Description of department: For the past 100 years, Cobb & Douglas Public Health (CDPH) has been dedicated to promoting and protecting the health and safety of our community. CDPH was the first PHAB-accredited health department in the state of Georgia. We are committed to improving quality of life by tracking and preventing the spread of disease, promoting health and safety through education, providing prevention services and ensuring our community is prepared for emergencies.
CDPH serves both Cobb and Douglas counties. Cobb County spans 340 miles and includes the municipalities of Acworth, Austell, Kennesaw, Marietta, Powder Springs, and Smyrna. Douglas County is one of the smallest counties in the state with just under 200 miles and includes the city of Douglasville.
CDPH protects the health and safety of the 906,484 residents of Cobb (760,141) and Douglas (146,343) counties. To accomplish this, CDPH employs 300 people across 30 programs that support services delivered in 7 locations.
Race and ethnicity demographics within District 3-1 vary. According to 2019 U.S. Census, 29% of Cobb residents were African-American, 62% were white and 13% were Hispanic. By contrast 45% of Douglas were white, 50% were African-American, and 10% were Hispanic.
CDPH is one of the largest health departments in Georgia and is made up of eight functional centers, including Administration (includes Emergency Preparedness), Community Health, Clinical Services, Environmental Health, Workforce Administration, Communications, Quality Management and Epidemiology/Infectious Disease.
Description of issue: According to the 2018 Forces of Change survey conducted by NACCHO, one-third of local health departments reported job losses in 2017. Over the past decade, public health departments have been challenged to "do more, with less" amid dwindling resources (including people). Recognizing our employees are our greatest resource, CDPH determined it would take a deliberate approach to strengthening the workforce. The employees provide the services which promote, protect, and improve the health of our residents. We embrace the philosophy of building a "learning culture" and are concerned with the impact of jobs lost due to attrition and retirements. It is important we develop, train, and retain our current employees for future vacancies.
Goals and objectives: CDPH's workforce development initiative is led by a multidisciplinary "Workforce Development (WFD) Committee". The initiative is one of five strategic initiatives tied to the agency strategic plan. Goals/objectives for this initiative were selected based on results of the core competency gap analysis, employee satisfaction survey and strategic planning process. The committee plans and manages the execution of the Workforce Development Plan projects and initiatives as identified in PHAB Domain 8; monitors progress on the objectives and metrics supported; stays current on environmental scanning data; identifies strategic issues that require attention; makes recommendations to leadership and develops new approaches to talent development; ensures execution of the WFD objectives and initiatives, and strategically responds to factors affecting talent development. 2019/2020 WFD goals included the following:
1. Create a merit-based pay plan
2. Develop succession plan
3. Implement cultural competency training
4. Establish a shared governance council
5. Create a young professionals retention strategy
6. Establish a management development strategy
Activities implemented:
1. Created a plan for merit-based pay aimed at decreasing turnover to include an educational reimbursement policy (adding hourly staff and paying for CEUs), Career Ladders for several job codes and a template for the remaining job codes.
2. Developed a succession plan for key positions in the agency in an effort to increase internal promotion by 10%.
3. Created a nursing shared governance council who completes two quality improvement projects per year in order to reduce turnover in nursing staff by 10%.
4. Created a management development strategy to include "Stepping Up to Supervisor" and "Supervisor Development" to improve employee satisfaction with supervisors by 5% and decrease turnover due to supervision by 10%.
5. Created a strategy in an effort to reduce turnover in young professionals by 10%.
Results/Outcomes: Upon implementation of the merit-based pay plan, the Merit-Based Pay committee was established. One outcome includes updating the education reimbursement policy that allows employees $1,500 per year to pursue CEUs, licensure, certifications and college-level courses. Another outcome is in addition to the career ladders already in place for customer service representatives, nurses, and environmental health, the committee developed career ladders for epidemiologist and accountants to support the goals of decreasing turnover and increasing internal promotion rates. We continue to work towards establishing prescribed career ladders for all other job codes. Furthermore, development of the succession plan increased internal promotion rates by 50% in 2020 and creation of the young professional's retention strategy reduced turnover in Generation Z staff by 231% in 2020, far exceeding the goals. Although realizing the full impact of the newly created management development strategy and nursing shared governance council will take time, the council has already resulted in a 6% decreased turnover, retaining staff who are difficult to replace during the COVID-19 pandemic.
Factors to success: Buy-in from our Health Director and Leadership was critical. The Director budgeted funding and staff time for our projects, supported our Training & Development Coordinator position which is imperative for these strategies to work. Also, feedback from the cross-functional members on the various committees were imperative for success. Program Managers' support was also critical. Many managers spent considerable time creating ladders and supporting staff to acquire skills necessary to progress.
Impact: The increased staff retention resulting from these initiatives, positively impacts public health by reducing disruptions in service delivery caused by inadequate/undertrained staff and hiring/training demands caused by turnover. The increased expertise through tenure and improved job satisfaction improve our ability to deliver high quality services.
Health inequities: CDPH has a separate initiative dedicated to health equity and previously developed an internal, cross-departmental Health Equity Committee. This committee was charged with developing a Health Equity Strategy that reduced inequities among our staff and better prepared staff to reduce inequities through our programs delivered to the community . The committee has launched mandatory, agency-wide training on health equity, social determinants of health and most recently a cultural competency course.
Website: http://www.cobbanddouglaspublichealth.org