NAPA HEALTHCARE INDUSTRY: A WORKFORCE NEEDS AND OPPORTUNITIES STUDY

Transcription

1 NAPA HEALTHCARE INDUSTRY: A WORKFORCE NEEDS AND OPPORTUNITIES STUDY AUGUST 2010

2 Napa Healthcare Industry: A Workforce Needs and Opportunities Study August 2010 Report Authors Jim Cassio, Workforce Development Analyst Napa County Workforce Investment Board 650 Imperial Way Napa, California Phone: (916) Bruce Wilson, Director Napa County Workforce Investment Board 650 Imperial Way Napa, California Phone: (707)

3 Table of Contents 3 Table of Contents Page 4 Preface 6 Healthcare Industry Overview 8 Sector Strategies 10 Workforce Needs and Opportunities Survey 25 Top Job Opportunities in the Healthcare Industry 26 Occupation and Training Profile 44 Challenges and Recommendations Updated September 3, 2010

4 4 Napa Healthcare Industry Preface When people think about Napa, they usually think about great wine and great food. However, the healthcare industry in Napa County is one of our most important industries. A major contributor to our local and regional economy, this industry includes nearly 700 employers and 10,000 jobs. The healthcare industry provides more jobs than any other single industry. And the jobs in healthcare generally pay well above what other industries pay. The healthcare industry has strong career pathways for individuals who want to acquire new skills or additional education in order to advance in their careers. How significant is this industry s contribution to our local economy? The contribution is very significant. Consider: 1. Aging baby boomers require increasing health-related services and will continue to drive the growth of new healthcare jobs. 2. The healthcare industry provides more jobs in Napa County than any other single industry. 3. It has the highest annual payroll (over $500 million) of any single industry in Napa County. The average annual wage for workers in this industry is $52,572, well above the $44,000 average for all industries. What is the purpose of this report? In late 2009, the Napa County Workforce Investment Board embarked on a new series of industry sector initiatives in order to better understand the needs of local employers specifically their workforce needs and challenges, and the opportunities they present. Six industry sector initiative projects each focus on a priority industry selected by the Workforce Investment Board (including healthcare). Each project includes: An initial community forum with business leaders representing those industries (includes focus group discussion) An extensive workforce needs and opportunities survey with industry employers A second community forum to present the findings of the survey and analysis, and to discuss the future of each industry group Industry sector initiatives have proven to be effective ways for workforce investment boards to develop more effective programs, services and policies in order to better prepare the local workforce to meet the challenges and opportunities of local employers. Another benefit of industry sector initiatives is that the business leaders who participate in the process often find themselves at the center of formal or informal advisory groups that represent the workforce and workforce development interests of their industry. In conducting this survey and preparing this report, certain workforce challenges and their inherent opportunities became apparent. They are included in a chapter entitled Challenges and Recommendations.

5 Preface 5 Who are we? We are the Napa County Workforce Investment Board (WIB). In partnership with the Napa County Board of Supervisors, the WIB oversees local workforce development activities and establishes programs and services in response to the workforce needs of Napa County. Our programs and services are designed to serve employers, employees, job seekers and youth in accordance with our 5 Year Strategic Plan. The plan describes the Workforce Investment Board's commitment to establishing a comprehensive, demand-driven workforce development system for Napa County. Our Business & Career Center, which is operated by WorkforceNapa, a consortium of local service providers, is the center of our local workforce development system. This important community resource offers a wealth of training and employment resources, and labor market information, to assist both job seekers and businesses. WorkforceNapa Business & Career Center 650 Imperial Way, Suite 101 Napa, California, Phone: (707) We also have a satellite career center at the Napa Main Library at 580 Coombs Street in Napa. Questions regarding the survey should be directed to Jim Cassio, our Workforce Development Analyst: Phone: (916) Jim7@cassio.com Other questions regarding this report or our industry sector initiatives should be directed to me. Sincerely, Bruce Wilson, Director Napa County Workforce Investment Board Phone: (707) Bruce.Wilson@countyofnapa.org

6 6 Napa Healthcare Industry Healthcare Industry Overview The healthcare industry in Napa County diagnoses, treats, and administers care to residents and visitors, responding to the needs of everyone from newborns to the terminally ill. The healthcare industry has more jobs than any other single industry in Napa County. Healthcare is projected to generate 3.2 million new jobs in the U.S. between 2008 and 2018, more than any other industry. The job growth is largely in response to the rapid growth of the elderly population. In Napa County, about 900 new healthcare jobs are expected to be created between 2006 and That reflects about 9% of all new jobs. Slightly more than 500 establishments make up the healthcare industry in Napa County; they vary greatly in terms of size, staffing patterns, and organizational structures. About 88% of healthcare establishments are offices of physicians, dentists, and other health practitioners. Although hospitals constitute only 3.4% of all healthcare establishments, they employ nearly 60% of all workers in this industry. In the rapidly changing healthcare industry, technological advances have made many new procedures and methods of diagnosis and treatment possible. Clinical developments, such as infection control, less invasive surgical techniques, advances in reproductive technology, and gene therapy for cancer treatment, continue to increase the longevity and improve the quality of life of many Americans. Advances in information technology have a perceived improvement on patient care and worker efficiency. Devices such as hand-held computers are used to record a patient s medical history. Information on vital signs and orders for tests are transferred electronically to a main database; this process eliminates the need for paper and reduces recordkeeping errors. Cost containment is also shaping the healthcare industry, as shown by the growing emphasis on providing services on an outpatient, ambulatory basis; limiting unnecessary or low-priority services; and stressing preventive care, which reduces the potential cost of undiagnosed, untreated medical conditions. Healthcare reform is also underway. Although outside the scope of this study, it is clear that healthcare reform will affect the number of people covered by some form of health insurance, the number of people being treated by healthcare providers, and the number and type of healthcare procedures that will be performed. Subsectors of the Healthcare Industry in Napa County (sorted by # of jobs) # of Firms # of Jobs NAICS code Hospitals 18 4, Ambulatory Health Care Services 459 2, Nursing and Residential Care Facilities Source: Dun & Bradstreet database, Winter Industry Sector Descriptions (NAICS) NAICS (aka the North American Industry Classification System) is the standard industry classification system used throughout North America. It is used by all U.S. Federal agencies in classifying business establishments for the purpose of collecting, analyzing, and publishing statistical data related to the U.S. economy. Hospitals This subsector includes hospitals that provide medical, diagnostic, and treatment services that include physician, nursing, and other health services to inpatients, and the specialized accommodation services required by inpatients. Hospitals may also provide outpatient services as a secondary activity. Ambulatory Health Care Services This subsector includes businesses that provide health care services directly or indirectly to ambulatory patients and do not usually provide inpatient services. Includes offices of dentists. Nursing and Residential Care Facilities This subsector includes facilities that provide residential care combined with either nursing, supervisory, or other types of care as required by the residents.

7 Industry Overview 7 Sample of Occupations The following 34 occupations are not exclusive to this industry, but are commonly found in this industry. These occupations also do not constitute a complete list of occupations found in this industry. They are simply the 34 occupations that are most often represented by the jobs in this industry. For a profile of each of these occupations, see the chapter entitled Occupation and Training Profile. 1. Billing and Posting Clerks and Machine Operators 2. Bookkeeping, Accounting, and Auditing Clerks 3. Cooks, Institution and Cafeteria 4. Counselors and Social Workers 5. Dental Assistants 6. Dental Hygienists 7. Dentists 8. Diagnostic Medical Sonographers 9. Dietitians and Nutritionists 10. Emergency Medical Technicians and Paramedics 11. Financial Managers 12. Food Preparation Workers 13. Home Health Aides 14. Janitors and Cleaners, Except Maids and Housekeeping Cleaners 15. Licensed Practical and Licensed Vocational Nurses 16. Marketing Managers 17. Medical and Clinical Laboratory Technicians 18. Medical and Clinical Laboratory Technologists 19. Medical and Public Health Social Workers 20. Medical Assistants 21. Medical Records and Health Information Technicians 22. Nursing Aides, Orderlies, and Attendants 23. Personal and Home Care Aides 24. Pharmacists 25. Pharmacy Technicians 26. Physician Assistants 27. Physicians and Surgeons 28. Public Relations Specialists 29. Radiologic Technologists and Technicians 30. Receptionists and Information Clerks 31. Registered Nurses 32. Respiratory Therapists 33. Secretaries 34. Surgical Technologists Annual Payroll and Wage Analysis With a total annual payroll of about $512 million, the healthcare industry in Napa County has the largest payroll of all the major industries. Total annual payroll is a combination of total jobs and the wages or salaries paid for those jobs (based on statistics from the California Employment Development Department s Labor Market Information Division). In Napa County, the average annual wage for workers in this industry is about $52,500. This is well above the average for all nonfarm industries of about $44,000 per year.

8 8 Napa Healthcare Industry Sector Strategies The Napa County Workforce Investment Board (WIB) embarked on a series of industry sector initiatives in late 2009 in order to better understand the needs of local employers specifically their workforce needs and challenges, and the opportunities they present. To initiate the sectoral strategy, the WIB selected six industry sector projects with each one focusing on a priority industry: 1. Food and Beverage Manufacturing 2. Durable Goods Manufacturing 3. Healthcare 4. Transportation, Warehousing and Utilities 5. Professional and Business Services 6. Construction and Renovation A seventh industry sector initiative project - a study of the green economy - has since been added to the list. What makes this green economy project different is the fact that many sectors of the green economy overlap with other industries, including several of those identified for the purposes of our industry sector initiatives. Each industry sector initiative project includes: An initial community forum with business leaders representing the subsectors of each industry (including focus group discussions) A workforce needs and opportunities survey with industry employers A second community forum to present the findings of the survey and to discuss the challenges and opportunities What are the objectives and outcomes of industry sector initiatives? Industry sector initiatives have proven to be effective ways for workforce investment boards to: 1. Better understand the workforce needs and challenges of specific industries 2. Bring together leaders from the business and workforce development communities to address the needs and challenges identified by the sector initiatives 3. Develop more effective workforce development programs, services and policies in order to better prepare the local and regional workforce 4. Develop industry-driven skill panels or employer advisory groups that represent the workforce and workforce development interests of their industries Outcome examples of industry sector initiatives: Partnerships can leverage resources to develop new training programs or seek funds for special projects Closer working relationship allows for better labor market research and an improved understanding of the industry s workforce needs and the workforce development system s programs and services Allows for the development of new programs and services for incumbent workers Allows for better mapping of career pathways and entry-level employment opportunities The role of education and training providers in industry sector initiatives Education and training providers play an important role in most sector initiatives. Many of the community-based organizations that operate long-standing sector initiatives, including workforce investment boards, began by providing or brokering training services. Moreover, public policy has increasingly encouraged the development of sector partnerships involving formal education providers such as community colleges and technical schools, and these relationships are growing in number.

9 Sector Strategies 9 Industry sector initiative resources National Association of Workforce Boards (NAWB) - The National Association of Workforce Boards represents the interests of the nation's business-led Workforce Investment Boards. NAWB is guided by a Board of Directors, composed primarily of Workforce Board chairs and past chairs that oversee job training at the local level. Founded in 1979, NAWB membership consists of local boards and governor-appointed state workforce investment boards representing approximately 15,000 volunteers from business and other sectors. Services available include customized-training, publications and information dissemination to workforce investment boards. National Network of Sector Partners (NNSP) - The National Network of Sector Partners is the trade association and resource center for organizations working to develop industry-specific workforce and economic development initiatives across the United States. NNSP can provide information on organizations conducting initiatives in specific sectors and can share strategies that have worked elsewhere. Visit NNSP for profiles of current initiatives, publications, conference announcements, resources, and a quarterly newsletter. Small grants, teleconferences on hot sector topics, and other resources are also available to members. Workforce Strategies Initiative - The Aspen Institute - The Aspen Institute Workforce Strategies Initiative has conducted evaluations, provided technical assistance, and designed key publications in the sector field. Search their website for key publications, findings, and materials on developing outcomes for both individual program participants and employer partners, including information specific to WIB-sponsored sector initiatives. Public/Private Ventures (P/PV) - Public/Private Ventures has developed key publications and evaluations on sector initiatives. They also offer training for workforce development professionals (Working Ventures) and run a small grants program to assist workforce organizations in key sector initiative areas. Search their website for a range of publications and materials of help to practitioners. Working for America Institute - AFL-CIO - The Working for America Institute supports the development of sectoral labor-management partnerships through publications, technical assistance, and workforce policy supports. Visit their website for information on labor-management sectoral programs in the building trades, healthcare, hospitality, and manufacturing sectors.

10 10 Napa Healthcare Industry Workforce Needs and Opportunities Survey This survey was conducted in March and April of 2010 following a focus group discussion with business leaders representing the healthcare industry in Napa County. In addition to the focus group participants, a total of 19 employers participated in the online survey which was conducted as a confidential survey using SurveyMonkey. The survey response constitutes a 47.2% response rate. Survey respondents were promised that they would not be identified by name or organization; therefore the survey results are summarized. 1. Of your current employees, how many are: Number Percent Full time: 4, % Part time: % On call: % Temp or seasonal: % TOTAL EMPLOYEES: 6, About what percent of your employees live outside Napa County? Average: 57% Individual responses ranged from 1% to a high of 95%. 3. Over the past 12 months, has your number of employees: Number of employers Percent of jobs Increased: % Decreased: % Remained about the same: 4 6.7% 4. For what jobs did you hire the most replacement workers over the past 2 years? (listed alphabetically) Caregivers (4x) Caregivers Non-Medical, In-Home (2x) Certified Nursing Assistant CNA), Emergency Medical Technician (EMT), Residential Assistant (RA), Dietary Supervisor, Maintenance Supervisor Clerical, Social Service Eligibility, Mental Health Workers (On-Call) Counselors (FT and On-Call), Case Managers Emergency Medical Technicians Marketing, Guest Services Medical Practitioner, Customer Service Nurses, LVN's, CNA's, Sanitation, Food Service Registered Dental Assistants RN, Charge nurse Social Workers, Doctors, Rehabilitation Social Workers, MSWs

11 Workforce Needs and Opportunities Survey For what jobs have you had significant difficulty finding qualified applicants who meet your hiring standards? Caregivers (4x) Caregivers Non-Medical, In-Home Counselors, Relief Counselors Marketing, Guest Services Medical Practitioners Paramedics Pharmacists, Coders, Nursing Managers, Clinical Lab Scientists, Surgery Techs, Ultrasound Techs, Radiation Therapy Techs, CT Techs, Financial staff, Dietitians, Speech Therapists, Physical Therapists Physicians and Surgeons, Stationary Engineers, Registered Dieticians Psychiatrists, Child Protective Service Workers, Public Health Nurses Residential Assistants (RAs), Dietary Supervisors, Maintenance Supervisors Senior management positions Social Workers, Doctors, Rehabilitation Sterilization Technicians 6. When you consider the new employees you have hired over the past 2 years, are there any specific knowledge, skills or abilities that you feel are in short supply? Bilingual Spanish skills. Computer skills. Experience in residential treatment for the mentally ill; minimum qualifications for education (i.e. A.A. and 6 years experience; B.S. and 4 years exp.; M.A. and 2 years exp.). Good customer service! Good work ethic, attitude and teamwork. Intermediate level computer skills for entry level positions. Homecare knowledge and experience. Reliability. Knowledge of nutrition, supplements, and homeopathy. Positive work ethic and attitude. Problem solving and critical thinking skills. Caregiver skills necessary for Hospice and Alzheimers patients. We have had excellent applicants - probably because of the recession. Typically, they are young and don't have much "life" experience. So following direction can be an issue. Poor financial decision making in their personal lives can also affect their employment. Work ethic and availability: Understanding that the employer sets the hours and not the employee. Employees think they can 'turn down' work they are assigned to do. 7. About how many new jobs do you expect to add during the next 2 years? Number of new jobs Percent of new jobs Full time: % Part time: % On call: % Temp or seasonal: % TOTAL: What types of jobs will make up the most new positions? Administrative Caregivers (4x) Caregivers Non-Medical, In-Home Counselors, Relief (on call) EMT's, CNA's EMT's, Paramedics, Dispatchers Medical practitioners RN's, LVN's, CNA's, Sanitation, Food Service Social Workers Social Workers, Doctors, Rehabilitation, Clerical, Nursing Sterilization Techs "Travelers" who replace nurses who are on leave

12 12 Napa Healthcare Industry 9. Do you expect your overall number of employees to be reduced over the next 2 years? Number of employers Yes: 1 No: 17 Not sure: If YES, about how many employees do you expect to lose? The single employer who responded YES to question 9 anticipated a loss of 5 or fewer positions, attributed to the economic downturn and state budget crisis. Another employer indicated that the growing elderly population will prevent net job loss. 11. What are the top trends that we should we be aware of that are affecting, or will affect, your industry? Aging population (3x) Anthem Blue Cross Healthy Families Program Changing licensing requirements for employees, OSHA regulations Documentation problems with caregivers hired privately (e.g. background checks, immigration, insurance) Healthcare reform (3x) High housing costs Increase in self-healthcare and alternative remedies (e.g. for menopause, high blood pressure, and high cholesterol) Increasing necessity of computer literacy skills (e.g. for documentation purposes) Insurance company regulations, state regulations Labor law regulations and rulings on Personal Attendants New CMS (Centers for Medicare & Medicaid Services) requirements, especially for CHTs (Certified Hemodialysis Technicians); problems with creating standardized tests for technical jobs State budget crisis (2x) 12. Are there any specific education or training programs in Napa County or nearby that you would like to recognize as excellent programs for preparing a skilled workforce? Napa County ROP CNA Program (2x) Napa Valley College EMT Program Napa Valley College Nursing Programs (3x) Napa Valley College Psychiatric Technician Program Napa Valley Hospice & Adult Day Services (2x) Sonoma State University Social Work Program, UC Berkeley Social Work Program, CSU Eastbay Social Work Program WorkforceNapa Career Center (hiring, interviewing and customer service classes)

13 Workforce Needs and Opportunities Survey Are there any specific education or training programs in Napa County or nearby that you would like to recognize as being deficient in their ability to prepare a skilled workforce? Responses to this question will be communicated directly to the education/training providers. 14. How much influence do you think your industry has on the education and training in our community that prepares people for your workforce? (Check one) Number of employers Percent of employers No influence: % Little influence: % Some influence: % Great influence: %

14 14 Napa Healthcare Industry 15. In what ways are you able to have that influence? Respondents who said No influence We are in the drug and alcohol rehabilitation industry. Most people who enter this workforce are recovering addicts and alcoholics themselves. Life experience makes them qualified to work in this industry. Respondents who said Little influence Through the Nursing Program at Napa Valley College. We re a niche business. Respondents who said Some influence By participating on the training program advisory committees. Discussion with medical assisting programs/schools as well as the ability to have these students extern with us. Napa Valley College will sometimes expand curriculum to prepare students for specific health & human services jobs, e.g. emergency medical services, alcohol & drug counseling, etc. On the Napa Valley College Workforce Committee. We have a group of hospitals that meet regularly and prepare for the future needs of healthcare by working with the local college and other educational institutions. Respondents who said Great influence Good dialogue with all the area colleges. By illuminating our needs to the clients we serve and people who are qualified to work, and transforming it into action by matching them together. Hence, we spread the good news of satisfaction and raise public standards of ethics and performance. 16. In general, how important are the following types of labor market information to you? Economic outlook reports by industry sector: Number of employers Percent of employers Extremely Important: 1 5.5% Very Important: % Somewhat Important: % Not Important: % 1 non-response to this question Occupational research reports: Number of employers Percent of employers Extremely Important: % Very Important: % Somewhat Important: % Not Important: % 1 non-response to this question Postsecondary education and training directory: Number of employers Percent of employers Extremely Important: % Very Important: % Somewhat Important: % Not Important: % 1 non-response to this question

15 Workforce Needs and Opportunities Survey In general, how difficult is it for you to find new employees who possess these BASIC SKILLS prior to employment: READING SKILLS: Number of employers Percent of employers Extremely Difficult: 0 0% Very Difficult: 0 0% Somewhat Difficult: % Not At All Difficult: % WRITING SKILLS: Number of employers Percent of employers Extremely Difficult: 0 0% Very Difficult: 1 5.3% Somewhat Difficult: % Not At All Difficult: % MATH SKILLS: Number of employers Percent of employers Extremely Difficult: 0 0% Very Difficult: % Somewhat Difficult: % Not At All Difficult: % COMPUTER SKILLS: Number of employers Percent of employers Extremely Difficult: % Very Difficult: % Somewhat Difficult: % Not At All Difficult: %

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17 Workforce Needs and Opportunities Survey In general, how difficult is it for you to find new employees who possess these WORKPLACE SKILLS prior to employment: TEAMWORK SKILLS: Number of employers Percent of employers Extremely Difficult: 0 0% Very Difficult: % Somewhat Difficult: % Not At All Difficult: % PROBLEM SOLVING/CRITICAL THINKING SKILLS: Number of employers Percent of employers Extremely Difficult: % Very Difficult: % Somewhat Difficult: % Not At All Difficult: % COMMUNICATION SKILLS: Number of employers Percent of employers Extremely Difficult: 1 5.3% Very Difficult: % Somewhat Difficult: % Not At All Difficult: % STRONG WORK ETHIC: Number of employers Percent of employers Extremely Difficult: % Very Difficult: % Somewhat Difficult: % Not At All Difficult: 1 5.3% ABILITY TO ADAPT TO CHANGE: Number of employers Percent of employers Extremely Difficult: % Very Difficult: % Somewhat Difficult: % Not At All Difficult: %

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19 Workforce Needs and Opportunities Survey What JOB SPECIFIC SKILLS are difficult for you to find in new employees prior to employment? Computer skills. Critical thinking skills, problem solving skills, follow basic schedule/time reporting requirements unsupervised. Hand eye coordination, dexterity, and ability to read instructions and follow them appropriately. Interpersonal communication skills, computer skills, and required license/certifications. Knowledge of safe lifting procedures. Knowledge of the industry. Leadership skills, intermediate computer skills, problem-solving skills, and critical thinking skills. Non-judgmental attitude, active listening skills, acceptance of diverse lifestyles, managing one's own emotional issues, treating people with dignity and respect, and counseling skills. Patient transfer skills/experience Physical fitness, strong motivation. Problem solving and communication skills, and strong work ethic. Product knowledge and sense of urgency. Public health nursing credentials and experience. Reliability and professionalism. Skilled nursing experience which you cannot get from school. 20. Do you agree or disagree with this statement: "There is a strong need for workforce education and training programs that prepare individuals with both basic skills and workplace skills prior to employment." Number of employers Percent of employers Strongly agree % Somewhat agree % Somewhat disagree % Strongly disagree 1 5.6%

20 20 Napa Healthcare Industry 21. If you agree with the above statement, what should be the focus of the training? Accountability/responsibility, teamwork skills, problem resolution, and critical thinking. Critical thinking, problem solving, good work ethic, and willingness to adapt to change. Employee relations, how to communicate with administration, and how to be an effective part of your team. Interpersonal communication, computer skills, and required license/certification. Interviewing skills and work ethic. Problem solving and critical thinking skills. Some entry level candidates would benefit from basic orientation and training on job applications, interviewing, organization, ability to present themselves, professional boundaries, and customer service. Start with basic skills of manners, courtesy, and customer service. Teamwork Teamwork and work ethic. What to expect when you start a full time 40 hour/week job. Work Ethic 101: Better interviewing skills, basic respect, better commitment to the terms of their job, policy compliance, basic schedule and attendance compliance, customer service - basic theories and practices.

21 Workforce Needs and Opportunities Survey Do your employees have job specific skill deficiencies that could be addressed by a new training program? Number of employers Percentage of Jobs Yes: % No: % No response: 2 3.0% 24. If YES, what kind of skill deficiencies? Computer training Intermediate computer skills. Microsoft Office, including Access. Skilled nursing training, e.g. diabetic testing, tube feeding, etc. Specific to our workplace, including regulatory compliance, conflict of interest, professional boundaries, etc.

22 22 Napa Healthcare Industry 25. How interested would you be in a local skills certification program that objectively evaluates the competencies of job applicants in basic skills, workplace skills, and job specific skills? (Check one) Number of employers Percent of employers Very interested: % Somewhat interested: % Not very interested: % Not at all interested: %

23 Workforce Needs and Opportunities Survey Are you familiar with the services available through the Napa Workforce Investment Board, or through its WorkforceNapa Business & Career Center? Number of employers Percent of employers Not at all familiar: % Somewhat familiar: % Very familiar: %

24 24 Napa Healthcare Industry 27. Please indicate which of the following services would be of value to you as an employer?

25 Top Job Opportunities in the Napa Healthcare Industry 25 Top Job Opportunities in the Healthcare Industry Here are the top local job opportunities in this industry based on what our employers have told us in our surveys and in focus group discussions. The matrix indicates whether the job is in-demand because of: A. Significant worker replacement needs B. Employer difficulty in finding qualified applicants C. Jobs that will offer the most new positions in the next two years A. Jobs with Significant Replacement Needs B. Difficulty Finding Qualified Applicants C. Jobs Expected to Add the Most New Positions in Next 2 Yrs X X Billing and Posting Clerks and Machine Operators Bookkeeping, Accounting, and Auditing Clerks Cooks, Institution and Cafeteria X X Counselors and Social Workers X X X Dental Assistants X Dental Hygienists Dentists Diagnostic Medical Sonographers X Dietitians and Nutritionists X X Emergency Medical Technicians and Paramedics X X X Financial Managers X Food Preparation Workers X X Home Health Aides X X X Janitors and Cleaners, Except Maids and Housekeeping Cleaners Licensed Practical and Licensed Vocational Nurses X X Marketing Managers X X Medical and Clinical Laboratory Technicians Medical and Clinical Laboratory Technologists X Medical and Public Health Social Workers X X X Medical Assistants Medical Records and Health Information Technicians X Nursing Aides, Orderlies, and Attendants X X Personal and Home Care Aides X X X Pharmacists X Pharmacy Technicians Physician Assistants Physicians and Surgeons X X X Public Relations Specialists Radiologic Technologists and Technicians X Receptionists and Information Clerks X Registered Nurses X X X Respiratory Therapists Secretaries X Surgical Technologists X X X

26 26 Napa Healthcare Industry Occupation and Training Profile The 34 occupations profiled on the following pages are not exclusive to this industry, but are commonly found in this industry. These occupations also do not constitute a complete list of occupations found in this industry. They are simply the 34 occupations that are most often represented by the jobs in this industry. Wages and employment statistics are for Napa County, unless otherwise noted, and are from the California Labor Market Information Division ( Note that wages and employment statistics for these occupations are not industry-specific. The O*NET Link leads to a profile for each occupation that provides comprehensive information on important knowledge, skills and abilities. O*NET is a product of the U.S. Department of Labor and is the nation s largest database of occupational qualifications and characteristics.

27 Occupation and Training Profile 27 Billing and Posting Clerks and Machine Operators Compile, compute, and record billing, accounting, statistical, and other numerical data for billing purposes. Prepare billing invoices for services rendered or for delivery or shipment of goods. Typical Education Level: Moderate-Term On-the-Job Training Median Annual Wage: $40,178 Estimated Jobs in 2006 & 2016: Projected Growth : 5.3% Slower than average growth 40 Napa Valley Adult School has a 1 year certificate program in Medical Office Training which includes coding and billing. They also offer an online course in Medical Billing and Coding. Bookkeeping, Accounting, and Auditing Clerks Compute, classify, and record numerical data to keep financial records complete. Perform any combination of routine calculating, posting, and verifying duties to obtain primary financial data for use in maintaining accounting records. May also check the accuracy of figures, calculations, and postings pertaining to business transactions recorded by other workers. Typical Education Level: Moderate-Term On-the-Job Training Median Annual Wage: $39,892 Estimated Jobs in 2006 & 2016: 1,150-1,310 Projected Growth : 13.9% Faster than average growth 340 Although this is an on-the-job training type occupation, Napa Valley College has a certificate program in bookkeeping and an AS degree program in accounting.

28 28 Napa Healthcare Industry Cooks, Institution and Cafeteria Prepare and cook large quantities of food for institutions, such as schools, hospitals, or cafeterias. Typical Education Level: Moderate-Term On-the-Job Training Median Annual Wage: $31,181 Estimated Jobs in 2006 & 2016: Projected Growth : 20.0% Much faster than average growth 20 Although this is an on-the-job training type occupation, Napa Valley College has a certificate program for cooks. Counselors and Social Workers Counselors and social workers work in diverse community settings designed to provide a variety of counseling, rehabilitation, and support services. Their duties vary greatly, depending on their specialty, which is determined by the setting in which they work and the population they serve. Although the specific setting may have an implied scope of practice, counselors who work in the healthcare industry frequently are challenged with children, adolescents, adults, or families that have multiple issues, such as mental health disorders and addiction, disability needs, and trauma. Counselors must recognize these issues in order to provide their clients with appropriate counseling and support. Typical Education Level: Median Annual Wage: Estimated Jobs in 2006 & 2016: Projected Growth : 31.5% Education requirements vary with the occupational specialty and state license requirements. A Master's degree is usually required to be licensed as a counselor, while a Bachelor s degree is often adequate for entry level jobs as social workers and case managers. $30,000 to $60,000 (varies by specialty) Much faster than average growth 270 Napa Valley College has 3 relevant Associate degree programs: Social/Behavioral Sciences, Human Services, and Psychiatric Tech. Also, Sonoma State University also has a Master s degree program in Counseling.

29 Occupation and Training Profile 29 Dental Assistants Assist dentist, set up patient and equipment, and keep records. Typical Education Level: Moderate-Term On-the-Job Training Median Annual Wage: $35,813 Estimated Jobs in 2006 & 2016: Projected Growth : 20.0% Much faster than average growth 80 No local certificate training or degree programs identified. The nearest program is at Santa Rosa Junior College. Dental Hygienists Clean teeth and examine oral areas, head, and neck for signs of oral disease. May educate patients on oral hygiene, take and develop X-rays, or apply fluoride or sealants. Typical Education Level: Associate Degree Median Annual Wage: Estimated Jobs in 2006 & 2016: Projected Growth : 16.7% $66,570 (Nationwide) Faster than average growth 40 No local certificate training or degree programs identified. The nearest program is at Santa Rosa Junior College.

30 30 Napa Healthcare Industry Dentists Diagnose and treat diseases, injuries, and malformations of teeth and gums and related oral structures. May treat diseases of nerve, pulp, and other dental tissues affecting vitality of teeth. Typical Education Level: Professional Degree Median Annual Wage: $131,250 Estimated Jobs in 2006 & 2016: Projected Growth : 0.0% Little or no change 10 No local programs identified. The nearest dental schools are degree programs at University of California, San Francisco and University of the Pacific s Arthur A. Dugoni School of Dentistry in San Francisco. Diagnostic Medical Sonographers Produce ultrasonic recordings of internal organs for use by physicians. Typical Education Level: Median Annual Wage: Estimated Jobs in 2006 & 2016: Projected Growth : Associate degree $74,400 (California) 3,300-3,900 (California) 18.0% (California) Faster than average growth (California) 100 (California) No local programs identified. The nearest program is at Foothill College in Los Altos Hills.

31 Occupation and Training Profile 31 Dietitians and Nutritionists Plan and conduct food service or nutritional programs to assist in the promotion of health and control of disease. May supervise activities of a department providing quantity food services, counsel individuals, or conduct nutritional research. Typical Education Level: Median Annual Wage: Estimated Jobs in 2006 & 2016: Projected Growth : Bachelor's Degree (California) $64,200 (California) 5,800-6,600 (California) 14.0 (California) Faster than average growth (California) 220 (California) No local programs identified. The nearest Dietetic Technician Programs are at Santa Rosa Junior College and Merritt College in Oakland. Emergency Medical Technicians and Paramedics Assess injuries, administer emergency medical care, and extricate trapped individuals. Transport injured or sick persons to medical facilities. Typical Education Level: Median Annual Wage: Estimated Jobs in 2006 & 2016: Projected Growth : Postsecondary Vocational or Technical Education (California) $31,100 (California) 12,100-14,800 (California) 22.0% (California) Much faster than average growth (California) 410 (California) Napa Valley College has certificate programs for Emergency Medical Technicians and Paramedics.

32 32 Napa Healthcare Industry Financial Managers Plan, direct, and coordinate accounting, investing, banking, insurance, securities, and other financial activities of a branch, office, or department of an establishment. Typical Education Level: Bachelor's Degree or Higher and Some Work Experience Median Annual Wage: $109,379 Estimated Jobs in 2006 & 2016: Projected Growth : 17.9% Faster than average growth 90 About 40% of the new hires for this occupation have a Bachelor s degree, usually in business administration, finance or accounting. Napa Valley College has various business-related certificate and Associate degree programs. Sonoma State University has both Bachelor s and Master s degree programs in business administration and is also home to the Wine Business Institute. Pacific Union College also offers Bachelor s degree programs in business administration. Food Preparation Workers Perform a variety of food preparation duties other than cooking, such as preparing cold foods and shellfish, slicing meat, and brewing coffee or tea. Typical Education Level: Short-Term On-the-Job Training Median Annual Wage: $23,804 Estimated Jobs in 2006 & 2016: Projected Growth : 25.0% Much faster than average growth 330 Although this is an on-the-job training type occupation, Napa Valley College has a certificate program for cooks.

33 Occupation and Training Profile 33 Home Health Aides Provide routine, personal healthcare, such as bathing, dressing, or grooming, to elderly, convalescent, or disabled persons in the home of patients or in a residential care facility. Typical Education Level: Short-Term On-the-Job Training Median Annual Wage: $23,127 Estimated Jobs in 2006 & 2016: Projected Growth : 58.8% Grow much faster than average 120 The Regional Occupational Program (ROP) in Napa County offers a nursing assistant program, but ROP in Napa is currently only available to high school students. For adults, the American Red Cross in Santa Rosa offers the nearest training programs for Certified Nursing Assistant and Home Health Aide. Janitors and Cleaners, Except Maids and Housekeeping Cleaners Keep buildings in clean and orderly condition. Perform heavy cleaning duties, such as cleaning floors, shampooing rugs, washing walls and glass, and removing rubbish. Duties may include tending furnace and boiler, performing routine maintenance activities, notifying management of need for repairs, and cleaning snow or debris from sidewalk. Typical Education Level: Short-Term On-the-Job Training Median Annual Wage: $25,156 Estimated Jobs in 2006 & 2016: 980-1,140 Projected Growth : 16.3% Faster than average growth 350 No local certificate training programs identified.

34 34 Napa Healthcare Industry Licensed Practical and Licensed Vocational Nurses Care for ill, injured, convalescent, or disabled persons in hospitals, nursing homes, clinics, private homes, group homes, and similar institutions. May work under the supervision of a registered nurse. Licensing required. Typical Education Level: Postsecondary Vocational or Technical Education Median Annual Wage: $43,101 Estimated Jobs in 2006 & 2016: Projected Growth : 20.0% Much faster than average growth 80 Napa Valley College offers a Vocational Nursing program for LVNs. Marketing Managers Determine the demand for products and services offered by a firm and its competitors and identify potential customers. Develop pricing strategies with the goal of maximizing the firm's profits or share of the market while ensuring the firm's customers are satisfied. Oversee product development or monitor trends that indicate the need for new products and services. Typical Education Level: Bachelor's Degree or Higher and Some Work Experience Median Annual Wage: $106,436 Estimated Jobs in 2006 & 2016: Projected Growth : 62.5% Much faster than average growth 70 About half of the new hires in this occupation have a Bachelor s degree, usually in business administration, sales, or marketing. Another 18% of the new hires have a graduate degree. Napa Valley College has various business-related certificate and Associate degree programs. Sonoma State University has both Bachelor s and Master s degree programs in business administration and is also home to the Wine Business Institute. Pacific Union College also offers Bachelor s degree programs in business administration.

35 and Training Profile 35 Medical and Clinical Laboratory Technicians Perform routine medical laboratory tests for the diagnosis, treatment, and prevention of disease. May work under the supervision of a medical technologist. Typical Education Level: Median Annual Wage: Estimated Jobs in 2006 & 2016: Projected Growth : 14.3% Associate Degree; however, note that about half of the new hires in this occupation have a Bachelor s degree. $38,300 (California) Faster than average growth 20 No local programs identified. The nearest programs are CSI Career College in Vacaville and De Anza College in Cupertino. Medical and Clinical Laboratory Technologists Perform complex medical laboratory tests for diagnosis, treatment, and prevention of disease. May train or supervise staff. Typical Education Level: Bachelor's Degree Median Annual Wage: $72,800 Estimated Jobs in 2006 & 2016: Projected Growth : 16.7% Faster than average growth 20 No local programs identified. The nearest program is at San Francisco State University.

36 36 Napa Healthcare Industry Medical and Public Health Social Workers Provide persons, families, or vulnerable populations with the psychosocial support needed to cope with chronic, acute, or terminal illnesses, such as Alzheimer's, cancer, or AIDS. Services include advising family care givers, providing patient education and counseling, and making necessary referrals for other social services. Typical Education Level: Median Annual Wage: Estimated Jobs in 2006 & 2016: Projected Growth : Bachelor's Degree (California) $57,000 (California) 10,800-12,900 (California) 19.0% (California) Faster than average growth (California) 440 (California) About 43% of the new hires for this occupation have a Bachelor s degree, and another 1/3 have a Master s degree. Napa Valley College has 3 relevant Associate degree programs: Social/Behavioral Sciences, Human Services, and Psychiatric Tech. Sonoma State University has Master s degree programs in Social Work and Counseling. Medical Assistants Perform administrative and certain clinical duties under the direction of physician. Administrative duties may include scheduling appointments, maintaining medical records, billing, and coding for insurance purposes. Clinical duties may include taking and recording vital signs and medical histories, preparing patients for examination, drawing blood, and administering medications as directed by physician. Typical Education Level: Moderate-Term On-the-Job Training Median Annual Wage: $31,028 Estimated Jobs in 2006 & 2016: Projected Growth : 24.0% Much faster than average growth 90 Boston Reed College in Napa has a certificate program for Clinical Medical Assistant. Santa Rosa Junior College, Solano Community College, and College of Marin also have programs for this occupation.

37 Occupation and Training Profile 37 Medical Records and Health Information Technicians Compile, process, and maintain medical records of hospital and clinic patients in a manner consistent with medical, administrative, ethical, legal, and regulatory requirements of the health care system. Process, maintain, compile, and report patient information for health requirements and standards. Typical Education Level: Associate Degree Median Annual Wage: $40,814 Estimated Jobs in 2006 & 2016: Projected Growth : 18.2% Faster than average growth 50 No local programs identified. The nearest program is at Empire College School of Business in Santa Rosa. Nursing Aides, Orderlies, and Attendants Provide basic patient care under direction of nursing staff. Perform duties, such as feed, bathe, dress, groom, or move patients, or change linens. Typical Education Level: Short-Term On-the-Job Training Median Annual Wage: $29,337 Estimated Jobs in 2006 & 2016: Projected Growth : 30.2% Much faster than average growth 170 The Regional Occupational Program (ROP) in Napa County offers a nursing assistant program, but ROP in Napa is currently only available to high school students. For adults, the American Red Cross in Santa Rosa offers the nearest training programs for Certified Nursing Assistant and Home Health Aide.