The North Carolina Caregiving Workforce Strategic Leadership Council met on September 11 to mark recent progress and renew its focus on strengthening the state’s caregiving workforce. The Council is addressing shortages in nursing, direct care, and mental health and substance use professions.
“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.”
Formed in late 2022 by the North Carolina Department of Health and Human Services (NCDHHS) together with the North Carolina Department of Commerce, the Council coordinates efforts among state agencies, educational institutions, and partner organizations 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.”
In 2024, after identifying key areas of need across the state, the Council set priorities for nursing, mental health/substance use treatment roles, and direct care. At this latest meeting, leaders provided updates on ongoing initiatives.
For nursing education retention rates have improved through an academic coaching pilot program funded by GlaxoSmithKline at six community colleges. The UNC System has also expanded Clinical Instructor Partnership programs statewide with Area Health Education Centers (AHEC), supporting bedside nurses who wish to become clinical instructors while maintaining their current positions—a step intended to address instructor shortages caused by pay disparities between clinical work and teaching roles.
Additionally, NCDHHS’ Office of Rural Health will launch an incentive program this fall offering loan forgiveness for registered nurses who commit up to four years serving in rural or medically underserved areas.
In mental health fields Session Law 2025-37 was signed into law July 1 by Governor Stein. It allows certain human services professionals with associate degrees—and relevant experience—to qualify for positions that previously required bachelor’s degrees. The legislature also appropriated $20 million for a loan repayment program designed to encourage providers to serve in underserved counties.
NCDHHS partnered with UNC School of Social Work to offer free standardized peer support specialist training statewide; online coursework began August 1 with an in-person component scheduled for October.
For direct care roles NCDHHS will launch its first National Core Indicators State of the Workforce Survey for Aging and Disabilities this fall. A new free Direct Support Professional Advanced training certificate was introduced at three pilot community colleges as part of a broader plan; $3 million has been awarded to agencies/employers for hiring bonuses, retention incentives, job training, and financial supports.
Council members discussed ongoing data collection efforts as well as strategies around wage improvements, retention measures, and expanding access to training opportunities.
Looking ahead The NC Center on the Workforce for Health—established in 2023—will take a leadership role supporting long-term implementation of these initiatives. According to Andy MacCracken: “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.”
State officials say NCDHHS and NC Commerce will remain central partners as projections show severe shortages ahead: by 2033 there could be shortfalls of about 12,500 registered nurses along with 5,000 licensed practical nurses; over 200,000 direct care job openings are expected through 2032; currently ninety-four out of one hundred counties are designated mental health professional shortage areas.
