On Wednesday, February 22, HC3 hosted the second session of our Future of Workforce – Education and Training: Creating Pathways for the Next Generation of Healthcare Leadership – presented in collaboration with the Chicagoland Healthcare Workforce Collaborative. The goal of this conversation will be to explore initiatives and programs that are curating investment and cultivating equitable pathways for job placement; this conversation will elevate solutions and opportunities happening at the local level to enhance the vitality of Chicago.
Moderator: April Harrington, Project Manager, Chicagoland Healthcare Workforce Collaborative
Rukiya Curvey Johnson, VP, Community Health Equity and Executive Director, Rush Education & Career Hub
Dena Giacometti, Director of Workforce and Career Pathways at Skills for Chicagoland's Future
Stacy Ignoffo, Executive Director of Community Health Innovation, Sinai Urban Health Institute
Eve Shapiro, Senior Director, Programs & Evaluation, West Side United
IN THE NEWS: CHICAGO LEADERS TALK IMPROVING THE WORKFORCE PIPELINE | Health News Illinois | 2.23.2023 | Article here
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The COVID-19 pandemic and the great resignation have forced companies to reimagine their workplace priorities. Business leaders are looking for ways to reinvent the employee experience and must address technology, workplace design, and overall wellness. As we look to build a sustainable future of work, how do we cultivate more purpose-driven models and opportunities for employers to safeguard the health and well-being of their employees?
April Harrington (AH): What strategies are you using to engage and retain workforce in health care?
Stacy Ignoffo (SI): SUHI has used a community-driven process to understand and address health inequities. SUHI addresses these issues through innovative solutions and has become nationally known for its expertise in the community health worker (CHW) model. Over time, SUHI has focused on scaling and integrating successful CHW models through testing utility in new settings or areas, developing and testing neighborhood-centered CHW models, and growing the Center for Research Outcomes and Workforce Development (CROWD). In recent years, SUHI has expanded its work to focus on workforce development opportunities and to build a population health career pathway program.
Eve Shapiro (ES): West Side United aims to address the disparity in life expectancy between West Side neighborhoods and the loop or downtown. A vital component of this work focuses on economic vitality and developing opportunities for increased income and wealth-building within West Side neighborhoods. West Side United has an Employee Professional Pathway Program working with incumbent hospital employees in food or environmental services to help them transition into a clinical career. The program provides pathways in medical assisting, phlebotomy, and health IT.
Dena Giacometti (DG): Skills for Chicagoland’s Future is a demand-driven workforce intermediary that works to close the gap between credential attainment and employment. They focus on direct placement across employers and sectors. Dena works in two program design models, one engages candidates who are not enrolled in any education/training, and the other captures candidates who are currently enrolled in a course and are close to credential attainment to ensure they have job readiness and submit them for hire.
Rukiya Curvey Johnson (RCJ): Rukiya leads community health equity and engagement at the Rush Education and Career Hub, which seeks to leverage human and economic resources to improve community vitality. Hiring locally is an important strategy to increase opportunities for people in the community. The Rush Education and Career Hub aims to tap into surrounding communities for talent and develop and provide career pathway programs for community members and incumbent employees. Several pipeline programs begin as early as middle school and go beyond.
AH: How are your organizations actively recruiting from previously underutilized talent pools and building accessible training models to fill those talent needs?
ES: There’s a disparity in unemployment among West Side residents compared to other Chicagoland residents. Sometimes incumbent employees want to transition to a different job and need extra support. That could mean covering tuition, which West Side has been able to provide through the Advancing Cities Grant. Some require a schedule and time adjustments by working with their managers to enable them to attend classes or fulfill an externship. West Side United saw with the first pathways cohort that unexpected barriers would arise, such as old outstanding fees, the need for a laptop, or someone needing to pass an admissions test but hadn’t taken a math class in 20 years. West Side United is learning to be creative to overcome such barriers.
AH: What is Rush doing to reach young people? And as we attempt to inspire young people to pursue careers in health care, what challenges and opportunities are we facing?
RCJ: There is a focus on strengthening academic preparation and stamina for STEM learning. Rush also does a health equity assessment tool to assess student needs, whether it be utility assistance, food needs, or things that can get in the way of learning. Creating opportunities for early work experience is another important strategy as the first job or second job is really important for building a resume and a sense of self-efficacy and agency for young people. Rush programs also provide exposure for young people to various health care careers outside of being a doctor or a nurse. Every year Rush has about 200 high school and college students in paid, work-based learning experiences; up to 90 percent persist in their STEM and health care careers, and over 75 percent earn their industry credentials through Rush’s programming.
AH: How are you ensuring that as the CHW field grows, it remains accessible to the populations you serve?
SI: SUHI’s approach has always been to work hand-in-hand with communities and bring together community residents, employers, and social service agencies to educate about the community health worker's role. Reiterating the scope of the community health worker, the purpose of the community health worker, and ensuring that organizations who want to embed community health workers are educated on that scope and purpose of the community health worker. SUHI believes that if you recruit the right people with the passion for the work, and the ability to connect with communities and provide the proper training and support, those are the people the community needs. It's not about education but rather the lived experience.
AH: How do you help people get in the door and reach that first credential? What sort of supports do you see that currently exist in the ecosystem?
DG: Skills has a department dedicated to community and strong strategic partnerships. They rely on a lot of those relationships for traditional areas like childcare and transportation. The in-house mentoring and the mental wellness component are among the most significant spaces of success and retention throughout the program. Skills has an in-house mentor who is a licensed social worker. There are weekly touchpoints with the mentor, which has contributed significantly to the candidate's persistence.
AH: What are we seeing as changes in what we need to do to support retention, and what should be done to keep people feeling secure and fulfilled in their roles?
RCJ: Taking a step back to think about how we engage staff year-round, not just at the mid-year or end-of-the-year performance review or when someone is ready to walk out the door. How are we engaging them all year long to understand what's happening and where they might need more wellness opportunities and resources? One area of focus at Rush focused on is seeing if people are willing to stay in the field. If a nurse doesn’t want to be on the floor, maybe they can be an educator. Rush is trying to think about other ways to engage people in ways that fulfill them personally and revisit how jobs are organized.
Rush has also looked at certain job descriptions to determine if a degree is needed for certain roles.
We need to think about a trauma-informed approach to workforce development. We should rely on something other than the same old traditional workforce development models, especially in the health care space. How do we think about attending to the whole person versus being narrowly focused on the educational and competency requirements but looking at that person?
The trauma-informed approach is so critical. We know that an individual's adverse childhood experience score directly contributes to their likeliness or unlikeliness to be employed, so addressing those issues through in-house mentoring is an impactful component.
During information sessions, Skills strives to outline employer opportunities beyond the first credential because they vary greatly. In that early phase, they try to lay out the career pathway options that candidates can find once they start in a certain field.
AH: What isthe state of our training workforce right now, and what are some ongoing challenges and opportunities for developing talent?
SI: SUHI has been intentionally developing its internal team through defined career pathways and providing that training along the way. One of these pathways is within CHW training and development, where experienced CHWs can go on to support the training and supportive services that SUHI offers. The main challenge has been balancing the demand with the number of experienced trainers. SUHI is utilizing its partnerships to develop a network of trainers to work with.
It's important to think creatively, work through partnerships, and be intentional in thinking about what you'll need and how you will develop your team appropriately.
RCJ: Rukiya is trying to think about how to leverage the virtual learning space. There might be ways to open up capacity through some virtual learning and partnerships with other organizations and training providers. In California, there's an organization called Futuro Health that does something like that.
AH: What other opportunities are there to leverage technical resources and tools?
ES: West Side United wants to build an online community hub on its website. This would include input from hospital partners who can provide information about job availability and training requirements and an access point for community members looking for jobs or internships.
Although there's a lot of convenience and accessibility through virtual spaces, one thing that was seen with some students before the pandemic was the utilization of each other in the cohort model as support. Beyond the extensive wraparound and professional development support they receive through the trainers, they connected with each other. There are creative and fantastic ways to facilitate that connection virtually as well.
DG: We often ask the talent pool or the candidates to attend two, three, and even four interviews, and it can be challenging to facilitate all of those in person. More often than not, the initial interviews are virtual now, creating access without having to get somewhere for every step of the process physically. Even though much of the process is virtual, we found that something like a text group chat could provide support within a cohort.
Audience Question: Is West Side United thinking about the hub approach in collaboration with other large initiatives and establishing similar hubs? Can those hubs work together rather than every region having its own?
ES: As people from different entry points can plug into the same center, there's more opportunity to identify potential connection points between them. So it’s a great idea.
AH: What are some of the challenges and opportunities around equitable pay and benefits, which we know are very critical to this work towards bringing people into roles and keeping them there? And how are your organizations looking to invest in sustainable and equitable employment?
SI: We have seen the wages for community health workers increase during the pandemic, especially with some of the minimum payment requirements. At the same time, we have seen progress within Illinois, with legislation passed to pave the way toward CHW certification and reimbursement. A statewide CHW Advisory board has begun to meet to guide these processes, and these meetings are open to the public for anybody interested in listening and providing comments. Illinois is working toward adding CHWs as a Medicaid providers and covering Medicaid services through a state plan amendment.
Challenges include ensuring that these wages can be sustained within emerging reimbursement models, that the career pathways within the CHW role are considered to grow and develop these pathways toward advancement, and that knowledgeable and supportive supervision is embedded within organizations. An additional challenge is that with most reimbursement models, there is a requirement to be supervised by a licensed health care professional, some of whom have no or little experience with CHWs.
These challenges also allow everyone to get involved in the discussion, develop community-based partnerships to advance the work, and continue the conversation around equity.