Challenges and Successes in the Local Health Department Workforce - PowerPoint PPT Presentation

Webinar: Recruitment and Retention Challenges and Successes in the Local Health Department Workforce Funded by the Robert Wood Johnson Foundation October 24, 2013

Research Team University of Illinois at Chicago, School of Public Health - (publichealth.uic.edu) – Julie Darnell PhD, MHSA, PI – Susan B. Cahn MA, MHS – Bernard J. Turnock MD, MPH Center for State and Local Government Excellence - (slge.org) – Joshua Franzel PhD, Co-PI – Christine Becker MPA – Danielle Miller Wagner MS The research team gratefully acknowledges the support of the Robert Wood Johnson Foundation, Public Health Services and Systems Research Program

Agenda Part 1: Recruitment and Retention • Joshua Franzel, Vice President of Research, SLGE, presentation of data and case study findings • Reaction by Aaron Kissler, Administrator, Florida Department of Health, Gadsden County • Audience Q&A Part 2: Succession Planning • Julie Darnell, Assistant Professor, UIC, presentation of data and case study findings • Reaction by Angela Smith, Commissioner, Morrow County Health Department • Audience Q&A Part 3: Future Outlook • Bernard Turnock, Clinical Professor, UIC, discussion of research findings and future outlook • Audience Q&A

Recruitment and Retention Joshua M. Franzel, PhD Center for State and Local Government Excellence The findings presented in the following slides are from the UIC / SLGE research team: Cahn, Darnell, Turnock (UIC) and Becker, Franzel, Miller Wagner (SLGE)

The Local Public Health Workforce • Data Analysis : The Workforce • Survey Results : Current recruitment and retention challenges in LHDs • Case Studies: Recruitment and retention lessons learned

Local Government Healthcare Workforce – The two healthcare-related major groups of the BLS Occupation Profiles are: (1) Healthcare Practitioners and Technical Occupations and (2) Healthcare Support Occupations . – Healthcare Practitioners and Technical Occupations decreased by 2% between 2004 and 2010. – Healthcare Support Occupations decreased by 13% between 2004 and 2010. Source: Research team analysis of U.S. BLS (1) Occupational Employment Statistics (2) Employment Projections .

Local Government Healthcare Workforce – BLS projections for 2020: • 13% growth in Healthcare Practitioner and Technical Occupations; 10% growth in Healthcare Support Occupations • Some of the core local health department positions with the largest growth projections: – Home Health Aid positions – Epidemiologists – Substance abuse, behavioral disorder, and mental health counselors and health care, mental health, and substance abuse social workers – Health educators, nurses, dietitians and nutritionists, medical and clinical laboratory technologists, and dentists – Most physician positions – Medical and clinical laboratory technicians Source: Research team analysis of U.S. BLS (1) Occupational Employment Statistics (2) Employment Projections

Local Public Health Positions: % of LHDs that lost FTEs between 2005 and 2010, by jurisdiction size 80% 69% 70% 60% 55% 55% 55% 52% 48% 50% 40% 37% 30% 20% 10% 0% Source: NACCHO - The National Profile of Local Health Departments Study Series (2005 - 2010)

Local Public Health Positions – Staff reductions increased between 2008- 2010. – According to the 2010 NACCHO Profile Study, personnel reductions were achieved through attrition, layoffs, reduced hours, and mandatory furloughs. – The use of layoffs and attrition generally grew by jurisdiction size. Source: Research team analysis of NACCHO National Profile of Local Health Departments

Current Recruitment and Retention Environment • Reductions in existing defined benefit pension plans do not offset lower salaries as much as they once did. • The implementation of the Affordable Care Act may alter demand for clinical services…how will this affect the personnel needs of LHDs? • Continued private sector competition for talent.

Recruitment and Retention Challenges: LHD executives’ level of concern about… Not at all Slightly Moderately Very Extremely 100% 90% 23% 26% 80% 40% 70% 60% 36% 36% 50% 30% 40% 30% 20% 10% 0% Finding well-qualified Retaining well-qualified Retaining currently-funded individuals individuals positions Source: UIC/SLGE Local Health Department Survey (2012)

Recruitment and Retention Challenges : ‘Very or Extremely’ Difficult to Fill Open Positions 60% 50% 40% 30% 20% 10% 0% Source: UIC/SLGE Local Health Department Survey (2012)

Workforce Recruitment Efforts… 80% 70% 60% 50% 40% 30% 20% 10% 0% Source: UIC/SLGE Local Health Department Survey (2012)

Workforce Retention Efforts… Pay for conferences Retirement benefits Pay for training Pay for CE/CME Informal mentoring Reassignments/job changes Unpaid recognition/awards Flex-time/flexible hours Post for internal candidates only Promotions Tuition assistance Competitive pay Rehire retirees Telecommuting Job sharing Formal mentoring Matching salary offers Formal rotational training program Supplemental pay 0% 20% 40% 60% 80% 100% Source: UIC/SLGE Local Health Department Survey (2012)

Recruitment and Retention Challenges Survey results indicate that : • Practitioner concerns about retaining funded positions are currently trumping recruitment and retention concerns. • LHD executives find it difficult to reward and promote valued employees under rigid human resource rules / procedures. • Lack of opportunities for advancement challenge LHD’s ability to retain well-qualified employees. Source: UIC/SLGE Local Health Department Survey (2012)

Recruitment and Retention Case Studies – Lessons Learned • Create a motivating work environment. • Focus on knowledge and expertise retention. • Support robust professional development and leadership training programs to motivate employees and serve as valuable retention tools. Source: UIC/SLGE local health department case studies (2013)

Recruitment and Retention Case Studies – Lessons Learned • Be a public service / public health advocate. • Plan early for workforce needs…and use data for planning and decision making. Source: UIC/SLGE local health department case studies (2013)

Local Health Department Perspective Aaron Kissler, MPH Florida Department of Health, Gadsden County

Local and State Health Departments: • State of Florida, Hillsborough County • State of Florida, Broward County • State of Louisiana • Jefferson County, Colorado • Clear Creek County, Colorado • State of Florida, Gadsden County

Major Challenges • Salary Range • Productivity Increase • Funding Sustainability • Public Health Loyalty • Retiring Workforce

Opportunities • Defining who we are • Schools of Public Health and Technical Schools • Individual Development Plans • Standards and Measures • Generalist Shift • Regional Resources

Two Challenging Positions for Retainment and Recruitment • Nurses • Health Officers

Public Health Nurses • Clinical Rotations • Regional Resources • Benefits of being a public health nurse

Health Officers • Survive and Thrive • Leadership Series • Local Leadership Groups • Mentorship • Business classes for Health Officers

Big Decisions • Public Health Professionals • Professionals that conduct Public Health • Training in Both

Succession Planning Julie Darnell, PhD, MHSA University of Illinois at Chicago The findings presented in the following slides are from the UIC / SLGE research team: Cahn, Darnell, Turnock (UIC) and Becker, Franzel, Miller Wagner (SLGE)

What is succession planning? We define succession planning as: “ intentionally identifying, developing and retaining individuals for future management and leadership roles”

Types of succession planning • Formal : – Health department has a written document that specifies a formal process for intentionally identifying, developing, and retaining staff for future management and leadership positions. • Informal : – Health department uses an informal process for identifying, developing, and retaining staff for future management and leadership positions but there is no written document or formal process.

Why did we focus on succession planning in LHDs? • Limited research • Long-standing, sustained interest among private companies and increasing interest among public agencies • Pertinent

Methods • Survey of Recruitment and Retention Activities in Local Health Departments – 225 local health departments responded – 22 items on survey focused on succession planning • 6 Case Studies of Promising Practices in Local Health Departments – 3 recruitment & retention – 3 succession planning

What is the need for succession planning? • 1.3 years : median number of years since LHD filled its last key leadership/management position • 56% filled a key position in the past 18 months • 59% of LHDs reported being “very” or “extremely” concerned about finding well-qualified individuals to fill open positions • 62% of LHDs reported being “very” or “extremely” concerned about retaining well- qualified employees in jobs. Source: UIC/SLGE Local Health Department Survey (2012)