The North Carolina Caregiving Workforce Strategic Leadership Council met on September 11 to review recent achievements and reinforce its ongoing commitment to strengthening the state’s caregiving workforce. The council, which was established in late 2022 by the North Carolina Department of Health and Human Services (NCDHHS) and the North Carolina Department of Commerce, focuses on nursing, direct care, and mental health and substance use fields.
“Building a robust caregiving workforce is critical to improving the life and wellbeing of everyone in North Carolina,” said NC Health and Human Services Secretary Dev Sangvai. “The caregiving sector is facing crisis level shortages, and we must invest now to ensure a sustainable workforce for the state’s growing and aging population.”
The council brings together representatives from state agencies, educational institutions, and partner organizations to coordinate efforts aimed at developing a sustainable caregiving workforce. NC Commerce Secretary Lee Lilley stated, “Caregiving professionals keep children, families and our workforce healthy, and support our thriving economy. By working together, we are strengthening the talent pipeline, meeting employers’ needs, and ensuring workers earn the competitive wages they deserve. This workforce is vital to North Carolina, now and in the future.”
In 2024, the council identified three main focus areas: nursing; mental health and substance use; and direct care. Leaders provided updates on initiatives underway in each area.
For nursing workforce development:
– The North Carolina Community College System completed a three-year pilot program funded by GlaxoSmithKline that increased student retention rates in nursing programs as well as improved pass rates for licensing exams.
– In May 2024, a partnership between UNC System and North Carolina Area Health Education Centers expanded Clinical Instructor Partnership programs statewide. This model enables bedside nurses to become clinical instructors while maintaining their current roles.
– NCDHHS’ Office of Rural Health plans to launch an incentive program this fall for registered nurses willing to work up to four years in rural or medically underserved parts of the state.
In mental health and substance use treatment:
– Session Law 2025-37 was signed into law on July 1 by Governor Stein. It allows human services professionals with associate degrees plus relevant experience to serve as Associates or Qualified Professionals—positions previously requiring bachelor’s degrees—thus expanding career pathways.
– The NC General Assembly allocated $20 million for loan repayment programs designed to encourage providers to work in underserved counties.
– NCDHHS partnered with UNC School of Social Work on free statewide peer support specialist training; an online component launched August 1 with an in-person portion set for October.
Direct care initiatives include:
– Launching North Carolina’s first National Core Indicators State of the Workforce Survey for Aging and Disabilities this fall.
– Offering free advanced training certificates for Direct Support Professionals at three pilot community colleges as part of a broader workforce plan. Additionally, $3 million has been awarded to agencies for recruitment bonuses, training support, retention incentives, and financial assistance.
During Thursday’s meeting members discussed progress made so far along with priorities such as data collection improvements, wage increases that allow workers to sustain themselves financially, better retention strategies, and expanded access to training opportunities.
Looking ahead, the NC Center on the Workforce for Health will play a leadership role supporting council operations as focus shifts toward long-term implementation. Formed in 2023 as a forum addressing critical health workforce challenges across stakeholders—including employers, educators, policymakers—the center will help organize public sector action at the state level.
“The work of this Council will continue to be essential as we coordinate a more cohesive public sector approach to ensuring North Carolina has the skilled, supported caregiving workforce our communities depend on,” said Andy MacCracken, Director of the NC Center on the Workforce for Health. “The Council recognizes the need for long-term persistence, and we are pleased to be a key partner in ongoing implementation of the strategies outlined in the report.”
NCDHHS estimates that by 2033 there will be shortages of about 12,500 registered nurses and 5,000 licensed practical nurses statewide. The supply of direct care workers is also projected not to meet demand; more than 200,000 job openings are expected through 2032. Mental health professional shortages persist across most counties—94 out of 100 are designated shortage areas.
