RALEIGH — North Carolina leaders today released a new report on the state’s caregiving workforce, announcing the next steps in strengthening this critical group of workers. The report comes from the Caregiving Workforce Strategic Leadership Council, a group convened by the North Carolina Department of Health and Human Services and the North Carolina Department of Commerce of leaders from government agencies, educational institutions and other key organizations deeply engaged in health care. The new report offers a roadmap of initiatives the state will take to strengthen and support its health care workforce.
“Caregivers are critical to the health of North Carolina and provide life-changing and live-saving care to thousands of people, whether they need help daily or during an emergency or crisis,” said N.C. Health and Human Services Secretary Kody H. Kinsley. “This collaborative work of state leaders is building a caregiver workforce pipeline and addressing financial strategies, so workers earn the competitive wages they deserve.”
The caregiving workforce directly improves the health and well-being of all North Carolinians. Nurses, physicians and behavioral health providers offer treatment when people are sick. Direct care workers, such as personal care aids and other assistants, help preserve dignity for those who, because of a health condition, disability and/or age, require support for daily activities like dressing, eating and following a medication schedule.
Following the state’s greatest areas of need, the council chose to focus on three areas: nursing, behavioral health and direct care workers. North Carolina faces significant shortages of all three professions, in particular behavioral health, in which 94 out of 100 counties have a shortage of mental health professionals.
For nursing, the state will face a shortage of approximately 12,500 registered nurses and 5,000 licensed practical nurses by 2033. Low wages and poor working conditions have spurred significant vacancies in the direct care workforce. With the state’s aging population continuing to increase, the demand for these workers is only projected to grow, with estimates predicting more than 186,000 job openings through 2028.
“Our state’s caregiving and health care workers not only help keep our children and families healthy, but they also keep our workforce healthy, which supports our businesses and keeps our economy strong,” said N.C. Commerce Secretary Machelle Baker Sanders. “They are a vital part of our workforce, and their recruitment and retention are critical to North Carolina’s future economic success.”
The action steps in the report cover several different targeted areas, including enhancing data collection to better understand the need, increasing availability of loan repayment programs and apprenticeships, and expanding access to training.
- Nursing: Establish academic coaches for community college students, enhance and invest in academic employer partnerships, improve employee retention and engagement, invest in social resources and NCCARE360 expansion, increase the number and availability of nurse and faculty loan repayment programs and stipends, readjust nurse faculty salaries and schedules.
- Behavioral Health: Advance the data landscape for the behavioral health workforce, define the unlicensed behavioral health workforce and professional pathways, incent recruitment and retention for publicly funded mental health roles, increase training and credentialling for peer support professionals, establish regular intervals for behavioral health rate adjustments.
- Direct Care Workers: Define what the direct care workforce is, advance the data landscape for the direct care workforce, expand apprenticeship programs, create a living wage for direct care workers.
With the release of the report, the focus will now shift towards implementation. Long-term success will depend on establishing a robust governance structure to deliver stability and guide the work forward. The council recognized the need for strong leadership to facilitate the ongoing engagement needed and identified NC Area Health Education Centers and the new Center on Workforce for Health as the right organizations for this role.
Their leadership will allow the state to leverage AHEC’s expertise in professional development and practice support and the Center on Workforce for Health’s platform to coordinate across multiple sectors. This structure will ensure the initiatives in the plan will be implemented to strengthen the workforce and, in turn, support the health and well-being of North Carolinians. It comes at a significant moment for the state, with the recent historic investment in behavioral health and the launch of Medicaid expansion.
