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Retention and Recruitment Toolkit

This action-oriented toolkit highlights strategies within the sphere of influence of public health professionals, focusing on areas with significant potential for improvement. It emphasizes opportunities where leaders, supervisors, and staff can take meaningful action to drive noticeable change.

The Public Health Foundation has analyzed data, reviewed literature, engaged with experts, and collaborated with practitioners and academics to gather, organize, and share practical resources to support public health retention and recruitment. The strategies, examples, and resources compiled in this toolkit focus mainly on retention. Retaining staff reduces the need for recruitment, which is time-intensive and costly, particularly in public health, where resources are limited. Effective retention and recruitment strategies require more than superficial efforts or short-term incentives to fill vacancies. Instead, they demand authentic, long-term commitments, making retention the primary focus.

The data on why people stay in public health include factors like organizational culture, organizational pride, advancement opportunities, satisfaction with supervisor, support and recognition, flexibility, meaningful or exciting work, and job satisfaction. People are drawn to the unique role of government, the important work in health departments, the proactive and preventive approach, and the opportunity to make a contribution. The examples provided are adaptable for implementation at any level within your agency, division, or workgroup, regardless of structure or governance.

PHF welcomes additional examples and resources to be added to this Toolkit. If you have any strategies, examples, or resources to share please email Mayela Arana at marana@phf.org.

Organizational Culture, Workplace Environment, & Employee Experience

Being known as a great place to work is priceless. An organization that prioritizes both its mission and the well-being of its staff gains a substantial advantage in retaining and attracting top talent.

Organizational Mission and Value

Employees are attracted to organizations with a clear and well-articulated mission. Achieving this requires strategic planning to develop or update the organization’s vision, mission, purpose, and values. Engaging employees from the start creates the best results and contributes to a sense of belonging, shared ownership, and organizational pride. This level of engagement enhances clarity which is essential in communications with boards, partners, and the community.

Organizational value can be demonstrated by making quality improvement and performance management integral parts of everyday work and the organizational culture, rather than being treated as sporadic add-ons. Create opportunities for staff to collaborate and learn from each other about their work. Continuously measuring and monitoring data while discussing it’s meaning and ways to improve, fosters a culture of shared accountability and makes it easier to clearly communicate the outputs and outcomes of health departments efforts.

Workplace Mental Health and Well-being

Workplace mental health and well-being continue to be a major focus across all sectors. Organizations are adopting intentional strategies to address these issues. A growing array of tools and resources has been developed to support these efforts, offering practical solutions to foster healthier and more supportive work environments. For example:

Belonging and Inclusion

Cultivating a genuine sense of belonging among staff within the organization is essential. Authentic inclusion cannot be mandated but must be fostered through intentional planning and implementation. Some strategies focus on one-to-one interactions, such as engaging in meaningful conversation or informal “coffee chats,” which may be simple. Involving employees at all levels in decision making promotes transparency and belonging throughout the organization. Some strategies may require formal processes to develop and implement, such as adopting trauma-informed approaches not only with and for clients, but also, intentionally in the workplace to support staff. Providing opportunities for individuals to find what works best for them is key. Some examples include establishing communities of practice for mutual learning, creating affinity groups for those with similarities or shared interest, and organizing social activities to provide staff an opportunity to get to know one another.

  • The Fostering Belonging Handout developed by the Progress Center at the American Institutes for Research provides guidance and resources aimed at fostering a sense of belonging within an organization. It offers strategies, tips, and activities to promote inclusivity, diversity, and a welcoming environment for all individuals involved.
Creativity and Innovation

Fostering an environment that values creativity and innovation enhances employee retention and serves as a powerful recruitment tool. Encouraging staff to collaborate in developing creative solutions not only leads to more effective and innovative outcomes but also fosters a sense of ownership and engagement with their work. By blending established practices with fresh ideas and leveraging the diverse perspectives of staff, organizations can create processes that are both effective and inclusive. This approach not only improves the employee experience but also supports organizational success and adaptability.

  • Hear from Jade Ramsdell, Jade Ramsdell the Performance Improvement Director for the Kansas Department of Health and Environment, and one of PHF’s expect consultants about the importance of balance and listening to various perspectives to create an inclusive and effective workplace by watching this short excerpt. Learn more about the Health for All Approach to Performance Improvement consulting services offered by PHF.
Autonomy

Studies show that people often choose public health careers because of the autonomy afforded public health workers. Greater autonomy promotes ownership and professional pride which also contributes to retention. Supervisors may need some support, encouragement and training on how to balance giving staff greater autonomy while maintaining accountability and productivity.

Modern Technology and Data Systems

Investing in modern technology and data systems helps attract and retain staff by enabling them to make a greater impact on communities. Tools like mobile platforms and user-friendly systems reduce time spent on repetitive tasks, allowing staff to focus more on direct service and meaningful work. This boosts efficiency and improves job satisfaction.

Professional Development

Professional development plays a critical role for growth and career advancement and can benefit individuals, teams, programs and the entire organization. At an organizational level, workforce development plans are key for ensuring a skilled workforce that aligns with the organizations strategic plan and community needs. By proactively planning and leveraging the strengths of employees, organizations empower their staff to excel, enabling them to make meaningful contributions to the overall mission.

Competency Sets

Competency sets provide a good starting point for professional development. For example:

In addition to the competency sets, there are valuable tools for assessing workforce competencies:

Agency Workforce Assessment and Planning

To effectively leverage the strengths and untapped potential of staff, organizations must first gain a clear understanding of the capabilities and aspirations of each staff. . This involves identifying both the developmental needs and desire for growth among staff while, ensuring alignment with the agency’s strategic goals.

Consider the following key questions:

  • What unique strengths and talents do staff possess?
  • How can these strengths and talents be leveraged to their fullest potential?
  • What are the specific developmental needs of staff?
  • In what areas do staff aspire to grow, and how can these aspirations be supported?
  • How do these growth goals align with the strategic priorities and needs of the agency?
  • A comprehensive workforce development plan incorporates a range of tools and strategies.

The following resources can help to support these efforts:

  • Laying the Groundwork: Essential for Public Health Workforce Development – This recorded webinar addresses the basics of workforce development planning and action, including why workforce development is important, how workforce development plays a role in health department accreditation, and how retention and recruitment relate to workforce development planning.
  • Expertise and Capacity Self- Assessment Tool – A downloadable tool Use this tool to assess your health department’s current level of expertise needed to provide the Foundational Public Health Services (FPHS) and capacity needed to implement FPHS in your community.
  • Public Health Workforce Calculator – A tool to help local health departments with workforce planning by utilizing information provided about the local health department to estimate the number of full-time equivalents (FTEs) needed to ensure the provision of the Foundational Public Health Services (FPHS). The Calculator is intended for use in decentralized public health systems with a jurisdiction size of 500,000 or less
  • Now What?! Tools to Move from Workforce Assessment to Strategic Decision Making – This recorded webinar discusses tools and methods developed by PHF to assist local health departments in advancing beyond the Public Health Workforce Calculator and Expertise and Capacity Self-Assessment. It focuses on prioritizing actions and making strategic decisions to address workforce needs effectively.
  • Competency-Based Workforce Development Plans – Samples of workforce development plans based on the Core Competencies for Public Health Professionals (Core Competencies) are provided below to assist organizations in incorporating the Core Competencies into their own workforce development plans.
  • Determining Essential Core Competencies for Public Health Jobs: A Prioritization Process – When developing a job description, it is important to determine which competencies are most essential for that position. This tool describes a process for prioritizing competencies for job descriptions using the 2021 version of the Core Competencies.
Career Ladders

Opportunities for career advancement play a critical role in employee retention. Employees seek recognition for their work and opportunities for upward mobility, which contribute to greater job satisfaction. Career ladders offer clear pathways for professional growth, providing structured frameworks that enable individuals to set goals, acquire new skills, and advance in their careers. This process ultimately fosters a more skilled and motivated public health workforce. Each step within a career ladder typically involves increasing expertise and/or broadening of responsibilities.

Training Plans

Training plans typically refer to customized learning experiences, created by individuals or organizations to outline specific or curated learning goals and steps to achieve them. These plans may focus on particular topics or desired competencies and can include a variety of training methods, such as courses, mentoring, experiential learning through rotating assignments or site visits, and stretch assignments.

Training plans can also be more specific to courses, or didactic instruction. The TRAIN Learning Network, for example, offers collections of courses developed by TRAIN Affiliates and National Course Providers, organized as training plans or blended learning series. Users can search the course catalog by “training plans” or “courses,” filtering by format to select “blended learning series.” The TRAIN Learning Network is a free online platform that provides a wide range of training opportunities, allowing public health, healthcare, and related professionals to track their progress and engage in continuous learning and professional development.

Learn more about how you can leverage the TRAIN Learning Network and how it can support your competency-based workforce development goals by watching the archived session: Maximizing Workforce Excellence: Leveraging the Core Competencies for Public Health Professionals and TRAIN Learning Network

Additional Strategies for Professional Development

Consider these approaches to support ongoing professional growth and development:

  • Implement a thoughtful onboarding process to help staff transition smoothly into the organization or new roles.
  • Consider pairing new employees with experienced colleagues who can serve as mentors and help them navigate the organization.
  • Develop personalized training plans that outline learning goals and steps for continuous professional growth.
  • Encourage internal mobility, facilitating transitions from generalist to specialist roles, and from frontline to program management positions.
  • Prioritize and invest in management and supervisor training, recognizing their pivotal role in staff success and retention.
  • Offer access to leadership development programs and opportunities for career advancement.
  • Allocate funds to support staff attendance at relevant in-state or out-of-state conferences each year.
  • Organize voluntary discussion groups centered on themes such as health equity or other priority topics, providing staff with opportunities to engage with new concepts and ideas.
  • Provide experiential learning opportunities, such as site visits, stretch assignments, and bi-directional mentoring or coaching relationships to enhance skills and knowledge.
  • Complement exit interviews with regular “stay interviews” to understand what drives staff engagement and satisfaction, helping to inform retention, recruitment, and strategic planning efforts.

These strategies focus on fostering an environment of continuous learning and career growth, ultimately benefiting both staff and the organization as a whole.

Human Resource (HR) Policies & Processes

Human resource policies, processes, and practices significantly influence workplace culture, employee experience, and ultimately, retention and recruitment. Distinguishing between mandatory legal regulations and organizational or division-specific policies and practices can help identify potential areas for improvement and change.

Enhancing workplace flexibility, optimizing opportunities for staff to leverage their strengths, utilizing tuition reimbursement and student loan repayment programs, or making targeted adjustments to the benefits package can have a substantial impact on both retention and recruitment.

Building Strong Relationships with HR Professionals

A key step in fostering a strong and effective workplace is developing a strong relationship with HR professionals, whether within your organization or in the broader governmental system. HR staff possess valuable insights and may offer perspectives that differ from those of public health professionals. Like any successful partnership, it’s important to approach these relationships with a collaborative mindset.

Taking the time to connect with HR staff before urgent needs arise can lead to more productive working relationships. Building mutual understanding and working together can help address shared objectives.

Flexibility in Work

Workplace flexibility is a key factor in both employee retention and attracting top talent. By offering diverse work settings (fieldwork, clinic environments, remote work, in-office, and community partner sites) and various scheduling options, organizations can ensure they don’t miss out on highly skilled individuals. This flexibility allows a broader range of people, including those with disabilities, caregiving responsibilities, or longer commutes, to participate in the workforce. Additionally, it contributes to a healthier work-life balance, helping to retain great employees while fostering an inclusive and supportive workplace.

Examples of workplace flexibility could include:

  • Remote work, or working from home
  • Flexible scheduling (four 10 hour days, or alternating schedules)
  • Built in work time for fitness/wellness
  • Flexible use of paid time off – for example extending the timeframe to use unused vacation time and allowing a reasonable carryover into the next year can improve employee satisfaction
  • Allowing infants at work
  • Allowing pets at work

Consider new ways to manage “on-call” scheduling. Analyzing call patterns can identify opportunities to reduce call volume by enhancing accessibility to essential information, such as hours of operation and service locations, through the website and phone answering systems.

  • Consider compensating staff with a per-diem rate for on-call time, offering additional pay for more intensive responses.
  • Share on-call responsibilities across multiple health departments (HDs), similar to how medical professionals in group practices alternate call duties.
  • Contract with a statewide or regional professional phone answering service may streamline and standardize responses to calls requiring public health expertise. Some state and local public health agencies have successfully collaborated to establish a single contract with a local poison control center, providing 24/7 phone coverage and implementing triage protocols, data collection procedures, and seamless hand-off to the appropriate public health agency.
Sharing or Loaning Staff and Third-Party Hiring

Consider pairing staff to maximize their expertise and enhance job satisfaction and retention. For example, a generalist with broad knowledge of a program and local community can partner with a staff member with specialist skilled in areas like data analysis or septic system review. This allows staff to function at the “top of their scope,” enhancing proficiency and job satisfaction.

When specialized expertise isn’t needed full-time, consider sharing experts across programs, divisions, or agencies. This approach is particularly useful for skills that are costly to recruit for or in areas with episodic demand. Sharing expertise can mean it is more widely distributed and thus enhances equitable access to the service.

When evaluating how to share staff, consider the following questions:

  • Under what circumstances would sharing staff with another division or agency be beneficial?
    • If it is difficult to hire staff with specialized expertise?
    • If there is intermittent or low demand for the specialized expertise so that it is difficult to justify a full-time position with these skills?
    • If sharing highly specialized staff across agencies and jurisdictions enable them to operate at their peak expertise most of the time thus increasing job satisfaction and value to the agencies and community?
    • If sharing staff could improve equitable access to specialized expertise for more communities?
  • How could sharing staff be achieved?
    • Which organization would hire, employ and provide benefits to the staff person?
    • How would the staff person be supervised?
    • How would funds for this arrangement be contracted and disbursed?
    • How would the loan, assignment or sharing arrangement be documented? How would it be evaluated?

Consider exploring these ideas with colleagues at other organizations, such as local, tribal, or state public health agencies; your state association of city/county health officials (SACHO); state public health association; Public Health Institutes (PHI); Public Health Training Centers (PHTC); academic institutions (potentially through an Academic Health Department (AHD) partnership); community-based organizations; hospitals; and other relevant entities in your area.

Another option is third-party hiring, where one organization manages the hiring process and “loans” or “assigns” staff members to a health department or other organizations. Several public health institutes also utilize this model to support state or local public health agencies.

Additional resources are available at the links below:

  • Service and Resource Sharing (SRS) – The PHAB Center for Innovation helps public health departments and systems collaborate and share across boundaries, with the common goal of encouraging better health and equity in the communities they serve.
  • 21st Century Learning Community (21C) – A group of state focused on intentional statewide public health system transformation.
Fringe Benefits

Benefits play a key role in retaining public health workers. Offering appealing, cost-effective benefits can give your organization a competitive edge. Consider your workforce’s needs and values, and consult with your HR specialists. Low-cost benefit options to explore include:

  • Orthodontia coverage in dental plans
  • Veterinary care insurance
  • Subsidized gym memberships
  • Wellness leave (e.g., 2 days/year)
Tuition Reimbursement and Student Loan Forgiveness

Many cities, counties, states, and public entities offer tuition assistance programs, such as tuition exemption at registration or reimbursement after successful course completion. Health departments may establish their own policies and funding sources to support education that aligns with the organization’s strategic and workforce development goals. Eligibility rules and program requirements vary by organization.

Loan forgiveness programs are also available for individuals who have completed specific educational or training programs. Consult your HR specialist for guidance on navigating these processes. Some examples are listed below:

  • HRSA National Health Service Corps Loan Repayment Program – Licensed primary care clinicians in eligible disciplines can receive loan repayment assistance through the NHSC Loan Repayment Program. In exchange for loan repayment, you must serve at least two years of service at an NHSC-approved site in a Health Professional Shortage Area (HPSA).
    • NHSC Loan Repayment Program
    • NHSC Substance Use Disorder Workforce Loan Repayment
      Program
    • NHSC Rural Community Loan Repayment Program
    • NHSC Students to Service
  • Public Service Loan Forgiveness Program – For employees of government or not-for profit organizations. The PSLF Program forgives the remaining balance on direct loans after the employee has made the equivalent of 120 qualifying monthly payments (10 years) under an accepted repayment plan, and while working full-time for an eligible employer.
  • HRSA Nurse Corps Loan Repayment Program – Pays up to 85% of unpaid nursing education debt for Registered nurses (RNs), Advanced practice registered nurses (APRNs), and Nurse faculty. If you receive an award, you must work two years in either an eligible health care facility with a critical shortage of nurses (critical shortage facility), or an eligible nursing school as nurse faculty.

Academic Health Department (AHD) Partnerships

What is an AHD Partnership?

An AHD partnership consists of at least one health department and at least one academic institution working together to achieve shared goals. This relationship is sometimes described as the public health equivalent of the “teaching hospital” partnership between hospitals and medical schools. AHD partnerships can enhance public health education and training, research, and service and may offer a variety of benefits, both for the organizations involved and for the community as a whole.

AHD partnerships contribute to employee professional development in a number of ways. Student interns at the public health agency provide supervision and teaching opportunities for staff. Some health departments that provide training and coaching to student supervisors found these employees grew in confidence and interest in pursuing more training and opportunities in supervision. AHD partnerships provide opportunities for staff to mentor students, lecture in classes and collaborate on projects and research alongside faculty and students. Such involvement can be invigorating and rewarding to staff. Additionally, these partnerships leverage students’ contributions to projects, bringing fresh knowledge and skills while also preparing them for future roles, thereby fostering recruitment into public health careers. AHD provide pathways into governmental public health.

Learn More

Workforce Pathways and Recruitment

Recruitment is an ongoing process that begins long before a hiring need arises. It should be a shared responsibility, integrated into everyday public health work. This involves leveraging both existing and new recruitment pathways, engaging with the next generation of professionals, and proactively refining the recruitment process to meet future needs.

Leverage Existing Pathway Programs

Pathways programs provide valuable opportunities for growth and can help build a strong pipeline for recruitment. Examples of such programs include:

Build Relationships

Build or strengthen relationships with like-minded and mission driven groups and individuals who already are interested in public health work. Consider reaching out to the following types of groups as part of ongoing career pathway development and recruitment.

  • Boards and people already involved with public health programs. For example, members of the local board of health or community health advisory board; participants in the local Medical Reserve Corps (MRC); youth who participate in public health tobacco or suicide prevention programs.
  • Service clubs or organization like: Kiwanis, Lions or Rotary Club; chamber of commerce; Veterans organizations; neighborhood association.
  • Professional organizations such as local chapters for the medical or nurses’ association, environmental organizations, community health workers, etc.
  • Local organizations for Returned Peace Corp Volunteers – they even have job boards for posting recruitment opportunities.

Never miss an opportunity to recruit. Mention of open positions or simply inviting people to join the agency as employees now or in the future can be part of every conversation and presentation.

Engage with the Next Generation

Engaging with young people and educators is essential in building and supporting public health careers. Some effective strategies include:

Engaging with Schools (K-12, Community Colleges, Universities)

  • Build relationships with career counselors. Establish a connection to stay informed about student interests and opportunities and to inform the counselors about opportunities in public health.
  • Participate in or be a guest speaker at the Parent-Teacher-Student Associations.
  • Join academic advisory boards to make connections. Engage with school leadership to influence curricula and create connections with students.
  • Participate in career fairs. Meet with students and promote public health as a career option.
  • Partner with teachers and faculty. Offer to be a guest speaker or lecturer in classrooms to share your experience and inspire students.
  • Participate in science fairs on the planning committee, as a coach or judge/evaluator. Help teachers and students make connections between their interests and public health.
  • Promote community service opportunities. Highlight public health opportunities that could meet community service or service-learning requirements for students.

Connecting with Youth Organizations – Reach out to organizations that serve youth and find opportunities to engage and help program staff, teachers, coaches, and kids see the link between public health and their activities. For example:

  • Boys & Girls Clubs
  • After School Programs
  • Programs hosted by public libraries
  • Future Farmers of America (FFA) or 4H Clubs
  • Scouting (Local Boys & Girls Troops)

Creating Hands-on Learning Opportunities – Provide youth with opportunities to observe and experience public health work in action, understand its impact, and see how it connects to their daily lives. Some health departments host annual day-camp-style programs, while others offer various hands-on experiences. For example:

Plan Ahead to Improve the Recruitment and Hiring Process

Continually Improve the Hiring Process – Delays in hiring often lead to losing qualified candidates, particularly in high demand fields like nursing and other specialized public health roles. Refine and improve the process. Get to know your HR staff in advance and work together to improve every part of the hiring and onboarding process and then do it again to keep improving.

Use Data to Improve the Hiring Process – Track key metrics (e.g., time-to-hire, candidate satisfaction) to evaluate the process, changes made and recruitment strategies. Use the data to make informed decisions and fine-tune the process.

Simplify the Hiring Process for Managers – Prepare all necessary documents in advance, including policy updates, guidelines and special forms for exceptions, to ensure a swift and smooth process for hiring managers. Before positions are posted, develop the interview questions and rating process and hold time on calendars for interviews to reduce delays.

Simplify the Hiring Process for Candidates – Make job postings as easy to find as possible by listing them on major job boards like Indeed, LinkedIn, and public health sites such as publichealthcareers.org. Allow candidates to apply for multiple positions with a single application. Explicitly encourage applicants to apply even if don’t have to meet all the position qualifications. Highlight that experience, potential, and willingness to learn are valued. Provide clear and transparent information on the actual starting salary (on-hire salary range), rather than only the whole wide salary band. Clearly outline flexible work arrangements and remote options. Use human oriented language in job descriptions. Include information on the work culture, team environment, and the meaningful impact of the role rather than focusing only on job duties. Highlight your organization’s values, mission, and culture to help candidates evaluate if your organization is a good fit for them.

Recruitment Strategies

Prioritize Critical Positions – Clearly identify and prioritize roles that are essential for immediate hiring. Allocate resources and prioritize filling these positions promptly. The following downloadable resources can help support your prioritization process. For additional resources visit the Foundational Public Health Services (FPHS) page.

Invest in Recruitment Resources – Allocate a budget for recruitment activities and consider hiring or contracting an experienced recruiter. Alternatively, collaborate with other organizations, your state association for city/county health officials (SACCHO), or state public health association to share the services of a recruiter.

Incorporate Technology into Your Recruitment Process – Use electronic job boards (e.g., Indeed, LinkedIn, publichealthcareers.org) for greater reach and efficiency. Incorporate video interviews for initial screenings to broaden access to candidates and save time.

Think Outside the Box – Applicants are looking for different experiences. Be bold and innovative. Highlight the unique benefits of living of the community (e.g., vibrant local arts scene, outdoor activities, community feel). Advertise positions in publications that target specific demographics (e.g., Outdoor magazines, Country Living magazines, Rural Living magazines) or promote the local area (e.g., local tourism websites). Consider joining forces with other public health agencies in your region or other organizations in your local area to pool resources and get noticed.

Expand Recruitment Efforts to New Candidate Pools – Broaden recruitment efforts to include candidates from diverse backgrounds and untapped candidate pools, such as: community health workers, medical reserve corps members, people returning to work, people with different lived experience, participants in public health programs, people changing careers, people with disabilities, veterans, seniors, and those from marginalized groups (e.g., refugees, formerly incarcerated individuals). Engage in targeted outreach through platforms like diversity job boards (e.g., https://diversejobs.net/) and networks like returned Peace Corps Volunteers who have their own job posting site.

Treat every interaction and interview as two-way conversations – Remember candidates are interviewing you too! Be authentic and transparent with candidates. Some public health leaders share their CVs or career journeys with candidates to illustrate the diverse pathways and growth opportunities in public health.

Continuous Recruitment – Recruitment is an ongoing effort. Use every opportunity, daily interaction, and tool to recruit potential candidates. Recruitment specialists say it takes up to 15 “touches” to get the attention and interest of potential candidates. Community outreach, events, and even social media can be great tools to help keep your organization top of mind. Encourage all team members to take part in recruitment, all the time. Everyone can contribute by sharing job opportunities and referring potential candidates. Leverage resources like the Region 2 Public Health Training Center’s Recruitment Toolkit to stay informed on proven recruitment strategies.

Additional Resources

From the Public Health Foundation
From the TRAIN Learning Network
From our Partners

Development of this resource is guided by the Retention and Recruitment (R&R) Workgroup​, an initiative of the Council on Linkages Between Academia and Public Health Practice​. For more information about the R&R Workgroup, please contact Mayela Arana at marana@phf.org.

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