Public Health Recruitment, Retention, and Workforce Development

WY MCH and MCH Epi have current staff sizes of eleven and four, respectively. This includes a term-limited CDC-assigned public health associate and a CSTE Applied Epidemiology Fellow. While staff turnover isn’t uncommon, it has slowed. Currently 40% of staff have been with WY MCH or MCH Epi for two years or less, down from 53% reported in last year’s submission. WY PHD tracks vacancy and turnover data for its 290 positions (including temporary COVID-19 staff). As of April 24, 2023, the vacancy percentage for PHD was 19.3% (56 vacant positions) and is virtually unchanged from last year at the same time. The turnover rate (number of separations in the past year divided by the number of positions), however, has declined from 15.2% reported in the last submission to 9.7% this year, representing 28 separations in the past year (down from 44). This speaks to an overall improvement in retention over the last year.

Also of note, in the 2023 budget session, the Wyoming Legislature authorized a second compensation increase for state employees, effective July 2023. Eligible employees will receive a base pay increase or a one-time bonus. The 2023 and 2022 compensation increases are intended to bring state employee wages into greater alignment with market values, which should aid retention.

WY MCH experienced some changes in staffing during the FFY22 year, to include both the Title V and CYSHCN directors. However, it has been relatively stable since then, with only one recent staff turnover.

When WY MCH has vacancies, the reach of the job posting is broadened to ensure qualified candidates are found. Job postings are distributed through division listservs, partner organizations, shared on the WY MCH Facebook page, and in the WY MCH quarterly newsletter whenever applicable. WY MCH has also purchased job posting support through the Association of Maternal and Child Health Programs (AMCHP) job board. Further, the WY PHD has also established a direct feed with PublicHealthCareers.org for all public health vacancies.

Challenges

The Wyoming public health workforce also faces unique challenges, such as geographic dispersion of the workforce, remote locations that challenge recruitment efforts, wage disparities between public and private sector, an aging workforce, lack of agency or division-level social media and streamlined public health communication, and boom-and-bust economic cycles which can lead to governmental budget reductions. All of these factors impact the ability to recruit and retain qualified staff, and can cause service delivery interruptions and setbacks during periods of transition.

WY MCH is not immune to these challenges. For this reason, WY MCH is prioritizing workforce development in a number of ways. The WY MCH Unit Manager works to align with division-level workforce development, and recruitment and retention efforts. The unit strives to have a culture that values staff, values rest, supports staff recovery and resilience, considers staff wellbeing in all aspects of our operations, and creates and maintains an environment of inclusivity and belonging. It further requires WY MCH to adopt practices and training/development that align with this culture. In FFY22 and beyond, WY MCH is committed to and/or promotes:

• “No-meeting” Fridays for the unit to reduce meeting fatigue and provide more time and space for accomplishing desired outcomes and engaging in professional development;
• A shared commitment to, and expectations for, “unplugging”
• Staff wellness, by encouraging staff to take advantage of division or agency-wide policies and practices that support employee health (e.g., staff can combine breaks for physical activity under agency policy, participate in wellness activities, etc); and
• Staff participation in a division-wide resilience journey, facilitated by the Resilience Institute.

Assessments and Needs

MCH Staff Expertise and Identified Needs

Following leadership transition in FFY22, the WY MCH team convened on December 1, 2022, for a team retreat, facilitated by public health consultant, Lolina Inc. During the retreat, staff developed a greater understanding of their individual and collective strengths, and worked together to define their needs. When asked what the team needs to be successful and effective in our work, the following were identified:

• Continuous quality improvement and data capacity
• Public health communication infrastructure and skills
• Community engagement and relationship building
• Authentic and culturally responsive tribal engagement and relationship building
• Health equity skills and opportunities
• Collaboration among our team and with other public health programs and partners

When reviewing these needs across the core public health functions identified on our Strategy Map, there is clear alignment with between staff needs and the following core functions:

• Equity, Justice, and Accessibility
• Partner, Family, and Community Engagement
• Data Capacity, Use, and Evaluation
• Health Communication and Education

To prepare for the retreat, WY MCH also requested a composite of the MCH Navigator scores across any existing staff who had taken the assessment. Those results indicated a greater gap between knowledge and skill for the following MCH leadership competencies, in order of largest gap to smallest:

• Cultural competency
• Critical thinking
• Policy
• Family-professional partnerships

These findings further underscore some of our identified areas of staff development or have significant cross over (e.g., equity, justice and accessibility, and cultural competency).

Public Health Core Competencies

WY PHD last completed a public health core competency assessment across all staff in early 2023. This assessment reflected the updated version of the core competencies revised and adopted by the Council on Linkages Between Academia and Public Health Practice in 2021. Participating staff each received an individual report, which can be used to inform goal-setting and professional development needs. Additionally, WY MCH received aggregate results across all participating staff.

MCH Unit Aggregate Core Competency Results

Aggregate responses illustrate a collective strength in community partnership. This is an area WY MCH can leverage and expand competency. Areas for continued growth and improvement are analytic/assessment, communication, and management and finance skills.

Public Health Workforce Interests and Needs Survey

Public Health Division staff, including WY MCH also participated in the 2021 iteration of the Public Health Workforce Interests and Needs Survey (PHWINS). The Division did not meet the benchmark response rate to receive a state-specific report. The national findings indicate that nearly one in three public health employees were considering leaving their organization in the next year, with work overload/burnout and stress being the second and fourth reason for leaving, respectively.

While the PHWINS administrators have since removed the Workforce Groups reports, which included MCH-specific needs, due to data quality issues, the data for MCH originally indicated that nationally:

• 22% of the MCH public health workforce was considering leaving, with work overload/burnout and stress being top reasons for considering leaving
• Key training needs for MCH supervisors included budget and financial management, systems/strategic thinking, change management, community engagement, cross-sectoral partnerships
• Key training needs for MCH non-supervisors: the same as above but with change management and systems/strategic thinking in reverse order
• Only about half of the MCH workforce agreed that leadership staff and employees communicate well and only 46% agreed that creativity and innovation are rewarded
• 18% of the MCH workforce rated their mental health as either poor or fair

Looking instead at Regions 7 and 8 combined, across all workforce groups, we see that that:

• 28% of the public health workforce was considering leaving in one year, with pay, work overload/burnout, and stress being top reasons
• Key training needs for public health supervisors included budget and financial management, systems/strategic thinking, justice, equity, diversity and inclusion, community engagement, change management, and policy engagement.
• Key training needs for non-supervisors: budget and financial management, change management, systems/strategic thinking, community engagement, and policy engagement
• About half of the workforce agreed that leadership staff and employees communicate well and that creativity and innovation are rewarded
• 26% of the workforce rated their mental health as either poor or fair

Meeting WY MCH Needs

In addition to fostering a culture that values and supports the staff, WY MCH established a 2021-2025 Title V Priority under the Cross-Cutting/Systems Building Domain: Strengthen MCH Workforce Capacity to Operationalize MCH Core Values.

Identified strategies under this priority will support ongoing staff assessment of professional development needs and require all new staff to complete the MCH Navigator self-assessment within six months of hire.

In FFY22, WY MCH developed a new employee orientation to also support onboarding and introduction to core competencies and WY MCH programs and values. WY MCH leadership may request technical assistance from the MCH Workforce Development Center to further develop new employee orientation and evaluate increased knowledge and/or skills related to key MCH competencies and WY MCH core values.

WY MCH staff are also encouraged to participate in training programs and professional development opportunities such as the AMCHP’s Leadership Lab or CityMatCH Leadership and MCH Epidemiology Conference.

WY MCH continues to support employee development through the use of StrengthsFinder 2.0, an online assessment to assist individuals in identifying, understanding, and maximizing their unique combination of strengths. StrengthsFinder assesses four domains of leadership strength (executing, influencing, relationship building, and strategic thinking) plus 34 themes, which are all critical to the overall effective functioning of a leadership group. All WY MCH staff complete the StrengthsFinder assessment upon hire and participate in an Introduction to Strengths session to learn about the assessment tool and receive their results from a trained coach. Additional strengths coaching and/or consultation is available for staff as requested. This offering is especially important in order to support a small staff tasked with expansive priorities. WY MCH currently contracts with Lolina, Inc. to offer this important workforce development opportunity to all staff. In the current and coming year of the grant cycle, WY MCH will consider how to adapt orientation and onboarding support for external partners, family leaders, and subrecipients.

During the 2023-2024 state performance management initiative (PMI) goal-setting period, WY MCH staff will determine how the broad findings across assessments, needs, and broader division expectations can be integrated into goals. [GJ1]

Finally, the WY MCH is developing a broader workforce development plan that will help us connect priorities to training and development, as well as further our commitment to team development. The plan also seeks to align with public health and MCH leadership competencies and MCHB’s strategic plan workforce recommendations.

Training Needs of MCH’s PHN Partners

Formerly suspended quarterly performance reports were reinstated in FFY22. The quarterly performance report asks about technical assistance and training needs related to MCH services. WY MCH will work with PHN on identified training needs, with WY MCH program managers serving as subject matter experts and providing training as needed and/or requested. Additionally, WY MCH staff will seek training opportunities that align with emerging needs, such as substance use training and support for home visitation and Plans of Safe Care implementation.

Innovations in Staffing Structures

While a small staff size presents capacity and resource challenges, it also allows for increased collaboration across population areas and improved cohesion related to advancing a shared vision. Often, decisions about future programming are made as a team instead of by an individual program manager.

WY MCH will continue leveraging opportunities to increase workforce capacity through internships, CDC’s Public Health Associate Program (PHAP), and AmeriCorps Volunteers in Service to America (VISTA) volunteers. A few representative examples include:

• Partnership with University of Wyoming School of Social Work to host bachelor and master-level students to meet MCH priorities. Another unit manager possesses the credentials to serve as the preceptor for these students in partnership with WY MCH.
• Participation in the Title V Internship Program through National MCH Workforce Development Center’s Title V Internship Program. WY MCH’s 2023 internship application focused on researching evidence-based strategies to reduce tobacco use and promote cessation during pregnancy and postpartum, particularly in rural and frontier communities. The WY MCH application was selected and matched for FFY23 completion.
• In FFY22, WY MCH applied for and was matched with another CDC PHAP associate. The associate is assigned to the YAYAHP to address sexual health and connectedness priorities. The associate began their time with WY MCH in FFY23 and will continue through FFY24.

[GJ1]Do you want to delete this since there are no goals.