Allied health job vacancy tracking report

              March 2012
Allied Health Job Vacancy Tracking Report
Eddie Alcorn, MHA, MBA; Katie Gaul, MA; Erin Fraher, PhD, MPP
Support for this study comes from the North Carolina Department of Commerce.
This is a collaborative effort of the Cecil G. Sheps Center for Health Services Research,
The Council for Allied Health in North Carolina, and the North Carolina Area Health Education Centers Program.
Introduction
Allied health professionals make up the largest
proportion (34%) of the health care workforce in
North Carolina (NC) (Figure 1), yet there is limited
information regarding the demand for their services
throughout the state. The Cecil G. Sheps Center for
Health Services Research, in collaboration with the
Council for Allied Health in North Carolina and the
North Carolina AHEC Program, seeks to fill this gap by
conducting bi-annual studies that track allied health job
vacancies in the state. This report highlights the results
of the latest study to inform the work of policymakers,
educators, and practitioners to ensure an adequate supply
and distribution of allied health professionals in North
Carolina.
The allied health job vacancy tracking project
estimates workforce demand for selected health
professionals in North Carolina by monitoring job
vacancy advertisements from both online and print
sources. There are multiple factors that could indicate a
shortage including rising salaries, long waiting times for
appointments, increased time needed to fill a position,
and high recruitment costs. The number of vacancies
advertised is one indicator of whether a profession is
facing increased demand. This report reflects tracking
that was conducted in Fall 2011, and is a continuation of
five previous reports.
Determining which professions fall into the “allied
health” workforce continues to be a topic of debate. For
the purposes of this report, an exclusionary definition
is assumed that defines allied health as all health
professionals with the exception of physicians, nurses,
chiropractors, dentists, optometrists, pharmacists,
podiatrists, nurse aides, orderlies and attendants.
Figure 1 shows that allied health accounted for more
than one in three health care professionals in the state.
Historically, there has been a high growth rate in allied
health employment, and this has continued even during
the recent economic recession. Figure 2 shows that, while
total employment decreased since 2000 (2% reduction),
the health care sector experienced marked expansion
(54% growth). Allied health jobs are particularly resilient
to the worsening economy, and outpaced both health
care and total employment with 61% growth since 2000.
As policymakers consider ways to stimulate the economy
and reduce unemployment, the allied health sector has
the potential to serve as a job creation engine.
Note: “Other” healthcare occupations include chiropractors, dentists, optometrists,
pharmacists and podiatrists.Source: North Carolina Health Professions Data System
with data derived from U.S. Bureau of Labor Statistics, Occupational Employment Statistics,
State Cross-Industry Estimates: 2010. URL: http://www.bls.gov/oes/oes_dl.htm.
Accessed 9/13/11, revised 3/21/12.
Figure 1.
Health Care Jobs in North Carolina, 2010
LPNs, 5%
Physicians, 5%
Other, 4%
RNs, 24%
Nurse aides,
orderlies and
attendants, 28%
Allied Health
Professions,
34%
Total Allied Health
Jobs = 129,920
Total Health Care
Jobs = 376,930
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Allied Health Job Vacancy Tracking Report • March 2012
Methodology
Demand for allied health professionals was
estimated by collecting information from job
advertisements over a ten-week span. Job postings
were collected once per week from online sources
and regional newspapers, and information was
recorded and analyzed in Microsoft Access®. When
counting positions, information about the weekly
time requirement for each job advertised was utilized.
Full-time positions were assigned a full-time equivalent
(FTE) value of 1, whereas those listed as part-time or
PRN (as needed) were allocated 0.5 FTEs. Positions
that were listed as ten-week contract positions were
allocated 1 FTE since most employers continue
to fill those slots on an ongoing basis. Data were
de-duplicated and counted as a single vacancy if the
advertisement appeared more than once for the same
job title, employer, location, and full- or part-time
status.
Between September 18 and November 26, 2011,
1,844 de-duplicated job vacancy advertisements were
collected. This total was reduced by 231 to account
for 462 part-time and PRN vacancies. An additional
14 listings were excluded from further analyses because
they lacked sufficient information on the geographic
location or employment setting of the advertised
vacancy. These exclusions left a final sample size of
1,599 job vacancies.
Given limitations regarding the number of allied
health professions that could be tracked each week,
members of the Council for Allied Health in North
Carolina (“Council”) were surveyed in September
2011 to help guide the selection of professions facing
the greatest demand. Council members were asked to
identify whether or not the profession they represented
was facing a shortage, provide evidence of the perceived
shortage, give AHEC regions and media sources where
vacancies for that profession may be advertised, and
suggest important issues facing the future of the allied
health workforce. The final list of ten professions was
based on the results of this survey and prior inclusion
in earlier tracking reports (Table 1).
Vacancy advertisements for the professions listed
in Table 1 were collected each week from online and
print sources. The online sources included job search
engines, healthcare system websites, and professional
organizations’ career postings pages. The print sources
were collected from the Sunday classifieds section of
ten newspapers representing the state’s nine AHEC
regions (Table 2).
For the online sources, consistent search terms
were used each week to allow for a more systematic
sampling of advertisements. Since job advertisements
Table 1. Professions Monitored
Clinical Laboratory Sciences
Emergency Medical Services
Health Information Management/Technology
Imaging (PET, MRI, CT)
Medical Assistants
Occupational Therapists
Occupational Therapy Assistants
Physical Therapists
Physical Therapist Assistants
Speech-Language Pathologists
Source: North Carolina Health Professions Data System with data derived from the U.S. Bureau
of Labor Statistics, Occupational Employment Statistics, State Cross-Industry Estimates:
2000-2010. URL: http://www.bls.gov/oes/oes_dl.htm. Accessed 9/13/11, revised 3/21/12.
Figure 2.
Percent Growth in NC Employment
Relative to 2000
-10%
0%
10%
20%
30%
40%
50%
60%
70%
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Allied Health 61%
Health Care
-2%
Year
Percent Growth
%
e %
54%
Total Employment
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Allied Health Job Vacancy Tracking Report • March 2012
for some professions like speech-language pathologists
vary seasonally with the school year, efforts were made
to adjust the number and types of sources monitored in
order to counteract low seasonal demand.
Similar to the way that tracking imaging
professions required collecting data on multiple
positions (e.g., radiologic technologist, sonographer,
dosimetrist), tracking clinical laboratory science
(CLS) or health information management (HIM)
positions required collecting job listings for several
different roles. For example, CLS positions included
health technicians and technologists, which may
have been advertised under different titles such as
cytotechnologist, histologist, and phlebotomist. HIM
professions included coders, health information
administrators, and health information technicians,
and were advertised under titles such as HIM director,
medical record manager, coder, and medical reviewer.
Methodological Limitations
Although past tracking reports have proven
successful at highlighting professions and areas in the
state facing increased shortages, several limitations
should be considered when interpreting the results.
Due to logistical limitations, we were unable to track
all allied health professions throughout the state
or monitor all sources of job advertisements. Also, it
is possible that some positions are filled in a fashion
other than through job vacancies advertised from this
report’s tracked sources (e.g., direct recruitment). Thus,
the sample collected may not be fully representative
of the overall demand for professionals or provide a
complete geographic distribution of job vacancies.
A preliminary analysis was done after four weeks
of data collection. Based on these results and feedback
received from employers, educators, and health care
professionals, additional hospital and professional
association websites were added to more accurately
reflect where job ads for certain professions such as
HIM were being posted. Because of the late additions,
some postings that were filled and taken down during
the first four weeks of data collection may not have
been captured. However, the advantages of gathering
more accurate vacancy information outweighed the
cons of potentially missing some job advertisements.
Addit iona l ly, vacancies may have been
undercounted if employers who were recruiting for
more than one position only posted one advertisement.
Advertisements were collected over a span of ten
weeks and may suffer the effects of seasonal or
Table 2. Media Sources Monitored
for Allied Health Vacancies
Online Sources
Advance for Healthcare Careers
AHIMA
American Speech-Language-Hearing Association
Carolinas HealthCare System
Cone Health
Duke University Health System
HIMSS
Indeed.com
North Carolina Occupational Therapy Association
North Carolina Office of State Personnel
North Carolina Physical Therapy Association
North Carolina Public Schools Application System
North Carolina Society for Clinical Laboratory Sciences
North Carolina Speech Hearing & Language Association
Novant Health
UNC Health Care
Vidant Health (University Health Systems of Eastern Carolina)
Newspaper Sources
Asheville Citizen Times
Charlotte Observer
Fayetteville Observer
Greensboro News and Record
Raleigh News and Observer
Rocky Mount Telegram
The Daily Reflector
Wilmington Star-News
Wilson Daily Times
Winston-Salem Journal
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Allied Health Job Vacancy Tracking Report • March 2012
temporal variation (e.g., speech-language pathologist
positions are commonly advertised in the summer
to recruit for positions in the school system). Finally,
some advertisements were excluded because they
had incomplete data with respect to geography or
employment setting.
Results
Similar to previous reports, the therapy professions,
including physical therapists (PTs), occupational
therapists (OTs), and speech-language pathologists
(SLPs) were near the top in terms of absolute vacancies
by profession. Specifically, PTs (17.1%), OTs (14.5%), and
SLPs (12.6%) accounted for 44% of total vacancies in the
state.
There was a sharp increase in HIM profession
vacancies from 17 ads (1.1% of total vacancies) in
Spring 2011 to 202 ads (12.6%) in Fall 2011.
Though assessing demand by examining the
absolute number of vacancies reveals important
information about the magnitude of shortages, it is also
important to measure demand relative to workforce
size. To more accurately compare the relative demand
for each profession, a vacancy index was calculated
by dividing the number of vacancy advertisements
for each profession by the total workforce size and
multiplying by 100. The vacancy index shown in
Table 3 reflects the number of open positions per 100
employed professionals. Comparing the differences
between vacancies for SLPs and OTAs shows the
usefulness of this index. SLPs (n=202) had twice as
many job advertisements as OTAs (n=102), but the
vacancy index was half as much for SLPs (5.6) as OTAs
(11.6) because the overall size of the workforce for each
profession differs dramatically (3,630 SLPs versus 880
OTAs). Thus, relative to workforce size, OTAs are in
higher demand than SLPs.
After adjusting for workforce size, OTAs emerged
as having the highest vacancy index (11.6), followed by
OTs (8.7). The vacancy index for OTAs returned to the
top spot after slipping to fifth highest in Spring 2011.
PTAs (8.4) and PTs (6.0) had the next highest vacancy
indices by profession.
Regional Variation in Workforce Demand
Information captured on the geographic location
of the vacancy was used to determine whether the
demand for allied health professions varies by region
of the state. Total vacancy numbers were adjusted
for population size within each AHEC region. On
average, there were 1.7 allied health vacancies per
10,000 population in North Carolina, with the highest
vacancy ratio in Greensboro AHEC (2.3 vacancies per
10,000 population) and the lowest vacancy ratio in
Mountain AHEC (1.0 vacancies per 10,000 population)
(Figure 3). Urban regions such as Greensboro (2.3),
Charlotte (1.9), and Wake (1.3) AHECs demonstrated
a wide range of vacancy ratios. The growing hospital
systems in these regions demand more health
professionals, but they are also able to draw from
a deeper pool of professionals from educational
institutions in these areas.
Therapy professions made up a large proportion
of absolute vacancies and the greatest percentages
Table 3. Vacancies and Vacancy Index by Profession
Profession
Workforce
Size
Vacant
Positions
Vacancy
Index
Occupational Therapy Assistant 880 102 11.6
Occupational Therapist 2,660 232 8.7
Physical Therapist Assistant 2,020 170 8.4
Physical Therapist 4,530 274 6.0
Speech-Language Pathologist 3,630 202 5.6
Health Information Management 5,110 202 4.0
Clinical Laboratory Sciences 9,090 139 1.5
Medical Assistant 11,970 164 1.4
Imaging 9,680 68 0.7
Emergency Medical Services 8,940 46 0.5
Note: Excludes listings missing employer location (N=14). Data are
based on a de-duplicated count of 1,599. Workforce size source:
May 2010 U.S. Bureau of Labor Statistics, Occupational Employment
Statistics, State Cross-Industry Estimates: 2010.
URL: http://www.bls.gov/oes/oes_dl.htm. Accessed 9/13/11.
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Allied Health Job Vacancy Tracking Report • March 2012
of therapy jobs were advertised in the Charlotte and
Greensboro AHEC regions (Table 4). Together, the
Charlotte and Greensboro AHEC regions accounted
for 30% or more vacancies for OTs, OTAs, PTs, and
PTAs. Also, Charlotte and Greensboro AHEC regions
made up around half of all advertisements for clinical
laboratory scientists (26% and 24%, respectively),
health information management (32% and 14%), and
medical assistants (28% and 21%).
Labor markets are regional and the demand for
specific professions varies by AHEC region. Table
5 shows the percent of each AHEC region’s total
advertisements from each profession. The regions with
the largest healthcare systems, Charlotte, Greensboro
and Wake, tended to have higher vacancies for hospital-affiliated
professions like CLS and HIM. There were
more diverse needs in the more rural regions. The
demand for OTAs relative to supply was the most
pronounced in Mountain AHEC, where OTAs
accounted for 19% of total vacancies, while the next
highest percentage was only 8% in Greensboro. Area L
continued to experience a high demand for therapists
relative to other regions, having the second-highest
percentage of vacancies in OTs, PTs, and PTAs (20%,
20%, and 22%). Combined with SLPs (17%), these
professions made up 79% of Area L’s vacancies.
Employment Setting
Demand for allied health professionals varies by
employment setting, since facilities deliver different
types of care to patients with conditions of varying
acuity (Table 6). Nearly 80% of the job postings
were from hospitals (37%), long-term care facilities
(21%), or practices (20%). This vacancy composition by
employment setting mirrors the actual 2010 distribution
of health care professionals across North Carolina
hospitals (35%), long-term care facilities (22%), and
practices (20%).i Hospitals had the highest percentage
of total vacancies across the disciplines of CLS (64%),
EMS (78%), HIM (74%), Imaging (65%) and PT (35%).
Long-term care facilities accounted for the highest
percentage of vacancies for OTs (34%), OTAs (54%),
PTAs (38%), and SLPs (30%), and they were second-highest
for PTs (22%). As noted in previous reports, the
vast majority of medical assistant vacancies (87%) were
in the “Practice” setting.
Mountain
1.0
Southern Regional
2.2
Area L
1.9
Figure 3.
Allied Health Job Vacancy Advertisements per 10,000 Population
by AHEC Region, North Carolina, Fall 2011
Notes: North Carolina newpapers and online listings for select allied health professions tracked from September 18, 2011 to November 26, 2011 (N=1,599).
Source: North Carolina Health Professions Data System, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 2012.
Population source: North Carolina Office of State Budget and Management, Socioeconomic Data, 2010. URL: http://www.osbm.state.nc.us/ncosbm/facts_and_figures/. Accessed 01/12/12.
NC average is 1.7 vacancies per 10,000 population
AHEC Boundary
County Boundary
Northwest
1.3
Greensboro
2.3
Wake
1.3
Charlotte 1.9
South East
1.6
Eastern
1.7
i NC Employment Security Commission. “Employment and Wage Data by Industry.” URL: http://eslmi23.esc.state.nc.us/ew/. Accessed 2/7/12.
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Allied Health Job Vacancy Tracking Report • March 2012
Table 5. Percent of AHECs’ Total Vacancies by Profession
AHEC Vacancies
Clincial Laboratory
Sciences
Emergency
Medical Services
Health Information
Management
Imaging
Medical Assistant
Occupational
Therapist
Occupational
Therapy Assistant
Physical Therapist
Physical Therapist
Assistant
Speech-Language
Pathologist
Total
n=139 n=46 n=202 n=68 n=164 n=232 n=102 n=274 n=170 n=202 n=1,599
Area L n=60 3 2 3 7 3 20 3 20 22 17 100
Charlotte n=345 10 2 19 4 14 13 6 16 7 9 100
Eastern n=179 7 3 11 1 4 19 6 17 8 24 100
Greensboro n=261 12 3 11 5 13 10 8 18 11 9 100
Mountain n=76 5 1 4 1 8 21 19 13 11 17 100
Northwest n=199 5 1 17 3 6 15 5 13 24 11 100
South East n=77 8 5 6 8 8 10 3 25 9 18 100
Southern Regional n=198 6 7 8 3 13 15 6 20 7 15 100
Wake n=204 12 2 15 7 11 16 4 18 7 8 100
NC n=1,599 9 3 13 4 10 14 6 17 11 13 100
Data are based on de-duplicated count of 1,599.
Table 4. Percent of Profession’s Total Vacancies by AHEC
AHEC Vacancies
Clincial Laboratory
Sciences
Emergency
Medical Services
Health Information
Management
Imaging
Medical Assistant
Occupational
Therapist
Occupational
Therapy Assistant
Physical Therapist
Physical Therapist
Assistant
Speech-Language
Pathologist
All Professions
n=139 n=46 n=202 n=68 n=164 n=232 n=102 n=274 n=170 n=202 n=1,599
Area L n=60 2 2 1 6 1 5 2 4 8 5 4
Charlotte n=345 26 15 32 22 28 19 21 20 14 15 22
Eastern n=179 9 13 9 3 4 14 11 11 9 21 11
Greensboro n=261 24 20 14 18 21 11 19 17 16 12 16
Mountain n=76 3 2 2 1 4 7 14 4 5 7 5
Northwest n=199 7 2 16 9 8 13 11 9 28 11 12
South East n=77 4 9 3 9 4 4 2 7 4 7 5
Southern Regional n=198 8 30 8 10 16 13 11 15 8 14 12
Wake n=204 17 7 15 22 14 14 9 13 8 8 13
NC n=1,599 100 100 100 100 100 100 100 100 100 100 100
Data are based on de-duplicated count of 1,599.
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Allied Health Job Vacancy Tracking Report • March 2012
Discussion
Therapy positions continue to exhibit strong
demand, with OTAs and OTs showing the strongest
demand. Even though the raw number of vacancies
is smaller for OTs and OTAs than for PTs and PTAs,
the vacancy index shows that they are in high demand
relative to the size of the OT and OTA workforce.
There was a twelve-fold increase in HIM vacancies
from Spring to Fall 2011. Reasons for this may include
better targeting of sources for collecting HIM job
ads and employer response to the development and
implementation of new HIM initiatives such as
meaningful use regulations, health information exchanges,
and the transition from ICD-9 to ICD-10 coding.
CLS showed a relatively high number of vacancies
(n=138). A large proportion of lab scientists are
reaching retirement age and academic programs may
not be producing enough graduates to meet industry
demand due to insufficient training opportunities.ii
Conclusion
The data presented in this report continue to
support anecdotal evidence of strong demand for
allied health professionals in the therapy fields.
Absolute demand was highest in urban areas where
several of North Carolina’s largest health systems are
located, but the rural areas continue to experience
difficulty recruiting health professionals, and they lack
educational programs that would enable them to train
professionals locally.
Allied Health Workforce Planning in North
Carolina: Past and Present
This is the sixth publication in a series of reports
monitoring allied health workforce demand in North
Carolina. The project has been generously funded by
the North Carolina Department of Commerce, the
North Carolina Health and Wellness Trust Fund, the
Florence Rogers Charitable Trust, the North Carolina
AHEC Program, and the Duke Endowment. As of
March 2012, a funding source for future analyses has
not been identified. This is despite the fact that the data
generated from the project have been used by a wide
range of policymakers in their efforts to ensure that
NC has the right mix of allied health professionals by
profession, geography and employment setting.
Table 6. Percent of Vacancies by Employment Setting
Setting Vacancies
Clincial Laboratory
Sciences
Emergency
Medical Services
Health Information
Management
Imaging
Medical Assistant
Occupational
Therapist
Occupational
Therapy Assistant
Physical Therapist
Physical Therapist
Assistant
Speech-Language
Pathologist
All Professions
n=139 n=46 n=202 n=68 n=164 n=232 n=102 n=274 n=170 n=202 n=1,599
Government n=36 6 7 4 3 — 1 1 2 1 3 2
Home Health n=127 — — — — — 2 11 19 19 14 8
Hospital n=594 64 78 74 65 7 27 15 35 27 20 37
Long-Term Care n=334 2 — 2 2 3 34 54 22 38 30 21
Other n=16 1 7 4 — 1 1 — — — — 1
Practice n=326 24 4 15 29 87 5 4 19 7 9 20
Rehabilitation n=25 — — — — — 1 4 1 6 3 2
School n=117 1 4 1 1 1 29 3 1 2 17 7
Staffing n=24 2 — — — 1 — 8 1 — 4 2
Total n=1,599 100 100 100 100 100 100 100 100 100 100 100
Data are based on de-duplicated count of 1,599.
iiMichel, Robert L. “When Recruiting and Training Generation Y to Work in Medical Laboratories, U.S.A and U.K. Face Same Challenges.”
URL: http://www.radmailer.com/t/ViewEmail/r/AE830426DDF21F89/624343686ADF091DC68C6A341B5D209E. Accessed 2/13/12.
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Allied Health Job Vacancy Tracking Report • March 2012
The Cecil G. Sheps Center for Health Services Research
The University of North Carolina at Chapel Hill
Campus Box 7590 • 725 Martin Luther King Jr. Blvd. • Chapel Hill, NC 27599-7590
http://www.shepscenter.unc.edu/hp • nchp@unc.edu • (919) 966-7112
The North Carolina Community College System,
The University of North Carolina General Administration,
and their constituent colleges and universities have used
the data along with other sources to evaluate the need
for new education programs and to justify expanding
existing ones. In these tight budgetary times, it is critical
that such decisions be driven by data so that limited state
funding is invested where it is most needed. For example,
the data have been used to support the development of
a new medical assisting program and a new pharmacy
technician program at A-B Technical Community
College in Asheville, a health studies degree completion
program at UNC Greensboro, and a bachelor of science
program in respiratory therapy at UNC Charlotte. The
data have also generated interest in expanding the
number of PT and OTA programs in the state.
The North Carolina AHEC Program office has used
the data to promote allied health professions as career
choices for students and displaced workers. The regional
AHEC centers use the data for pipeline development
and for planning the numbers and types of continuing
education programs offered.
Allied health vacancy data were instrumental in
securing an allied health sector strategy grant from the
National Governors Association (NGA). The NGA
funds were used by the North Carolina Commission
on Workforce Development to fund four allied
health regional skills partnerships (RSPs).iii RSPs were
comprised of employers, educators, and workforce
development stakeholders in the Centralina (Charlotte
and Northwest AHEC regions), Capital Area (Wake
AHEC), Lumber River (Southern Regional AHEC), and
Turning Point (Area L AHEC) Workforce Development
Board regions. The RSPs used the vacancy report data
to develop and implement strategies to create new jobs
and career advancement opportunities for high-demand
occupations in the allied health sector. One goal was to
make unemployed workers from traditional industries,
such as manufacturing, aware of allied health career
opportunities in their local area.
Out of the 2011 Institute for Emerging Issues (IEI)
Forum came a charge to focus on health workforce
innovations. The IEI convened stakeholders to identify
strategies to build the state’s allied health workforce
and created an expert working group that drew on their
own knowledge and data from the allied health vacancy
reports to develop a model demonstration project. The
project supports the transition of long-term unemployed
workers in rural communities into allied health jobs
through career guidance, educational programs,
employer collaborations, and individual support systems.
Vacancy report data were used by North Carolina’s
Forgivable Education Loans for Service (FELS) program
to determine which health professions were in critical
shortage. The FELS program provides loan forgiveness
to students in approved health sciences and education
degree programs.
These few select examplesiv show how valuable the
data have been to policymakers. The need for robust
data on demand for allied health professionals will only
intensify as NC’s population continues to rapidly expand,
as the proportion of the population over age 65 continues
to grow, and with insurance coverage expansions that
will result if health reform is implemented. We can
either plan for this future workforce driven by anecdote
or by data. The latter approach is much more likely to
result in investments of taxpayer dollars that match the
health workforce needs of our state.
Maps and graphics were produced by the North Carolina Health Professions Data System, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.
300 copies of this public document were printed at a cost of $330.23, or $1.10 each.
iiiNorth Carolina Commission on Workforce Development. URL: http://www.nccommerce.com/wf/about-us/plans-policies-reports-initiatives/initiatives. Accessed 3/21/12.
iv Examples gathered through personal communication with Renee Batts, NCCCS; Alan Brown, NC AHEC; Sarah Langer, IEI; Terrence Scarborough, FELS Program, NCSEAA; and Alisa Debnam, CAHNC. March 23-29, 2012.