The fifth season of the STAR² Center Talks Workforce Success podcast highlights Primary Care Organizations (PCAs), Community Health Centers (CHCs), and National Training and Technical Assistant Partners (NTTAPs) who successfully used, disseminated, and/or implemented practices, strategies, tools, and more gathered from the STAR² Center’s training opportunities, technical assistance, or original resources. In this episode, Michelle Fernández Gabilondo is joined by Malulani Eccleshall, Human Resources Director at Waimānalo Health Center. Malulani shares the health center’s unique approach to recruitment and retention and the successful implementation of strategies learned at a recent STAR² Center workshop to enhance their team cohesion and connection with the local community. Learn more about the Waimānalo Health Center Cultural Health and Waimānalo Community.

Transcript by Rev.com

Michelle Fernández Gabilondo: Welcome everyone. My name is Michelle Fernández Gabilondo. I am the Associate Director of Workforce Development here at ACU, or the Association of Clinicians for the Underserved, for the STAR² Center program. We’re super excited today. We’re going to be talking to Malulani Eccleshall, who is the Human Resource Director at Waimānalo Health Center.

Welcome, Malulani. We’re so excited to have you here today, and I’m just going to go ahead and jump right in. We start all of our podcasts the same way. Could you introduce yourself, tell us a little bit more about your professional journey, your role, your organization, really anything you would like to share with the audience about yourself.

Malulani Eccleshall: Yes, absolutely. Aloha everyone. My name is Malulani Eccleshall, and I have been in human resources field for over 30 years. I’ve been working at the health center for the last about seven years. We are a small community located on the eastern end of Oahu. We have the second-largest population of native Hawaiians in our community. Our health center began in 1992 as just a one-building facility with two exam rooms. There was a reception area and some admin offices. Today we have three sites, and six separate buildings, and we are currently planning for an expansion here beginning in 2024.

Michelle Fernández Gabilondo: That is so exciting, and we always love to hear about the start of health centers, how so many of them are very small and how they’ve been able to grow from that. And obviously the work that y’all do in your community, which I know is amazing. Is there anything else you wanted to share? I know I kind of jumped in.

Malulani Eccleshall: Well, I live in this community so it was such an honor and blessing for me to be able to work here. But I wished I had been working here through my whole career. But at least I’m here now and doing whatever I can to help the health center, the employees here, and the patients.

Michelle Fernández Gabilondo: Wonderful, and I have no doubt that they appreciate it. As I’m sure you know, and this is across I think all 50 states, all US territories, just every state is really unique in the workforce challenges that they are facing. So could you share with the audience what some of those workforce challenges are for you, and really front of mind for your health center, and especially with the community you serve?

Malulani Eccleshall: Yes. I think our biggest problem that we’re facing is recruitment and retention. We are a very small community with a population of about 6,000, so finding qualified staff that lives in this community or the surrounding communities has been very difficult. Another challenge is the pay. We’re not able to compete with the hospitals. Their pay and benefits are much richer than our community health center’s is, and most of them are unionized, so it’s a struggle in that area.

We do our best really to communicate that we do have an extraordinary work environment here at our health center, and how we are very connected to our core values, which are Aloha, which means love, kindness, harmony. Then we have Mālama I Ka Pono which means trust, balance, and righteousness. The next one is Mālama I Ka ʻOhana, which is family, so we treat everyone like family. And the last one is Mālama I Ka ʻĀina, which is sense of place, and caring, and honoring the land that we have here in Waimānalo.

So our core values are really our way of life here. They’re not just words. We demonstrate and live the values in everything we do at the health center. And that’s why we have an extraordinary work environment. We have worked on improving pay and benefits the best we can with the budget that we have. What we’ve done is something that’s a little different, is we have what’s called wellness bucks and wellness time.

So employees get to take two hours biweekly off with pay from their regular schedule to do a wellness activity. That could be anything from going to canoe practice, paddling practice, exercising at the gym, surfing, taking their children to their football practice or baseball practice, going to the dentist, doctor. There’s so many reasons you could use the two hours for. It just has to be linked to a wellness activity.

The other thing we do is, we have $200 a year in wellness bucks that we can spend on a wellness activity. So a lot of people use that for massages, a sporting event like running in one of the Fun Runs, or paying for their gym membership, things like that. So that has been a huge success and much appreciated by the staff, having the wellness hours and the wellness bucks. So that’s a little bit different than your normal benefits.

We also pay the full premium for the medical coverage for an employee, and we pay a substantial portion of the either two-party or family plan. So that’s another huge benefit that we have here. Let’s see. We also have a longevity benefit, which is, you get a longevity bonus after you’ve been here for five years, and you get it every year after that. So about two weeks to 30 days after your anniversary date, you’ll get a bonus check for your longevity.

Michelle Fernández Gabilondo: I have to say, the benefits are amazing in your health center. Because everything you were saying, we hear across the board of the difficulty with recruitment and retention, especially being in smaller communities. You know, how difficult it is to get staff to join. But I always remind health centers, I think your strength and your health center definitely highlights and exemplifies this, is the culture that you can build and how much you care for your workforce. I think everything you laid out exemplifies that absolutely. And those wellness hours, that is such an amazing idea. Is that something you have found to be really effective with your workforce?

Malulani Eccleshall: Yes, it’s much appreciated by the staff here. Another thing that we have that is really different is, we give the employees $400 a year in medical, dental, vision, cultural health benefits, which you have to use at our health centers. So you have to become a patient here to use it. But everybody uses mostly the dental. They use everything. But the one that’s really, really popular is the cultural health, because in that department they integrate the Hawaiian medicine with the Western medicine and they do things like lomilomi.

They have what’s called lāʻau lapaʻau, which is the medicine. They make teas, and salves, and other kinds of medicines from plants, and they give that to the patients as well as the employees who use those services like for blood pressure, diabetes, lots of different illnesses or medical condition you can use the Hawaiian medicine.

Michelle Fernández Gabilondo: I have to say I absolutely love that, and I wish that was a practice that was more common across the board, not just with health centers but with all of our health care here in the US. My background is actually Cuban-Colombian, and I remember when I was little my grandma would give me like specific teas when I was feeling sick, and you just don’t get that in many places where you go get health care. So that, I’m just blown away. Absolutely love everything y’all are doing. And obviously you’re speaking directly to your community. That is so, so important.

Now I’m going to switch gears a little bit. This season of our podcast is actually Season Five, and what we’re focusing on are the STAR² Center resources to see how different health centers or PCAs may have used them. That is the other question. And I know that you’ve been part of some of our trainings, specifically the training that we recently did in Hawaii. Can you tell us a little bit more about what you found helpful about that and the resources that we’ve been able to offer?

Malulani Eccleshall: Well, in particular, we’ve used the ACE-15 tool to assess perception of teamness here. We learned it in the ACU workforce trainings and utilize it to get a baseline score from two departments with the highest rate of turnover, which was Medical Assistants and Front Office. The results helped us formulate an action plan to address areas with the lowest scores. We use that quite extensively, and it’s a work in progress still.

Another thing that we’ve done in our recruiting strategies is, in our job postings, and we learned this at the workshop, is we put our values in our job postings. That has attracted people. In fact, currently what we’re working on that we didn’t learn at the workforce trainings, however, because of the trainings we thought of something else. And that something else is, we are currently videoing one-to-three-minute sessions with staff out in our garden here. In that one to three minutes the staff is sharing how they experience one of our core values.

Michelle Fernández Gabilondo: Oh, that’s amazing.

Malulani Eccleshall: Yeah. We’re going to put that … Our target audience actually is all of our staff, but also potential applicants. So that will be on the page where people go to apply for jobs. We’ll have these videos that are showing one to three minutes, and then it’ll have another one. It’ll just keep rotating. We plan to do about 30 of those. We just started doing that. So we got a lot of ideas from the workshops to do. I can’t go into it all, but it was very helpful.

Michelle Fernández Gabilondo: You know, we always appreciate hearing that. And one of the things that you mentioned, and we talk a lot about this in most of the trainings that we do, is health centers are such a well-kept secret that sometimes people don’t really know just how great it is to work at a health center, and how unique the benefits are, and the effort and time that the human resource department leadership, people involved in workforce, are really making to ensure that their staff wants to work there, and enjoys working there.

And having you really highlight that, highlight your values in the job announcements, highlighting unique benefits, I think is such a wonderful idea. And I really do hope that it helps with recruitment because I think there’s a lot of people out there looking for that mission-driven work. It’s just hard to know where to look sometimes.

Malulani Eccleshall: Absolutely.

Michelle Fernández Gabilondo: Have you found that your recruitment and retention with some of these things that you’ve implemented has improved, or are you … I know also we have to look long term, so oftentimes it’s not an immediate thing. But have you found it to be helpful?
Malulani Eccleshall: Yes, actually I have. I’ve noticed a slight improvement, probably more than slight. We’re getting more applicants now, so I’ve noticed that that has picked up. And I’m hoping it’s because of our values, and our mission, and the worthwhile work that we do here. I think that word has gotten around that we really have caring, encouraging environment here at our health center.

Michelle Fernández Gabilondo: Absolutely, and that is a rare thing to find in many jobs. And that’s what people are looking for, especially newer people coming into the workforce. Having that support is just absolutely great. I don’t think I can compliment your health center anymore. I’m just like in awe sitting over here and being like, “Y’all are doing amazing work,” and I’m so glad that we’re getting to showcase that.

And also just really happy to hear that the training and some of those resources were really helpful, because obviously that’s why we put them out there. And it’s really great to hear that you also implemented some of those practices. Is there anything else you want to share with the recruitment, retention, or workforce, at your health center?

Malulani Eccleshall: I don’t think I mentioned that when we were using the ACE-15 tool, the two areas with the lowest scores, Front Office and Medical, what we did is we conducted meetings to establish methods to improve communications to eliminate the finger pointing and improve efficiency. We also looked at the videos I just mentioned to create those.

Michelle Fernández Gabilondo: People love, love videos. We had another health center that did something pretty similar, and they actually put a link to the video in their job announcements, and people loved it. Because they got to learn about the community, or those who were from the community felt even more connected to wanting to go work at a health center. So yeah, thank you for sharing all of that.

And again, anybody who’s listening, I’m 100% this is the model to follow. So really we went through all of the questions and I think just got such a wonderful insight in the excellent work that you are doing and your health center is doing. So before we end today, I do want to ask you, this is really your time to talk about any workforce efforts, or other resources, or anything with your organization in general that you would like to share with the audience.

Malulani Eccleshall: I think the last thing I want to share is that we had started planning to conduct stay interviews prior to attending the ACU workforce trainings. However, the training at the workshop enhanced our action plans. So we actually started doing stay interviews in October of 2022, and we ended it on December 16th, 2022. We interviewed 115 staff members. HR compiled and aggregated all the data. The aggregated results were shared via all staff meeting. And we also met with management and each group like Front Office, or Medical, or Finance, to share the specific aggregated data for their particular group.

The goal was to improve in areas that were brought out in the interviews and put the health center on track to becoming, our goal is to be an employer of choice. We are also currently doing stay interviews for any employee who has been here for six months. We just started doing those for those people that started around January, and I definitely see an improvement. There’s more positivity in the responses to the questions, and the staff that were hired at that time seem to be very encouraged, and engaged, and feel supported in their job here at the health center.

Michelle Fernández Gabilondo: That is wonderful. And it’s also really powerful to from the very beginning have someone involved in that stay interview process. I think it really speaks volumes to them about the type of culture that they’re starting when they’re going to work at your health center. The other thing that we are going to make sure to do is, in the description so all of you can learn more, we will make sure to put the link to your health center and any other resources you may like to share with the audience.

But as I said throughout, I really think your health center is just hitting the mark on everything that is needed to really take care and support the workforce, focus on their wellness. And again, just blown away by how many initiatives you are doing, and also being in such a small community because sometimes that makes it even more of a struggle.

So I just want to say thank you so much for being here today. This was a wonderful interview. I feel like I learned so much. For everybody, again, I am Michelle Fernández Gabilondo. Today we were talking with Malulani Eccleshall, the Human Resource Director at Waimānalo Health Center. Malulani, thank you so much for being here. We’re so grateful to have you.

Malulani Eccleshall: Thank you for having me. Mahalo nui loa, aloha to everybody, and mālama pono.

Michelle Fernández Gabilondo: Thank you.