out on the pavement but to to make
48:12 sure you have a bench of people and when the times get tough, you reach to that
48:17 bench. You know, that's I love it. I I appreciate this conversation. I appreciate the insight
48:23 of from a leader, from a woman that's in this space that had to overcome her own struggles to get here. Um, we we thank
48:31 you. We thank you for being representation. I always say when I get on and I've interviewed hundreds already
48:38 this year, very small amount as you know is a woman of color
48:44 and a a woman of Latina. Forget that. Like that is even smaller. You know what I mean? So we appreciate you being
48:50 representation. We thank you for everything you continue to do and we know that you're going to continue to keep that growth going and who knows who
48:56 knows you still got so many years ahead of you to to do so much more. Maybe someone else is knocking on your door in
49:02 a couple of years after they see the success you're doing here. So, we thank you guys. Make sure that you guys go ahead and follow. Make sure you guys go
49:07 show some love. Visit the website so you guys can see more and also find those locations near you. And as you know,
49:13 they're growing. So, kind of be on the lookout for those that are coming as well. We mentioned Mexico. We mentioned Miami. So, if you're listening from any
49:18 of those places, make sure you guys do tap in. But I'm I'm this is Dr. Teresa. We'll catch you guys in the next one.
49:24 Latest.

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Susan Burton
A New Way of Life

Susan Burton has spent 20 years building community health infrastructure across rural America.Her organization now serves 43,000 patients annually through 12 clinics in 4 states.She is a nationally recognized advocate for healthcare access and technology adoption in underserved communitie

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