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Preliminary!Baseline Data - Health Professions in Wisconsin!! ! Department of Workforce Development( Dept. of

Regulation & Licensing(

Other

2000 OES Code

Licensed Health Occupations, and others requiring education beyond the bachelor’s degree

2008 Estimated Employment (2008-2010 short-term projection)

2008 Estimated Employment (2008-2018 long term projection)

2009 OES Employment Estimates (does not include self-employed)

6-30-09 Total Active Licenses (New + Renewal)

2006 WCMEW

(based on AMA

Masterfile)

Physician-MD 22,567 9,856

Physician DO 1,270

29-1061 Anesthesiologists 770 1,030 900

29-1062 Family and general practitioners* 3,710 3,010 2,630

29-1063 Internists, general* 1,130 1,320 1,170

29-1064 Obstetricians and gynecologists 390 390 350

29-1065 Pediatricians, general* 410 360 320

29-1066 Psychiatrists 500 320 280

29-1067 Surgeons 1,420 1,140 1,000

29-1069 Physicians and surgeons, all other 3,550 7,080 5,970

Total Physicians - DWD data 11,880 14,650 12,620

*Total in Primary Care Disciplines (some

may be specialists) 5,250 4,690 4,120 4,660

Licensed Physicians - DRL 23,837

29-1071 Physician Assistant 1,220 1,670 1,630 1,807

2010 RN

Survey

29-1111 Registered Nurse (RN) 52,830 54,420 53,510 81,966

77,553 licensed

61,542 active in WI

25-1072 Nursing instructors and teachers,

postsecondary 1,330 1,430 1,240

Nurse Midwife (CNM) 179

Advanced Practice Nurse Prescriber 3,146

Certified Registered Nurse Anesthetists (CRNA)

Nurse Practitioner (NP)

Clinical Nurse Specialist (CNS)

29-2061 Licensed Practical Nurse 11,560 10,820 10,710 15,532

Midwife (non-RN) 62

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! ! Department of Workforce Development( Dept. of Regulation & Licensing(

Other

Acupuncturist 456

29-1011 Chiropractor 1,810 1,470 810 2,059

Chiropractic Radiological Technician n.a.

Chiropractic Technician n.a.

29-1021 Dentists 2,440 2,450 1,760 4,628

29-1022 Oral and maxillofacial surgeons 70 30

29-1029 Dentists, all other specialists * * *

29-1023 Orthodontists 200 90 70

29-1024 Prosthedontists * * *

Total Dentists-DWD data 2,710 2,570 1,830

Licensed Dentists-DRL 4,628

29-2021 Dental Hygienist 4,320 4,920 4,870 5,141

29-1031 Certified Dietitian 1,330 1,280 1,160 1,539

29-1121 Audiologist 270 330 320 353

Hearing Instrument Specialist 201

29-1127 Speech-Language Pathologist 2,680 2,920 2,410 1,863

29-1122 Occupational Therapist 3,110 2,950 2,650 3,332

31-2011 Occupational therapist assistants 810 850 790 1,265

29-1041 Optometrist 550 760 570 1,162

Perfusionist 94

29-1051 Pharmacist 5,090 5,330 5,190 6,949

29-1123 Physical Therapist 4,280 4,520 4,100 4,838

31-2021 Physical Therapist Assistant 1,330 1,420 1,380 1,497

29-1126 Respiratory Care Practitioner 1,880 2,240 2,220 2,887

29-1081 Podiatrist 110 170 140 368

DHS survey of Clinical Labs

29-2011 Medical and clinical laboratory technologists 3660 3,650 3,500 10,892

29-2012 Medical and clinical laboratory technicians 2620 2,630 1,870 3,675

Psychologist 1,647

School Psychologist 70

19-3031 Clinical, counseling, and school

psychologists 3,650 3,620 2,180

19-3039 Psychologists, all other 160 170 110

Psychologists - DWD data 3,810 3,790 2,290

Licensed Psychologists -DRL 1,717

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!! ! Department of Workforce Development( Dept. of

Regulation & Licensing(

Other

Social Worker 5,813

Advanced Practice Social Worker 1,909

Independent Social Worker 404

Licensed Clinical Social Worker 3,520

Social Worker Training Cert 392

21-1021 Child, family, and school social workers 6,090 4,590 4,380

21-1022 Medical and public health social workers 2,620 3,070 2,890

21-1023 Mental health and substance abuse

social workers 2,370 3,460 3,170

21-1029 Social workers, all other 1,190 550 500

Social Workers-DWD total 12,270 11,670 10,940

Licensed Social Workers-DRL 12,038

29-1199 Health diagnosing and treating practitioners, all other 680 1,150 850

11-9111 Medical and health services managers 4,510 5,080 4,730

11-9151 Social and community service managers 2,760 9,250 1,950

Nursing Home Administrators 928

19-1041 Epidemiologists * 100 90

25-1071 Health specialties teachers, postsecondary 3,510 4,570 3,960

21-1091 Health educators 780 750 750

29-2041 Emergency medical technicians and paramedics 7,530 5,640 5,720

Registered Sanitarian 442

17-2081 Environmental engineers 1,160 980 910

17-2111 Health and safety engineers, except mining safety engineers and inspectors 270 260 240

17-3025 Environmental engineering technicians * * 180

19-2041 Environmental scientists and specialists, including health 1,410 1,120 1,010

19-4091 Environmental science and protection technicians, including health 430 450 420

19-4092 Forensic science technicians 80 140 130

29-1131 Veterinarian 1,820 1,880 1,710 3,308

29-2056 Veterinary Technician 1,620 1,530 1,480 1,245

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Technical Notes:

The data reported in this publication reflects a survey mandated under Chapter 106.30 Wis.Stats for all Wisconsin registered nurses (RNs). The survey was conducted as an element in the biannual license renewal requirement from January 6, 2010 and March 1, 2010. The mandate was communicated to registered nurses through numerous venues and organizations as well as employers.

Two forms of the survey were used, an on-line internet version and a mail-in paper version. The data summarized in this report includes all paper responses received prior to March 17, 2010. The two versions are substantially the same, though the paper survey contains missing responses while the on-line version required responses to all questions. The dataset includes 77,553 responses, of which 3,111 are from the paper survey. (See the Additional Information Section for contact information to receive additional technical background and information on accessing the dataset for specific analyses.) The survey instrument was constructed and processed by Wisconsin Department of Workforce Development in consultation with the Wisconsin Health Workforce Data Collaborative. The survey reflects multiple surveys of the registered nurse community and contains all data elements of the National Nursing Workforce Minimum Dataset: Supply.

The survey was administered by the Wisconsin Department of Regulation and Licensing.

This project is funded in part by the Healthier Wisconsin Partnership Program, a component of the Advancing a Healthier Wisconsin endowment at the Medical College of Wisconsin.

Additional InformationTo receive additional copies of this publication visit the DWD Website, WORKnet at !""#$%%&'()*+",&-./'*.-*,0'1%23.4556(7

For additional survey information, email Nelse Grundvig at [email protected]

Send mail requests to:

Nelse Grundvig Attn: Nurses SurveyLabor Market Information SectionDepartment of Workforce Development201 E. Washington AveP.O. Box 7944Madison WI, 53707

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!"#$%&'"(&)*+),"$-&.)/"%012"34)/&$&")*+)5132*(31(4)67-8)9:;: At a Glance: Wisconsin Clinical Laboratory Science Workforce Survey, 2010

Laboratory science professionals are among the health disciplines that constitute the public health workforce. As demonstrated by the recent Novel Influenza A (H1N1) outbreak, laboratory science

professionals address public health challenges. They conduct testing to report results for certain infectious diseases (e.g., HIV, influenza, and Lyme disease), emerging communicable diseases, and chronic diseases; they also assist in monitoring individual health and wellness. In March and April, 2010, the Wisconsin Department of Health Services (DHS) conducted this survey to assist educational institutions, hospitals, clinics, and others in workforce planning to assure a sufficient, competent, and diverse workforce.

There were 3,374 CLIA-certified (Clinical Laboratory Improvement Amendments certification) laboratories in Wisconsin as of September 2, 2009. CLIA certification ranges from Certificate of Waiver (can perform only relatively simple tests) to Certificate of Compliance and Certificate of Accreditation (can perform tests of high complexity). A sample of 746 laboratories, stratified by CLIA type and DHS region, was drawn from the full list of laboratories. There was a 43% response rate, with 319 laboratories completing the survey. Results were weighted to represent all clinical laboratories in Wisconsin (see Survey Methods).

CLIA-Certified Laboratories, Wisconsin, 2010 Number of Laboratories by DHS Region Number of Laboratories by CLIA Type

Certificate of Waiver

64%(2,154)

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11%(364)

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Performed Microscopy

13%(444)

Certificate of Compliance

12%(412)

Source: Wisconsin Department of Health Services, Wisconsin Clinical Laboratory Science Workforce Survey, 2010.

Employees of Respondent Laboratories by Age and Race/Ethnicity, Wisconsin 2010

Age Race and Ethnicity

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Source: Wisconsin Department of Health Services, Wisconsin Clinical Laboratory Science Workforce Survey, 2010. Note: In the 319 laboratories that completed the survey, there were a total of 8,558 personnel whose job directly related to laboratory testing.

Page 1

Page 2

Emergency Preparedness and Response

70% of 289 respondent clinical laboratories indicated they had an Emergency Preparedness and Response Plan. Of the 282 laboratories responding to the emergency response training question, 93 laboratories (33%) indicated that

100% of their employees were trained in emergency response and preparedness.

Estimated Statewide Full-Time Equivalent (FTE) Laboratory Employees by Job Title, Wisconsin, 2010

Job Title/Discipline Estimated FTEs

Statewide Estimated FTE

Vacancies, Statewide Staff with clinical laboratory professional education and training Pathologists 737 8 Pathology Assistants 76 0 Managers/Administrators 2,917 38 Certified Medical Technologists – MT(ASCP), CLS(NCA), etc. 7,826 130 Medical Technologists (non-certified) 3,066 0 Certified Medical Laboratory Technicians – MLT(ASCP), CLT(NCA), etc. 2,981 277 Medical Laboratory Technicians (non-certified) 694 9 Phlebotomists 5,210 258 Histotechnologists (Bachelor of Science degree, B.S.) 303 0 Histotechnician 570 36 Cytologists 428 0 Cytogenetic Technologists 246 0 Molecular Biologists 47 0 Other professionals who perform laboratory testing Registered Nurses 4,571 108 Licensed Practical Nurses 2,986 100 CMA/MA 1,061 28 CNA/NA 8,198 280 Other 9,420 454 Total 51,337 1,726

Source: Wisconsin Department of Health Services, Wisconsin Clinical Laboratory Science Workforce Survey, 2010. Note: Estimated statewide numbers of FTE laboratory employees by job title were based on FTEs reported by the respondent laboratories, and calculated using a multiplier of 9.5. These estimates assume that all Wisconsin laboratories have a distribution of employees by discipline similar to that of the 319 respondent laboratories that completed the survey. Formula used to calculate the multiplier: 319/3,374 x 100 = 9.5.

Survey Methods: The survey universe consisted of 3,374 laboratories in Wisconsin that were CLIA-certified as of September 2, 2009. A sample of 746 laboratories stratified by CLIA type and DHS region was drawn from the universe list. In March 2010, laboratories in the sample were contacted by U.S. mail and asked to complete the survey on the Internet at the Wisconsin DHS, Division of Quality Assurance (DQA) Clinical Laboratory website. Two follow-up postcards were mailed to laboratories that did not respond to the initial request. This yielded a response rate of 43%, with 319 of 746 laboratories completing the survey. The data were adjusted by post-stratification weighting so the results conformed to the characteristics (CLIA laboratory type and DHS region) of the survey universe. This survey does not include local health departments, because their workforce is included in the Local Health Department Survey at http://dhs.wisconsin.gov/stats/index.htm. Clinical Laboratory Improvement Amendments (CLIA) Certification: To ensure that laboratory testing is of a consistently high quality, the Centers for Medicare & Medicaid Services regulates all laboratory testing (except research) performed on humans in the U.S. through CLIA, as follows: 1) Certificate of Waiver (COW) laboratories can only perform waived tests; 2) Certificate of Provider Performed Microscopy (PPM) laboratories, in addition to waived tests, may also perform certain microscopic examinations during the course of a patient visit using specimens that are not easily transportable; 3) Certificate of Compliance (COC) laboratories and Certificate of Accreditation (COA) laboratories can perform waived tests, as well as tests of moderate and high complexity. Acknowledgement: The Department of Health Services completed this survey for the Collaborative Response to a Growing Workforce Crisis program, funded by the Healthier Wisconsin Partnership Program, “Advancing a Healthier Wisconsin” endowment at the Medical College of Wisconsin. Further Information: Yiwu Zhang at [email protected] or Karl Pearson at [email protected]. Access this report at http://dhs.wisconsin.gov/stats/quickfacts.htm.

P-00199 (07/10 Rev. 09/10)

Health Science Career ClusterCluster Knowledge and Skill Statements

Cluster Topic HLC01

ACADEMIC FOUNDATIONS: Achieve additional academic knowledge and skills required to pursue the full range of career and postsecondary education opportunities within a career cluster.

HLC01.01 Health care workers will know the academic subject matter required for proficiency within their area. They will use this knowledge as needed in their role. In addition to state high school graduation requirements, the following are included:

HLC01.01.01 Use a knowledge of human structure and function to conduct health care role.

Sample indicatorsDescribe the basic structures and functions of cells, tissues, organs, and systems as they relate to homeostasis.Compare relationships among cells, tissues, organs, and systems.Explain body planes, directional terms, quadrants, and cavities.Analyze the interdependence of the body systems as they relate to wellness, disease, disorders, therapies, and care rehabilitation.

HLC01.01.02 Use a knowledge of diseases and disorders to conduct health care role.

Sample indicatorsCompare selected diseases/disorders including respective classification(s), causes, diagnoses, therapies, and care/rehabilitation to include biotechnological applications.Analyze methods to control the spread of pathogenic microorganisms.Contrast various types of immunities.Analyze body system changes in light of diseases, disorders and wellness.Compare the aging process among the body systems.

Cluster Topic HLC02

COMMUNICATIONS: Use oral and written communication skills in creating, expressing and interpreting information and ideas including technical terminology and information.No additional statements in the topic beyond those found in the Essential Knowledge and Skills Chart.

Cluster Topic HLC03

PROBLEM-SOLVING AND CRITICAL THINKING: Solve problems using critical thinking skills (analyze, synthesize, and evaluate) independently and in teams. Solve problems using creativity and innovation.

No additional statements in the topic beyond those found in the Essential Knowledge and Skills Chart.

Cluster Topic HLC04

INFORMATION TECHNOLOGY APPLICATIONS: Use information technology tools specific to the career cluster to access, manage, integrate, and create information.

The following Cluster (Foundation) Knowledge and Skill Chart provides statements that apply to all careers in the Health Science Cluster. Persons preparing for careers in the Health Science Cluster should be able to demonstrate these skills in addition to those found on the Essential Knowledge and Skills Chart. The Pathway Knowledge and Skill Charts are available in separate documents.

Last Revised 10/6/2008Health Science

Career Cluster Statements Page 1


No additional statements in the topic beyond those found in the Essential Knowledge and Skills Chart.

Cluster Topic HLC05

SYSTEMS: Understand roles within teams, work units, departments, organizations, inter-organizational systems, and the larger environment. Identify how key organizational systems affect organizational performance and the quality of products and services. Understand global context of industries and careers.

HLC05.01 Health care workers will understand how their role fits into their department, their organization and the overall health care environment. They will identify how key systems affect services they perform and quality of care.

HLC05.01.01 Explain systems theory as it applies to the health care environment.Sample indicators Describe systems theory and its components.

Construct a general systems model using inputs, throughputs, and a feedback loop.HLC05.01.02 Explain the health care delivery system.

Sample indicators Construct a healthcare delivery system model.Predict where and how factors such as cost, managed care, technology, an aging population, access to care, alternative therapies, and lifestyle/behavior changes may affect various health care delivery system models.

Project outcomes as interconnected components of a modified health care system.Calculate the cost effectiveness of two separate health care delivery systems using the same client procedure.

HLC05.01.03 Health care workers will understand the existing and potential hazards to clients, co-workers, and self. They will prevent injury or illness through safe work practices and follow health and safety policies and procedures.

Sample indicatorsDiagram the interdependence of health care professions within a given health care delivery system and pertaining to the delivery of quality health care.Design a system analysis process that evaluates the following outcomes; client satisfaction, productivity, cost effectiveness, and efficiency.Evaluate the impact of enhanced technology on the health care delivery system.

HLC05.01.04 Explain the concept of system change as it applies to the health care environment.

Sample indicators

Analyze the cause and effect on health care system change based on the influence of technology, epidemiology, bio-ethics, socio-economics, and various forms of complimentary (non-traditional) medicine.

Cluster Topic HLC06

SAFETY, HEALTH AND ENVIRONMENTAL: Understand the importance of health, safety, and environmental management systems in organizations and their importance to organizational performance and regulatory compliance. Follow organizational policies and procedures and contribute to continuous improvement in performance and compliance.




HLC06.01 Health care workers will understand the existing and potential hazards to clients, co-workers, and self. They will prevent injury or illness through safe work practices and follow health and safety policies and procedures.

HLC06.01.01 Explain infection control practices and procedures.Sample indicators Practice infection control procedures.

Practice appropriate cleaning, disinfecting, and sterilizing processes.Contrast medical and surgical asepsis.

HLC06.01.02 Employ personal safety practices.Sample indicators Manage a personal exposure incident in compliance with OSHA regulations.

Apply principles of body mechanics and ergonomics.Use personal protective equipment as appropriate to the environment.

HLC06.01.03 Use techniques to insure environmental safety.Sample indicators Modify the environment to create safe working conditions.

Demonstrate methods of fire prevention in the health care setting.Prevent accidents by using proper safety techniques.Practice good housekeeping by maintaining a safe work environment.

HLC06.01.04 Identify common safety hazards.Sample indicators Use Materials Safety Data Sheets (MSDS).

Adhere to hazardous labeling requirements.Comply with safety signs, symbols, and labels.Take appropriate action when observing a hazardous material problem.Apply safety principles within given environment.Handle hazardous chemicals commonly used in the health care environment in an appropriate manner.

HLC06.01.05 Use emergency procedures and protocols.Sample indicators Interpret the evacuation plan for the health care setting.

Construct an emergency plan for a health care setting in response to a natural disaster or other emergency.Follow the facility procedure when a fire is discovered.

HLC06.01.06 Describe healthy behaviors.Sample indicators Apply behaviors that promote health and wellness.

Advocate available preventive health screening and examinations.Use practices that promote the prevention of disease and injury.Use appropriate safety practices as related to high-risk behaviors.Evaluate the validity of alternative health practices.

Cluster Topic HLC07

LEADERSHIP AND TEAMWORK: Use leadership and teamwork skills in collaborating with others to accomplish organizational goals and objectives.

HLC07.01 Health care workers will understand the roles and responsibilities of individual members as part of the health care team, including their ability to promote the delivery of quality health care.

HLC07.01.01 Describe health care teams.Sample indicators Apply the team concept in providing quality patient/client care.

Recognize characteristics of effective teams.




Analyze roles of various team participants.Respond to given critical situations appropriately as a team member/leader.Accept compromise as necessary to ensure a best outcome.

HLC07.01.02 Describe team member participation.

Sample indicatorsCommunicate verbally and nonverbally with team colleagues to assure a best result for the client.Collaborate with others to formulate team objectives.Act responsibly as a team member, completing assigned tasks in a timely and effective manner.Actively listen to other team members.Exercise leadership skills as appropriate.Respect and value the expertise and contributions of all team members.Work collaboratively with persons from diverse backgrounds to accomplish a common goal.Apply corrective action to an acknowledged conflict situation.Exhibit a strong sense of team identity and commitment to purpose.

Cluster Topic HLC08

ETHICS AND LEGAL RESPONSIBILITIES: Know and understand the importance of professional ethics and legal responsibilities.

HLC08.01 Health care workers will understand the legal responsibilities, limitations, and implications of their actions within the health care delivery setting in order to deliver services within legal requirements.

HLC08.01.01 Describe legal implications affecting health care workers.Sample indicators Analyze legal responsibilities, limitations, and implications of actions.

Use problem-solving techniques when confronted with legal dilemmas or issues.Compare and contrast behaviors and practices that could result in malpractice, liability, or negligence.Comply with policies and requirements for documentation and record keeping.Comply with established risk management criteria and procedures.Determine when an incident is reportable.Comply with non-discriminatory laws.Comply with institutional policy and procedure.

HLC08.01.02 Describe legal practices employed by health care workers.

Sample indicators Perform duties according to regulations, policies, laws, and legislated rights of clients.Maintain clients’ rights according to the Patients’ Bill of Rights.

Maintain confidentiality according to Health Information Portability Access Act (HIPAA) .

Practice within licensure, certification, registration, and legislated scope of practice.Apply the doctrine of informed consent.Evaluate technological threats to confidentiality.Follow mandated standards for workplace safety, i.e., OSHA, CDC, CLIA.Apply mandated standards for harassment, labor, and employment laws.




HLC08.02 Health care workers will understand accepted ethical practices with respect to cultural, social, and ethnic differences within the health care environment. They will perform quality health care delivery.

HLC08.02.01 Describe legal and ethical boundaries in health care delivery.

Sample indicatorsDifferentiate between morality and ethics and the relationship of each to health care outcomes.Differentiate between ethical and legal issues impacting health care.Contract personal, professional, and organizational ethics.Analyze legal and ethical aspects of confidentiality.Discuss bio-ethical issues related to health care.Analyze and evaluate the implications of medical ethics.

HLC08.02.02 Describe ethical practice as it applies to health care delivery.

Sample indicatorsDemonstrate professionalism when interacting with fellow students, patients/clients, co-workers, and the organization.Respect interdisciplinary roles of team members.Report activities and behaviors by self and others that adversely affect the health, safety, or welfare of students, patients/clients, or co-workers.Demonstrate fairness and equal treatment of all persons.Practice responsibly within the ethical framework of the Patients’ Bill of Rights.Value clients’ independence and determination.

HLC08.02.03 Explain cultural, social, and ethnic diversity as it applies to health care delivery.

Sample indicatorsDiscuss the impact of religions and cultures on those giving and receiving health care with an understanding of past and present events.Demonstrate respect of individual cultural, social, and ethnic diversity within the health care environment.

Cluster Topic EDC09

EMPLOYABILITY AND CAREER DEVELOPMENT: Know and understand the importance of employability skills. Explore, plan, and effectively manage careers. Know and understand the importance of entrepreneurship skills. No additional statements in the topic beyond those found in the Essential Knowledge and Skills Chart.

Cluster Topic EDC10

TECHNICAL SKILLS: Use the technical knowledge and skills required to pursue the targeted careers for all pathways in the career cluster, including knowledge of design, operation, and maintenance of technological systems critical to the career cluster.

HLC10.01 Health care workers will apply technical skills required for all career specialties. They will demonstrate skills and knowledge as appropriate to conduct health care related tasks.

HLC10.01.01 Employ occupational safety techniques.

Sample indicatorsApply Standard Precautions as described in the rules and regulations set forth by the Occupational Safety and Health Administration (OSHA).Demonstrate safety procedures to protect clients, co-workers, and self.Obtain Cardiopulmonary Resuscitation (CPR) certification.Obtain First Aid Certification.



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State FactsWisconsin’s Direct-Care Workforce

W isconsin’s direct-care workers are the state’s frontline paid caregivers providing daily living services and supports to persons with disabilities and chronic care needs, including elders and those with physical or intellectual and develop-

mental disabilities. The majority of this largely female workforce works in the consumer’s own home, or in residential or community-based settings such as nursing homes, assisted living facilities, and group homes.

Responsible for 70 to 80 percent of paid hands-on care, these workers attend to the health, well-being, and safety of their clients. They assist with self-care and everyday living activ-ities, such as eating, bathing, and dressing, and sometimes also with paramedical tasks.

In standardized government surveys of employment and compensation,1 direct-care workers are of!cially counted as Personal Care Aides;2 Home Health Aides;3 and Nursing Aides, Orderlies and Attendants.4 The !rst occupational category also includes direct sup-port professionals—workers who provide services and supports to individuals with intel-lectual and developmental disabilities.

A large and growing workforceWisconsin’s direct-care workforce today totals nearly 90,000 workers and is larger than any other occupational grouping in the state.

Wisconsin’s Largest Occupational Groups

This Fact Sheet was supported by a Wisconsin State Health Care Workforce Development Planning Grant. State Facts is a series of short issue briefs and fact sheets on the regional status of the direct-care workforce. For more information about PHI and to access other PHI publications see www.PHInational.org

Direct-Care Workers

Retail Salespersons

Teachers from Preschool to 12th Grade

Metal Workers and Plastic Workers

RNs and LPNs

Truck Drivers

December 2011

0 20,000 40,000 60,000 80,000 100,000

87,797

76,180

73,910

70,920

63,330

60,040

The majority of direct-care workers in Wisconsin (57%) are employed as home health aides, personal care aides, and independent providers hired by consum-ers receiving services in public programs.5 These workers are largely employed in home and community-based settings.

Among the state’s fastest-growing occupations creating the most new jobsAll three direct-care occupations make the list of occupations projected to create the most new jobs in Wisconsin between 2008 and 2018.

Furthermore, Home Health Aides and Personal Care Aides are projected to be the fastest and third fastest-growing occupations in the state, increasing by 38 percent and 34 percent, respectively. In contrast, jobs overall in the state of Wisconsin are expected to increase by 3 percent over the same period.

In total, the Wisconsin Of!ce of Economic Advisors projects demand for nearly 30,000 direct-care jobs from 2008 to 2018, with two-thirds due to new growth and an additional one-third due to replacement needs.6

PHI State Facts 2

Breakdown of Wisconsin’s Direct-Care Workforce, 2010

Occupations Generating the Most New Jobs, 2008–2018Occupation Openings due to growth

1. Registered Nurses 10,600

2. Home Health Aides 7,9003. Personal Care Aides 7,400

4. Food Prep, Serving & Fast Food Workers 7,3005. Customer Service Reps 6,000

6. Nursing Aides, Orderlies, & Attendants 5,100

Personal Care Aides (Agency Employed)

19,630Nursing Aides, Orderlies and Attendants

37,630Home Health Aides

22,080

8,457 Independent Providers in Public Programs

Significant proportion of Wisconsin’s health care workforceDirect-care workers account for 32 percent of Wisconsin’s entire health care workforce, far outnumbering other health care practitioners such as physicians, nurses, and therapists. Direct-care workers also outnumber by nearly three to one all allied health occupations, such as medical and dental assistants, and therapy assistants and aides.7

Uncompetitive wages for home and community-based direct-care jobsThe median hourly wage for all occupations in Wisconsin was $15.78 in 2010. In sharp contrast, wages for Personal Care Aides and Home Health Aides are among the state’s lowest, with levels that fall between 150 percent and 200 percent of the federal poverty line for a single person. The 200 percent poverty level ($10.42) is low enough to qualify households for many state and federal assistance programs. Wages for Nursing Aides are higher, yet still far below the state’s median wage.

WISCONSIN3

Fastest-Growing Occupations, 2008–2018Occupation Growth Rate

1. Home Health Aides 38.3%

2. Network Systems and Data Communications Analysts 36.9%

3. Personal Care Aides 34.0%

4. Financial Examiners 31.8%5. Ambulance Drivers/Attendants, Exec. EMTs 32.1%6. Athletic Trainers 27.3%

Wisconsin’s Health Care Workforce, 2010

*Includes Independent Providers in public programs

Allied Health Occupations (excluding Direct-Care Workers)

Health Care Practitioners and Technical Occupations

55.6%12.4%

Direct-Care Workers*32.0%

Over the last 10 years, in"ation-adjusted hourly wages (i.e., “real wages”) for all three direct-care worker occupations have declined. Personal Care Aides experienced the greatest decline in real wages, at 10 percent.

Public subsidies required to meet basic needs• Earnings and labor force participation. A high incidence of part-time work

combined with low wages limits the annual earnings of Wisconsin’s home care

PHI State Facts 4

Median Hourly Wages in Wisconsin, 2010

Wisconsin’s Median Wages for Direct-Care Workers, adjusted for inflation (2010 dollars)

$20.00

$15.00

$10.00

$5.00

$0.00Home Health

AidesPersonal Care

Aides200% of the

Federal Poverty Line

Nursing Aides, Orderlies & Attendants

All Occupations

$9.00

$10.00

$11.00

$12.00

$13.00

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

$9.62 $10.35 $10.42$12.00

$15.78

Nursing Aides, Orderlies & Attendants

Home Health Aides

Personal Care Aides

$12.34$12.00

$10.99

$10.69$10.35

$9.62

workers. Of aides employed in home health care services in Wisconsin and other states in the East North Central Region,8 62 percent report working part time, compared to 44 percent of aides working in nursing care facilities.

Median annual earnings for direct-care workers averaged $17,000 during this period. Earnings ranged from $12,000 in home health care agencies to $19,000 in nursing care facilities.

• Poverty status. A high percentage (43 percent) of direct-care workers in Wisconsin and nearby states live in households with incomes at or below 200 percent of the federal poverty line, a near-poverty threshold that typically makes households eligible for public assistance programs. In this region, half of Personal Care Aides live in these very low-income households and 41 percent of Nursing Aides.

• Reliance on public bene!ts. Over 40 percent of direct-care workers in Wisconsin and surrounding states rely on some form of public assistance such as food stamps or Medicaid. The estimated !scal cost of providing these bene!ts in 2009 was upwards of $180 million. These bene!ts are tantamount to a public subsidy of $1 to $2 for every hour worked by a Wisconsin direct-care worker.

Summing upWisconsin’s direct-care workers now constitute the largest occupational grouping in the state. Totaling nearly 90,000, the number of direct-care workers exceeds the state’s core manufacturing employment (metal and plastic workers and machin-ists), RNs and LPNs, and teachers from kindergarten through high school. The magnitude of this workforce re"ects the fact that these have been among the fastest-growing jobs in the state.

In addition, direct-care workers have assumed a pivotal role in Wisconsin’s health care workforce, accounting for nearly a third of the state’s health care workforce and far outnumbering doctors, nurses, and other health care occupations.

At the same time, poor job quality—more than four in ten direct-care workers rely on public assistance as a result of low wages and part-time hours—hampers recruitment and retention for this workforce. Wisconsin’s booming demand for direct-care workers cannot be met without making these jobs more competitive so that they attract enough workers, especially at a time when the state has set goals to offer more long-term supports and services options to elders, their fami-lies, and persons living with disabilities. Careful injection of public and private investment can help re-shape the structure and quality of these vital occupations so that they can re"ect the importance of this work and these jobs to Wisconsin families and communities.

WISCONSIN5

Endnotes1. These surveys are conducted under the auspices of the Bureau of Labor Statistics, the Census Bureau and state labor market

information agencies.

2. Personal Care Aides may work in either private or group homes. They have many titles, including personal care attendant, personal assistant, and direct support professional. In addition to providing assistance with activities of daily living (ADLs)—such as eating, dressing, bathing, and toileting—these aides often help with housekeeping chores, meal preparation, and medication management. They also help individuals go to work and remain engaged in their communities. A growing number of personal assistance workers are independent providers employed and supervised directly by consumers.

3. Home Health Aides provide essentially the same care and services as nursing assistants, but they assist people in their own homes or in community settings under the supervision of a nurse or therapist. They may also perform light housekeeping tasks.

4. Nursing Aides generally work in nursing homes, although some work in assisted living facilities, other community-based set-tings, or hospitals. They assist residents with ADLs, and also perform clinical tasks such as range-of-motion exercises and blood pressure readings. In some states, they may also administer oral medications.

5. Independent Providers tend to be heavily undercounted in government surveys. For source of PHI estimate of independent providers, see Data Sources below.

6. Total demand includes new jobs due to growth as well as replacement needs, which refer to the number of workers leaving an occupation due, for example, to voluntary or involuntary turnover, retirement, promotion, labor force withdrawal, or death.

7. Allied Health Occupations refer to Healthcare Support Occupations (SOC Code 31-0000).

8. The East North Central Region consists of the following states: IL, IN, MI, OH, and WI.

Data SourcesOccupational projections data are from Wisconsin Workforce and Labor Market Information System, available at: http://worknet.wisconsin.gov/worknet/default.aspx.

Employment and wage data are from the U.S. Department of Labor, Bureau of Labor Statistics, Occupational Employment Statistics (OES) Program, available at: http://www.bls.gov/oes/tables.htm.

PHI’s estimate of the number of independent providers (IPs) working in public programs is derived from counts provided by IRIS and the Family Care Program.

Data on health insurance coverage, earnings, labor force participation, poverty status and reliance on public bene!ts are from PHI’s analysis of U.S. Census Bureau, Current Population Survey, pooled state data for East North Central Census Division from the 2008, 2009, and 2010 Annual Social & Economic (ASEC) Supplements. The East North Central Census Division includes IL, IN, MI, OH, and WI.

PHI’s estimate of the total !scal cost of the reliance of Wisconsin direct-care workers on public bene!ts includes Wisconsin’s state and federal costs for Food Stamps, School Lunch, WIC, and Medicaid for adults and children in the BadgerCare Program. Estimates of the percentage of direct-care worker households relying on each public assistance program are for the East North Central Division and are derived as speci!ed in the data source above. Average annual costs per WI participant or household were obtained from program data published by the Food and Nutrition Service at the U.S. Department of Agriculture for food and nutrition programs, and the Kaiser Family Foundation’s State Medicaid Fact Sheets for Medicaid.

PHI State Facts 6

PHI (www.PHInational.org), works to improve the lives of people who need home and residential care—and the lives of the workers who provide that care. Using our workplace and policy expertise, we help consumers, workers, employers, and policymakers improve eldercare/disability services by creating

quality direct-care jobs. Our goal is to ensure caring, stable relationships between consumers and workers, so that both may live with dignity, respect, and independence.

For more information contact:Hollis Turnham, PHI Midwest Director • 517.327.0331 • E-Mail: [email protected] see PHI PolicyWorks, our policy website: www.PHInational.org/policy

© Paraprofessional Healthcare Institute, December 2011

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