Posted: 06 May 2021 12 min. read

State and local public health departments are hiring thousands of employees, but do they have a long-term game plan?

By Libby Bacon, principal and Randolph Gordon, M.D., managing director, Deloitte Consulting LLP

The American Rescue Plan Act (ARPA) could result in more than 100,000 new employees being added to state, tribal, local, and territorial (STLT) health departments over the next several years. The ARPA directs $7.7 billion to public health departments to establish, expand, and sustain the public health workforce. Public health leaders will need to identify, recruit, hire, and train this new workforce quickly and efficiently. More importantly, STLT governments should think strategically about how these new hires can make an impact now and how they might be redeployed once the threat of the pandemic has subsided. Decisions made today could have lasting implications for the future of public health. What’s the game plan?

In the immediate term, public health departments are likely to use ARPA funding to recruit a mix of case investigators, contact tracers, community health workers, public health nurses, epidemiologists, and laboratory personnel. STLT leaders should consider pursuing open talent strategies to meet immediate needs more quickly while setting up their organizations for longer-term success. In setting this overall strategy, leaders should understand flexibilities on how to access talent, develop systems/tools that allow for long-term talent management, and more.

Creating a transformational vision for a new public health workforce

STLT health departments have a unique opportunity to use the incoming funding to transform the practice and delivery of public health. This transformation should be based on a vision that leverages the traditional mission and core functions of public health.1 It should also take advantage of emerging technologies and new health care business models. STLT leaders should consider the timing, specialization, and sourcing components that might impact how talent is accessed and deployed to meet immediate and long-term goals. For example, the new public health workforce is emphasizing data scientists while building on the skills of epidemiology and other core health sciences. Without a clear transformational vision, however, just augmenting the current workforce will likely only reinforce inadequacies in the traditional public health infrastructure. 

Strategies for finding, accessing, and training talent

How can states, cities, and public health organizations use new federal funds to fill an immediate need for workers while also building a future workforce based on a transformed vision? The first step should be to identify existing skill gaps, misaligned skills, and underutilized skills that could be filled with new hires. Organizations should also identify work that could be augmented or replaced by smart technologies (e.g., data entry, front-line customer support).

STLT leaders have opportunities that go well beyond the traditional acquisition of temporary or permanent full-time employees. Here are three key priorities that could help balance the need for speed with the desire for long-term success:

1. Assess ecosystem partnerships and joint-venture opportunities: Many state and local health departments have recognized a skills gap, particularly in data science, contact tracing, and in engaging high-risk underserved communities. Sharing expertise, capacity, and capabilities through partnerships and joint ventures could play a critical role in sourcing and training new talent, and in reskilling and upskilling existing employees. Ecosystem partnerships might include relationships with other government and non-profit organizations. Joint ventures could be partnerships with large corporations and public-private partnerships. Potential partners include: 

  • Ecosystem partnerships with public-health schools to help identify alumni networks to fill volunteer slots or promote applications
  • Ecosystem partnerships with colleges and universities to assist with highly specialized requests (e.g., data science programs or contact-tracing certifications)
  • Joint-ventures with data or cloud platforms that provide scalable solutions and open-source training for data scientists or informaticians

2. Identify opportunities to augment workforce with digital support: Digital resources, such as automated bots and cognitive AI machines, can be used to quickly and efficiently complete low-skill or task-based work. Bots typically are not cost-prohibitive, nor do they take as long to develop as many people think. Digital-support options include:

  • Data cleaning and processing
  • Call-center support
  • Disease-tracking and contract-tracing capabilities
  • Financial-management dashboards
  • Self-help chat bots

3. Avoid hiring full-time staff for limited functions: Once most of the population has been vaccinated, there will likely be less demand for people to schedule appointments or to conduct contact tracing. Some of these employees could be redeployed to other areas. Other roles could be filled by tapping into the gig-economy. Using qualified gig workers for short-term assignments could make it easier to expand and shrink the workforce as needed. Such strategies could include:

  • Recruiting furloughed hospitality workers to fill various customer-service roles
  • Hiring gig workers or volunteers to increase vaccine uptake
  • Accessing people who are working for other organizations on a shift-based platform (e.g., trained PH contact tracers who pickup evening or weekend shifts as they want/are able to)

In the days and weeks ahead, STLT leaders will likely be making critical decisions about their workforce investments. They might face public and political pressure to create an impact. These leaders should begin the process by identifying the skills they need to achieve their missions both today and in the future. To successfully reach the recovery phase, public health leaders should invest in their existing employees and create teams to handle workforce management and strategic workforce planning. We anticipate that leaders will recognize opportunities for new approaches to enhance and align the skills of their current and future workforce via reskilling (provision of training to develop new skills to do a new job), upskilling (enhancement of the existing skills of the workforce to elevate rigor in current job function), and task-shifting (shifting or sharing tasks among workers who do not normally have competencies for those tasks to deliver them).

An approach that addresses the spectrum of full-time employees, contractors, gig workers, and everything in between will likely be key in understanding how to attract and redeploy an effective public-health workforce to meet immediate and long-term goals. Decisions made today could have lasting implications for the future of public health.  

Join us May 2021 for a webinar that explores The Public Health Workforce: Immediate Needs and Long Term Strategies.


1. The Future of Public Health, Institute of Medicine Committee for the Study of the Future of Public Health, 1988

Return to the Health Forward home page to discover more insights from our leaders.

Subscribe to the Health Forward blog via email