794: Inaugural PHIG Impact Report Features Kentucky Success

SUMMER JOHNSON: 

This is the award-winning Public Health Review Morning Edition for Tuesday, November 19, 2024. I'm Summer Johnson. Now, today's news from the Association of State and Territorial Health Officials.

Today we're kicking off a new segment that highlights the transformative impact of the Public Health Infrastructure Grant, or PHIG, on the U.S. public health system. The segment is called 'Investing in Tomorrow: PHIG Impact Report. Right here on this newscast, we hope to bring you meaningful information about PHIG, like updates, resources, and inspiring stories of change in public health across the country. Today's interview is with Dr. Steven Stack, ASTHO's immediate past president and the commissioner of the Kentucky Department for Public Health.

Hi, Dr. Stack, thank you for helping us kick off the PHIG Impact Report. The Public Health Infrastructure Grant is something a lot of health departments are grateful to have right now. What about you? How important is PHIG to the work your team is doing every day?

STEVEN STACK: 

So, our partnership with the CDC through the Public Health Infrastructure Grant has been really invaluable to our work at the Kentucky Department for Public Health, and that extends to our engagement with the Kentucky State University. So, we have worked to create pipeline programs that reach down all the way to high school, through college, and then all the way through the post-graduate phase, to make sure that people are aware of opportunities for careers in public health and that they have pathways that they can pursue, to explore and then hopefully enter into those careers. KSU is a historically black college and university. It's directly across the street from our offices here in the capital and so they've been a wonderful partner, and we look forward to the opportunities to further improve the diversity of our workforce; to make sure that we have a workforce that is representative of the people we serve and to ensure that there's a wide variety of Kentuckians who have the opportunity to pursue public health careers.

JOHNSON: 

When you say a wide variety of Kentuckians have the opportunity to pursue public health careers, can you tell us why a diverse workforce is invaluable?

STACK: 

Well, we know that people generally are more receptive of messages when they come from people who look and sound like them, people who walk a similar path through life. So, it's important to have trusted messengers. And when your workforce does not reflect the people you serve, you set up a barrier in that trusted messenger model. And so, it's important that we work to make sure we have adequate representation for men and for women and for race and ethnicity and for rural and for urban and many other types of demographics, so that everybody in society has the chance to reach their full potential, and everybody has the opportunity to benefit from the services and supports we provide because they have trust and confidence in the people bringing those services and supports to them.

JOHNSON: 

Your department used PHIG to support the workforce. Can you tell our audience exactly how you did that?

STACK: 

Well, we, sadly, as a nation, under-invested in our public health workforce for far too long. And I think when we entered COVID, we were really in distress, not just because of the magnitude of COVID, but because there was such a long period of degradation in investing in the education, the training, the compensation, and other things that are necessary to retain a talented workforce. The PHIG grant has given us resources to address some of those problems, so we have tuition assistances programs for current employees. We have subscribed to Coursera, which is an online, on-demand learning platform, and we have hundreds of our employees who make use of that to pursue educational curiosities of their own interests, and also many of which are beneficial to the work we do here at KDPH. We also have invested in our employees by providing retention payments on a quarterly basis for employees who end a quarter in good standing, they receive a modest retention payment to keep them as a member of the workforce and to demonstrate the appreciation for their contributions. These things have had incredible impacts. We have found that in the span of a little over a year and a half, we have gone from about 20% of our workforce saying that they would seek opportunities outside public health by the end of the year, and we've cut that in half to about 10%

JOHNSON: 

That sounds like a big undertaking. What were the lessons that you and your team took away from it?

STACK: 

Well, I think we needed to think a little bit outside the box. We previously had no resources to do robust outreach to high school students or college students. We've also offered, I can't believe I overlooked this: internship programs, and so we've had more than 100 interns go through our agency using PHIG-related funds, and we have hired, I think, more than nine of them to be employees in our agency. So, we've had wonderful success so far, exposing people to the work we do, capturing their interest, and getting them to go on a journey with us that led, for some of them, to employment along the way. I think we've learned to appreciate and value particularly the feedback and input that our interns, that our current workforce, and that the students give us, so we can continually calibrate these programs to make sure we're responding to interests and needs of the people we're trying to serve, rather than just speculating what they might like or might enjoy.

JOHNSON: 

You were able to see significant results in workforce satisfaction. Are there any other notable changes that came from the PHIG grant?

STACK: 

Some of the achievements I'm most proud of for our PHIG-related work really is having a workforce that has become stabilized. We have now some of the lowest vacancy rates in our workforce that we have had in well over five to 10 years. So, we are in many areas, completely staffed for the first time anyone can remember. And not only are we completely staffed, as I referenced before, we have cut in half from roughly 20% to 10% the employees who say they would seek employment elsewhere in the next year, and we have maintained a workforce that more than 92% of which says that they are satisfied in their roles here at KDPH. So, I, in my estimation, feel that you get to excellence not by just hiring. You get to excellence by retaining a talented workforce, because it's when people are fully trained and retained that they understand the work they're doing, the people they're doing it with, and are able then really to achieve higher levels of performance. So, success over time will be, "Can we continue to retain and inspire through growth and education and collaboration a workforce that feels empowered to do really phenomenal things for Kentuckians?"

JOHNSON: 

PHIG has helped many departments throughout the country undertake some major, much-needed projects, but you hope that public health is relying on sustainable public health funding. Talk to us about that.

STACK: 

Right, so, one of the challenges in these state programs is the 'boom and bust cycle' of funding. Three fourths of all the funding that flows through the Department for Public Health at the state comes from the federal government. And as we all know, budget cycles wax and wane, and often crises such as COVID or 10 years earlier than COVID- or more than 10 years earlier - the H1N1 worries in 2009 led to additional funding, and when that additional funding comes in, we do the best we can to deploy it, but then the tide goes out. When the tide goes out, there's less money, and you can't keep up these initiatives. So, I'm grateful that the CDC has been committed to doing everything it can to provide a sustainable public health workforce. Funding, the current grant, if I recall correctly, goes to 2027 and hopefully they'll be able to find a way to continue it past them, so we can keep up these important initiatives, which I believe are having a significant and profoundly positive impact in our state.

JOHNSON: 

Thank you, Dr. Stack for joining the newscast and keep up the great work.

Also, ASTHO and the National Community Action Partnership are hosting a webinar focused on lessons learned from the Vaccine Equity Project. This is your chance to explore more ways to address health disparities. The webinar is on November 20 at 2:00 p.m. ET. Use the link in the show notes to sign up.

Finally, this morning, California has confirmed the first known case of clade I mpox in the United States. The risk of clade I mpox to the public remains low at this time, but we do have a link to the latest information in the show notes.

That'll do it for today. We're back tomorrow morning with more ASTHO news and information. I'm Summer Johnson. You're listening to the award-winning Public Health Review Morning Edition. Have a great day.