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Getting and Keeping the Right People: Baltimore, MD
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It can be a challenge to get and keep the right staff. In homeless services, staffing issues are often compounded by the demands of the environment and client caseloads. Health Care for the Homeless in Baltimore, Maryland shares some strategies for finding the right people, and keeping them on board.
 Getting and Keeping the Right People: Baltimore, MD

Common Challenges

Like many organizations, Health Care for the Homeless (HCH) in Baltimore, MD faces recruitment and retention challenges. “In nursing and social work,” says Kevin Lindamood, Vice President of External Affairs, “it has been increasingly difficult to hire and retain staff, because they can often find places in the external community that pay more, so that has been a challenge.”
It has also been difficult to hire people who understand HCH’s mission. It is a perspective that is not often taught in academic programs. “We really need to identify people who have a high degree of poverty literacy, understand the issues associated with compliance treatment regimens, and other barriers that the homeless population faces.”
Getting the Right People

Of course, a lot of recruitment happens through old-fashioned word of mouth. “We always post internally to see if there are any internal candidates because when you reach a staff size of 125, it is amazing how those networks can expand,” says Kevin.
HCH also collaborates with schools of nursing, public policy, social work and addictions treatment. These relationships introduce students to this work, and plant seeds for recruitment. Kevin’s career path illustrates this experiential recruitment strategy:
I showed up in Baltimore, immediately after graduating from college in 1993, as a member of the Lutheran Volunteer Corps. I was placed at Health Care for the Homeless as an outreach worker and case worker. I was immediately taken with the work and with the organization's commitment to direct services and advocacy.

After six months, I approached our Clinical Operations Director and said "I'm not going to be ready to leave after my volunteer year. Do you think there might be a job for me here?" So six months later, I was hired as a caseworker with 20% of my time dedicated to public policy and advocacy work.  I stayed for two years.  This experience was completely transformative. It showed me that one could actually find full time work that was consistent with one's personal values. I left to attend the School of Social Work at the University of Michigan with no real intention of ever returning to the east coast.

I continued to work in homeless services in Michigan. About a decade ago, I visited my old housemate in Baltimore.  I told only one individual at HCH about my visit, mentioned that I'd stop by the clinic, and told her not to tell anyone or to make a big deal of it.  When I showed up in her office, she said "I had to tell the CEO you were coming because two days ago, he asked me for your phone number.  I told him he could talk to you in person.”  A few hours later, he asked me to return to Baltimore and take a job doing national and local policy and advocacy work.

Keeping the Right People

In 2008, HCH had a 78 percent retention rate for all staff, up from 76 percent in 2007. The agency recognizes that recruitment is the foundation for retention. The costs of replacing employees are simply too high. Paying thoughtful attention to recruitment helps to avoid future turnover.
Although day-to-day job duties are the primary focus of HCH employees, it is important to leave room for growth and professional advancement. “All staff need access to professional development funds,” says Kevin. The organization offers continuing education that counts toward license renewal. An association of non-profits also hosts “Lunch and Learns,” which offer low-cost trainings for the medical community.
HCH Baltimore closely monitors potential retention issues. “When we noticed we were losing nurses to higher paying local hospitals, we conducted exit interviews and talked with staff to uncover the issues. It became clear that we had a salary problem.” After looking at three salary surveys in Maryland, HCH determined the ranges and adjusted all of their nursing salaries to land at the upper level of the middle range. They have since applied this method to all of their positions to remain competitive.

HCH also adopted a “living wage” policy. This is tied to the US Department of Housing and Urban Development’s designation of the hourly wage needed to afford housing at fair market rent. “We wanted to make sure that our personnel policies were consistent with our advocacy work and that our employees weren't at risk of homelessness.”

HCH values supervision. “We established a management team meeting made up of anyone who supervises anyone else. This has resulted in better supervision,” says Kevin.

Helping Staff to See the Big Picture

HCH involves all staff in decision-making, policy and advocacy work as much as possible. Kevin shared this story:

“I needed to get clinical staff involved in advocacy work and I kept trying to talk to this one guy about it. He always came back to me saying that he had too much to do, too many clients, not enough time.”

Kevin tried for a few years to encourage him. One year, the funding was cut for his position. This motivated the employee and he agreed to testify before a highly conservative senate committee. After telling frontline stories of being an outreach worker, he closed with, “I know this works, because it was an outreach worker who met me at the gates of the state penitentiary when I was released.”

Not only did the line item not get cut, it was given an increase. After this experience, the outreach worker was back in Kevin’s office every day asking, “What can I do? How can I help?”

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