When Nadie Gonzalez arrived from Mexico to south Modesto, she knew no one outside of her family and didn’t speak the language.
She was afraid, dealing with mental health problems, and didn’t know how to navigate local resources. But then she learned about a RAIZ Promotora group and met a group of women who looked and spoke like her, plus also understood her experience as an immigrant.
“When you arrive in a country that is not yours, you arrive anxious, frustrated, afraid… a program like this that you find right when you arrive is fabulous,” Gonzalez said in Spanish. “If you are well, I will be well. And we will all be well. This is about helping each other.”
Five years later, this same program will be shuttering by June 30 along with dozens of other promotora groups across Stanislaus County due to funding changes. The closures will leave close to 400 community members without essential lifelines to resources and information.
When voters passed Proposition 1 in March 2024, it overhauled the 2004 Mental Health Services Act (MHSA), also renaming it the Behavioral Health Services Act (BHSA). Under the old MHSA, community outreach programs like Stanislaus County’s promotoras were funded through the act’s “Prevention and Early Intervention” dollars. But under the new BHSA, it deprioritizes these broader community programs and instead requires counties to prioritize funding for programs that focus on several mental health needs, substance abuse disorders and homelessness.
The measure shifted approximately $140 million in annual existing tax revenue for mental health and addiction care away from the counties and gave it to the state. It also authorized up to $6.38 billion in bonds to fund housing for homeless individuals and veterans.
Looking for funding alternatives
Started in 2008, the RAIZ Promotores (also referred to as Community Health Outreach Workers) program in Stanislaus County was an initiative designed to provide community-based health education and prevention to historically underserved populations, particularly Latino immigrant communities.
The program relied on “promotores” — the gender neutral term for promotoras, the Spanish word for community health workers — who are indigenous to the communities they serve, speak the same language, and are intrinsically involved with local residents. By providing what they call “servicio de corazón” (heartfelt service), these workers are uniquely positioned to establish deep trust and provide culturally sensitive care, acting as a bridge between professional health care institutions and the community.
Stanislaus Behavioral Health Director Ruben Imperial was instrumental in starting and running these promotora programs across the county. The program funds 13 promotora programs spanning from Patterson to Hughson, with each serving 20 to 30 people.
Now most will be cut and closed by the end of the month, though Imperial said the agency is exploring alternatives to be able retain a handful of workers, by shifting their priorities from preventative care to treatment care and perhaps utilizing Medi-Cal to acquire funding. But, he said, there’s no way to keep all 13 groups active.
“We had already begun to think about how to evolve this program from keeping it as prevention but also reimagining it so that it supports people in treatment,” Imperial says. “They’re still going to be able to do the community‑building work. They’re just going to have to have a balance between the community‑building work and the enhanced community health worker services, but this is just evolving our model from the prevention model to the treatment model, which is a good thing.”
Karina Franco is the director of Family Resource Centers with Sierra Vista Child and Family Services, one of the nonprofit organizations that partner with Stanislaus County for their promotora programs.
Franco led the opening of their South Modesto Family Resource Center, where Gonzales found community when she first arrived in the county, and advocated for this center along with the promotora programit houses.
She said that these programs, which have existed in Stanislaus County for close to 20 years, allow people who understand the language and culture of the communities they serve. Having to inform folks that they will no longer be able to serve them in this way saddens her.
“It’s always very somber when you hear there’s going to be closure of programs that are very impactful to communities,” Franco said. “These groups have been around a really long time. They provide a safety net for families…When our community has less access to these services, there’s more opportunity for them not to get their needs met.”
Promotora Adela Ruiz, who has been attending the meetings at the south Modesto Sierra Vista location for more than a year, said she is sad and disappointed that the program will be closing.
“There are many people who are very shy, who don’t say what is happening inside their home or their lives or don’t know how to communicate what is happening in their neighborhoods. Here they express themselves a little more,” Ruiz said in Spanish. “I have seen the development of many fellow women. By coming to these meetings they have developed a little more. They have lost their fear of communicating and expressing themselves.”
‘Most needed’ services being cut
Stanislaus State CHW instructor Kimberly Robinson collaborates with the United Way on its management of a bilingual cohort of promotoras/community health workers based in Modesto. Her group members come from all over the county, from Newman to Patterson. She said in the Central Valley particularly, because of the region’s demographics and logistics, the experience of community health workers is deeply unique in comparison to anywhere else.
“The services that are being cut are the ones that are most needed,” Robinson said. “When you take away a person’s ability to be able to self‑sustain themselves, then you leave a community that is going to be really impacted.”
Sharee Wilburn Grimes, another CHW instructor at Stanislaus State, said to make up the difference during the uncertain times of these funding changes, partnership and collaboration will be essential. She hopes more groups will step up to replace what was lost for underserved communities by closing these programs.
“We cannot work in silos. With the hits we’re taking with tax cuts and funding changes and everything that’s on the line, we have to know who our supporters are,” Grimes said. “We’re going to be making sure that this ‘heart hard work’ that we do is not gone on deaf ears, but that we are actually collaborating and making sure we’re filling in these gaps.”
Ximena Loeza is the bilingual communities reporter for The Modesto Focus, a project of the nonprofit Central Valley Journalism Collaborative. Contact her at ximena@themodestofocus.org.