STAR² Center Talks Workforce Success PodcastIn the introductory season of the STAR² Center Talks Workforce Success podcast, Sabrina Edgington, Director of Learning and Curriculum Design at ACU, gives you a glimpse into the integral role Chief Workforce Officers (CWO) play in advancing health center workforce success. In this episode, Sabrina interviews Kathy Brieger, Chief of Workforce Development at HRHCare in New York and Executive Director of Planetree, about career ladders for health center staff and the importance of building the skills and experience staff need to meet future workforce needs.

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Full Transcript: Health Center Staff Career Ladders

Introduction: Welcome to STAR² Center Chats with Workforce Leaders, which features the voices of health center experts from around the nation. We know this invaluable information will help in your journey to advance the workforce initiatives of your organization.

Sabrina Edgington: Well, welcome everyone. My name is Sabrina Edgington. I’m the director of learning and curriculum design at the Association of Clinicians for the Underserved and today’s podcast, I’m interviewing Kathy Brieger from HRH Care, where she serves as the chief of workforce development. And today we’re talking about career ladders. Kathy, thank you for joining us.

Kathy Brieger: Oh, it’s a pleasure to be here, Sabrina.

Sabrina Edgington: Well, we like to start our podcast with the context that health centers were started by communities for communities and aim to build a workforce that is reflective of the communities in which they serve. But that in mind, can you tell us a little bit about your health center, where it’s located and the patients you serve?

Kathy Brieger: Sure. We are located actually throughout New York state. We have a site that’s far as north as Hudson, New York, which is near Albany. And then we go all the way through the Sullivan county, Rockland county, Westchester.

Kathy Brieger: I think there are at least 12 counties that we cover all the way up to Suffolk county, which is Long Island and then all through the boroughs of New York City. So we’re a very diverse group. We have patients who are rural, who are migrant and seasonal farm workers. And then we have some urban patients who live in urban areas, as well as small populations of homeless patients that we take care of. So right now we have about 245,000 patients under our care.

Sabrina Edgington: And just to go to our next question, you were recently recognized by the Migrant Clinicians Network as one of the 30 clinicians making a difference. And they publish a beautiful piece that describes your beginnings as an organizer with Farm Workers United at the age of 17 and how you continue to support farm workers when you began working at HRH Care as a dietician, and today you oversee the development of a 2000 plus person workforce. So I have two questions for you. First, what does a chief of workforce development do? And how has your community organizing and clinical experience influenced this work?

Kathy Brieger: I think that with workforce development is really key and central to the success of any health center. Because as you look at this health center serve communities that are diverse and in order to be effective, you really have to recruit from the communities that you serve and then develop those people based on the skills that are needed to meet the needs of the health center. So as a chief workforce officer, some of the skills are to really look strategically at the health centers needs. And to say, for instance, now with telemedicine being a very important aspect, you might want to look at how are the skills needed for people who are going to be using telemedicine.

Kathy Brieger: Then you might also as a chief workforce officer look at how can you build career ladders so that people can actually enter maybe at a frontline position, but grow as they develop skills. And so that by the end of their career, they would reach the VP level or a level that would be very important to the organization. So I think as a chief workforce officer, it’s really strategically looking at not only the organizational needs, but also the healthcare industry needs, what’s coming up that might be maybe needing some new skills, some technical skills. And then the other aspects of chief workforce is also how do we allow people to gain confidence and skills that maybe no one in their family had been involved with? The second question that you ask is how is my experience related to this? And I would have to say that over the years I have worked for 30, I guess it’s about 35 years, just maybe a little shy of 35 years in community health centers.

Kathy Brieger: And what I’ve seen is that when people enter the workforce and they’ve come from areas that might be they might’ve just had a high school degree, then come in and they don’t have any skills with technical software, we need to prepare them for success. And how we do that is by offering them programs after doing an assessment, how are they doing with the different skills? What do they need most? And then helping them to build confidence in these skills. Because as a regular employer, if you go to a sophisticated business, they may expect these skills to be in place, but as a community health center and as a chief workforce officer, we’re looking to say, “We’re hiring you from the community. We know you might not have all the skills that are needed, but we’re going to help you get there. We’re going to help you get there so that you can be a success and then also make the health center a success.”

Kathy Brieger: So I think in my experience in the field has shown me that people need support as they’re going through these transitions. And sometimes we don’t want to assume that people have had an experience or may know how to handle things just because we have. I think it’s really important to keep an open mind and to really ask people what are their needs so that we’re not missing anything big.

Sabrina Edgington: What are some ways that your health center is paved away for career advancement?

Kathy Brieger: When we look at people who’ve come in and say… I’m going to give you an example of someone who she had graduated from high school and then started as a patient rep, which is a front desk person. And she showed excellent customer service skills, excellent organizational skills. She was trained to be a senior patient rep after a year or so. After being in that position for a couple of years, she again, mastered many of the skills needed as the front desk person.

Kathy Brieger: And we actually pulled her into some of our groups that would allow her to start to develop other skills that were more managerial. But one of the things we did, we formed something that’s called think tanks. And the think tanks are made up of people who say, in the case of this front desk area we want to know, what do they need as far as training for everyone? What are some of the jobs skills that we might need to build into the job description? Some of the other things might be, how do we train them? And then how do we actually deliver training? And so this person in particular was pulled into the training and the think tank activities so that she could actually help us to shape some of the curriculum, shape the performance appraisal. And then with time, she was very reluctant to give a presentation.

Kathy Brieger: But after a few years, we convinced her to be part of our training program or training institute, which is led by our Planetree program. And I’ll tell you a little bit about that in a few minutes, but what happened to the staff member was that she was very reluctant at first and then after doing this and getting support from us. After a few years, she became one of our most seasoned trainers. And the funny thing was just about two years ago, she actually did a presentation before our board of directors. So she went from a front desk person to really getting to be a senior person in her title. Now is she’s actually a health center director overseeing and not just one but two sites. So I think that that is allowing people to participate sometimes in these committees or groups, encouraging their participation in full engagement, and then actually making sure that you’re giving them the support they need to step up into some of these activities is really important.

Sabrina Edgington: Great. And you mentioned earlier the Planetree, can you talk to us about what that is?

Kathy Brieger: So I’m so excited to talk a little bit about Planetree because it’s been under the Planetree Institute of HRH Care that a lot of these activities have occurred. So HRH Care became an affiliate of this international group that has a name of Planetree. And Planetree is really about delivering persons centered care. And it includes not only engaging staff, but it looks at how do we include patients in transformation of care. And so HRH care became a Planetree affiliate about 29 years ago. We are one of the first health centers to become a Planetree affiliate. And then over last year we actually became certified. We just became a silver level certified as a Planetree organization and that makes us the first and only recognized certified health center in the country.

Kathy Brieger: And so under the Planetree Institute, many of these programs that I’ve talked about has really been developed and then coordinated. So even today under the Planetree Institute, that is really where a lot of this activity happens to develop staff, engage staff and give them these opportunities to really last them. So Planetree is our culture or orientation program that’s given normally at least six times a year. It’s a two day retreat. And we talk about everything from culture to teamwork, cultural diversity, our history of our health center and who we get to speak, or some of these rising stars, I call them rising stars of HRH care. So Planetree offers another vehicle for these folks to get this experience and to be recognized as up and coming leaders.

Sabrina Edgington: Thank you, Kathy. So I’m going to change the subject just a little bit. Let’s talk about the new generation of workers entering the workforce. Millennials and now Generation Z tend to not stay in their positions as long as generations before them. Obviously health centers want to be more than a stepping stone for compassionate and skilled workers. What do health centers need to know when it comes to retaining the new generation of workers?

Kathy Brieger: I think that when we look at young people, I’m going to use my son who’s 32 as an example. They’re very interested in mission driven work. There’s absolutely this connection and importance for them. They also want to see that people are listening to their ideas. They don’t want to work in a place where they feel like they have no voice. So it’s actually vital for health centers to step up and say, “Let’s include these young people in committees. Let’s make sure that we’re not only having them on committees, but that they’re actually able to speak and lead things.” And that when you see the workforce, especially in health centers is getting older.

Kathy Brieger: And so succession planning becomes really important. How do we offer opportunities for these people to feel that they’re able to grow in a position and actually change positions so they’re not stuck? That’s how you can really retain people and make sure that you’re not losing these folks to hospitals and other organizations.

Sabrina Edgington: And how do you know when it’s time to talk to somebody about advancement?

Kathy Brieger: I think this has to be part of an ongoing process that every… I know some of our supervisors are really good at this, some are not so good at this. And the ones that are not so good at this have a higher turnover, but we have actually monthly check-ins for people. And I think that is a good way of just touching, taking a pulse and saying, “What’s going on?

Kathy Brieger: How are you doing?” I know every month or every two weeks, I have a 30 check-in with my senior staff. And then they have a check-ins with their staff a little more, maybe every two weeks or three weeks. But I think those check-ins are really a valuable time to see what’s going on. And how are you doing? How are you really doing? Because this way we’re able to say, “Is the project too much is the project not enough?” And I think that those are vital. You don’t want to wait till the annual performance review and leave it at an annual review because you will have definitely lost your people. People need a lot more support and really connection to keep going.

Sabrina Edgington: What do you say to organizations that lack opportunities to advance either because they’re small or because they aren’t seeing turnover and mid-level and senior positions?

Kathy Brieger: This is an interesting concept because health centers are not, they’re not able to spend lots of money on salaries and things like that. So sometimes there are other ways to look at how do we promote somebody to maybe associate or an assistant level so that they’re not maybe in the chief position or the VP position, but that there is a way, there’s a path forward. If the health center can build a path forward that maybe is a year or two years, they’re much more likely to be able to stay in, hang in there.

Kathy Brieger: If you have an opportunity where people want to retire, but maybe they can work part time. It’s a great way to start bringing in people who were at the level just below them, that they can get some good experience while the senior person is still there. And yet they’re given that experience so they can feel freer to go ahead and try new things. And actually maybe at the end of the year, or maybe it’s a two year period, they could see that there is some opportunity for growth.

Sabrina Edgington: Thank you so much, Kathy. This is really informative and it was such a pleasure talking to you and learning about the good work you do.

Kathy Brieger: And it was a pleasure talking to you too. Take care.

Sabrina Edgington: Thank you.

Closing: Thank you very much for joining us today. We hope today’s conversation provided you with great insight into the important role a chief workforce officer plays in the overall success of your health center. Check out all of our free workforce tools and resources on  health center staff career ladders and more at