healthcare workforce management

Local governments are at a pivotal moment. As retirements accelerate and community needs shift, traditional hiring methods are no longer enough to build resilient, diverse teams. More than half of U.S. states, including the state of Washington, have adopted policies encouraging skills-based hiring, and in states with these policies, 22 out of 25 saw their share of job postings without degree requirements increase (National Governors Association, 2024). This shift is helping governments address talent shortages and diversify their workforce. To meet today’s challenges, local governments must embrace skill-based recruitment—an approach that values practical abilities and real-world experience. 

For further guidance, see the State of Washington’s Executive Order 24-04 Toolkit. While the Executive Order applies to state agencies, local governments may find these resources helpful in shaping their own skills-based hiring practices. 

Why traditional hiring methods are no longer enough 

In today’s public sector, workforce shortages are common, and the pace of change is relentless. New challenges in public health, infrastructure, and digital services demand skills that may not be reflected in a candidate’s formal education or years of experience. Too often, traditional hiring overlooks those who have gained expertise through nontraditional paths—military service, community leadership, or hands-on technical work. 

Local governments must ask themselves: Are we missing out on talent by focusing too much on credentials? By shifting the lens to skills and competencies, agencies can tap into a broader pool of candidates, foster innovation, and ensure continuity in essential services. 

The challenge of credential-focused hiring 

Credential-focused hiring can unintentionally create barriers. Job postings that require specific degrees or a set number of years in a particular field may exclude candidates with relevant experience gained elsewhere. This approach also tends to favor those with uninterrupted career paths, overlooking individuals who have taken employment gaps for caregiving, education, or other reasons. 

Consider the resident who has managed complex projects in a local nonprofit or led teams in a small business. They may be just as qualified as someone with a formal degree, but rigid requirements keep them out. Overreliance on credentials can also lead to homogeneous teams, limiting diversity of thought and experience—something local governments cannot afford as they strive to serve increasingly diverse communities. 

Best practice: Audit your job postings. Are there degree or experience requirements that could be replaced with practical skills? 

Building community talent pipelines 

The solution starts with community engagement. Local governments can build robust talent pipelines by partnering with colleges, trade schools, and organizations that serve nontraditional candidates. These partnerships help align curricula with the real needs of public service, ensuring graduates are ready for the challenges ahead. 

Welcoming candidates from alternative career paths—veterans, caregivers returning to work, or those switching industries—broadens the talent pool and strengthens the workforce. Outreach programs and mentorship are critical for raising awareness of local government careers and helping candidates develop the skills needed for success. 

Best practice: Reach out to local schools and organizations. Launch an outreach campaign to promote public sector opportunities and offer mentorship to new candidates. 

Shifting from degree requirements to demonstrated competencies

At the heart of skill-based recruitment is a focus on competencies. Local governments should define the core skills required for each role, moving away from unnecessary degree requirements. Hiring managers can be encouraged to value diverse experiences, recognizing that adaptability, problem-solving, and communication are often more important than formal credentials.

Updating job descriptions to emphasize essential and adaptive skills helps attract a wider range of applicants. Clearly distinguishing between “must-have” and “nice-to-have” requirements ensures postings are realistic and inclusive. 

Best practice: Rewrite one job posting this quarter to focus on skills and competencies instead of degrees. 

Rethinking resumes and screening processes 

Skill-based recruitment means looking beyond degrees and job titles. Reviewers should seek evidence of practical experience—project outcomes, leadership roles, technical achievements. Removing bias is crucial: anonymizing applications and training hiring managers to recognize unconscious bias helps ensure fairness. Using objective, skill-based criteria for initial screening levels the playing field for all candidates. 

Practical assessments, such as job-relevant tasks or simulations, allow agencies to evaluate problem-solving, communication, and technical skills directly. Fairness and transparency in assessment methods are essential, and candidates should be evaluated based on real-world achievements. 

Best practice: Pilot a resume review process that highlights skills and anonymizes candidate information. Add a practical skills assessment to your next hiring process. 

The payoff: a diverse and adaptable workforce 

Skill-based recruitment offers significant benefits. By focusing on what candidates can do, local governments build teams that are more diverse, adaptable, and resilient. This approach helps fill critical gaps, fosters innovation, and ensures that public services remain responsive to changing needs. 

Embracing innovative hiring practices is not just a matter of policy—it is a commitment to building a future-ready workforce. Local governments must lead by example, adopting inclusive and practical recruitment strategies that reflect the values and needs of their communities. 

A call to action for local government leaders 

Now is the time to review hiring practices, update job descriptions, and invest in outreach and training programs that prioritize skills over credentials. By taking these steps, local governments will open doors to a wider range of candidates, strengthen their teams, and deliver better outcomes for residents. 

Building a future-ready workforce requires courage, creativity, and collaboration. By embracing skill-based recruitment, local governments can empower progress and drive public sector excellence for years to come. 

Focused on inspiring organizations to transform and innovate, BerryDunn’s Local Government Practice Group can help you solve your biggest challenges for your organization as a whole and in specific areas. Our team is comprised of broadly specialized consultants and former local government employees that exclusively serve local government clients. Learn more about our services and team. 

Launching a Constituent Relationship Management (CRM) initiative isn’t just a software upgrade, it’s a strategic shift in how your organization connects with constituents. Think of it like stepping onto the field for a high-stakes match: success requires preparation, agility, and a game plan that puts constituent experience at the center. 

At BerryDunn, we’ve helped organizations navigate CRM transformations from kickoff to post-launch refinement. The difference between a CRM that drives loyalty and one that fizzles out? It’s all about alignment, execution, and continuous engagement. 

Building your CRM game plan 

• Start with clarity: Begin with clarity—define your constituent engagement goals, map out existing pain points, and bring stakeholders into alignment early. 
• Implement with intention: Implementation is a team sport—procurement, configuration, and change management need clear roles, flexible tactics, and a shared commitment to customer-centricity. 
• Keep improving: Your CRM journey doesn’t end at launch. Monitor engagement metrics, support your teams with ongoing training, and refine workflows based on real constituent feedback. 

Field-tested insights for successful CRM implementations

A well-designed CRM can transform scattered constituent data into actionable insights that fuel personalized experiences. Because constituent information is usually spread across multiple platforms, without a centralized view, it’s difficult to understand constituent behavior or respond proactively to issues. CRM bridges these gaps by consolidating data into a single source of truth. 

Neutral, strategic guidance helps you avoid vendor bias and stay focused on what matters: meaningful engagement. Don’t fall for the promise of AI chatbots that will answer all constituent questions. Stay focused on how the solution meets and maps to your organizational needs, interoperates with your existing system, and provides better data visibility to empower employees  

Success grows with phased rollouts, tailored training, and processes that scale with your organization’s increased capacity and capabilities. A phased approach allows the focus to remain on high-impact use cases first, and once the intake and response for urgent cases is optimized, gathering additional feedback and refining workflows to further expanding system capabilities becomes an iterative process. It also minimizes disruption by aligning rollout with staff readiness and operational priorities.    

Keys to winning in the long term 

In our experience helping local governments plan, implement, and optimize, successful CRM implementations follow these guidelines:  

• Leadership drives adoption—your team needs active champions, not just a project manager. 
• Technology isn’t a cure-all—a sleek interface won’t fix broken constituent journeys. 
• Strategy comes first—features should follow vision, not the other way around. 
• Experience is valuable—veteran insight transforms complexity into clarity-guiding teams and anticipating hurdles 

How BerryDunn can help 

CRM success is more than software, it’s about building trust, empowering personnel, informing operations, and creating lasting customer relationships. Whether you’re just starting out or refining your approach, the right strategy can turn your CRM into a powerhouse for engagement. 

Ready to build your CRM playbook? Let’s talk about how our vendor-neutral approach can help you connect with constituent in smarter, more sustainable ways. 

BerryDunn is not affiliated with any specific software vendor, allowing us to be truly objective. We stay abreast of the best solutions in the market, as well as industry best practices, emerging trends, and updates in the software vendor community. Our independence allows us to provide objective system consulting services and offer recommendations that serve your organization’s best interests. Learn more about our local government services and team.  
   

Patient care is built on trust—and that trust can be compromised when financial relationships aren’t transparent. That’s why compliance laws like the Anti-Kickback Statute (AKS), the Sunshine Act, and the Open Payments Program (OPP) exist. They are designed to promote transparency in healthcare. This article breaks down the essentials and explores what the laws mean for healthcare organizations and clinicians. 

The AKS: Why free isn’t always free  

Imagine this: A medical device company offers a clinician an all-expenses-paid trip to a conference in Maui. Sounds great, right? Under AKS, it could be a felony. 

What the AKS says 

According to the AKS, it’s illegal to offer, solicit, or receive anything of value to influence referrals for services covered by federal healthcare programs. 

Real-world example: 

A physician accepts lavish dinners from a pharmaceutical representative and then prescribes that company’s drug more often. That’s a red flag under AKS. 

The penalties for convictions under the AKS are up to $100,000 per violation, 10 years in prison, and exclusion from Medicare/Medicaid. 

The Sunshine Act and OPP: Shining a light on industry relationships 

The Sunshine Act, enacted in 2010 as part of the Affordable Care Act, created the Open Payments Program (OPP) to make financial relationships between healthcare providers and the industry more transparent. 

How the Sunshine Act and OPP work 

Manufacturers of drugs, devices, and biologics report payments or transfers of value to physicians and teaching hospitals. CMS publishes OPP data annually, and anyone can look it up.  

Real-world example: 

A clinician attends a dinner sponsored by a medical device manufacturing company. That $150 meal? It’s reported and will appear in the Open Payments database for anyone to see. 

In 2024, CMS reported $13.18 billion in disclosed payments made to clinicians and hospitals, including general payments, research payments, and ownership or investment interests. Patients, journalists, and regulators review this data—so accuracy and transparency are critical. California now requires physicians to inform new patients about reviewing provider data in the OPP.

Key dates for the Sunshine Act and OPP: 

• Data is collected year-round and submitted annually between February 1 and March 31. 
• Covered recipients can review and dispute reported data between April 1 and May 30. 
• Data for the preceding year is published by June 30 and then made publicly available. 

Practical tips for healthcare organizations:

• Develop organizational policies: Many hospitals and healthcare organizations have ethical guidelines and policies surrounding the acceptance of gifts and other remuneration. 
• Educate your team: Share basics with new staff as part of orientation and provide education regarding organizational policies, reporting limits, and how to review and dispute Open Payments data. 
• Review annually: Ensure compliance by reviewing data reported under your institution yearly. 

Practical tips for clinicians:

• Familiarize yourself with policies: Know your organization's ethics guidelines and gifts policies. 
• Learn how to review data reported under your name:
  • Check your OPP profile: Review your Open Payments data annually between April 1 and May 15 to ensure accuracy and dispute any reported data, if necessary.  
  • Ask before you accept: If it feels like a reward, ask yourself, Would I do this if there were no gift involved? If unsure, consult your organization’s compliance department.

Why transparency matters 

Compliance isn’t about saying no to everything—it’s about making informed decisions that protect patients and your reputation. A “gift horse” might look appealing, but if it compromises trust and reputation, it’s not worth the ride. 

BerryDunn can help 

Our healthcare compliance team incorporates deep, hands-on knowledge with industry best practices to help your organization manage compliance and revenue integrity risks. Learn more about BerryDunn’s team and services.   

Additional resources on healthcare transparency laws 

• 42 C.F.R § 403.902 (definitions) 
• 42 C.F.R Section 403.906 (reports of physician ownership and investment interests) 
• American Medical Association, physician transparency reports (Sunshine Act) 
• US Department of Health and Human Services, Office of Inspector General (OIG), “Special Fraud Alert: Speaker Programs”, November 16, 2020 
• CMS Medical booklet, “Medicare Fraud & Abuse: Prevent, Detect, Report  
• OIG guidance on overall compliance education for physicians 

In small towns and rural communities, parks and recreation spaces are vital to quality of life. They’re where neighbors connect, children play, and local traditions thrive. Yet, developing a master plan for these spaces can feel overwhelming—especially with limited budgets and staff. The good news is that effective planning doesn’t have to be complicated or costly. With a right-sized approach, small communities can create practical, actionable master plans that reflect their unique needs and aspirations. 

Learn from real-world success 

Across the country, small communities are proving that right-sized planning works. The most successful efforts share common traits: 

• A clear, shared vision. 
• Strong community engagement. 
• Practical, phased implementation. 

These communities don’t try to do everything at once. Instead, they focus on what matters most, build momentum with early successes, and adapt as they go. 

Let’s break it down: 

1. Build a shared vision for your community, with your community

A compelling vision is the foundation of any master plan. This vision should capture the hopes and dreams of the community, not just the preferences of a few. 

To build this vision: 

• Learn about your community's demographics, existing facilities, and unique character. 
• Engage residents, staff, and local leaders in open conversations. 
• Host visioning workshops to gather ideas and priorities. 
• Draft a vision statement and set strategic, measurable goals. 
• Validate your vision with the community to ensure broad support. 

2. Take stock: inventory and level of service 

Understanding what you have is just as important as knowing what you want. Conduct a thorough inventory of parks, trails, and amenities, and analyze how well they serve the community. 

Key steps include: 

• Mapping all facilities and amenities. 
• Assessing access and quality using level of service (LOS) analysis. 
• Identifying underserved neighborhoods or groups. 
• Visualizing gaps and opportunities for improvement. 

3. Engage the community creatively 

Community engagement is the heart of right-sized planning. Small communities may lack big budgets, but they have strong relationships and local knowledge. 

Effective engagement strategies: 

• Meet people where they are—at markets, festivals, or parks. 
• Use pop-up booths and intercept surveys for informal feedback. 
• Form advisory groups representing diverse interests. 
• Leverage existing community events to reach more residents. 
• Use digital tools like online surveys and interactive maps for broader input. 
• A mixed-method approach ensures everyone has a voice, from youth to seniors. 

4. Conduct a needs assessment 

A thoughtful needs assessment combines data with lived experience. This process uncovers what’s working, what’s missing, and what could be improved. 

Best practices: 

• Collect quantitative data (surveys, usage stats, demographics). 
• Gather qualitative insights (focus groups, interviews). 
• Pay special attention to underserved groups. 
• Compare current offerings with community desires to identify clear priorities. 

5. Prioritize and implement your master plan strategically 

Not every idea can be implemented at once. Prioritization ensures resources are used effectively and progress is visible. 

How to prioritize: 

• Focus on actionable, high-impact projects rather than long wish lists. 
• Break large projects into manageable phases. 
• Match available resources—funding, staff, partnerships—to your goals. 
• Collaborate with local schools, nonprofits, and neighboring communities. 

A helpful tool is the urgency-versus-feasibility matrix: 

Here's an example of how an urgency/feasibility matrix may look:

Right-sized planning empowers small communities to create parks and recreation master plans that are practical, inclusive, and achievable. By clarifying your purpose, building a shared vision, assessing needs, and prioritizing action, even the smallest community can create parks and recreation spaces that enrich lives for generations to come. 

BerryDunn's consultants work with you to improve operations, drive innovation, identify improvements to services based on community need, and elevate your brand and image―all from the perspective of our team’s combined 100 years of hands-on experience. We provide practical park solutions, recreation expertise, and library consulting. Learn more about our team and services. 

The FDIC's Quarterly Banking Profile for quarter three 2025 reports the performance for the 3,953 community banks evaluated. Here are the key highlights: 

Note: Graphs are for all FDIC-insured institutions unless the graph indicates it is only for FDIC-insured community banks. 

Financial Performance 

• Quarterly net income rose by $756.9 million (9.9%) from the previous quarter to $8.4 billion, with 63.9% of community banks reporting an increase. 

• Pretax return on assets increased to 1.46%, up 13 basis points quarter over quarter and 25 basis points year over year. 

• Net interest margin rose to 3.73%, up 10 basis points from the prior quarter and 37 basis points year over year.

Costs and Efficiency 

• Noninterest expense increased by $303 million (1.7%) from the previous quarter and has increased 7.9% year over year. 

• Provision expenses decreased by 0.5% quarter over quarter and have increased 33.1% year over year, signaling growing concern over potential credit losses. 

• Efficiency ratio declined to 60.28%, down 2.59% basis points from the prior quarter, indicating better cost control relative to revenue. 

Loan and Deposit Trends 

• Loan and lease balances increased by $24.4 billion (1.3%) quarter over quarter and 5.2% year over year, led by nonfarm nonresidential CRE and 1–4 family residential loans. 

• Domestic deposits rose 1.6% quarter over quarter and 5.1% year over year, with stronger growth in noninterest-bearing than interest-bearing accounts. 

• Nearly 70% (69.5%) of community banks reported loan growth, and 60% reported deposit growth during the quarter. 

Asset Quality 

• Past-due and nonaccrual loans (PDNA) decreased one basis point to 1.26%. 

• Net charge-off ratio increased four basis points from the prior quarter to 0.23%, rising above the pre-pandemic average of 0.15%. 

• Reserve coverage ratio continued to decline to 157.1%, indicating that allowance growth lagged increases in noncurrent loan balances. 

Capital and Structural Stability

• Capital ratios improved modestly across the board: CBLR rose to 14.27%, and the leverage capital ratio remained at 11%. 

• Unrealized losses on securities fell by $7.8 billion (18.8%) from the prior quarter to $33.6 billion total. 

• Community bank count declined by 26 during the quarter due to mergers and transitions. 

Conclusion and Outlook 

The third quarter of 2025 reflected steady progress for community banks, with net income rising nearly 10% from the prior quarter and more than six in 10 institutions reporting stronger earnings. Net interest margin continued its upward trajectory, climbing 37 basis points year over year, while pretax return on assets also improved. At the same time, efficiency gains were evident as the ratio declined, signaling better cost management relative to revenue. However, rising noninterest expenses and elevated provision costs underscore ongoing concerns about credit quality. Although past-due and nonaccrual loans edged lower, net charge-offs increased above pre-pandemic averages, and reserve coverage ratios continued to weaken, suggesting that allowance growth will continue to rise for the foreseeable future. 

As we move deeper into the final stretch of 2025, community banks must remain attentive to both economic and regulatory developments. Recent federal tax changes allowing deductions for vehicle loan interest could stimulate consumer lending activity, particularly in auto finance, but may also introduce new competitive pressures and portfolio concentration risks. In this article, we provide further information on the impacts of the change in taxes on vehicle loan interest. Meanwhile, the issuance of ASU 2025-08 introduces updated accounting guidance that will affect recognition and measurement practices for acquisitive institutions, requiring banks to reassess reporting processes and internal controls related to the accounting for acquired loans. Further discussion of this change can be found in this article. Speaking of internal controls, the FDIC recently issued a final rule raising several key thresholds, including those that determine which institutions must comply with Part 363’s audit and internal control requirements. The final rule notably raises the asset threshold requiring an independent attestation of internal control effectiveness over financial reporting from $1 billion to $5 billion. To learn more, including a summary of the other threshold changes, read this article. Coupled with the active merger and acquisition market—evidenced by the decline in community bank count—these shifts highlight the importance of adaptability. With credit risk likely to continue to rise and regulatory changes on the horizon, community banks face a complex environment where resilience and proactive risk management will be critical. 

BerryDunn has a Federal Impacts page, where we frequently post updates related to the federal landscape. Check out this page for timely information that may impact your institution or your institution’s borrowers. We wish you the best of holidays and, as always, your BerryDunn team is here to help.