In 1964, Hilliard worked as a first grade teacher at Bright Functions School in
Monrovia, Liberia as a volunteer for the American Women in Liberia organization. In 1975, Hillard was the first African-American women to work as a board member for the South San Francisco Unified School District. In 1993, Hilliard became the first woman and African-American to be elected as mayor in the city of
East Point, Georgia and in the state of Georgia. Hilliard served as mayor of East Point until 2006, longer than any other mayor of that town. Hilliard hosted the television talk show "In the Know with Patsy Jo" in 2007. Hilliard also served as the CEO of Waset Educational Production Company. Hilliard has collaborated with a variety of groups throughout the course of her career, including the East Point Business Association, the Superintendents Advisory Board of the Fulton County School District, the Atlanta Airport Rotary Club, the Atlanta High Museum of Art, and the DeYoung Museum of Art. She has served as President of the Atlanta chapter of Links, Inc. and the Atlanta Alumnae chapter of
Delta Sigma Theta sorority. She has also served on the Executive Board of the Atlanta chapter of the
NAACP. ==Honors==