Recruitment Toolkit

Written by Heather Krasna, PhD

The governmental public health workforce in the United States plays a crucial role in the health of every person. COVID-19 made it incredibly clear how important it is to have a well-staffed system of local, state, Tribal, territorial, and federal public health departments, and laid bare the consequences of decades of underfunding of this workforce. The Biden Administration announced on Jan. 21, 2021, and again in May, 2021, a $7.4 billion investment in the public health workforce, and around $3.2 billion was made available for governmental health departments to apply for in summer 2022. The recipients were announced in November.

This new funding creates a special opportunity for health departments to replenish their workforce, at least temporarily. If used strategically, health departments could deliberately transform to be as inclusive as possible and transition these grant-funded hires to permanent ones–if they have the right resources to identify their needs, attract the right candidates, onboard them, and convert them to permanent hires. This page is meant to be a one-stop shopping resource for full-cycle recruitment for local, state, Tribal and territorial government health departments.

Disclaimer: This resource will be continually updated. This resource in its draft form reflects some of my own views and opinions. Some of the resources were created as part of  my role at Columbia University, and some I created as a consultant or volunteer, and of course I’m also referring to the the excellent work of many others in this small but mighty field of public health workforce development and research.

Here are some key resources to get you started:

The Recruiting Cycle: Six Keys Steps (plus a Seventh)

The recruitment process has six key steps, and this toolkit is organized into these six areas. Many health departments, especially accredited ones, have spent time on workforce planning (covered in step 1), but haven’t had resources (or regulatory ability) to devote to updating job descriptions (step 2), and haven’t had budget or staff to build recruitment pipelines, conduct recruitment marketing or outreach, or develop an employer brand (step 3). When it comes to selection (step 4), some health departments are restricted by civil service hiring rules, making the hiring process far slower than the private sector (which can result in good candidates giving up on the process). Onboarding–step 5, and crucial for retention–may be challenging in a situation where staff are overburdened or burned out. Evaluation (step 6) helps keep recruitment efforts on track. A seventh step–advocacy–is specific to public health, since we must fiercely advocate for resources to replenish the workforce. I focus mostly on Steps 2 and 3, since they are my area of expertise, but hope to provide resources for every step as this toolkit is updated. And, I’ll be building a full online training on this topic for Region II Public Health Training Center soon–so sign up for news and updates.

  1. Identify hiring needs
  2. Write job descriptions
  3. Build recruitment pipelines, advertise jobs
  4. Select candidates
  5. Onboarding and retention
  6. Assess & Evaluate
  7. …and advocate for more funding & a better recruiting system

1. Identify Hiring Needs

A new tool, the Public Health Workforce Calculator, can be used by certain health departments (specifically local health departments in decentralized public health systems, which serve fewer than 500,000 residents) to estimate how many staff they need in order to deliver the Foundational Public Health Services. This calculator can be a great first step in determining how many staff you really need, but translating the numbers into job descriptions takes some additional steps.

One step is to take the raw numbers and compare with information you already have from a workforce development plan, if you have one. This plan may include the following elements:

    • Workforce analysis
      • Environmental scan and gap analysis (what is the gap between current staffing and the staff needed to achieve your mission/mandate)
      • Review of rules and regulations (What rules govern the hiring process? What is the labor structure? What are the pay grades? What is the process to reform regulations if needed?)
      • Identify competencies needed for the staff required to achieve your mandate (see “job descriptions” section below for details on both cross-cutting and occupation-specific competencies)
      • Training needs assessment
      • Writing, implementing, monitoring & evaluating the plan
    • This can also include:
      • Assessing current staff—who they are, what their skills are, what motivates them; demographics of current staff with regards to diversity & inclusion)
      • Planning for possible attrition or retirement plans of existing staff, with a plan to replace them or create succession plans
      • Estimate of hiring needs based on gap analysis–which specific staff are you missing? What budget is needed to hire them? What budget is available permanently, vs. via grants?
      • Assessment of organizational culture–what causes people to stay at the organization? What is driving them to leave?
    • A third step after comparing the raw numbers to your workforce development plan, is to also consider your Community Health Assessment, strategic plan, or other data, and also discussing the priorities and needs within your own team.
    • Finally, you may want to prioritize your hiring needs. A tool to consider for this is here.
    • Resources:

2. Create Job Descriptions

Visit https://www.rvphtc.org/public-health-model-job-descriptions-project/ to access model job descriptions through the Public Health Model Job Descriptions Project.

I’ve been the key contributor to a new job descriptions & job postings project via Region V Public Health Training Center and University of Minnesota Center for Public Health Systems, and in order to create evidence-based and attractive job descriptions, we followed the steps below:

3. Recruitment pipelines, candidate sourcing, advertising

 

KEY RESOURCE: publichealthcareers.org

KEY RESOURCE: New Resources and Creative Strategies for Recruiting Candidates for Health Departments

Once your job postings are ready, you have to disseminate them to attract candidates to apply for jobs. To help with this, I’m proud to have contributed to publichealthcareers.org, an ASTHO-led website specifically designed to educate the public about careers in governmental public health departments. This site includes a job board, overview of careers in the field, high-quality videos of people in public health jobs, and a linked map bringing people to the job board for each state and territorial health department (hopefully local ones will be added too). If there’s one key resource to use in this toolkit, it’s this one.

Besides having updated job descriptions, health departments need the most help in establishing recruitment pipelines and attracting candidates to apply (and to stick with it through the often long hiring process). To build a recruitment pipeline, it’s critical to identify talent sources that match your job requirements (which is why steps 1 and 2 must be completed first), and will generate candidates who reflect the communities you serve. To have successful recruitment partnerships, you must build long-term partnerships. You may also have to be proactive, and think about your employer brand. Here are a few ideas about how to build talent pipelines:

Partnerships with Academia

  • Identify your target schools (majors, demographics)
    • National Association of Colleges & Employers (NACE) is the nation’s largest association for college recruiters and career services staff. If you plan to hire college graduates, join and get involved.
    • Association of Schools & Programs of Public Health https://publichealthjobs.org/
  • Find the contact person at each school: career services, field practice, faculty, student group leaders
  • Post your jobs, and develop Internships, Practica, Service learning opportunities for students
  • Attend Career fairs, Employer presentations, Alumni panels
  • Offer a guest presentation in a class or student groups; offer a Field trip
  • Resources:

Other Talent Sources

Public health departments need candidates from a diverse range of sources; and for many roles, college recruitment is not the right source. Here are other talent sources:

4. Screening, Selection, Hiring

This is the step in the process where, from my view, things can become very tough for a health department. Many candidates cannot wait for a 4-6 month long hiring process. Anything you can do to speed up the hiring process, or at minimum maintain good communication with candidates, is key. This step is also another one where you must be intentional to ensure the process is anti-racist and inclusive! Some government agencies have been able to alter their processes, work with their central HR team or civil service department, or even change regulations to allow flexibility in hiring in some cases. I’m actively seeking examples of success stories like this–contact me if you have ideas. I’ll be adding more here soon. This process includes:

5. Onboarding and Retention

Recruitment is useless if your candidates quit after a week on the job. An exciting program, New to Public Health, builds in evidence-based interventions to keep people engaged, like building a community of practice and matching with mentors. Additionally, considering the culture of the organization, and ensuring it is a healthy and inclusive work environment, is crucial for retention. In our current environment, some health departments face an uphill battle to maintain a safe and positive environment for staff so this is an advocacy issue (see step 7).

Also, health departments might need to hire new staff who are funded by the ARPA CDC workforce grant via third-party entities; or might like to hire their Public Health AmeriCorps members as staff. The potential to convert these new hires to permanent staff, especially if more sustained funding is achieved or even if current staff retire or leave and new hires can fill their vacant roles, is an important aspect of being intentional in the use of the ARPA funding. Training new staff on how to navigate the civil service process in your jurisdiction may be an important part of onboarding.

6. Evaluation

Evaluating your recruitment effort will help you improve in future, and is important for reporting to funders. Just like with any program where you use a logic model, you can track outputs, short-term outcomes, and long-term outcomes.

7. Advocacy

Advocacy for sustainable, permanent funding for the public health workforce can be tiring and even discouraging. But every person whose life depends on the work of their public health department should be your allies. In Summer of 2023, I’ll be launching a Massive Open Online Course via Columbia University to train public health students and graduates on advocacy. Just a small handful of topics to advocate for include:

  • $7.4 billion over 5 years is a game-changing level of investment in public health workforce… but it’s really only a small percentage of the funding needed to replenish the workforce, and it’s temporary. A permanent, $10-15 billion increase each year, to hire the 80,000 new staff to provide basic staffing to health departments, is needed to meet Foundational Public Health Services.
  • Equitable pay for governmental public health workers. It’s very difficult to recruit candidates when salaries are markedly lower than the competition. Advocating to improve salaries has been successful in a range of states
  • Review of civil service exams & processes to ensure equity, avoid bias and create shorter time to hire
  • Modernized applicant tracking systems and processes
  • Revision of job descriptions
  • Culture change: ensuring an inclusive work environment
  • Funding for job advertising, marketing, etc.
  • Student loan repayment for public health students who work in governmental public health departments… for which I’ve helped lead the nation’s first National Public Health Students & Graduates Hill Week
  • Resources:

Additional trainings and toolkits:

Articles and Research

1.           Yeager VA, Wisniewski JM. Factors That Influence the Recruitment and Retention of Nurses in Public Health Agencies. Public Health Rep. 2017;132(5):556-562. doi:10.1177/0033354917719704

2.           Krasna H, Fried LP. Generation Public Health: Fixing the Broken Bridge Between Public Health Education and the Governmental Workforce. American Journal Of Public Health. Published July 2021.

3.           Krasna H, Czabanowska K, Beck A, Cushman LF, Leider JP. Labour market competition for public health graduates in the United States: A comparison of workforce taxonomies with job postings before and during the COVID-19 pandemic. The International Journal of Health Planning and Management. n/a(n/a). doi:https://doi.org/10.1002/hpm.3128

4.           Locke R, McGinty M, Guerrero Ramirez G, Sellers K. Attracting New Talent to the Governmental Public Health Workforce: Strategies for Improved Recruitment of Public Health Graduates. J Public Health Manag Pract. Published online February 2, 2021. doi:10.1097/PHH.0000000000001336

5.           Yeager V, Leider J. The Role of Salary in Recruiting Employees in State and Local Governmental Public Health: PH WINS 2017. ajph.aphapublications.org; 2019. https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2019.305008

6.           Yeager VA, Wisniewski JM, Amos K, Bialek R. What Matters in Recruiting Public Health Employees: Considerations for Filling Workforce GapsAm J Public Health. 2015;105(12):e33-36. doi:10.2105/AJPH.2015.302805

7.           Yeager VA, Wisniewski JM, Amos K, Bialek R. Why Do People Work in Public Health? Exploring Recruitment and Retention Among Public Health Workers. J Public Health Manag Pract. 2016;22(6):559-566. doi:10.1097/PHH.0000000000000380

8.           Horney JA, Davis MK, Ricchetti-Masterson KL, MacDonald PDM. Fueling the public health workforce pipeline through student surge capacity response teams. J Community Health. 2014;39(1):35-39. doi:10.1007/s10900-013-9750-5

9.           Manske J, Hayes H, Zahner S. The New to Public Health Residency Program Supports Transition to Public Health Practice. J Public Health Manag Pract. 2022;28(5):E728-E733. doi:10.1097/PHH.0000000000001569

10. Hare Bork RRobins MSchaffer KLeider JP, Brian C Castrucci, Workplace Perceptions and Experiences Related to COVID-19 Response Efforts Among Public Health Workers – Public Health Workforce Interests and Needs Survey, United States, September 2021-January 2022

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