Key Points
- Flexible clinical staffing helps public health departments sustain access and equity amid persistent workforce gaps.
- Locum tenens strengthens preparedness by providing surge capacity for outbreaks, disasters, and emerging community needs.
- When measured by community impact, not hourly cost, locums become a strategic partner in delivering public health outcomes.
Public health departments are being asked to carry more clinical responsibility than ever. Behavioral health needs continue to rise, maternal health initiatives are expanding, chronic disease management demands steady follow up, and overdose response requires rapid coordination and consistent access points.
At the same time, many local health departments are navigating workforce churn and budget uncertainty.
of local health departments reported job losses in 2023, and expectations for budget cuts remained high heading into FY2025.
National Association of County and City Health Officials (NACCHO) 2024 Forces of Change report
of public health officials report experiencing at least one symptom of burnout.
2024 PH WINS survey
That tension is now a defining operating condition. Public health leaders are expected to sustain essential clinical services, meet state and federal priorities, deliver on grant metrics, and maintain accreditation readiness. Often, they must do so with fewer permanent staff than the work requires.
This is where flexible clinical staffing, including locum tenens, deserves a closer look. Not as a last-minute fix, but as part of the infrastructure that keeps services available and communities protected.
Why This Matters Now: Your Workforce Strategy is a Preparedness Strategy
Emergency readiness is about more than about plans, caches, and protocols. It is also about whether you can staff a response when the community needs you most.
The CDC’s preparedness guidance for 2024 to 2028 emphasizes building workforce capacity to meet surge management needs, while improving recruitment, retention, and resilience. At the same time, national oversight and infrastructure reviews have highlighted concerns that temporary funding produces temporary workforce gains, which can leave readiness fragile when a crisis ends and resources contract.
In plain terms, if clinical staffing is brittle, your system is brittle.
Locum tenens is one of the few tools that can add qualified capacity quickly and can do it in a way that supports both day-to-day continuity and emergency surge.
Rethinking Locum Tenens: More Than a Stopgap for Short-Staffed Clinics
In public health, locums can be easy to dismiss as “something hospitals do.” There is also a common hesitation that locums are “too expensive” or “too clinical” compared to the broader, upstream work public health teams lead.
That perception is understandable, but it is incomplete.
Locums clinicians can help public health departments:
- Maintain essential clinic access while permanent hiring catches up.
- Bridge hard-to-fill roles, especially in rural or underserved communities.
- Pilot or stand up time-bound programs tied to grant deliverables.
- Add specialty coverage where recruitment is slow or the need is intermittent.
The key shift is this: when locums support is connected to your Community Health Improvement Plan (CHIP), service line priorities, and emergency operations planning, it stops looking like a last resort and starts looking like a strategic lever.
Curious how this could align with your CHIP priorities or service line goals? A brief conversation can help clarify where locums support fits.
Three Ways Locums Can Strengthen Public Health in Your Jurisdiction
1
Maintain access and advance equity, especially where options are already limited.
Many public health departments directly provide services through county clinics and targeted programs such as:
- School-based health services.
- Maternal and child health programs.
- TB control and respiratory clinics.
- Behavioral health and substance use services.
- Correctional health partnerships.
- Immunization and travel clinics.
When clinical capacity drops, the impact is immediate. Hours get reduced. Appointment backlogs grow. Outreach momentum slows. Communities that already face barriers to care feel the disruption first.
Locums can help departments protect access by:
- Preventing clinic closures or reduced hours when recruiting stalls.
- Keeping high-priority services available in rural counties and underserved neighborhoods.
- Providing targeted specialty coverage, such as OB, psychiatry, or addiction medicine, where hiring is most difficult.
In a public health context, that is not only a staffing win. It is an equity intervention, because it helps preserve access for populations that are most likely to experience downstream harm from interruptions.
2
Build surge capacity and strengthen emergency readiness.
Public health emergencies do not wait for hiring cycles.
Locums can add surge clinical capacity for:
- Outbreak response, such as vaccine clinics and testing sites.
- Natural disasters, when local staff are displaced or cannot report.
- Seasonal surges and localized crises, including overdose spikes, shelter outbreaks, or unexpected displacement and migration needs.
This aligns with CDC preparedness priorities that emphasize surge management and building a response-ready workforce.
Practical use cases include:
- Staffing extended clinic hours during vaccination pushes.
- Temporary coverage in shelters, mobile clinics, correctional settings, or isolation and quarantine operations.
- Backfilling clinical roles when core staff are reassigned to incident command functions.
3
Support your core clinical team and stabilize your partner network.
Public health departments often operate with a small core clinical team while also relying on partner organizations, including FQHCs, community clinics, and hospitals, to deliver services and referrals.
When your staffing is thin, the “hidden cost” is not only patient volume. It is workforce resilience.
PH WINS 2024 data underscores that burnout remains widespread in the public health workforce. Locums can reduce pressure on small teams by providing coverage so clinicians can:
- Take planned leave without program disruption.
- Participate in training and preparedness exercises.
- Sustain service continuity during turnover transitions.
Locums can also function as a bridge when a key clinician leaves, such as a medical director, nurse practitioner, or a lead clinician in a flagship program.
There is also a network effect. If partners are short-staffed too, which is increasingly common, stabilizing one part of the system can prevent a ripple of missed handoffs, delayed referrals, and inconsistent follow up.
Across the country, public health agencies already rely on locum tenens clinicians to stabilize services during transition periods, launch new initiatives tied to funding timelines, and maintain access in hard‑to‑staff locations. These use cases are most effective when locums are integrated into broader workforce and preparedness planning, rather than deployed only in crisis mode.
Measuring What Matters: Shift from Hourly Cost to Community Impact + Program Performance
Budget constraints are real, and it is natural to focus on hourly rates. But hourly cost is a narrow lens for a mission-driven system.
A more useful question is: What community impact do we preserve by preventing clinical disruption?
This is also where locums can become easier to justify to governing bodies and funders. NACCHO’s Forces of Change findings highlight staffing instability and financial uncertainty across local health departments. A measurement approach grounded in access, continuity, and deliverables turns the conversation from “added spend” to “protected capacity.”
These metrics help shift the conversation from “What does it cost?” to “What does it protect?”
Cost concerns are valid, particularly in a funding environment shaped by time‑limited grants and fiscal oversight. But the more relevant comparison is often not locum tenens cost versus salary. It is locums cost versus vacancy. Prolonged vacancies can lead to canceled clinics, missed grant deliverables, delayed care, and downstream costs that are harder to quantify but very real.
Many public health departments also find flexibility in how locums support is structured. Engagements can be scoped to specific programs, time‑bound initiatives, or surge periods rather than open‑ended coverage. In some cases, locums‑supported services may be allowable under grant funding when tied directly to access, continuity, or preparedness objectives. When evaluated this way, locums are less an added expense and more a tool for cost control, preventing service disruption before it becomes more expensive to fix.
Access + equity metrics.
Track whether locums prevented reductions in availability for priority populations.
- Number of clinic days preserved that otherwise would have been closed.
- Appointment availability, such as average days to next appointment for priority services.
- Visits delivered in target zip codes or among priority populations.
- Continuity of service lines in rural sites and underserved neighborhoods.
Program performance metrics.
Track whether staffing stability protected grant and program outcomes.
- Progress toward grant deliverables, such as screenings completed, vaccinations administered, and follow-up visits achieved.
- Time to launch, or sustain, new programs tied to funding or community priorities.
- Percentage of scheduled clinic sessions fully staffed across the reporting period.
Workforce resilience metrics.
Track whether locums reduced avoidable strain on core teams.
- Vacancy duration in critical clinical roles.
- Overtime levels and schedule gaps for core clinicians.
- Staff turnover signals, such as intent-to-leave measures, unscheduled absences, or burnout indicators.
- Ability to maintain operations during outbreaks or emergencies without canceling core services.
A Quick-Start Approach: How to Operationalize Locums Proactively, not Reactively
If locums only enter the conversation when a clinic is about to close, you are forced into urgent, expensive decisions.
A more strategic approach is to define “triggers” that automatically move locums from optional to planned.
Consider setting triggers such as:
- A vacancy in a critical clinical role exceeds a defined number of days.
- A program is at risk of missing a grant deliverable due to staffing gaps.
- Forecasted seasonal demand exceeds staffed capacity.
- Your emergency operations plan requires a surge clinic model that exceeds internal capacity.
CDC’s preparedness guidance also points to the importance of having plans and processes in place to augment staffing during a response. Locums can be one of those augmentation paths, if it is designed before the crisis hits.
Locums as a Strategic Partner in Community Health
Locum tenens is not a replacement for long-term hiring, workforce development, and partner collaboration. But it can be a powerful complement.
Used proactively, locums can help public health departments protect essential services, meet program commitments, and respond flexibly to evolving community needs. They can preserve access and continuity, strengthen surge readiness, and reduce pressure on small clinical teams.
Most importantly, when you measure locum tenens utilization by community impact, not just hourly cost, locums become something different: a strategic partner in delivering public health outcomes.
For public health leaders planning the next budget cycle, accreditation review, or emergency response update, the question is no longer whether flexible staffing has a role, but whether it is being planned for with intention.
Why partner with Jackson and Coker
We connect public health departments and mission driven organizations with qualified clinicians across a wide range of specialties and care settings. With deep experience supporting public sector healthcare, we understand the urgency, compliance requirements, and community impact considerations that shape public health staffing decisions. Our scale and specialty coverage allow departments to respond faster, whether the need is maintaining essential clinic access, supporting grant funded programs, or building surge capacity for emergencies.
Explore how locum tenens can support access, equity, and preparedness in your community.
