Work Force and PCAs

1. Work Force and PCAs DelRay Florida November 2008

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

3. 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

4. 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

5. 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: • What is the appropriate role(s) for PCAs in the WF arena? • What are some examples of successful PCA efforts to positively impact WF issues? • What are the barriers or challenges that PCAs will need to address? • What are the kind of resources and assistance PCAs will need to address the concerns identified in #3, above?

6. 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

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

8. Work Force: the Differing Views

9. 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

10. Survey Results: WF Staffing Varies Across PCAs • 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

11. Survey Results: PCAs Focus on Recruitment • 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

12. 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

13. Survey Results: Limited PCA Focus on Retention • 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

14. Survey Results: Few Mentoring Activities • 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

15. 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.

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

17. 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

18. Survey Results: Resources(One-Time BPHC Funding) • 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

19. Survey Results: Resources(Collaborations)

20. 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

21. 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

22. Survey Results: Many WF Barriers were Identified:

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

24. 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.

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

26. 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 Recruitment—Pros & Cons

27. 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.