Think Big When Applying for Infrastructure Funding: 12 Recommendations for Health Agencies

June 30, 2022 | Liljana Baddour

Public health agencies have an opportunity to recruit for and retain a diverse and skilled workforce. As new funding opportunities emerge, such as the CDC Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems grant, ASTHO recommends a focus on proof, people, and processes.

The following recommendations are based on a five-year funding cycle, which allows agencies to invest in their workforce, demonstrate the need and value for new positions and/or benefits, and make progress on longer-term workforce improvements.

Proof

Use this grant to prove your impact with performance measures and data trends.

1. Evaluate and communicate return on investment

Include evaluation alongside your innovative, big ideas to demonstrate proof of concept and return on investment. Evaluating the success of these strategies will allow for their continued use and long-term adoption. Identify baseline measures, collect relevant data, and track progress so you can tell your story widely. State and federal legislators and the public through media outlets, social media, as well as through partners including ASTHO. Embed successful new strategies into routine, long-term practices.

People

Protect your investment in your greatest asset—people—and make processes, information, and systems employee-centric.

2. Work closely with those who serve your workforce

Build workforce support teams to improve organizational culture, retention, internal communications, quality improvement, and a people-focused team. Situate your workforce staff partners closest to leadership. Invest in infrastructure to maintain communication and to understand risk and opportunities.

3. Make employee wellbeing and trauma-informed approaches part of your agency culture

Use data such as PH WINS data to identify priorities for addressing burnout, morale, retention, and recruitment. Identify evidence-based, innovative, proactive, and responsive initiatives to address broad workforce wellness. Train, use, and support trauma-informed approaches in internal management practices and externally. Support and train leadership and management to supervise and coach with clear performance goals and measures of success paired with open discussions to support employees in reaching their goals.

4. Prioritize professional development opportunities

Team members and managers should identify professional development opportunities beyond compliance training. Artificial intelligence will change our workforce needs in the near future. Start to plan with this in mind. Invest in mentorship programs and leadership training for all staff—not just for people leaders. Promote resources such as listservs, podcasts, learning communities, and other training modalities for different types of learners. Employees often depart due to difficulties with management. Therefore, managers should receive coaching, resources, training, and job aids to strengthen their leadership skills.

5. Build ongoing learning opportunities and support to increase diversity, equity, and inclusion

Incorporate and strengthen evidence-based practices to reduce biases and encourage equitable recruitment, hiring, and promotions. Include training, job aids, and resources in onboarding and ongoing growth opportunities to equip staff with an equity-minded lens. Ensure staff have internal technical assistance or coaching to support their development in equity, hiring diverse teams reflective of the populations they serve, and building a psychologically safe and inclusive team culture.

6. Support loan-forgiveness programs

Offer information and support for current and potential team members to take advantage of the Public Service Loan Forgiveness Program. Consider how the health agency could provide a matched percentage towards repayment as a benefit starting after an eligibility period that is tied to retention at the health agency for a set amount of time. Explore creative benefits to offer to new and current team members especially if pay caps are restrictive.

7. Strengthen organizational infrastructure to support the employee experience

Strengthen infrastructure capabilities, including internal and external communications, to support the employee experience. Encourage connections and synergy within the agency to provide information, improve knowledge sharing, build trust, and engage employee participation and feedback. Tell the story of your work to show the value that health agency investments bring to the public to inspire the future public health workforce. Consider opportunities to elevate organizational, employee, and team rewards and recognition.

Processes

Ineffective or unclear processes can lead to frustration and, over time, burnout. Infrastructure funding can provide the time and resources to address some of the leading frustrations in these ways:

8. Optimize internal processes and information accessibility

Avoidable frustrations can lead to or enhance burnout and stress. Leverage new funding to integrate or build automated systems and processes, and ensure information is accessible. With ongoing hiring, ensure processes are employee-centric and that information and processes are accessible, understandable, and current. Use quality improvement tools and methods to improve processes, ensuring those involved in the process are on the improvement team. Invest in processes that enable high efficiency remote or hybrid work arrangements. Prepare and plan as artificial intelligence begins to impact more of our processes and workforce.

9. Identify a lead to examine policy and practice (including Civil Service) reforms affecting recruitment and retention

Evaluate pay scales, job descriptions, position requirements (ensuring qualifications are evidence-based and equitable practices), processes, inefficiencies, and legacy practices versus regulations. Work with process owners or Civil Service to determine reforms to modernize and address challenges to recruitment and retention.

10. Invest in enhanced recruitment and hiring practices

Improve recruitment strategies including evaluating successful candidates’ and high performers’ recruitment experiences. Ensure positions are competitive in the job market. Stay competitive by providing total remote or hybrid work environments, or provide relocation costs. If pay rates have unavoidable caps, consider creative compensation options such as loan or tuition payment, professional development, certifications, and mental health support. Expand recruitment through posting on a national public health careers website with funding for recruitment subscription models. Shore up staffing gaps by contracting with partners, such as public health institutes, universities including HBCUs, staffing agencies, and foundations. Review position requirements and update them to meet modern market standards.

11. Build up mental health supports as a critical component of employee well-being

To minimize public health workforce burnout, moral injury, and turnover, invest in strategies to support the mental health and wellbeing of your workforce including at the organizational level. Strategies may include dedicated staffing, partnerships or contractors, updating policies and procedures, internal communications, employee assistance programs, recognition and gratitude, therapy animals, peer groups, and funds for home office equipment. Ensure holistic behavioral health resources are widely available to all staff.

12. Evaluate and ensure your agency’s modernization to provide the foundational capabilities including data infrastructure

Ingrain people-centric practices to collect training needs information that is actionable, followed through upon, funded, and staffed. Modernize your data infrastructure to deploy scalable, flexible, and sustainable technologies to collect, analyze, and disseminate data. Ensure team members are connected to onboarding, training, and technology in data and informatics.