Before Government welfare was widely available, African-American religious and civic groups were already providing 'healthcare' and other resources to the community. One such example, the Philadelphia-based group, Free African Society. FAS was in many ways an "insurance" policy that provided social services to those within the community. The entire venture was sustained with donations from the community.
According to Wikipedia:
"To encourage responsibility and create a common aid fund, the FAS asked members to pay dues of one shilling per month. If they failed to pay dues for three months, they were cut off from the society, no longer able to share in its benefits. The dues collected were the fund for the community service projects that the FAS organized. Among these was a food program to help support the community’s poor and widowed."
Learn more about this amazing organization: http://www.socialwelfarehistory.com/eras/free-african-society/
