The North Carolina Caregiving Workforce Strategic Leadership Council reconvened Thursday, Sept. 11, to celebrate achievements and reaffirm its commitment to strengthen the state’s caregiving workforce, specifically in the fields of nursing, direct care, and mental health and substance use. 

“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.”

Launched in late 2022 by the North Carolina Department of Health and Human Services and the North Carolina Department of Commerce, the Council brings together state agencies, educational institutions and partner organizations to strategically align state efforts to develop a sustainable caregiving workforce. 

“Caregiving professionals keep children, families and our workforce healthy, and support our thriving economy,” said NC Commerce Secretary Lee Lilley. “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.”

Following the state’s greatest areas of need, the Council chose to focus on three areas: nursing, mental health and substance use, and direct care. In 2024, the Council outlined key priorities and action steps needed to strengthen these workforce groups.

Today, leaders shared updates on several initiatives in motion and celebrated some of the achievements so far. 

Nursing Workforce Initiatives:

• Expand Academic Coaching for Community College Students: The North Carolina Community College System (NCCCS) completed a successful three-year pilot program, funded by a grant from NC GlaxoSmithKline, that demonstrated higher nursing program student retention rates and improved NCLEX pass rates across six health science colleges, underscoring the value of dedicated academic coaching in strengthening student success.
• Invest in Clinical Partnerships: In May 2024, a partnership between UNC System and the North Carolina Area Health Education Centers (AHEC) expanded the number of Clinical Instructor Partnership (CIP) programs statewide. The CIP program supports bedside nurses to become RN clinical instructors while staying in their current clinical role. This model addresses the shortage of nursing instructors by offsetting the traditional compensation gap that exists between bedside nursing and educational settings.
• Expanding Loan Forgiveness Programs for Registered Nurses: NCDHHS’ Office of Rural Health plans to launch a new incentive program to support registered nurses and clinical nurse specialists this fall. In order to qualify, interested RNs must commit up to 4 years in rural, medically underserved areas of the state.

Mental Health and Substance Use Treatment Workforce Initiatives:

• Expand Career Pathways for Unlicensed Professionals: Session Law 2025-37, signed by Governor Stein on July 1, allows Associates-prepared human services professionals with a specified number of years of relevant professional experience to practice as an Associate or Qualified Professional, roles that currently require a Bachelor’s degree. This greatly expands the pipeline for human services professionals and provides a new career path for those with an associate’s degree.
• Incent Recruitment and Retention for Publicly Funded Mental Health Roles: The NC General Assembly appropriated $20 million for loan repayment program designed to strengthen North Carolina’s mental health and substance use workforce by incentivizing providers to serve in underserved counties, helping to close critical care gaps across the state.
• Increase Training and Credentialing for Peer Support Professionals: NCDHHS partnered with UNC School of Social Work and NC certified peers to create a free, state-wide, standardized peer support specialist training and certification process. Foundations of Peer Support, Part I, launched on August 1st and the second, in-person aspect of the training will go live in October. 

Direct Care Workforce Initiatives:

• Advance the Data Landscape for the Direct Care Workforce: NCDHHS is launching NC’s inaugural National Core Indicators State of the Workforce Survey for Aging and Disabilities this Fall to help advance the data landscape for direct care.
• Build Career Pathways for the Direct Care Workforce: NCDHHS launched its free Direct Support Professional (DSP) Advanced training certificate this Fall at three pilot community colleges as part of its Direct Support Professional Workforce Plan. The Department also awarded $3 million to agencies and employers to recruit, support, train and retain DSPs through hiring and retention bonuses, on-the-job training and direct financial supports.

During the meeting today, council members discussed progress as well as future priority actions such as data collection, creating life-sustaining wages, improving retention, and expanding access to training.

The NC Center on the Workforce for Health will take a leadership role in supporting the Council’s operations and direction moving forward as focus shifts to long-term implementation. The Center formed in 2023 to provide a forum to address critical health workforce challenges, and it will be instrumental in organizing state-level, public sector action to advance the work of the NC Caregiving Workforce Council.

“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 and NC Commerce will continue to play a critical role in the Council’s work to strengthen the caregiving workforce in North Carolina as the state faces devastating shortages in the next decade. The state will face a shortage of approximately 12,500 registered nurses and 5,000 licensed practical nurses by 2033. The supply of direct care workers is also insufficient and only projected to grow, with estimates predicting more than 200,000 job openings in NC through 2032. Ninety-four of NC’s 100 counties are designated as mental health professional shortage areas.  

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About the NC Center on the Workforce for Health
The NC Center on the Workforce for Health launched in 2023 to provide a forum for health employers, workers, educators, policymakers, and other key stakeholders across the state to address critical workforce challenges, share best practices, and identify solutions. This statewide forum builds on a partnership between NC AHEC, NC Institute of Medicine, and the Sheps Center Program on Health Workforce Research and Policy, to provide coordinated, persistent action and track progress with measurable outcomes. For more information, visit workforceforhealth.org.