04/13/18 — Board of Health talks job vacancies

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Board of Health talks job vacancies

By Phyllis Moore
Published in News on April 13, 2018 5:50 AM

The Board of Health made quick work of approving the proposed $8.5 million budget -- a 2.2 percent increase from last year's request -- but spent 30 minutes discussing the prickly problem the Health Department has recruiting and retaining employees.

The budget overall is fairly stable, health director Davin Madden told the board.

"We're not in the business of making money," he said. "But we're one of the departments that generates money."

Personnel and fringe benefits make up a large portion of the yearly budget, said Ken Stern, administrative officer for the department, before turning over the reins for the 2018-2019 request.

Leah Grimmer, lab manager, has been interning in the business office as part of her education in health services management at East Carolina University, he said.

The budget process starts in January, with all managers assessing programming and operational needs. It must then be approved by the board and will be presented to the county budget team on April 23 before being forwarded to the county commission.

There are currently 13 vacancies within the Health Department -- including five social workers, three public health nurses and three processing assistants. But the openings are not attributed to retirements, transfers, terminations or RIFs, or reduction in force, she said.

"Our 2017-2018 goal, employee retention and recruitment, is 12 percent, which is down from 18 percent (the year before) and I just recently found out today that the national average for health care is about 19 percent turnover, so we're below that," Grimmer said.

Board member Ed Cromartie expressed concern about the vacancies and where recruitment efforts are centered to remedy them.

"What, if anything, as a county can we do to enhance the number of folk who are getting trained in the jobs that we have in the county that consistently run short of the applicant pool?" he said.

"I'll just be blunt about that, Mr. Cromartie," Madden said. "The biggest issue we see and the common factor for employee retention is salary.

"Increasing salary, we would expand the applicant pool because you get more interested parties that are willing to come in for those rates, especially in the nursing program. I mean, the nurse can work in the private sector and make significantly more money than what we bring them in."

This does not mean there is an inequity in the value of the job, though, he added.

Madden said he and Stern typically explain to potential applicants and staff about the value of county employment -- which goes beyond the paycheck amount, as it includes a retirement package, 401(k) matching and benefits.

That is not always enough, however.

"When we see people leave, everyone does an exit interview," Madden said. "It's not that they go out maliciously. They just put on there for 'Why are you leaving?' sometimes it's a 'better pay elsewhere' type thing."

Cromartie, who is a county commissioner, likened it to school system seeking certified teachers, saying that it ultimately all comes down to dollars.

"I just say that out loud because as a board we're going to have to do something about the dollars," he said.

Board member Bob Cagle said this problem has seemed to grow bigger over the years within the county.

"We serve as a training ground for positions," he said. "There's some fairly technical positions that they come here and because we have vacancies, maybe spend three years getting the experience they need and then they jump to Johnston County or to Pitt County or to someplace else where they can make more money based on the education, the training that they gained here in Wayne County."

He suggested there be efforts made to remedy this, such as requiring employees to stay in the job for a certain amount of time after receiving training.

Madden said the time frame was much less than the suggested three years.

"A lot of the hires that left in the last year, the 18 percent turnover, they were here less than a year," he said.

"Actually, our what they call new employee turnover rate, which is basically the percentage of your vacated positions that were held for less than a year, our new hire turnover rate is 25 percent right now for last year," Stern added.

This has been particularly true in the area of environmental health.

The Health Department has worked hard to address that area, which translated to "costly training" for environmental specialists, Madden said.

"For the first six months they can't even do any work because they have to be authorized," he said. "So for six months they're just basically in training process, running around with our staff learning.

"So you're paying six months' worth of salary for no yield and then once you get them authorized, they work for about another three to six months and they leave. You're paying to train them for another county."

Cagle said this has been an ongoing concern, which has improved slightly but only because the salaries were re-evaluated.

Coupled with perpetual changes in state, local and Medicaid funding, however, the situation will not likely go away.

"We're doing more with less and at some point we'll be asked to do everything with nothing," he said.