State Leaders Celebrate Progress, Outline Future Plans to Address Healthcare Worker Crisis
RALEIGH, N.C. — North Carolina officials announced significant progress in addressing the state’s caregiving workforce shortage during a Thursday meeting of the NC Caregiving Workforce Strategic Leadership Council, while acknowledging that critical shortages continue to threaten healthcare delivery across the state.
The council, which reconvened September 11, highlighted achievements in nursing, mental health, substance use treatment, and direct care sectors while outlining ambitious plans to strengthen these essential workforces.
Shortage Reaches Crisis Levels
State projections paint a stark picture of North Carolina’s healthcare workforce challenges. By 2033, the state faces a projected shortage of approximately 12,500 registered nurses and 5,000 licensed practical nurses. The direct care sector shows similarly concerning trends, with estimates predicting more than 200,000 job openings through 2032. Additionally, 94 of the state’s 100 counties are designated as mental health professional shortage areas.
“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.”
Nursing Workforce Gains Momentum
Academic Support Shows Results
The North Carolina Community College System completed a successful three-year pilot program that demonstrated the value of dedicated academic coaching. Funded by a GlaxoSmithKline grant, the program achieved higher nursing student retention rates and improved NCLEX pass rates across six health science colleges.
Clinical Partnerships Expand Statewide
In May 2024, a partnership between the UNC System and North Carolina Area Health Education Centers expanded Clinical Instructor Partnership programs statewide. The innovative CIP model allows bedside nurses to become RN clinical instructors while maintaining their current clinical roles, addressing the critical shortage of nursing instructors by bridging the traditional compensation gap between bedside nursing and educational settings.
New Loan Forgiveness Program
The NC Department of Health and Human Services’ Office of Rural Health plans to launch a new incentive program this fall, targeting registered nurses and clinical nurse specialists willing to commit up to four years of service in rural, medically underserved areas.
Mental Health Workforce Receives Legislative Support
Expanded Career Pathways
Governor Roy Cooper signed Session Law 2025-37 on July 1, allowing associates-degree professionals with relevant experience to practice as Associate or Qualified Professionals—roles that previously required bachelor’s degrees. This legislative change significantly expands the pipeline for human services professionals.
$20 Million Investment
The NC General Assembly appropriated $20 million for a loan repayment program designed to incentivize mental health and substance use providers to serve in underserved counties, directly addressing critical care gaps across the state.
Standardized Peer Support Training
NCDHHS partnered with UNC School of Social Work and certified peers to create a free, statewide peer support specialist training and certification process. The “Foundations of Peer Support, Part I” launched August 1, with in-person training components scheduled for October.
Direct Care Workforce Initiatives Launch
Data Collection Improvements
NCDHHS is launching North Carolina’s inaugural National Core Indicators State of the Workforce Survey for Aging and Disabilities this fall to improve data collection on the direct care workforce.
Career Development Programs
The department launched its free Direct Support Professional Advanced training certificate at three pilot community colleges as part of its comprehensive workforce plan. Additionally, $3 million was awarded to agencies and employers for recruitment, training, and retention efforts, including hiring bonuses, on-the-job training, and direct financial support.
Long-Term Strategy Takes Shape
The NC Center on the Workforce for Health will assume a leadership role in supporting the council’s operations as focus shifts toward long-term implementation. Formed in 2023, the center provides a forum for addressing critical health workforce challenges and will coordinate state-level action to advance the council’s work.
“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.
Economic Impact Recognition
NC Commerce Secretary Lee Lilley emphasized the broader economic implications of the workforce shortage. “Caregiving professionals keep children, families and our workforce healthy, and support our thriving economy,” Lilley said. “By working together, we are strengthening the talent pipeline, meeting employers’ needs, and ensuring workers earn the competitive wages they deserve.”
Moving Forward
The Strategic Leadership Council, launched in late 2022 through collaboration between the NC Department of Health and Human Services and the NC Department of Commerce, brings together state agencies, educational institutions, and partner organizations to align efforts across the caregiving sector.
Council members identified ongoing priorities including enhanced data collection, creating sustainable wages, improving retention rates, and expanding training access as essential components of their long-term strategy to address North Carolina’s caregiving workforce crisis.
