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Ahead of the Curve: Region 1’s Public Health Workforce Plan
A conversation between Erin Braasch & Sarah Tennyson
11/13/23
Erin Braasch: Good morning, Sarah.
Sarah Tennyson: Hey, Erin. Good morning.
Erin Braasch: I’m so glad to be able to spend this time talking with you about a project we got to do together. So, everybody watching: I’m Erin Braasch and the executive director for WNC Health Network. We had the pleasure of supporting Public Health Region One in developing their public health workforce plan. We know that it’s been put to use and there’s been some interest across the state in how you did this and so, just wanted to spend some time today talking about that project. Before we launch, Sarah, tell us a little bit about who you are and your role with Public Health Region One and the kinds of things you do day-to-day.
Sarah Tennyson: My name is Sarah Tennyson, I’m the Workforce Development Director for Region One Health Departments. The region one health departments go over from Cherokee County to Haywood & Transylvania, so it’s eight counties in the far west. As the Workforce Development Director, I’m technical assistant to each of the health departments, especially when it comes to recruiting and retaining staff. 46% of our public health staff left after COVID [nationwide]. And so this position was created to help fill those gaps of figuring out ways to support our existing workforce and recruit our workforce coming into public health.
Erin Braasch: So shifting to talk about this specific project that we worked on together, can you give us a little bit of background about it?
Sarah Tennyson: The way that this project worked was the health departments received a grant; it was the ARPA grant – the American Rescue Plan Act funding. After COVID happened, like I was mentioning, there was an exodus of the public health staff. With this funding, it was really to help us fill some gaps in the foundational capabilities of public health. And so the way that we did this is there was quite a bit of data that was collected. We interviewed staff for health departments across the state to see what do you need in your position, what kind of training technical assistance support do you need in your day-to-day life in the health department? So we got a lot of information back from our staff to figure out ways to help support them. We heard directly from the people that are most affected.
But as it happens with public health money, oftentimes we get the funding [but] we have such a short turnaround of how we’re going to spend that money. And so we have to make some very quick decisions. And so this is just kind of how we operate in public health. What we thought as the Region One Health Departments is that we have a limited amount of money, we had a limited timeframe. And so we needed to be very smart with our money in terms of making longer, sustainable impacts. We had this money, we wanted to make it last so what we wanted to do was to come up with a strategic plan to help guide us over the next five years, to make sure we were making informed decisions and the smartest decisions for the region. And so we decided that a strategic plan would be the way to help us get there.
We’ve worked with the [WNC] Health Network over the years to do things like this and my experience with the Health Network is that when we have a complex issue, we have a variety of different agencies with different agendas, different priorities, different capacity, is that we needed to be able to bring an external partner in and so the Health Network was a good fit for this kind of thing. To come in, bring all these different diverse people, personalities, agendas together, in a short amount of time to be able to synthesize a plan for us to be able to follow over the next five years. And so that was what got us to the point to want to develop a formal plan.
Erin Braasch: And who remind us who was all at the table? When you say “we,” who was involved in coming up with a plan.
Sarah Tennyson: It was the Region One Health Departments, and so it was each of the health directors from the county so that would be Cherokee, Clay, Graham, Macon, Swain, Jackson, Haywood, and Transylvania and myself. We think about it like, Oh, I couldn’t possibly facilitate this. But what I find so nice is having kind of an external neutral party that comes in because that helps me as the director of the program participate in the process as well, and also to kind of have that external support. So it’s kind of a neutral party that’s able to come in to help facilitate the process. So that I find is really nice to have someone like you all come in to do that.
Erin Braasch: Thank you, Sarah. We certainly appreciate the depth in which you participate. One of our values when we provide this kind of support is co-design so that we know that we’re uniquely meeting the need. So you, you know you had a very clear vision of what needed to happen and it was exciting.
Sarah Tennyson: I just wanted to add as I was thinking about the answer to this question ahead of time, and part of it is, Emily Kujawa was the facilitator along with you, which was really nice, but Emily and I before that session, we had many many meetings ahead of time and so I think that’s really important distinction. During that meeting I was the neutral person but ahead of time, her and I really did codesign that together — the process, the questions, the product. And so I really appreciate that aspect because I was right there with the process ahead of time, during, and after but then the day of it I could try to step back. And so that was just an important distinction. So I appreciate you bringing that up.
Erin Braasch: So now that this project happened a good while ago, what’s going on with the plan?
Sarah Tennyson: Well, it’s been really, really nice because, you know, in public health, oftentimes, funding is what we sometimes call braided funding, because it’s never straightforward. It’s rarely straightforward. Oftentimes, we have an issue or something we’re trying to address and we have to figure out ways to make it work. One thing I will mention about the Regional Health Departments is they’re very resilient. They’re used to working together. They’re used to… taking a small amount of money, expanding it, finding other ways to fund certain project to build the capacity for something and so what we’ve been able to do is take that plan and approach different funders and apply for different grant funding streams, where we prioritize certain pieces of this workforce plan. So I can apply to a certain funder for something that would fit appropriately what that funder is looking for where we’re also getting other funds for the state. We can kind of piece together what we’re able to fund from different sources. And so, I’ve used that plan multiple times over the last year and it’s so nice to just have this nice, tangible product that really supports my work and leveraging additional funds. And so it helps me be successful for the region. It’s really nice to have that.
Erin Braasch: You mentioned the state and I’m curious what the response has been in other parts of the state to your plan or from the state itself.
Sarah Tennyson: We’ve gotten a lot of really positive feedback from other regions in the state and the reason why is because we knew that these funds would end in May of 2024 and we’re prepared for that. So we did this plan last year kind of anticipating we would have a year left. I think when grants wrap up a lot of times, it’s like, oh, sustainability, what are we going to do next? And so I kind of feel like our region was ahead of the curve, because we had already gone through this process. We already had these pieces in place. And so across the state I had been sharing about our process to my counterparts and other regions in the state. And so they were very curious and would reach out to me to say, How did you do this? What questions did you ask, what was your process? Can we see the plan? And so I got a lot of really nice feedback from other regions across the state, wanting to replicate or get some feedback on how they could do something similar.
Erin Braasch: Great, Sarah. We certainly enjoyed working with you on this project. Thank you for being a great partner with us.
Sarah Tennyson: Yeah, it was awesome. Thank you so much for helping us, it’s been really really wonderful.
To learn more about Region 1 Public Health Workforce, email Sarah Tennyson at sarah.tennyson@transylvaniacounty.org. To learn more about WNC Health Network’s services that can support your work, visit here.
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In August, 2023 Erin Braasch, Executive Director of WNC Health Network, interviewed Norma Duran Brown, Executive Director of UNETE. Norma shared about UNETE’s partnership with WNC Health Network and local health departments in western NC to vaccinate older adults, as well as the overall work of their organization and the community health worker model.
Learn more about UNETE at: https://unetenc.org/.
Erin: Will you please tell us a little about the work of UNETE?
Norma: Absolutely. UNETE is a very new organization. We started in 2021. So as new as it can be. The good thing is that we are rooted in two decades of grassroots effort and community work in our region – which was very, very helpful in securing a contract with NC DHHS Office of Rural Health. Because that investment in that grassroots work that allowed us to get the contract for a one year and renew for six months. And it was absolutely amazing, challenging, but amazing to be able to train and deploy 32 community field workers in our region in five counties.
Erin: And that contract was in response to the COVID pandemic.
Norma: Exactly, exactly. And it was such an experience and often I said we were building the plane while we were flying it. But, but – you know, the creativity, the commitment of people that want to become community health workers have to take the courses and pass the course and be certified was just inspiring. You know, you can relate with me – we didn’t think many many years ago that we would be executive directors – and here we are!
Erin: Norma, in addition to building and flying the plane during COVID, y’all were also partnering. So, can you talk a little bit about how during that time you were partnering with WNC Health Network?
Norma: We did, yes we did. And that was a great experience with the My Reason campaign. And we have one of our very fresh Community Care Workers sharing the experience, the reason why he got vaccinated… you know, every story you showed was inspiring. Of course when we go show one of our own, we love it. It was a great collaboration. We have it in so many meetings together, learning of the impact of using social media platforms, and supporting that work we do. Raising awareness. Prevention. Learning from you all and serving five counties. And we continue beyond that contract, which ended. We continue serving.
Erin: Well and speaking of continuing, we’re thrilled to be building on that partnership with the project that we’re doing now. So working more closely together on this project that we have funding from the National Council on Aging to support. So for the folks listening, this is a one year project that’s aimed at increasing COVID-19 and influenza vaccination rates among particularly our older, at-risk populations in our region.
We have three tracks of this project working together. So that raising awareness that you spoke about, understanding the importance of vaccinations through community-driven marketing, and education outreach. We’re also leveraging relationships with local health departments across five counties to increase access to vaccinations to clinics in some of their outreach. And then the part you’re here to talk about is connecting with individuals directly and building that trust within communities through that grassroots outreach that you all specialize in and have expertise in.
This project is really rooted in your community health worker model. I’d love for you to share with us what your experience has been so far working on this project. We’re about four months in. What have y’all achieved so far?
Norma: We are happy that we have achieved over 100 people vaccinated, which is wonderful. And you know, speak about how the community healthcare worker model is such an amazing tool. Even though we are so strategic in that our community health workers mirror the communities they serve, we were like woah the only one fitting the category of older adults on my team is me. So we were like “how is this going to work?” And I think the fact that they can identify with the sons and daughters trying to keep their parents or grandparents protected and healthy was a very important point of connection in outreach in this community. Also, you know, the skills and the talents and how seasoned our community health workers are.E verybody says “there is such an energy in their presence.” Basically because they believe what they are doing is real and tangible and is to keep people healthier and you know, living healthy lives to their full potential. And we know how certain illness, COVID-19 – the long effects that you will see, can affect all that. So, I think part of the success is, besides that we are you know in food distributions, we are present in free clinics, we have all these amazing relationships with health departments, and their support is so crucial in this matter. We are in agricultural places, in factories. Besides all that, what we are doing is that honest commitment and believing in our mission that we’re wellness for the whole person and the full community. Because…they just…a colleague said, “I love to be wherever UNETE is because the chances are that I leave with my belly filled, happy, and my soul too.”
Erin: That’s beautiful, Norma. That is really beautiful. And that you are sharing that embodied joy and commitment to supporting communities is just a beautiful thing.
So, I know that this work isn’t always easy. So what are some of the challenges that you’re facing with this project in particular?
Norma: The main challenge is related to the challenges of finding COVID-19 vaccines and vaccinators. Because we in our beautiful partnership with health departments we know they’re also facing their own challenges in providing these. And obviously before we have all these…we almost could choose, with the support of other organizations, you know vaccinators from here, vaccinators from there. Now there is not a pool to choose from. So, so that has been the greatest challenge right now. And also from free clinics and the health department, it is the same commitment to serve. So they bring us COVID-19 vaccines, they bring Shingles – very important for our elders to be protected. They also bring Tetanus and Hepatitis. So when the resources are there, the collaboration and the mutual support is very tangible. The problem is when they don’t have access to those resources. And obviously we provide non-clinician services so we have to rely on vaccines with the experts. So that has been a challenge that we wish we can do more to relieve the burden that some organizations are experiencing in this arena.
Erin: Norma, is there anything else you’d like to say about what you’re particularly feeling proud about with this work?
Norma: Mostly it’s the creativity of our community health workers team. The willingness of you all to share all these tools and platforms that we can use – the “View From Here”. Because we need everything we can put our hands on to, you know, keep doing these very challenging missions of serving through a lifespan – our community. Obviously UNETE is not doing this by ourself. I was sharing yesterday, in July only, we have reached over 1,200 people in our five counties. But, it’s not because we are doing it by ourselves, it’s because we are collaborating with so many organizations that allowed us to be present, offer our expertise, offer our resources, and outreach people and bring vaccines, bring information, and connect with resources. And the creativity, how our team, you know, “try this’ and “try that” and go to nursing homes or go to, I don’t know, places to get to know our elders and be there for them. So yeah, the understanding that this work is professional work but service too.
Erin: I really appreciate you lifting up just how wholeheartedly you and your team bring your expertise and your openness to engage and utilize the expertise of the health departments and the Health Communicators Collaborative. That is critical for us all to be able to serve our mission. So thanks for lifting that up.
Norma: We serve all, we serve all – we include pets in that “all.” We’ve vaccinated pets too! All means all.
Erin: Maybe even some elderly pets.
Norma: Absolutely. Of course, of course!
Erin: Before we go Norma, from what you and your team have learned across this project and through your years during the pandemic emergency, what advice do you have for communities trying to increase vaccinations?
Norma: Yeah, that is very very important. It’s just to tap into the wisdom of the community. The community knows what the community needs. The problem is who they are going to entrust with the knowledge to say, “This is what I need. And I want to let you know what I need. And I trust you. You are going to deliver those services, or connect me, with cultural humility.” It goes way beyond being from the same ethnicity or speaking the language. So just listen carefully and look for those representatives from that particular neighborhood, of that particular community that will be your allies and share wants, their needs, and the other one – the resources. Make that connection, build on that trust, and just be absolutely transparent. I will say what wrongly we call “communities difficult to reach,” we have very easy tools to outreach. Justas with any underserved sector of our population, we have these “tomb raiders” that we can tell when somebody is wholly present and committed or you know, there is some agenda. So I think, just be yourself, listen, and look for these crucial allies that they will trust you with their needs. And just remember to serve.
Erin: Well thanks so much for your time today, Norma. And thank you for trusting this partnership. We’re so grateful to be working with you to help build healthy and thriving people and communities in western North Carolina. For those of you listening, please stay tuned in our newsletter, we’ll be sure to give updates on how this project is finishing up. Thank you Norma.
Norma: Thank you, Erin. See you soon.
