1. What Do the Results Mean for Workforce Development? September 16, 2015

2. Objectives Summarize data from the 2014-15 Kansas Public Health Workforce Assessment Identify workforce competency gaps based on local and state reporting criteria Discuss workforce development strategies to address competency gaps

3. Overview of Participation Kansas Department of Health and Environment staff had a 76% participation rate Local public health department employees had a 61% participation rate Total participation rate of 67% A total of 1,648 respondents Testing was conducted with representatives from all tiers, all bureaus at KDHE, and representatives from small, medium, and large health departments

4. Local Health Department Participation 66% participation rate (875 respondents out of a total of 1,429) 27 health departments had a 100% participation rate 49 health departments had a participation rate of 75% or above 69 health departments had a participation rate of 50% or above 96% of health departments had at least one participant

5. Kansas Department of Health and Environment Local Health Departments Gender

6. Kansas Department of Health and Environment Local Health Departments Age

7. Kansas Department of Health and Environment Local Health Departments Race

8. Kansas Department of Health and Environment Local Health Departments Level of Education

9. Kansas Department of Health and Environment Local Health Departments Years in Public Health

10. Kansas Department of Health and Environment Local Health Departments Plans to Leave Position Within 5 Years

11. Tiers Tier A—administrative and facilities support Tier 1--public health professionals who carry out the day-to-day tasks of public health organizations and are not in management positions. Tier 2--individuals with program management and/or supervisory responsibilities Tier 3--senior/management level and leaders of public health organizations

12. Domains Covered on Assessment Communication Cultural Competency Analytical/Assessment Policy Development/Program Planning Community Dimensions of Practice Public Health Sciences Financial Planning and Management Leadership and Systems Thinking

13. Respondents by Tier Tier Total LHD Respondents Total KDHE Respondents Tier 1346 (39%)317 (41%) Tier 2172 (20%)229 (30%) Tier 3113 (13%)50 (6%) Tier A244 (28%)177 (23%) Total875773

23. Tier A— Training/Education – KDHE Percentage Agree/Strongly Agree KDHELHDs At work, I have opportunities to learn and grow. 74.29%77.49% Employees are continually developed through training, education, and opportunities for promotion. 51.52%66.67% I have the skills I need to do my job.96.84%93.91% Training is implemented as part of an overall system of employee development. 66.67%68.14% I am comfortable with technology-based training. 96.05%89.13%

24. Local Health Departments Kansas Department of Health and Environment  Communication Skills (highest across tiers)  Cultural Competency (Tier 1 only)  Community Dimensions of Practice Skills (Tiers 1 and 2)  Leadership and Systems Thinking Skills (Tiers 2 and 3)  Financial Planning and Management Skills (Tier 3 only)  Communication Skills  Analytical and Assessment Skills  Leadership and Systems Thinking Skills (Tiers 2 and 3) Areas of Highest Proficiency

25. Areas of Lowest Proficiency Local Health Departments Kansas Department of Health and Environment  Public Health Sciences Skills (lowest across tiers)  Financial Planning and Management Skills (Tiers 1 and 2)  Analytical and Assessment Skills (Tiers 2 and 3)  Policy Development/Program Planning (Tiers 1 and 2)  Cultural Competency (Tier 3 only)  Public Health Sciences Skills  Financial Planning and Management Skills  Cultural Competency  Leadership and Systems Thinking Skills (Tier 1 only)

26. Areas with High Percentages Who Don’t Think Competencies Apply Local Health Departments Kansas Department of Health and Environment  Financial Planning and Management Skills (Tiers 1 and 2)  Policy Development/Program Planning (Tier 1 only)  Analytical and Assessment Skills (Tiers 1 and 2)  Public Health Sciences Skills (Tiers 2 and 3)  Cultural Competency  Public Health Sciences Skills  Community Dimensions of Practice Skills  Financial Planning and Management Skills (Tier 1 only)

27. Tier 1—Prioritized Competencies Rank2010 CompetencyDomain 2014 Revised Competency Language 1 Describe the local, state, and federal public health and health care systems Financial Planning and Management Skills Describes public health funding mechanisms (e.g., categorical grants, fees, third-party reimbursement, tobacco taxes) 2 Describe the organizational structures, functions, and authorities of local, state, and federal public health agencies Financial Planning and Management Skills Describes the structures, functions, and authorizations of governmental public health programs and organizations 3Describe the impact of changes in the public health system, and larger social, political, economic environment on organizational practices Leadership and Systems Thinking Skills Describes the impact of changes (e.g., social, political, economic, scientific) on organizational practices

28. Tier 2—Prioritized Competencies Rank2010 CompetencyDomain 2014 Revised Competency Language 1 Relate public health science skills to the Core Public Health Functions and Ten Essential Services of Public Health Public Health Science Skills Applies public health sciences (e.g., biostatistics, epidemiology, environmental health sciences, health services administration, social and behavioral sciences, and public health informatics) in the delivery of the 10 Essential Public Health Services 2 Implement the judicial and operational procedures of the governing body and/or administrative unit that oversees the operations of the public health organization Financial Planning and Management Skills Implements policies and procedures of the governing body or administrative unit that oversees the organization (e.g., board of health, chief executive’s office, Tribal council) 3Incorporate public health informatics practices Policy Development and Program Planning Skills Uses public health informatics in developing, implementing, evaluating, and improving policies, programs, and services (e.g., integrated data systems, electronic reporting, knowledge management systems, geographic information systems)

29. Tier 3—Prioritized Competencies Rank2010 CompetencyDomain 2014 Revised Competency Language 1 Manage the implementation of the judicial and operational procedures of the administrative unit that oversees the operations of the public health organization Financial Planning and Management Skills Manages the implementation of policies and procedures of the governing body or administrative unit that oversees the organization (e.g., board of health, chief executive’s office, Tribal council) 2 Integrate a review of the scientific evidence related to a public health/environmental issue, concern, or, intervention into the practice of public health Public Health Science Skills Ensures the use of evidence in developing, implementing, evaluating, and improving policies, programs, and services 3 Resolves gaps in data sourcesAnalytical and Assessment Skills Resolves gaps in data

30. Major Findings  The domain with the lowest proficiency rating across all tiers for both local health departments and KDHE was Public Health Science Skills (with the exception of KDHE Tier 3).  KDHE had significant percentages of people reporting that competencies in several domains did not apply to their jobs (significantly higher in comparison with local health departments): o Cultural competence—43% for Tier 1; 33% for Tier 2; 20% for Tier 3 o Public Health Sciences—50% for Tier 1; 42% for Tier 2; 22% for Tier 3 o Community Dimensions of Practice—49% for Tier 1; 34% for Tier 2; 22% for Tier 3.

31. Major Findings  Significant percentages of local health department and KDHE staff reported that the competencies in the “Financial Planning and Management Skills” domain do not apply to their jobs (64% of local health departments - Tier 1; 51% of KDHE - Tier 1).  There is a significant percentage of the workforce close to retirement age with a limited number of new, young staff entering the workforce  With the exception of some specific communities, the race and ethnicity demographics of the workforce are not similar in percentage to those of the state

32. Major Findings  Respondents indicated interest in a public health certificate program (no specifics were defined). For local health departments, 38% reported definite interest and 31% were unsure.  The Northwest region of counties was the area of the state with lower self-reported proficiency scores than most other regions across all domains, especially for Tier 1.  For respondents in Tier A, the question with the lowest percentage of responses in the agree/strongly agree group was “Employees are continually developed through training, education, and opportunities for promotion;” KDHE—51.52%, local health departments—66.67% (lowest overall for both).

33. Overall Themes from Comments Perceived lack of workforce development opportunities/training Perceived lack of opportunities for advancement Identified need for cross-training Staff not utilized to full potential—skills, training, education not utilized Identified need for training in multiple areas including cultural competence, specific software Environmental staff do not see how they are connected to public health

34. Results from Fort Riley

36. Results from an LHD Workforce Survey 48% of participating LHD staff are very unlikely to pursue a degree/additional degree 62% of those interested in pursuing a degree are very unlikely to pursue a Master of Public Health Major barriers to additional education included cost, family obligations, and age 41% would be much more likely to pursue education with scholarship support 41% of participating LHD staff were very/somewhat interested in an Associate’s Degree in Public Health 47% of participating LHD staff were very/somewhat interested in a Bachelor’s Degree in Public Health

37. Public Health Certificate 59.5% of participants in the local health department survey were very/somewhat interested in attaining a public health certificate Regarding definition of a public health certificate, 47% preferred it as part of coursework toward a college degree while 34% preferred that it is a document that recognizes specific competencies/expertise have been attained 34% would be somewhat less interested and 34% would be much less interested if there was a cost to take associated courses

38. Workforce Development Opportunities at Kansas Health Departments

39. Activity Pair up with someone sitting next to you Discuss the following questions: What surprised you the most from all of the results shared? What do you think is most critical to address related to workforce development? Based on the information presented, what ideas do you have for workforce development for your organization? The System? Volunteers to briefly share what you discussed

40. Recommendations  Develop training that is targeted to address the areas of lowest proficiency and applicability, a strategy that is already underway  Retool existing training such as the “Evidence-Based Public Health Course” to include content that specifically addresses competency gaps  Target communication efforts to assist staff in better understanding the core competencies and how the competencies apply to their work

41. Recommendations  Explore recruitment strategies, including use of social media, to increase awareness about the field of public health and to create interest among high school and college students  Investigate opportunities to offer additional education in public health at the bachelor’s and associate’s degree levels, which could result in a new population of public health workforce candidates  Use results to establish a direction for workforce development in the Kansas Public Health System

42. Resources Reports are available for local health departments with enough participants (at least six per tier) as well as bureaus and divisions at Kansas Department of Health and Environment Presentations can be provided for staff about the results and how to use them at the organizational level Technical assistance is available for interpreting and utilizing results (call or e-mail Cristi Cain)

43. Acknowledgements Funding support was provided by the Kansas Health Foundation through the Public Health Practice Program. This report was prepared by the Kansas Public Health Workforce Development Coordinating Council. The instrument questions are based on the Council on Linkages Core Competencies for Public Health Professionals.

44. Contact Information For more information about the Kansas Public Health Workforce Assessment, visit http://www.kdheks.gov/olrh/workforce_development.htm. http://www.kdheks.gov/olrh/workforce_development.htm Cristi Cain, Interim Director, Local Public Health Program, Kansas Department of Health and Environment, 785-296-3641 ccain@kdheks.gov