Public Health Workforce Recruitment, Retention and Promotion in the Civil Service System

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Public Health Workforce Recruitment, Retention
and Promotion in the Civil Service System
2004 Pfizer Faculty Scholar Award in Public
Health Recipient Patricia M. Sweeney, JD, MPH,
RN Center for Public Health Practice Graduate
School of Public Health University of Pittsburgh
psweeney_at_pitt.edu
Funded by the Pfizer Faculty Scholar Award in
Public Health


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Background

• Healthy People 2010 infrastructure objective
• Incorporate into personnel systems, competencies
  in the knowledge skills and attitudes needed to
  perform the essential public health services
• Public Health Systems Research Agenda
• Impact of civil service laws upon public health
  workforce unknown

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Purpose

• Assess the use of competencies in state public
  health department personnel systems
• Define state public health department personnel
  processes
• Demonstrate the impact of state civil service
  laws upon the public health personnel system

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Phase One Methods
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Phase One Survey Findingsn 24
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Phase One Survey Findings
Reasons positions are difficult to recruit
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Phase One Results

• Entry level Registered Nurse
• Baccalaureate degree w/ no experience
• Associate degree w/ minimal experience
• Senior level Epidemiologist
• PhD, Physician, Senior Scientist
• Manager, Director of Epi program

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Phase Two
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Purpose

• Assess the use of competencies in the state
  public health department personnel processes
• Define state public health department personnel
  processes and responsibilities

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Methods

• Requests made to every US state and territorial
  health department
• Submit job descriptions for entry level
  RN and Senior EPI
• Submit copies of tools used to assess
  candidate appropriateness for employment with
  state public health department

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Methods

• Job candidate assessment materials received from
  38 US state and territorial health departments
• 49 Senior level Epidemiology positions
• 55 Entry level Registered Nurse positions

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Competencies

• Quad Council
• Public health nursing
• AACON
• Baccalaureate nursing
• Council on Linkages
• Public health core
• CSTE and CDC
• Epidemiology

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MAXqda2
Initially Each competency set was entered as a
word list Each assessment tool was scanned into
the software Analysis found 0 matches. NO
state health department assessment tool assesses
registered nurses or epidemiologists for ANY of
the core public health or discipline specific
competencies.as written..
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Data analysis

• Key phrases and key words were isolated from the
  competency statements
• Key phrases and key words inputted into word
  lists and used for competency analysis

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Competencies
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Conclusions

• Current state health department
• personnel assessment tools
• do not address
• the breadth of
• skills, knowledge and attitudes
• needed to meet contemporary
• public health challenges.

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Phase Three
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Purpose

• Define the personnel procedures utilized by state
  health departments for hiring and promotion
• Demonstrate the effect of the states civil
  service laws upon the personnel system of each
  state health department

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Methods
National Survey Phase Three

• Survey questions
• What department in your state conducts the
  identified personnel activities?
• 2. To what extent do your states civil service
  laws affect your state health departments
  ability to conduct the identified personnel
  activities?

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Phase Three Results

• 31 surveys returned representing 29 states
• AL, AK, AZ, CA, CO, GA(2), ID, IN, IA, LA, OK,
  NY, ND, OH, OK(2), PA,WA, WV, WI, RI, SC, VT, US
  VI, VA, MN, MO, NE, NV, NH.

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Phase Three Results

• State Human Resource (HR) Departments
• 90 create health department job classifications
• 87 revise health department job classifications
• 60 can alter health department salaries
• 73 can change personnel processes in response to
  market forces

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Phase Three Results

• State Departments of Health (DOH)
• Almost 90 report they are the hiring authority
• 42 create health department job classifications
• 45 revise health department job classifications
• 42 can alter health department salaries
• 32 can change personnel processes in response to
  market forces

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Phase Three Results

• State DOH prioritize candidates for hire by
• 77 past experience
• 81 formal education
• 36 of State H R Departments and
• 23 of State DOH utilize written tests to assess
  candidates for hiring

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Phase Three Results

• 29 report banding rules not applicable in
  their state
• 68 report use of either a rule of three, six, or
  other banding rule
• 10 of state DOH able to change banding rules
• Requires action by
• State HR Department
• State legislature
• Governor

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Phase Three Results
State DOH promotions determined by
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Phase Three Results

• ¼ of states require legislative action to change
  DOH salaries
• Less than 1/5 (19 ) of state DOH can increase
  salaries for attainment of performance standards

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Phase Three Findings
24 states report that state DOH hiring and
promotion is regulated by civil service laws
n30
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Phase Three Findings

• Hinders
• Salary restrictions
• Inefficient rule of three
• Restrictive ranking/scoring laws
• Minimum qualifications too restrictive
• Lengthy, cumbersome application/testing process

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Phase Three Findings

• No Effect
• Funding is the issue, not laws
• Collective bargaining constrains hiring not civil
  service
• Helps all had revised civil service laws
• Permit immediate offers and salary flexibility
• Position specific recruiting for RNs, EPIs
• Electronic resume submission

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Phase Three Findings

• Impact of civil service laws upon state health
  departments ability to change personnel processes
  in response to market forces affecting the
  recruitment and retention of
• RNs 52 constrains 3 permits
• EPIs 62 constrains 3 permits

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Public Health Workforce Recruitment, Retention
and Promotion in the Civil Service System
2004 Pfizer Faculty Scholar Award in Public
Health Recipient Patricia M. Sweeney, JD, MPH,
RN Center for Public Health Practice Graduate
School of Public Health University of Pittsburgh
psweeney_at_pitt.edu
Funded by the Pfizer Faculty Scholar Award in
Public Health