Minnesota recognizes that in order to advance optimal and equitable health outcomes for MCH populations, we must recruit and retain a skilled and diverse workforce that is representative of Minnesota’s communities. Strengthening Minnesota’s workforce requires a multifaceted approach in addition to recruitment and retention, including understanding and being responsive to the training and development needs for Title V staff and partners, as well as innovations in staffing structures that include key partnerships and pathways to the MCH workforce.

Recruitment and Retention of Staff

The Minnesota Department of Health (MDH) hires approximately 200 employees every year to fulfill its mission of protecting, maintaining, and improving the health of all Minnesotans. MDH, including the Child and Family Health Division (CFH), recruitment efforts have expanded in recent years with an aim to increase the diversity of its’ workforce and be representative of Minnesota’s communities – especially those communities who are most impacted by health disparities. This has included changes in the following:

• Hiring practices – For example, qualifications on job postings have been modified to include relevant job experiences rather than focusing on educational requirements.
• Outreach efforts – For example, posting open positions on job boards that are likely to be frequented by persons from diverse backgrounds and sharing job announcements through listservs that reach specific communities.

Minnesota is also focused on amplifying retention efforts for all staff, but particularly staff who are representative of Minnesota’s communities most impacted by health disparities, and historically less likely to access careers in public health. Responses from MDH’s 2020 Employee Engagement Survey, with an 84% response rate, provide guidance on areas the CFH Division can focus on, including the following:

• 77% of respondents reported being highly satisfied/satisfied in Overall Employee Satisfaction
• 81% of respondents indicated that having a “Good relationship with immediate supervisor” was the most important to their job satisfaction, followed by “Flexible working conditions (e.g., flex schedule, telecommute)” (77%), and “Good relationships with co-workers (72%)
• 64% of respondents indicated they have “Adequate training opportunities available”
• 35% of respondents indicated “Career advancement opportunities exist at MDH”
• 73% of respondents reported “Very Likely/Likely” that If they had a choice between working at MDH or somewhere else, they would remain working at MDH through the next 12 months.
• 53% of respondents indicated Overall, my division/office works to actively create an environment that cultivates and/or champions…my growth as an employee
• 47% of respondents indicated Overall, my division/office works to actively create an environment that cultivates and/or champions…my leadership development as an employee

In 2021, the CFH Division aimed to increase employee engagement and satisfaction through the development of several workgroups, as indicated by staff interest through a division-wide employee survey. The following groups were created:

• Black, Indigenous, and People of Color (BIPOC) Community of Practice – whose aim is to provide a space for BIPOC staff and allies to support one another and amplify the voices and experiences of BIPOC CFH staff and the BIPOC communities we serve. The workgroup also works to create learning opportunities about race, equity, and social justice for CFH staff; provide recommendations to leadership about how to create a more equitable work environment; and advocate for racial equity in public health practice, systems, and policies; and welcome white allies who share these goals.
• Collaboration and Connections Workgroup – whose aim is to improve communication, increase the exchange of ideas, and create a sense of community among staff through modeling collaborative behavior; supporting a sense of community; providing opportunities to enhance collaborative skills; creating a cooperative culture; and fostering team building by sharing strategies, activities, and tools for teams to use in their work together.
• Health Equity Measurement Workgroup – whose aim is to provide a forum for communication and infrastructure for sharing and creating resources that can increase valid and efficient utilization of equity data and help ensure continued support for improving health equity.
• New Employee Orientation Workgroup – whose aim is to create a welcome platform to help new staff get connected to other staff, as well as opportunities and resources, including updating the CFH New Employee Manual and creating quarterly cohorts of new Division staff to facilitation connection and onboarding.  

Training and Growth Opportunities

MDH, including the CFH Division, is committed to fostering a learning environment in which employees develop professionally and personally. MDH encourages building key competencies within our workforce – including key public health competencies – by providing diverse internal opportunities for learning and personal development, as well as encouraging external learning opportunities that fit staff goals and responsibilities.

The Workforce Development Team within the Human Resources Department at MDH is responsible for developing and carrying out MDH’s Workforce Development Plan. The Workforce Development team builds key competencies within the MDH workforce by providing a range of training, services, and resources. Additionally, the Learning and Development Team within the Workforce Development Team “is committed to empowering employees by providing growth and development opportunities”. 

Employee development is an ongoing process which includes a variety of activities and experiences designed to improve and/or increase the skills, knowledge, and abilities of employees. Employees are required to develop individual development plans as a part of their annual performance review process. Individual development plans include development goals and an action plan of the learning activities the employee will complete to meet those goals. Typical learning activities include classroom instruction, independent study, e-learning, project or task force assignments, supervisory coaching, on-the job training, orientation, job rotation, and attending conferences.

Workforce Innovation

Governor’s One Minnesota Council on Inclusion and Equity – Promoting an Equitable State Workforce in Minnesota

On his second day in office, Governor Tim Walz renewed the state’s commitment to equity and inclusion through his first Executive Order, which established the One Minnesota Council on Inclusion and Equity. The Council is tasked with making sure institutions across the state look like and support the people we are working for – working toward the goal of creating an inclusive state workforce that retains at least 75% of newly hired employees for at least two years and achieves this retention rate for American Indians, people of color, people who have a disability, and veterans by 2022. The Council looks at supporting metrics like turnover, proportion of the state workforce, proportion of state managers, proportion of employees exiting state service, inclusive climate survey, and proportion of employees earning promotion. Over the last two years, the Council has worked on developing a long-term plan outlining recommendations to drive diversity, equity, and inclusion efforts throughout the state enterprise – release of this plan is estimated for late 2023 or early 2024.  

Student Internships

The CFH Division is committed to the growth and development of emerging public health professionals – particularly those with interest in MCH – through partnerships with local higher education institutions, as well as national programs such as HRSA MCHB’s Title V Intern program and CityMatCH’s Intern program. These opportunities create pathways for learning and connection for students interested in a public health career and are supported across the Division. The following are examples of student partnerships in all five sections of the Division.

• Division-wide - Through partnership with the University of Minnesota’s (UMN) Center for Leadership in MCH, CFH regularly has several students on deployments from the Center during their graduate studies. These students work closely with CFH employees on special project during their 1-2 years with the Division. Additionally, the Divisions regularly hires student workers to provide support to a variety of programs and projects.
• Director’s Office –Through partnership with UMN’s Center for Leadership in MCH, student interns and workers have supported Title V Needs Assessment and epidemiology work. For example, one student previously created briefs on Title V priority areas, including adding sections to emphasize systemic factors contributing to disparities in health outcomes.

• MCH Section - Through partnership with UMN’s Center for Leadership in MCH, student interns and workers have supported critical MCH public health initiatives including developing a survey that will be used to capture doulas’ experiences working throughout the state and conducting a literature review on fetal development and reproductive health. Additionally, the MCH Section has a new Memorandum of Understanding (MOU) in place with Metro State University to host nursing students as part of their clinical practice requirements, as well as begun conversations with St. Thomas University’s School of Nursing to host nursing students as part of community experiences for women’s health and pediatric courses. Student Workers are critical to MCH work, including:
  • On-going data analysis and writing projects for the Title V Needs Assessment and Annual Report and Plan.
  • Ongoing support for the operation of the Minnesota Pregnancy Risk Assessment Monitoring System.
  • Ongoing support to the Child and Teen Check-Ups training program including updating materials, support to training events, and researching new topics.
• CYSHN Section - Through partnership with UMN’s Center for Leadership in MCH, student interns and workers regularly support staff and programs within the CYSHN Section on a variety of projects, including:
  • Supporting community partnerships with the Sickle Cell Foundation through the SCD Data Collection Program.
  • Analyzing and reporting data on special topics (e.g., publication in MMWR on Delayed Identification of Infants who are Deaf or Hard of Hearing).
  • Expanding opportunities for parent to parent support for Children and Youth with Special Health Needs.

Additionally, CYSHN staff take advantage of opportunities to provide reciprocal learning by serving as mentors through the UMN School of Public Health, and providing annual lectures to nursing and public health students at the UMN School of Nursing, UMN Center for Leadership Education, and Gustavus Adolphus College.

• Women, Infant, and Children (WIC) Section – Through partnership with UMN’s Center for Leadership in MCH, Public Health AmeriCorps, and HRSA MCHB’s Title V Intern program, student interns and workers regularly support staff and programs within the WIC Section on a variety of projects, including:
  • Helping with data analysis, survey analysis and reporting.
  • Developing a webpage for WIC-related research and evaluation resources.
  • Conducting a survey of Minnesota hospital maternity care practices, including use of donor human milk in hospitals, as well as conducting in-depth interviews with 9 lactation care providers - their findings are summarized in the Infant Feeding Practices Survey.
  • Comparing rates of preterm birth and low birth weight among Medicaid births between those who participated in WIC with those who did not participate in WIC.
  • Looking at associations with housing instability and infant feeding practices (formula-feeding) in post neonatal mortality among Minnesota births and among WIC participants.
  • Completing papers on (1) the impact of WIC breastfeeding peer programs on breastfeeding rates in Minnesota rural counties, and (2) trends in maternal weight disparities: differences in rural and urban Minnesota residents.
  • Analyzing factors that may influence infant feeding across two pregnancies for WIC participants.
  • Looking at how participation in the peer program may have had impacts beyond breastfeeding before and during the pandemic, for example in participation and/or utilization of benefits.

• Family Home Visiting (FHV) Section – Through various partnerships, student interns and workers regularly support staff and programs within the FHV Section on a variety of projects, including:
  • Research
  • Evaluation
  • Communities of Practice

Additionally, FHV staff take advantage of opportunities to provide reciprocal learning by serving as mentors through the UMN-Master of Public Health program.

External Workforce Development Opportunities

In its’ commitment to foster a learning environment, MDH and CFH support external workforce development opportunities for staff with to build capacity for meeting program, community, and population needs. Several key partners that Title V staff have continued to seek growth and technical assistance opportunities with, and are currently engaged with, include the following:

• CityMatCH – Title V and other CFH Division staff are participating in CityMatCH’s Alignment for Action Learning Collaborative for Region 5. The overarching goal of the collaborative is to “align plans, activities, partnerships as applicable to push MCH more efficiently and effectively towards achieving health equity by 2030”. The collaborative includes partnership with other state and local-level organizations, efforts, and people, as applicable, as well as participation in a Culture of Equity Assessment with Dr. Vijaya Hogan.
• Maternal Health Learning & Innovation Center at UNC-Chapel Hill – Through a Supporting State-led Maternal Health Innovation Grant from HRSA, MDH’s Innovations for Maternal Health Outcomes in Minnesota (I-MOM) staff are participating in a Learning Institute & Leadership Academy sponsored by the Maternal Health Learning & Innovation Center. The purpose of I-MOM is to “align and strengthen the implementation of innovative, data-driven, community-informed and supported perinatal health programs to improve outcomes for communities experiencing the highest rates of disparities.
• National Maternal and Child Health Workforce Development Center at UNC-Chapel Hill – Title V and other Division staff are participating in a workforce development project through the National Maternal and Child Health Workforce Development Center. This project, called a Learning Journey, connects team members to tools, resources, and support for tackling a self-identified challenge they'd like to address. For our Minnesota team, this project is building capacity and shared approaches for embedding and elevating equity within our work.