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Workforce Development: Public Health Career Maps

State: OR Type: Promising Practice Year: 2020

Multnomah County Health Department (MCHD) is the designated local public health authority for Multnomah County. Multnomah County, located in the northwest corner of Oregon, is home to the state's largest and fourth largest cities (Portland and Gresham, respectively). Despite being the smallest in square miles, Multnomah is the state's most populous county (811,880 residents). The population is 7% African / African American,9% Asian, 11% Latino, 3% Native American / Alaskan Native, 1% Native Hawaiian / Pacific Islander, and 71% White non-Latino. As the social and economic hub of Oregon, Multnomah County works closely with neighboring counties in the Portland metro area, providing services for a population of over 1.8 million people.  More information about MCHD can be found at https://multco.us/health.

MCHD operations are guided by core values of honoring individual and community-level approaches to health and well-being, building strong organizational partnerships across the community, addressing the underlying social inequities that determine good health, and emphasizing prevention and early intervention. Organizational goals seek to assure that individuals, families, and communities gain greater control of the factors that influence their health, and that the department continually adapts to the population in order to serve as an effective and accountable local public health authority and provider of community health services.

MCHD is the State's largest local health department, with approximately 1,600 employees. The department is made up of eight (8) divisions, including the Public Health Division, Mental Health & Addictions Services, Corrections Health and Integrated Clinical Services.

The Public Health Division is made up of approximately 300 employees.  Workforce development is a critical public health issue and priority for the division, largely due to an aging workforce who will be retiring over the next 5 10 years.  It was important to develop a process to intentionally identify, develop, train and retain individuals for future management and leadership roles in order to create a well-rounded pool of candidates for promotional considerations and succession planning.

For this reason, we proposed to develop Public Health Career Maps with the objective of educating staff, interns and students on the various career paths in public health.  The goal of this project was to develop a toolkit for supervisors to explain the opportunities for professional growth available to employees in a specific classification.  In addition, career maps could also be used to show basic education and skills required for various paths in public health for students interested in pursuing healthcare careers. 

While there is a general relationship between time and opportunities, there is no direct, one for one relationship between any particular job, training, education level, or opportunity and the career path highlighted in the career maps.  Supervisors can use the maps any time an employee has questions about career paths or opportunities.  While the maps are not exhaustive or completely comprehensive, they provide an opportunity for employees and supervisors to talk about the many professional opportunities available in each classification, to illustrate where employees are at in their career progression, and discuss long-term goals and actions that might be helpful in achieving professional growth.

The Public Health Career Maps took about two (2) years to develop.  The project was broken up into different phases.  For Phase 1, we looked at job classifications that were part of a series (e.g., Office Assistant 1, 2 and Senior; Program Technician, Specialist and Specialist Senior, etc.).  Once the Phase 1 career maps were created, we developed career maps for classifications that were not part of a series nor had any visual career trajectory (i.e. Health Educator, Nutrition Assistant, etc.).  As a result, we created thirty (30) Public Health Career Maps by the time the project was completed.  We presented our report during a Public Health Managers / Supervisors meeting in August 2019, which was our kick off to implementation.

We feel that the implementation of the career maps was successful in meeting the project's objectives.  Managers / supervisors are using the maps with their staff during annual reviews, and staff are taking charge of their own professional development by using the career maps to take an active approach to positioning themselves for career advancement.  The impact of the career maps enhances the division's succession planning efforts to have the right people with the right skills at the right time”.  Ultimately, success cannot happen without managers, supervisors and senior leadership participation, influence and support.

We feel the development of Public Health Career Maps is new to the field of public health workforce development.  We were unable to find literature documenting the usage of career maps by local public health or other health agencies.  A search of the NACCHO model practice database revealed no career maps were found.  We feel that this is an innovative practice that can be replicated in other public health jurisdictions.  With the impending Silver Tsunami”, the public health workforce will see Baby Boomers retiring in droves over the next 5 – 10 years.  We believe career maps will be a helpful tool in succession planning to build up a workforce to fill in the gaps when this happens.

Goals and objectives:

Practice Goal: Develop a practical toolkit of Public Health Career Maps for managers and supervisors to explain the opportunities for professional growth available to employees in specific job classifications in order to identify, develop, train and retain individuals for future management and leadership roles and strengthen long-term strategic efforts for workforce development and succession planning.

Primary Objectives: (1) Develop career maps for job classifications in Public Health – our organization did not have a standard template for managers and supervisors to discuss career planning with their staff during annual reviews.  Career mapping as a public health practice is an innovative practice for workforce development and succession planning. (2) Educate staff, interns and students on the various career paths in public health – career maps not only support professional development for our public health employees, but they can also be used to show students and interns interested in pursuing healthcare careers the basic education and skills required for various jobs in public health.

Implementation:  In order to achieve the goals and objectives, the project was divided into phases.  In Phase 1, we identified the job classifications in the Public Health Division that were part of a clear career path or trajectory.  Eleven (11) line-staff and four (4) management-level career maps were drafted in Phase 1.  We reviewed the class specifications for each job class and pulled out high-level information to plug into the career maps, including minimum qualifications for education and job-related skills.  The career maps highlighted two alternative paths, one leading up to management and another leading to other advanced career opportunities for staff who did not want to manage people.  Once the Phase 1 career maps were developed, we met with employees who had lived experience and worked in the job class or with the managers / supervisors who oversaw staff in a particular job class.  This served as the criteria for selecting people to develop and pilot the practice. These informational interviews provided greater insight to creating job-specific competencies for each career map and identified other advanced career opportunities for people moving out of those job classes.  The job-specific competencies for each career map were developed through a combination of meeting with internal stakeholders and also aligning them with the Council on Linkages' Core Competencies for Public Health Professionals.

In Phase 2, we developed career maps for classifications that were not part of a series nor had any visual career trajectory.  Using the process outlined in Phase 1, we reviewed the class specifications for each job class and pulled out high-level information to plug into the career maps.  We then met with employees who had lived experience and worked in the job class or with the managers / supervisors who oversaw staff in that particular job class.  Overall, we built out Phase 1 during the first year of the practice and had managers / supervisors pilot test the career maps for one (1) year while we built out the Phase 2 career maps.  Once the career map templates were created, we officially launched the practice by presenting the toolkit, with a total of thirty (30) career maps, at the Public Health Division's managers / supervisors meeting on August 13, 2019.  From there, information was shared to the rest of the Division at the Public Health All Staff meeting on November 19, 2019.

Stakeholders: The primary stakeholders for the practice were internal staff in the Public Health Division, including line-staff and their managers / supervisors.  Those who were involved in the development of the practice either had lived experience in the job classifications or supervised those who were in them.  Stakeholders were involved in reviewing the practice and assisted developing and approving the job-specific competencies in the career maps.  In addition, stakeholders also identified other advanced career opportunities that were not listed on the main career path.  Once the practice was launched, stakeholders could begin using the career maps during annual reviews to plan for professional development opportunities that enabled career advancement or share information with students and interns about the multiple career opportunities in public health.

Outside of staffing costs, no costs were required for the implementation or start-up of the project to develop the practice (Public Health Career Maps).  All activities to develop the practice were paid for by Multnomah County General Fund to cover staff time for a Project Manager to create and implement the practice.  A final report of the practice toolkit was released October 25, 2019 to be used by other divisions at Multnomah County who wished to replicate this public health practice.

Prior to the development of the practice, we conducted focus groups with public health program leaders to identify the kinds of support they wanted around workforce development.  Several ideas emerged from these focus groups, including development of an internship process, university partnerships, recruitment resources, leadership development opportunities, succession planning and career pathways.  Focusing on the succession planning and career pathways, we solidified our objectives to develop career maps for job classifications in the Public Health Division and to educate staff, interns and students on the various career paths in public health.

Once we completed Phase 1 of the practice development, we sent out an evaluation to program managers and supervisors regarding the draft career templates.  We asked if the career maps were easy to follow. 71.4% (total of 7 respondents) said they were easy to follow.  When asked if the career maps had the right amount of information, 57.1% (total of 7 respondents) said they were unsure.  This told us that we needed to provide some training on how to use this practice throughout the organization.  We also asked if managers / supervisors would use this practice to discuss career development opportunities with their staff.  71.4% (total of 7 respondents) said that they would use this practice.  This served as the impetus to move into Phase 2 in development of additional career maps for the practice.

Meetings with the stakeholders, including those who had lived experience in the job classifications or had supervised the staff who were in them, resulted in modifications to the practice as the templates were reviewed and edited.  Stakeholders provided key insights to the development of job-specific competencies and identification of additional career opportunities for moving out of a particular job class.

Since the practice was implemented with the release of the report in October 2019, we have not conducted a formal evaluation of its usage, but we plan to do so in the next calendar year.

Next Steps: we are broadening the practice to include all other divisions of the Health Department and expanding the career maps to include our clinical professionals (physicians, pharmacist, dentists), mental health (case managers, mental health consultants), corrections health (eligibility specialists, pre-commitment investigators), business services (contracts, procurement and finance), medical examiners (pathologists and deputy medical examiners), and human resources (technicians, analysts and HR managers).  We will utilize our process from Phase 1 and will work with a new set of stakeholders to develop the career maps for the other divisions of the Health Department.  Evaluation will include stakeholder interviews to review the current practice and see if there are any revisions that need to be made on any of the existing templates.  We anticipate completing these additional templates by April 2020.  Once the additional templates are developed, we plan to partner with schools and community organizations that can help reach out to students and potential interns about the different career paths in healthcare to get their input and feedback on the practice.

In order to remain viable and sustainable, the practice must be integrated into the Health Department's Human Resources (HR) division and staff must be trained on using the toolkit.  Multnomah County has made a commitment to workforce equity, and human resources divisions within the county are being resourced to support the Workforce Equity Strategic Plan.  In addition, the current practice is being replicated in a larger Multnomah County Leadership Academy project to expand the toolkit to include career maps for all other divisions of Health outside of Public Health.  The sponsor of the Leadership Academy project is the Health HR Director, so we know that stakeholder commitment and engagement is there to sustain the practice.  The goal is to hand over the toolkit to Health HR to update the maps when job classifications are added, modified, or removed.  In order to ensure continuation of the career maps, we would need to work with Health HR to develop working guidelines, discuss and select processes to create new career maps, develop procedures to respond to requests from stakeholders to modify existing templates, and determine communications protocols to inform staff, community partners, students and interns about the toolkit.  We would need to develop these protocols in order to ensure a sustainable methodology for the practice.

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