Work Force and PCAs DelRay Florida November 2008

Agenda Background Survey Results & Analysis Best Practices Recruitment Pros & Cons Next Steps

The Work Force (WF) Workgroup Formed in Spring 2008 Response to prioritization process by PCA/NACHC Steering Committee Broad-based representation Considered information flow across other WF activities

Workgroup Composition Members: – Annette Kowal, Co-Chair – Joe Pierle, Co-Chair – Sonya Bruton – Shawn Frick – Bruce Gray – Kevin Lewis – Mary Looker – Patrick Monahan – Tom Curtin – Joe Gallegos – John Sawyer – Suzanne Rossel

Purpose/Charge The WF Workgroup examined the role of PCAs in supporting Health Centers’ (HCs) WF issues and identified recommendations for. As part of this charge, the Workgroup considered a series of questions: 1.What is the appropriate role(s) for PCAs in the WF arena? 2.What are some examples of successful PCA efforts to positively impact WF issues? 3.What are the barriers or challenges that PCAs will need to address? 4.What are the kind of resources and assistance PCAs will need to address the concerns identified in #3, above?

Work to Date Developed and Implemented Survey Assessed Additional Information thru Follow- up Questions Undertook Multi-tiered Analyses Coordinated with other WF activities Identified Best Practices Outlined Next Steps for Developing Long- Term Strategies

Survey Summary 33 Survey Respondents; Targeted follow up on “one-time” funding yielded an additional 3 responses;

Work Force: the Differing Views

Survey Results: WF Efforts Vary Across PCAs PCA Board WF Committee – A limited number of respondents, 18%, indicated that they had a Board WF-focused Committee – Charges for the committees included: Recruitment & retention Clinical support--clinical performance measures, recruitment & retention CHC competency and new staff orientation Newly formed committee, focus to be determined

PCA Staffing: – 100% of PCA respondents indicated that they had WF staff: The average number of staff positions = 1.7 The average FTEs =.9 The highest FTE = 3.0 FTEs The lowest FTE = 0.05 FTEs 24% of PCAs had less than a 0.5 FTE – 18% utilized consultants for some aspect of WF – Titles and responsibilities varied widely Survey Results: WF Staffing Varies Across PCAs

Many identified a strong PCA recruitment role: – 70% of all PCA respondents undertake recruitment efforts on behalf of HCs – Providers (physicians, dentists, mid-levels and behavioral health clinicians) are predominantly recruited by PCAs – Nearly 50% of respondents undertake senior leadership recruitment on behalf of HCs Survey Results: PCAs Focus on Recruitment

A Variety of Recruitment Definitions: – Recruitment activities include a wide breadth of services: PCA staff recruit Health Center providers and staff HC Recruitment is Contracted/Collaborative On-line job posting/Internet career placement Job Fairs Coordination with NHSC and SEARCH program Survey Results: PCAs Focus on Recruitment

PCA retention effort were limited: – 27% of PCA respondents indicated that TA was provided to support the development of HC incentive based compensation plan. – Several other retention activities identified were undertaken by only one PCA respondent each: Learning teams Compensation, benchmarking, salary survey Training programs through distance learning and/or at annual conferences Survey Results: Limited PCA Focus on Retention

Limited PCA mentoring activities were identified: – 33% indicated they provide some mentoring across various areas: 12% (of total respondents) are involved SEARCH program activities 6% developed handbooks/toolkits NHSC, programs for youth, and meetings were identified as mentoring activities by select PCAs Survey Results: Few Mentoring Activities

Survey Results: PCA Pipeline Activities are Limited Limited Pipeline Activities were identified: – 12% work with the SEARCH program; – 21% indicated collaboration/work with AHECs; – Limited visits to residency/training programs.

Survey Results: Resources It is clear that WF issues are involved and weighty. Currently, resources to support PCA WF efforts are limited.

Survey Results: Resources (Funding) PCAs depend on BPHC for WF funds (97%) Members’ dues (46%) and fees (18%) support PCAs’ WF activities Other Federal (HRSA-27%) and State (21%) funding is utilized for WF Other support identified comes through: – Dept. of Labor Pass through – Private Foundations – AHECs

One-Time (HRSA/BPHC) Funding Uses (36 respondents) – 47% recruitment supplies & materials, etc. – 36% Targeted T/TA – 31% (As of 6/08) had not determined use – 31% Building/Strengthening partnerships & collaborations Survey Results: Resources (One-Time BPHC Funding)

Survey Results: Resources (Collaborations)

PCO seen by PCAs as a strong partner Limited partnerships/collaborations were noted with: – Medical & Dental Societies – Medical & Dental Schools – Residency Programs Survey Results: Resources (Collaborations)

PCAs identified a wide range of joint collaborations, select top efforts included: – 39% Recruiting – 30% Building/Enhancing Strategic Partnerships – 30% Developing/Implementing HC training/tools – 27% Building Relationships with Higher Education/Residencies Survey Results: Resources (Collaborations)

Survey Results: Many WF Barriers were Identified:

Best Practices Pipeline: – Florida: PCA and AHEC collaboration – Mississippi: Rotation of medical and dental students through HCs using Medicaid carve-out

Best Practices Retention – 27% of PCA respondents indicated that TA was provided to support the development of HC incentive based compensation plan – 82% of respondents expressed some success with State loan repayment/redemption/tuition reimbursement program or provider incentives.

Best Practices Recruitment – Referral approach in NM, TN, WY – MO approach to contracting with contingency search firms

Recruitment—Pros & Cons Pros – Addresses vacancy issues in the short-term – Has quantifiable outcome – Responds to members needs/requests Cons – Short-term focus of limited resources on long-term and growing issue – PCA Effectiveness against professional firms – PCA limited/no control post placement-retention

Next Steps Continue the “conversation;” – Define key terms/concepts – Develop high-level/best practice models for: Recruitment Retention Pipeline – PCA Work Force Development Summit Identify strategies to communicate among and between key HRSA Bureaus; Continue to Coordinate with existing work force workgroups and initiatives.