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THE CLIENT
North Carolina Association of Local Health Directors Region 7 comprises seven Local Health Departments (LHDs) in north/central North Carolina. Participating counties include Franklin, Granville, Johnston, Nash, Vance, Wake, Warren, and Wilson representing 1.78 million residents. T he Lead LHD for Region 7 is Granville Vance Public Health, a district health department which serves both Granville and Vance counties. Region 7 is representative of North Carolina in terms of county population, population density, and economic viability.
BACKGROUND
Beginning in March 2023, Health Management Associates (HMA), Evergreen Solutions, LLC, and Trailhead Strategies (collectively, the “HMA team”) partnered with Region 7 to assist with efforts to improve its public health workforce. These partnered projects included the (1) Workforce Investment and Modernization Study, which aimed to improve the competitiveness and retention of the public health workforce in Region 7; (2) the Cost Study to assess Region 7’s capacity to provide public health services and estimate total costs associated with delivering Foundational Public Health Services and Capabilities (FPHSCs); and (3) a supplementary Labor Market Analysis which collected data on the current state and projected needs of the public health workforce. These projects (shown in Figure 1) provide support for each county within Region 7 to create a scalable and flexible approach for implementing future changes in its public health workforce.
APPROACH
To complete the Workforce Investment and Modernization Study, the HMA team implemented a multi-phased approach to develop a set of workforce retention recommendations, including conducting a class and compensation assessment, market survey, qualitative interviews with regional staff to assess workforce perceptions, and a literature review of peer-reviewed best practices and cost methodologies to develop two reports. The effort required bringing together experts in public health workforce and services, as well as local staff who understand the unique nature of North Carolina’s individual counties. The strong partnership and rapport established throughout the project allowed everyone to effectively tailor recommendations and final products to ensure that they would be effective and actionable for Region 7 to both invest in and sustain a public health workforce.
For the Cost Study, HMA expanded on one such recommendation which advised that Region 7 counties develop a 5- to 10-year plan to promote public health workforce class and compensation competitiveness. To help accomplish this, HMA developed the Cost Study Tool to assess Region 7 LHDs’ current capacity for providing FPHSCs and support each county within the Region to create a scalable and flexible approach for implementing future changes in its public health workforce. To develop the Cost Study Tool, the HMA team conducted a literature review of various public health cost methodologies to determine the most applicable one for use in this work, resulting in the development and refinement of the Cost Study Tool to estimate the 5-year costs of providing FPHSCs.
Finally, the HMA team also conducted the Labor Market Analysis to enhance Region 7’s understanding of the current state and projected needs in the North Carolina public health system and, as a result, inform long-term decision-making and strategic planning (e.g., taking proactive measures to address potential shortages or shifts in skill requirements).
TESTIMONIAL
“HMA provided Region 7 with a carefully constructed evaluation of LHDs’ recruitment and retention practices, recommendations for modernization efforts, and the tools and data needed to quantify current and future costs and staffing to provide FPHSCs. HMA’s subject matter expertise and understanding of our individual health departments resulted in an integrated plan for modernizing our health departments as we advocate for and support an incredible public health workforce in North Carolina now and in the future.”
Lisa Macon Harrison, Health Director, Granville Vance Public Health
RESULTS
For each project, the HMA team developed a robust report of quantitative and qualitative findings associated with the project’s objectives.
For the Workforce Investment and Modernization Study, this included summaries of the class and compensation results for each county in Region 7 and qualitative interviews with public health staff. The report also included 15 recommendations related to: class and compensation; strategic planning, evaluation, and continuous quality improvement; recruitment and human resource practices; retention and workplace culture; local and regional partnerships and shared services; and technology, equipment, and physical location.
For the Cost Study, the report summarized HMA’s literature review of public health cost methodologies and described how the HMA team applied the selected methodology to develop and refine a prototype data-driven tool to estimate the costs of providing FPHSCs in each Region 7 county. Concurrent with the report, the HMA team also developed a user guide to accompany the Cost Study Tool, both of which are to be distributed for Region 7 LHDs’ use. Finally, the HMA team provided a report detailing the following Region 7 factors:
- Region Overview
- Occupation Selection
- Labor Market Growth and Occupation Trends
- Job Posting Data
- Major Employers
- Demographics (Race and Ethnicity, Gender, Age)
- Skill Analysis
- Occupation Forecasting
- 10-Year Analysis
- Educational Alignment
- Aging Population
HMA believes that, in partnership, these studies will provide each LHD of Region 7 with the tools necessary to develop a sustainable, actionable public health workforce that will be prepared to continuously serve and improve the health of all North Carolinians now and in the future.
THE CLIENT
North Carolina Association of Local Health Directors Region 7 comprises seven Local Health Departments (LHDs) in north/central North Carolina. Participating counties include Franklin, Granville, Johnston, Nash, Vance, Wake, Warren, and Wilson representing 1.78 million residents. T he Lead LHD for Region 7 is Granville Vance Public Health, a district health department which serves both Granville and Vance counties. Region 7 is representative of North Carolina in terms of county population, population density, and economic viability.
BACKGROUND
Beginning in March 2023, Health Management Associates (HMA), Evergreen Solutions, LLC, and Trailhead Strategies (collectively, the “HMA team”) partnered with Region 7 to assist with efforts to improve its public health workforce. These partnered projects included the (1) Workforce Investment and Modernization Study, which aimed to improve the competitiveness and retention of the public health workforce in Region 7; (2) the Cost Study to assess Region 7’s capacity to provide public health services and estimate total costs associated with delivering Foundational Public Health Services and Capabilities (FPHSCs); and (3) a supplementary Labor Market Analysis which collected data on the current state and projected needs of the public health workforce. These projects (shown in Figure 1) provide support for each county within Region 7 to create a scalable and flexible approach for implementing future changes in its public health workforce.
APPROACH
To complete the Workforce Investment and Modernization Study, the HMA team implemented a multi-phased approach to develop a set of workforce retention recommendations, including conducting a class and compensation assessment, market survey, qualitative interviews with regional staff to assess workforce perceptions, and a literature review of peer-reviewed best practices and cost methodologies to develop two reports. The effort required bringing together experts in public health workforce and services, as well as local staff who understand the unique nature of North Carolina’s individual counties. The strong partnership and rapport established throughout the project allowed everyone to effectively tailor recommendations and final products to ensure that they would be effective and actionable for Region 7 to both invest in and sustain a public health workforce.
For the Cost Study, HMA expanded on one such recommendation which advised that Region 7 counties develop a 5- to 10-year plan to promote public health workforce class and compensation competitiveness. To help accomplish this, HMA developed the Cost Study Tool to assess Region 7 LHDs’ current capacity for providing FPHSCs and support each county within the Region to create a scalable and flexible approach for implementing future changes in its public health workforce. To develop the Cost Study Tool, the HMA team conducted a literature review of various public health cost methodologies to determine the most applicable one for use in this work, resulting in the development and refinement of the Cost Study Tool to estimate the 5-year costs of providing FPHSCs.
Finally, the HMA team also conducted the Labor Market Analysis to enhance Region 7’s understanding of the current state and projected needs in the North Carolina public health system and, as a result, inform long-term decision-making and strategic planning (e.g., taking proactive measures to address potential shortages or shifts in skill requirements).
TESTIMONIAL
“HMA provided Region 7 with a carefully constructed evaluation of LHDs’ recruitment and retention practices, recommendations for modernization efforts, and the tools and data needed to quantify current and future costs and staffing to provide FPHSCs. HMA’s subject matter expertise and understanding of our individual health departments resulted in an integrated plan for modernizing our health departments as we advocate for and support an incredible public health workforce in North Carolina now and in the future.”
Lisa Macon Harrison, Health Director, Granville Vance Public Health
RESULTS
For each project, the HMA team developed a robust report of quantitative and qualitative findings associated with the project’s objectives.
For the Workforce Investment and Modernization Study, this included summaries of the class and compensation results for each county in Region 7 and qualitative interviews with public health staff. The report also included 15 recommendations related to: class and compensation; strategic planning, evaluation, and continuous quality improvement; recruitment and human resource practices; retention and workplace culture; local and regional partnerships and shared services; and technology, equipment, and physical location.
For the Cost Study, the report summarized HMA’s literature review of public health cost methodologies and described how the HMA team applied the selected methodology to develop and refine a prototype data-driven tool to estimate the costs of providing FPHSCs in each Region 7 county. Concurrent with the report, the HMA team also developed a user guide to accompany the Cost Study Tool, both of which are to be distributed for Region 7 LHDs’ use. Finally, the HMA team provided a report detailing the following Region 7 factors:
- Region Overview
- Occupation Selection
- Labor Market Growth and Occupation Trends
- Job Posting Data
- Major Employers
- Demographics (Race and Ethnicity, Gender, Age)
- Skill Analysis
- Occupation Forecasting
- 10-Year Analysis
- Educational Alignment
- Aging Population
HMA believes that, in partnership, these studies will provide each LHD of Region 7 with the tools necessary to develop a sustainable, actionable public health workforce that will be prepared to continuously serve and improve the health of all North Carolinians now and in the future.
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