2014 Health Occupations Report

April 15, 2014

Paul LeparuloPrincipal Economic Research Analyst

AgendaReview important information about this reportDiscuss key findings for the health sector Present occupation specific highlights

About this reportContent - Data Sources - Methodology

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

Summary Statistics: Dieticians & Related

Workforce Characteristics Dieticians& Nutritionists

DieteticTechnicians

Employment (2012) 240 130 Employment per1,000 population 0.18 0.10

versus U.S. Average Above avg. Average annual startingwage (Maine) $38,600 $22,980

Median annual wage (Maine) $53,960 $31,450U.S. median annual wage $55,240 $26,260Median wage for alloccupations in Maine $32,590 $32,590

Minimum EducationRequirement Bachelor's degree High school diploma

or equivalentJob Growth Projections 19% 16%National Median Age 47.4 NATop Industry of Employment Hospitals Hospitals

Licensure Board Board of Licensing ofDietetic Practice

Board of Licensing of Dietetic Practice

What data was used in creating this report?

Maine Dept. Labor

Bureau Labor

StatisticsNational Center for Education

StatisticsCensu

s

Occupational Employment

StatisticsEmployme

nt ProjectionsIntegrated

Postsecondary Education Statistics

American Community

Survey

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

Employment projections10 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.

Integrated Postsecondary Education Data System (IPEDS)

Primary source for postsecondary education data in the U.S.

High response ratesData 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.

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.

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

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, 2007-2011Methodology

• Sensitivity analyses

Exclusions

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

Health SectorKey trends for the health sector and health occupations in aggregate

1. Employment growth has been remarkable.

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

0

20

40

60

80

100

120

Th

ou

san

ds

of

Job

s, M

ain

e

10% statewide employm

ent

18% statewide

employment

+ 80% growth in

employment4% growth/year

2% growth/yearHealth Sector Employment

Net jobs created by sector, 2001-2011

Healt

hca

re

-25000

-20000

-15000

-10000

-5000

0

5000

10000

15000

20000A

dm

inis

trati

ve

Aco

mm

odati

ons

Educa

tion s

vcs

Mgt

of

cos

Public

Adm

in

Pro

f &

Tech

Svc

s

Art

s, E

nte

rtain

ment

Min

ing

Agri

cult

ure

, Fo

rest

ry

Oth

er

Tra

nsp

.

Real Est

ate

Uti

litie

s

Whole

sale

Tra

de

Finance

Info

rmati

on

Const

ruct

ion

Reta

il

Mfg

Within the health sector, hospitals have been the primary driver of employment

growth.

Contribution to health sector employment growth, 2001-2011

Ambulatory healthcare

services

Hospitals Nursing and resi-dential care facili-

ties

Social Assistance

15%

51%

13%

21%

Pe

rce

nt

Co

ntr

ibu

tio

n

Driven by an aging population and technological innovations, the employment outlook remains robust.

2010-2020 Employment Projections, Change in employment

Healthcare sector Health occupations All occupations

16% 17%

6%

Ambulatory health svcs Hospitals Nursing & residential care Social Assistance

8%

30%

10% 10%

Healthcare employment projections are strong for

Maine, and even stronger nationally.

Health

care

sec

tor

Health

occ

upat

ions

All oc

cupa

tions

16% 17%

6%

34%

29%

14%

U.S

2010-2020 Employment Projections

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

Health workforce demographics, Maine vs. U.S.

Percent of workforce over 50 years

Dentists Psychologists

49%53%

U.S.

65% 68%

Maine

Percent of workforce over 50 years, Maine vs. U.S.

RNs

Phar

mac

ists

Phys

icia

ns &

Sur

geon

sLP

N

Nurse

Pra

ctiti

oner

s

37%33%

40%35%

41%43%

48%44%

47%50%

Percent of workforce above 50 years

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

3. The response from higher education has been increased production

2007 2008 2009 2010 20110

1000

2000

3000

4000

Nu

mb

er

of

gra

du

ate

s

2007 2008 2009 2010 20110

200

400

600

800

1000

1200

1400

1600

1800

Nu

mb

er

of

gra

du

ate

s

Bachelor & graduate credentials, +12%

Associate degrees, +39%

Certificates (<2 years), +87%

Source: IPEDS, CWRI

+33%

A majority of the growth in certificates awarded (< 2 years) was driven by schools other than community colleges.

Certificates < 2 years

2007 2008 2009 2010 20110

100

200

300

400

500

600

700

nu

mb

er

of

gra

du

ate

s

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.

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

residents

Health workers per thousand population

2000 2004 2008 2010 20120

5

10

15

20

25

30

35

40

45

50 47

37

MaineUSA

He

alt

h w

ork

ers

pe

r th

ou

san

d r

esi

de

nts

New England

5. The distribution of Maine’s health workforce is uneven and concentrated around the major hospital

centers.

Total-Maine

47

Sagadahoc

Waldo

Oxford

York

Linco

ln

Franklin

Wash

ington

Hancock

Knox

Somerset

Piscataquis

Penobscot

Androsco

ggin

Aroosto

ok

Kennebec

Cumberland

25

70Cumberland County: 31% of the workforce and 21% of Maine’s population = 50% more health workers per thousand populationOxford County: 2% of the

workforce; 4% of the population = 50% fewer health workers per thousand population

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.

Occupational Highlights

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.

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

RNs per thousand residents, 2012

U.S

.

New

Ham

pshi

re

Conne

ctic

ut

Verm

ont

Mai

ne

New

Eng

land

Rhode

Isla

nd

Mas

sach

uset

ts0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

8.49.5 9.7 10.1

10.7 10.9 11.312.0

RN

s p

er

tho

usan

d p

op

.

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

Sagad

ahoc

Linco

ln

York

Oxf

ord

Han

cock

Wal

do

Was

hing

ton

Somer

set

Pisca

taqu

is

Aroos

took

Total

Frank

lin

Penob

scot

Andro

scog

gin

Kenne

bec

Cumbe

rland

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

18.0

5.3 5.4 5.96.6 6.7

8.0 8.39.3

10.410.711.8

13.113.313.7

16.4

RN

s p

er

tho

usan

d r

esid

en

ts

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

IOM Goal Maine0%

20%

40%

60%

80%

100%

120%

Baccalaureate degree or higher Associate degree

Pro

po

rtio

n o

f n

urs

es

wit

h a

b

acc

ala

ure

ate

de

gre

e

Goal: 80% with a baccalaureate degree by 2020

2012-2013: ~55% of Maine’s nurses have at least a baccalaureate degree

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.

2007 2008 2009 2010 20110

500

1000

1500

2000

2500

3000

Gra

du

ate

s p

er

ye

ar

Number of graduates from all health education programs EXCLUDING RN programs, +47%

RN programs, +2%

BSN, +6%ADN, +3%Graduate, -12%

RNsHospitals 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.

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.

The size of Maine’s physician workforce is average for a New England state.

Physicians & surgeons per thousand residents, 2010

U.S

.

New

Ham

pshi

re

Conne

cticut

Mai

ne

New

Eng

land

Mas

sach

usse

tts

Verm

ont

Rhode

Isla

nd

2.2 2.2 2.3

3.0 3.0 3.1

4.34.8

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

Oxfor

d

Hanco

ck

Was

hing

ton

Andr

osco

ggin

York

Peno

bsco

t

Kenn

ebec

Aroo

stoo

k

Mai

ne A

vg.

Cumbe

rland

0.0

1.0

2.0

3.0

4.0

5.0

6.0

0.5 0.5 0.6 0.8 0.9 1.0

2.0 2.5 2.6

5.2

Pra

ctit

ioners

per

1,0

00 p

op.

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

2004 2006 2008 2010

580505

542 587

Maine U.S.A.

0.440.42

Age structure of the dentist workforce

Proportion of dentists above and below 50 years old, 2006-2010 ACS

U.S. Maine0%

10%

20%

30%

40%

50%

60%

70%

51%

35%

49%

65%

Less than 50 years50 years or older

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.

Direct care occupations are low paying relative to other health occupations.

* Excludes direct care occupations

Direct care occupations

$10.0 $10.7 $11.7 $12.3 $12.8 $13.5

$17.2$19.3

$35.6

Average hourly wage, 2011

Medical assistants, medical equipment preparers, dietetic tech, OT & PT aides, pharmacy tech & aides

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

0%10%20%30%40%50%60%

4%

50%37%

7%2%

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.

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.

For more detail: http://www.maine.gov/labor/cwri/publications/pdf/2014HealthOccupationsReport.pdf

Questions?a.paul.leparulo@maine.gov