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UNC City and Regional Planning Workshop on Direct Care Workforce (Final Report)

By CED Program Interns & Students

Published May 28, 2010


Adam Parker is a Masters in Public Administration alumnus at UNC Chapel Hill. Parker is entering UNC Law in the fall and currently works with Lenoir County, North Carolina.

During the spring 2010 semester, Professor Nichola Lowe and several students from the Department of City and Regional Planning and Public Administration program completed a study examining opportunities for workforce advancement in the direct care workforce in Lenoir County and surrounding areas. This post provides a summary of that document, as well as the final report.

The final report can be found by clicking here.

The Department of City and Regional Planning (DCRP) held a workshop in spring 2010 to focus on the direct care workforce in Lenoir County. This was done at the request of RHA Howell, an organization that provides direct care services for individuals with disabilities. DCRP students and Masters in Public Administration students participated in the workshop to explore avenues for expansion and collaboration around a direct care career ladder program.

Career Ladder Programs and the Workforce Investment Network

RHA Howell already utilizes a career ladder program for its direct care workers, the Workforce Investment Network (WIN). Direct care positions are typically low-wage, high stress positions that involve the most direct interaction with patients. There has been a large amount of turnover in this field, and WIN is a response to address that turnover. WIN essentially provides tuition to individuals while working for RHA Howell, as well as numerous support services to help its employees who are often non-traditional college students. Support involves child care, counseling, scheduling assistance, and numerous other services to ensure that WIN participants are successful. WIN has support from the Duke Endowment and numerous other partners and is seeking to expand its operations.

Report Elements

Our report considered quantitative and qualitative elements. We reviewed the demographic and socioeconomic characteristics of health care consumers and providers. We also performed a labor market analysis to determine future needs and demands on direct care and the broader health industry. Lastly, we interviewed numerous stakeholders in Lenoir County to learn more about their anticipated needs and what current gaps existed.

Major Recommendations

After our analysis, the report presented two major recommendations to RHA Howell and other regional actors to begin addressing staffing needs:

  • Reach out to smaller health care providers in Lenoir and surrounding counties
  • Promote a regional labor market collaboration involving multiple health care providers, including regional hospitals and training facilities in eastern North Carolina.

Health-related fields are becoming increasingly important in Lenoir County and elsewhere. Agricultural and manufacturing jobs continue to stagnate in the region, making health poised to become its largest employment sector. Direct care is often an entry point into this industry, but for many it is also an exit as well. Developing successful transitioning strategies from this entry level position becomes extremely important to ensuring a quality workforce and lowering costs for providers (due to turnover).

Some Selected Items and Findings

  • As you can see from this graph below  (pulled from the report), direct care professionals make significantly less than the aggregated average of all state occupations. This is surprising to some, especially considering the high stress nature of their work and overall expense of health care.

  • We discovered several other career ladder and advancement programs through interviews with local stakeholders. The potential to lose autonomy was cited as a concern by some, although all parties expressed a interest in cooperating and collaborating with one another.
  • Several health career ladders are considered as case studies within the report, including collaborations in Baltimore, Boston, Denver, West Palm Beach, and others.

A Few Words of Thanks

The report should provide some insights into the overall state of the health workforce in Lenoir County and its surrounding region. We hope it will be of use to stakeholders in Lenoir County and want to thank RHA Howell, the many interviewees, data providers, faculty, and CCP staff for making this report possible. Lastly, I would like to thank my fellow workshop partners Frederick Davis, Scott Edmonds, Tamara Failor, Benjamin Houck, Jamaal Green, Dyah Kartikawening Miller, Michael Levengood, Tan Ngo, and Ashley Yingling.

Published May 28, 2010 By CED Program Interns & Students

Adam Parker is a Masters in Public Administration alumnus at UNC Chapel Hill. Parker is entering UNC Law in the fall and currently works with Lenoir County, North Carolina.

During the spring 2010 semester, Professor Nichola Lowe and several students from the Department of City and Regional Planning and Public Administration program completed a study examining opportunities for workforce advancement in the direct care workforce in Lenoir County and surrounding areas. This post provides a summary of that document, as well as the final report.

The final report can be found by clicking here.

The Department of City and Regional Planning (DCRP) held a workshop in spring 2010 to focus on the direct care workforce in Lenoir County. This was done at the request of RHA Howell, an organization that provides direct care services for individuals with disabilities. DCRP students and Masters in Public Administration students participated in the workshop to explore avenues for expansion and collaboration around a direct care career ladder program.

Career Ladder Programs and the Workforce Investment Network

RHA Howell already utilizes a career ladder program for its direct care workers, the Workforce Investment Network (WIN). Direct care positions are typically low-wage, high stress positions that involve the most direct interaction with patients. There has been a large amount of turnover in this field, and WIN is a response to address that turnover. WIN essentially provides tuition to individuals while working for RHA Howell, as well as numerous support services to help its employees who are often non-traditional college students. Support involves child care, counseling, scheduling assistance, and numerous other services to ensure that WIN participants are successful. WIN has support from the Duke Endowment and numerous other partners and is seeking to expand its operations.

Report Elements

Our report considered quantitative and qualitative elements. We reviewed the demographic and socioeconomic characteristics of health care consumers and providers. We also performed a labor market analysis to determine future needs and demands on direct care and the broader health industry. Lastly, we interviewed numerous stakeholders in Lenoir County to learn more about their anticipated needs and what current gaps existed.

Major Recommendations

After our analysis, the report presented two major recommendations to RHA Howell and other regional actors to begin addressing staffing needs:

  • Reach out to smaller health care providers in Lenoir and surrounding counties
  • Promote a regional labor market collaboration involving multiple health care providers, including regional hospitals and training facilities in eastern North Carolina.

Health-related fields are becoming increasingly important in Lenoir County and elsewhere. Agricultural and manufacturing jobs continue to stagnate in the region, making health poised to become its largest employment sector. Direct care is often an entry point into this industry, but for many it is also an exit as well. Developing successful transitioning strategies from this entry level position becomes extremely important to ensuring a quality workforce and lowering costs for providers (due to turnover).

Some Selected Items and Findings

  • As you can see from this graph below  (pulled from the report), direct care professionals make significantly less than the aggregated average of all state occupations. This is surprising to some, especially considering the high stress nature of their work and overall expense of health care.

  • We discovered several other career ladder and advancement programs through interviews with local stakeholders. The potential to lose autonomy was cited as a concern by some, although all parties expressed a interest in cooperating and collaborating with one another.
  • Several health career ladders are considered as case studies within the report, including collaborations in Baltimore, Boston, Denver, West Palm Beach, and others.

A Few Words of Thanks

The report should provide some insights into the overall state of the health workforce in Lenoir County and its surrounding region. We hope it will be of use to stakeholders in Lenoir County and want to thank RHA Howell, the many interviewees, data providers, faculty, and CCP staff for making this report possible. Lastly, I would like to thank my fellow workshop partners Frederick Davis, Scott Edmonds, Tamara Failor, Benjamin Houck, Jamaal Green, Dyah Kartikawening Miller, Michael Levengood, Tan Ngo, and Ashley Yingling.

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