Laura Beeth, VP for Workforce Partnerships at Fairview Health Services: Tips for Reaching Untapped Labor Pools

Van Ton-Quinlivan: Welcome to WorkforceRx with Futuro Health, where future-focused leaders in education, workforce development and healthcare explore new innovations and approaches. I’m your host, Van Ton-Quinlivan, CEO of Futuro Health.

Workforce issues such as shortages in key positions and staff burnout continue to be ranked by hospital executives as their number one challenge. Today on WorkforceRx, we’re joined by Laura Beeth, a human resources veteran who will help us understand the problems more fully and share some initiatives she’s overseeing in her role as vice president for Workforce Partnerships at Fairview Health Services, the second largest private employer in Minnesota.

Under her leadership, Fairview has won wide recognition for its innovative workforce development initiatives, including being tapped for the White House Hope Street Healthcare Career Pathways Network. In addition to her work at Fairview, Laura serves on a variety of workforce employment boards at the state and national level and is a content expert for numerous publications focused on healthcare workforce best practices. Oh, we speak the same languages!

Thanks so much for joining us today, Laura.

Laura Beeth: I’m so happy to be here with you, Van, and I look forward to this interview together.

Van: Well, Laura, I want to hear the origin story. Martin Scaglione, who formerly headed up the Hope Street Group, called you the ‘godmother of healthcare workforce development.’ How did you get started in healthcare workforce development?

Laura: Well, I’m very proud of my background. I had worked in both hospital and urgent cares and clinics early in my history and was involved in very innovative programs. I started the first urgent cares in Minnesota and then worked in occupational medicine and I wanted to use that skill from helping patients to helping employees and people in the community.  I always feel like my job is to help people succeed through education and employment.

So, in 1995, I was tasked with opening up a career resource center, a job transition center and our first workforce development center at Fairview Health Services. I believe we were the only health institution that had those services. Immediately, in the first year, we were doing proactive career development, helping people that had any type of disability find permanent and regular employment. Soon after, when we had a reduction in force, we needed to redeploy people through job transition and it was just like a light went off. We need to develop retraining programs and job programs.

So, over the course of twenty-five years, I’ve offered and led our institution in running many registered apprenticeship programs, as well as short-term training programs and programs from two weeks in length to doctorate level programs and they’re all based on critical needs in our organization. Now more than ever, we’ve been doing just more and more partnerships with the community to really work with untapped labor pools to bring them into healthcare.

This journey has been over twenty-five years — actually twenty-eight years — and it’s just been an honor and a privilege to be part of helping hundreds of thousands of people get jobs and get scholarships and help them with their vision and dream of working in healthcare.

Van: Well, Fairview was ahead of its time — and you as its leader were clearly ahead of your time — in terms of doing the work to bring the untapped into the healthcare labor market. What are you experiencing right now at Fairview? Maybe you could give us some descriptive information about what’s going on.

Laura: As one of the largest employers in the state and the academic medical center in the state of Minnesota, we have great challenges. They range from frontline workers, people in nursing assistant roles that are critical, all the allied health professions — surgical technologists, respiratory therapists, medical lab careers, imaging careers — and of course, nursing and mental health physicians.

I’m tasked with tripling the number of earn and learn programs we have in our organization. I’ll just say the work that we do — and, Van, what you do — is very intentional work. No longer can we count on people just proactively looking for us and going on our applicant tracking system. We’re really going out deeply into the communities, especially communities with high social determinants of health, and really working that vision and partnership to help them move into healthcare careers. One-third of our external hires come from the workforce development team and these are people that would probably not find us unless there was an intervention, unless there was a job fair, a community partnership, a scholarship, an earn and learn program, some kind of pathway.

So, it’s really changing our demographics. We look at our BIPOC demographics every month, and we are increasing our racial diversity with a goal of having one third of our employees be people of color by in the next five years, and we’re well on our way. And so that outreach is bringing in people that were serving as patients, now they’re working for us in our institutions as well.

Van: Congratulations on all those statistics. Great work. Most of healthcare employers, if they didn’t already have full-fledged programs, have begun tiptoeing into this, doing intentional work on workforce development and finding the funding for the team that takes on the work, but also the funding for the learn and earn. Are those budgets central? How do you budget as an organization for those activities?

Laura: When I started this work, it was our CEO’s initiative to be the champion and support having a workforce development center and workforce development services. So, we have infrastructure, and it’s a centralized budget for the employees on my team that do this mission work in the communities. What I would say with paying for programs, there’s always been ROI.

On occasion, like many of the large health systems, we’ve been fortunate to partner on many, many grants, including the first apprenticeship grants out there. That money is to get us started in that, but then we sustain that funding. So, while some of our earn and learn programs may have started with grant funding, we continue them on. We do apply for other grants, but we try to braid funding. We’ll look at our tuition benefit, which is $5,250 a year, and then we offer additional scholarships. If it’s a critical job, an earn and learn program like an apprenticeship program, then we’ll add another $4,500 to it. We’re trying to make the cost of education near zero for the individuals and, of course, they’re earning a wage while they’re in these programs.

What I have found with my history, these are not the individuals that leave our organization. These are the people that stay. There’s loyalty. When I started our operating room program, it filled 90% of our jobs, and 95% of the people stayed, and there was like a major life event for someone to leave. Now with after the pandemic, it’s probably like 80% because a lot happened with people wanting to be home with their kids and so on. But what I have found is, you know, you can give money away on a sign on bonus or other type of bonuses. But when you invest in people and believe in people, and it’s a long-term commitment before they start, while they’re in their earn and learn program and working, after we provide job navigation skills with wraparound support for people that need that, it’s like they family. I mean, they want to stay. They’re not the people leaving.

We track a number of things in our organization to prove that case. I developed a case for workforce development that’s published and that is to explain to others why investing in people is important. So, we’ll track how many people we’ve hired in zip codes that have high social determinants of health. Those numbers we track every single month. We track how many people we’re hiring at events that we actually like worked with someone in an event and helped them apply. It could be someone homeless that didn’t have a place and would not probably have made it through our system if they didn’t have a place to interview. We track the number of students that are unpaid that we’re working with on red carpets to get them in and out and through experiences, and then we also track all the earn and learns.

Every month I’m turning in those numbers and at the end of the year, we’ll probably have 4,000 of those people that were hired just this year and that goes into thousands and thousands. I’ve run talent management and talent acquisition in the past as well with the recruiting functions for physician recruitment, regular recruiting, executive recruitment, contingent as well, but this work is where you’re investing in people and it’s very intentional.

Van: Laura, you mentioned that all these metrics are published. So if someone in the audience were interested in pulling the report, where would they find it?

Laura: So I would say, of course, my LinkedIn profile has a lot on there with publications. Fairview Health Services has also signed on as one of the key authors and signatories for the Healthcare Workforce Impact Commitment and so we publish our work through them as well. We turn in our data with the number of hires, the number of impact hires where we’re moving people on career pathways. We also have been the National Fund for Workforce Solutions champion where there was a profile done on us as well. We’ve been part of New America, Opportunity America, a number of publications around investing in people and earn and learn programs.

Van: Wonderful, wonderful. Now, given your history with healthcare workforce development, do you observe the shortages to be worsening or cyclical?

Laura: I’ve seen both over my time. I would say since COVID, it’s worse than it was just cyclical. I think we’ve seen just Americans in general look at rebalancing their lives. Some of them have decided to retire out early and maybe are going to come back now, and we want them to come back and I see there’s great opportunities for them to come back. We’ve seen families decide to have single income versus dual income and we’ve seen people that once they work from home, many people want to work from home now. So, I think it’s been a little more challenging to inspire people to come back.

It’s a calling. People run to this work, not away from it. What we’re doing to mitigate that is really going out into communities. Our growth in population in Minnesota is new Americans and so many new Americans could be first generation and may not know the opportunity. So, we are doing a lot of work to reach communities we serve: International Institute; Hired; CLUES…I can go on and on with the different groups to really then inspire people to go on to these careers, show them what’s possible. We have scrubs camps for students to go to learn about healthcare careers that we fund. We have paid internships for first generation students.

Again, we are out there with not just bringing people in, but trying to move them up. The state of Minnesota offered new American grants that were for people from other countries that have medical credentials to get recredentialed here. So, we’re trying to do those crosswalks for people here as well. There’s a lot of work to be done to really promote and inspire again, but these are careers that touch your heart and last a lifetime.

I’ll just say as well on Minnesota, I’m honored to be the chair of our Governor’s Workforce Development Board. I’ve served for twenty years for three governors. I also chair the Caring Professions Committee with the governor, which is about making sure direct care workers have family sustaining wages, opportunity voice, and so on. We also have the Healthcare Anchor Network that we signed on to as a key employer. I’m part of the team that authored that to look at bringing people in from zip codes that have high social determinants of health, providing good paying jobs and benefits, also providing education opportunities, earn and learn programs, job navigation, how we instruct our leaders on DE&I, and just looking at goals on hiring and retaining and promoting people of color. It’s pretty extensive document that we signed on to. Very proud that we’re one of seventeen organizations in the country that signed on.  I’ve also been working with the National Fund on good jobs and part of that team that was brought together.

I’ll just add one more piece. In my career serving as the chair of the Governor’s Workforce Development Board, that gave me a seat at the National Governors Association. So, I’ve worked hard to prove myself there and I have been fortunate to be on the executive committee for eight years. That journey was executive committee to being voted in as vice chair, and then unanimously being voted in as chair for fifty states and five territories. I’m the past chair now. But we are also working on healthcare. I mean, this is a national effort in the state of Minnesota. It’s a key focus for us.

Let me also tell you about Health Force Minnesota. We’re one of the states in the country that has had a convening group that is the Governor’s Healthcare Center of Excellence and we’re working on those healthcare pathways too. I’ve been the chair for that group since it started. So, it’s what I do. It’s what I wake up at night and think about. It’s my passion. We’ve got a lot of work to do, but it’s work that is so fulfilling. Just seeing the results, even one by one, is just so rewarding. When people find that niche and we help them and then they move on, it changes their life and changes their family’s life.

Van: Well, Laura, I’m not surprised at all that these bodies tapped you to be in leadership roles and in chair roles. As a matter of fact, you and I met at the NGA in Chicago, right?

Laura: Yes. We were on the panel for the healthcare section.

Van: Well, it’s great to be keeping track of your career and all your good works. I have a question. When I had my sons back many moons ago, nurses from Malaysia were taking care of me and so it seems like we keep repeating this cycle of nursing shortages, in particular. Now, why do you think that is? Do we have a hard time learning a lesson in this country?

Laura: Yeah, I think there’s a lot of complexities to it. From my journey in Minnesota, we have a center for nursing excellence and we’re focused on this. We had two tracks all the time. We had an associate degree track and a baccalaureate and entry-level master’s track. At one time, you know, with quality and safety, we all wanted four-year degree nurses and above. I think now what we’ve done is we bring in everyone, because sometimes individuals that go to a two-year program, that’s their entry in and they’re fantastic and we can help them get their baccalaureate degree.

I think we’ve sometimes in the past have had these standards — you had to be this degree or that degree — and I think that the health systems are embracing people where they’re at and helping them on their career journey more than I’ve seen before. I would say we start really early. My team runs an on-site nursing assistant program that we pay wages and the education for. We run that multiple times a month. It’s our key feeder for nursing assistant. Once people complete that track that we pay for, the next thing is to have them become an NST. We pay for that and then we work with them. We provide job navigation. What’s next? How can we help them go back to school to be a nurse? We do have those examples and journeys.

We also had a formal registered apprenticeship for RN AD to BSN. So, anyone that was an AD to help them finish their BSN, not just with the tuition support, but adjusting their calendars, working with them, looking at pathways. We also run the RN operating room nurse program, which is our key feeder for operating room nurses in our system.

But what I’ve seen is there’s many pathways, and it’s not going to just always be that traditional one with a student going directly to nursing. We see more and more of our community colleges running fantastic programs with people in their 30s and 40s coming into nursing. We embrace them. We help them pay for that education. We offer loan forgiveness as well. If they’re not an employee and we’re helping them with tuition assistance, we can help them pay for it after with the loan forgiveness program. Why I’m using these examples is I think there’s a lot of support out there for anyone going into the nursing workforce to help them pay, so that’s not the issue. We want someone to be able to freely go into nursing education and how we can support you and embrace you with that?

People have a lot of career choices, but if you’re a nurse, you can do about anything you want. In our organization, it’s endless what our nurses can do. We do a lot with people that are published. We’re an academic medical center with specialties so we try to be a role model in this space with our university partners. So, we’re hoping that we inspire more and more people to go into nursing.

I do think it’s been cyclical, but the pandemic was challenging for nursing students to complete their experiences and graduate and then I think the schools were under-enrolled for a while. So we’re kind of in that downturn. We’re trying to get back up again. We also have a lot of people retiring. Our state has more retirees than new babies.

Van: Well, certainly Fairview is a role model and exemplar in demonstrating the role of the employer and how an employer can lean in and lead these workforce development initiatives. I’m wondering if perhaps you can do a little compare and contrast for an employer organization that is starting out versus maybe mid-stage or more mature in terms of workforce development programs? What were some of the key lessons you learned along the way that, you know, like the Laura back then did differently compared to the Laura now?

Laura: Well, I speak on this many times. I’ll get asked by a chamber or another party to talk about how can a smaller employer or a new employer get started? One thing I’ll say is in workforce development, we’re all in it together. When we partner, we raise everyone up, so I’ve never felt it was a competition in this space because it’s hard work, it’s long-term work.

Anything we’ve done, like the registered apprenticeship programs that we’ve developed, can be pulled off a shelf in the state of Minnesota for the next employer to take. When we went through that process, we developed it, but then we vetted it with people in the hospital association, with Health Force Minnesota and other employers so they could see it. They do not have to create it now. They can pull it off a shelf. That creation takes infrastructure and time and resources.

I share our models. Like, we might take a hundred nurse interns, and we don’t just take that summer nurse intern, they do their clinicals with us, they do their capstones with us, they do their winter nurse internship with us. They might have a part-time job and we prep them for the NCLEX. So, if this next employer takes five, they’re doing their piece. It doesn’t mean they have to take 100. But what we’ll do in the state is we’ll have a group that gets together on that with all of the bylaws and rules so someone can come up and say, “I’m doing this for the first time. I’ll take one.”  But then they learn. And same with our scrubs camp. If you can’t sponsor 100 people, you might be able to sponsor one, but that changed that one person’s life. We always are willing, and I’m always willing, to share because this is where we all need to help.

I think for smaller employers or groups that are new to this, my advice would be to learn from the others. It’s all about partnerships. Just last week, I was at UCLA with the Healthcare Anchor Network, and my presentation was on building community partnerships to aid in recruiting and retention. I was there as the seasoned person that has done this work for a long time, coupled with someone that just started. So, you could see and contrast both journeys and learn, but that was really helpful for that other person too, because many people in the room were newer, but they don’t have to start from scratch. There’s toolkits, there’s models out there.

So, we just need to work with others to help them get started.

Van: Well, I certainly echo your learnings. I say workforce development is a team sport, not an individual sport, right? You have to learn that through the School of Hard Knocks.

Laura: Yeah, exactly.

Van: So, as we wrap up, I’d love to get your observations on major trends in the future of care that you think will affect workforce development.

Laura: I think that we’re really looking at more and more untapped labor pools right now. We have invested in a lot of new Americans and a lot of ESL, a lot of job navigation, cross walking people to say if they were a physician in another country and they may not ever be a physician in this country, what credential can they obtain so they feel fulfilled and they can go on? Also, really getting in there with students and really doing more to inspire students is important. I think that working with older adults would be key too, especially when I think of the roles in long-term care, how critical they could be.

So, we’re going to have to keep looking at innovations. We’re going to have to keep looking at simulation. We constantly are looking at who we’re partnering with. It’s all about partnerships, like you and I just said. If we don’t see someone coming to us and they’re part of the patient population, we go to those groups and figure out what we can do to get more individuals involved, because we can’t leave any populations out right now.  I think before, it used to be that people would get their applicant pool and they could screen through them. We have a different approach now. A recruiter may be just screening through applications, but we end up meeting people and finding out what they can do in our organization. People come to our events and it might not match up, but we figure out what they can do and how they get there. And I think that’s a different way of thinking: there is space for everyone and let’s figure out if it’s a perfect match. If not, how do we match it up? That’s the kind of mindset we need, to be flexible and to find out what that person wants as well to make a good connection.

Van: Well, you are an inspiration, Laura…inspiring us to think differently and really just creatively about how to change and impact lives out there. Thank you very much for spending time with us today.

Laura: It’s such an honor to work with you. You are just the best in our field. So, thank you so much.

Van: Likewise, likewise. I’m Van Ton-Quinlivan with Futuro Health. Thanks for checking out this episode of WorkforceRx. I hope you will join us again as we continue to explore how to create a future-focused workforce in America.