1. 2014 Health Occupations Report April 15, 2014 Paul Leparulo Principal Economic Research Analyst

2. Review important information about this report Discuss key findings for the health sector Present occupation specific highlights

3. Content - Data Sources - Methodology

4. What’s in the report? 2014 Health Occupations Report More than 50 occupational profiles Occupation description, education requirements, employment and wage characteristics, school & program completer data, employment outlook. Demographic, work setting information, distribution, per capita statistics, plus more Sector Analysis

5. Summary Statistics: Dieticians & Related Workforce Characteristics Dieticians & Nutritionists Dietetic Technicians Employment (2012)240130 Employment per 1,000 population 0.180.10 versus U.S.AverageAbove avg. Average annual starting wage (Maine) $38,600$22,980 Median annual wage (Maine)$53,960$31,450 U.S. median annual wage$55,240$26,260 Median wage for all occupations in Maine $32,590 Minimum Education Requirement Bachelor's degree High school diploma or equivalent Job Growth Projections19%16% National Median Age47.4NA Top Industry of EmploymentHospitals Licensure Board Board of Licensing of Dietetic Practice

6. What data was used in creating this report? Maine Dept. Labor Bureau Labor Statistics National Center for Education Statistics Census Occupational Employment Statistics Employment Projections Integrated Postsecondary Education Statistics American Community Survey

7. Occupational Employment Estimates (OES) Employment and wage estimates for more than 800 occupations, based on surveys of employers Consistent methodology across occupations and states. Does not include the self-employed Data is subject to suppression Employees are part and full-time workers Not designed for time series analysis 2012 data

8. Employment projections 10 year employment projections for every Maine industry and over 800 occupations. Produced every other year and currently spans 201o-2020. Occupational projections estimate job openings from new growth and replacement needs. Estimates include the self-employed. Assumes the status quo in the way healthcare is organized and delivered. Current projections do not incorporate assumptions about ACA. 2012-2022 projections coming later this year.

9. Integrated Postsecondary Education Data System (IPEDS) Primary source for postsecondary education data in the U.S. High response rates Data is self-reported and not verified by IPEDS. Not all programs/schools participate in the federal student loan program. Does not include adult education data.

10. American Community Survey (ACS) Provides estimates of the demographic, economic and social characteristics of the population. 2006-2010 ACS Large confidence intervals can result when analyzing occupational data at a state level. ACS data not included for all occupations.

11. Context & Review Valerie Landry, Chair of the Maine Health Workforce Forum Charles Dwyer, Program Officer at Maine Health Access Foundation Matthew Chandler, Director, Rural Health and Primary Care, Maine CDC The Maine Health Workforce Forum (the Forum), as represented by Sally Sutton, Project Director Ann Sossong, Associate Professor of Nursing, University of Maine School of Nursing Lisa Harvey-McPherson, Vice President Continuum of Care & Chief Advocacy Officer EMHS Ellen Libby, Program Director, EMMC School of Medical Laboratory Science Judith Feinstein, Director, Maine CDC Oral Health Program Sheila Comerford, Director, Maine Psychological Association

12. Size the workforce by occupation Employment and wages Per population Distribution Demographics Race, gender, age Educational attainment Maine vs. U.S. Projected job openings New growth Replacement Program completers Schools, programs Number of graduates, 2007-2011 Methodology Sensitivity analyses

13. Exclusions State licensure data Adult and continuing education data Health Practitioner Shortage Area Statistics Maine job vacancy survey Longitudinal data Help wanted job postings

14. Key trends for the health sector and health occupations in aggregate

15. 1. Employment growth has been remarkable. 10% statewide employment 18% statewide employment + 80% growth in employment Health Sector Employment

16. Net jobs created by sector, 2001-2011

17. Within the health sector, hospitals have been the primary driver of employment growth. Contribution to health sector employment growth, 2001-2011

18. Driven by an aging population and technological innovations, the employment outlook remains robust. 2010-2020 Employment Projections, Change in employment

19. The hospital industry is expected to continue to add jobs more rapidly than other health industries. 2010-2020 Employment Projections, Change in employment

20. While the employment outlook is bright for Maine’s health sector and occupations, job growth is expected to be even stronger nationally. 2010-2020 Employment Projections

21. 2. The aging of the workforce amplifies the need for a pipeline of skilled providers. New Growth Replacement Total job openings Replacement needs Total Job Openings Population demographics Workforce demographics

22. Health workforce demographics, Maine vs. U.S.

24. 2,800 RNs 2,400 direct care workers > 1,000 social workers and counselors > 700 physicians & surgeons 170 dentists Projected job openings due to replacement needs, 2010-2020 410 medical assistants 140 physician assistants 120 Clinical lab technologists

25. 3. The response from higher education has been increased production Source: IPEDS, CWRI +33%

26. The highest growth rates in credentials awarded occurred at the lower end of the degree spectrum. Associate degrees, +39% Certificates awarded (< 2 years), +87%

27. A majority of the growth in certificates awarded (< 2 years) was driven by schools other than community colleges. Certificates < 2 years Community colleges Other than community colleges Other than community colleges includes Beal College, Intercoast Career Institute, Northeast Technical Institute, St. Joseph’s College of Maine, Seacoast Career Schools, University of Maine at Augusta, Spa Tech Institute, Kaplan, and Pierre’s School of Cosmetology.

28. 4. Compared to the nation, Maine has more heath practitioners & support workers per thousand residents Health workers per thousand population

29. 5. The distribution of Maine’s health workforce is uneven and concentrated around the major hospital centers. Cumberland County: 31% of the workforce and 21% of Maine’s population = 50% more health workers per thousand population Oxford County: 2% of the workforce; 4% of the population = 50% fewer health workers per thousand population

30. Distribution challenges 41% of the population lives in rural areas that have lower incomes, higher rates of poverty and unemployment, and lower levels of educational attainment (USDA Economic Research Service) A shifting industry landscape— employment is gradually becoming more centralized in the urban areas. Population demographics—an aging population requires more specialist providers, which tend to be located at large hospital centers.

32. Nursing Robust growth +29% employment growth, 2000-2010 +20% growth projected, 2010-2020 Supply & distribution ▫ A comparable number of RNs per population (000) for New England, but 28% more than that of the nation.

33. Maine has 28% more RNs per thousand residents than the nation, but an average amount for New England. RNs per thousand residents, 2012

34. The distribution of RN employment is uneven. One third of the workforce is employed in Cumberland County, resulting in 53% more RNs per thousand residents than the state average. RN employment per thousand residents 2012

35. Demand for nurses with a baccalaureate degree is expected to grow faster than average as care giving becomes more complex. Educational attainment: Institute of Medicine (IOM) Goal vs. Current Goal: 80% with a baccalaureate degree by 2020 2012-2013: ~55% of Maine’s nurses have at least a baccalaureate degree

36. Although demand for RNs is expected to be robust, growth in RN graduates has been flat. Growth in other areas of healthcare instruction has been much stronger. RN programs, +2% BSN, +6% ADN, +3% Graduate, -12%

37. RNs Hospitals represent the majority of hiring demand and are large enough to absorb Maine’s entire yearly supply of BSN graduates. A limited pool of teaching faculty is a barrier to capacity expansion.

38. Physicians & Surgeons Workforce Size ~4,000 physicians & surgeons working in Maine, 2010 Average number of practitioners per thousand residents for New England. Substantially more practitioners per population than the nation.

39. The size of Maine’s physician workforce is average for a New England state. Physicians & surgeons per thousand residents, 2010

40. The distribution of physician and surgeon employment is uneven. Forty-two percent were employed in Cumberland County, resulting in twice the number of practitioners per thousand residents as the state average. Physician & Surgeon employment per thousand residents, 2012

41. The number of dentists practicing in Maine has been flat. The size of Maine’s dentist workforce is comparable to that of the nation, per thousand population. Dentists practicing in Maine (includes self-employed) Dentists per 1,000 population (2010); includes self-employed

42. Age structure of the dentist workforce Proportion of dentists above and below 50 years old, 2006-2010 ACS

43. Direct Care ~22,000 providing direct care services ▫Largest health occupational group ▫Larger than the U.S. direct care workforce, per pop. Robust growth prospects Low pay and high emotional and physical demands makes recruiting and retaining workers a challenge.

44. Direct care occupations are low paying relative to other health occupations. * Excludes direct care occupations Direct care occupations Medical assistants, medical equipment preparers, dietetic tech, OT & PT aides, pharmacy tech & aides

45. Forty six percent of Maine’s direct care workers have education credentials above the minimum required for the occupations. Educational attainment of Maine’s direct care workforce, 2006-2010 ACS

46. Mental Health Psychologists 67% of Maine’s psychologists > 50 years old. 22% fewer practitioners per population (compared to U.S.) The number graduating with the doctoral credentials necessary to practice is less than half of projected job openings.

47. Technologists & Technicians Medical Lab Technologists Only one clinical lab sciences program in Maine Number of graduates is well below projected job openings. 16% fewer practitioners (per 1,000 population) than the nation.

48. http://www.maine.gov/labor/cwri/publications/Word/2014Healt hOccupationsReport.docx http://www.maine.gov/labor/cwri/publications/Word/2014Healt hOccupationsReport.docx http://www.maine.gov/labor/cwri/publications/pdf/2014HealthO ccupationsReport.pdf http://www.maine.gov/labor/cwri/publications/pdf/2014HealthO ccupationsReport.pdf

49. a.paul.leparulo@maine.gov