American Recovery and Reinvestment Act

2011 The Needs and Demands of the Healthcare Industry in the Brockton Workforce Area American Recovery and Reinvestment Act This project is funded by a Healthcare Skills Gap Partnership grant through the Executive Office of Labor and Workforce Development. The grant program is funded by the American Recovery and Reinvestment Act and is administered by Commonwealth Corporation. The Brockton Area Workforce Investment Board, 34 School Street, Brockton, MA 02301 508 584-3234 www.bawib.org

This report was prepared by Irene Donoghue on behalf of BAWIB and the Healthcare Skills Gap Partnership. Irene Donoghue Irene has years of experience in higher education successfully directing the operations of corporation and community education training divisions. She also has many years of experience as a corporate trainer. Her extensive personal knowledge of the training needs of our region provided a good down- to-earth perspective in recommending training strategies to help us prepare for future demands in the healthcare area. Irene lives in Massachusetts with her family finishing up her Master degree in Organizational Leadership. When there is time, she enjoys quilting, cooking, gardening, and reading. Irene can be contacted at dgdonoghue@comcast.net.

TABLE OF CONTENTS INTRODUCTION... 1 Purpose... 1 Methodology... 1 DEMOGRAPHICS... 2 BAWIB Service Territory... 2 Population... 3 Workforce Employed / Unemployed... 8 Section Conclusion Demographics... 14 HEALTHCARE INDUSTRY IN THE REGION... 15 Healthcare in the Area... 15 Healthcare Careers... 17 Employment and Wage Trends... 18 Employers... 21 Healthcare Vacancies... 23 Section Conclusion Healthcare Industry in the Region... 25 HEALTHCARE TRAINING... 27 Education Requirements... 27 Current Training Programs Available... 28 Healthcare Training Needs... 30 Career Ladders... 33 Section Conclusion - Healthcare Training... 36 FINAL CONCLUSIONS AND RECOMMENDATIONS... 37 Recommendations - Demographics... 37 Recommendations - Healthcare Industry in the Region... 38 Recommendations - Healthcare Training... 40 Closing Remarks... 42 Sources Cited in BAWIB Analysis Report... 43 Appendix... 44

INTRODUCTION INTRODUCTION Purpose The purpose of this report is to collect and analyze Labor Market Information regarding workforce needs and demands of the Healthcare Industry in the Southeastern Massachusetts area. The focus of this report is the Brockton Area Workforce Investment Board (BAWIB) training area along with other surrounding communities including Fall River, New Bedford, Taunton, Attleboro and North Attleboro. The goal of this effort is to identify critical healthcare workforce issues to allow BAWIB and partners to address healthcare disparities to meet the unique needs of their diverse training communities. Methodology In the course of preparing this report, a variety of materials were collected and reviewed. This included earlier surveys and reports by BAWIB, the MA Department of Workforce Development, the U.S. Bureau of Labor Statistics, the U.S. Census Bureau, and others. Additional current information was gathered to supplement this report by surveying healthcare providers and educators in the Southeastern Massachusetts service area. Topics to be discussed in this analysis include demographics, healthcare industry in the region, and healthcare training. The conclusions and recommendations are based upon the strengths and weaknesses revealed by analysis of data in these areas and the possible synergies that could be provided by BAWIB and its partners. Page 1

DEMOGRAPHICS BAWIB Service Territory The Brockton Area Workforce Investment Board (BAWIB) is one of 16 Workforce Investment Boards (WIBs) statewide. BAWIB is a business driven, non-profit organization established to create public/private training partnerships. BAWIB oversees and implements workforce development in the Greater Brockton region service area including ten towns/cities. They help connect employers with job seekers and provide current members of the workforce, and those seeking employment with the training they need. The BAWIB training service area as well parts of the neighboring New Bedford and Bristol County workforce areas (Fall River, New Bedford, Taunton, Attleboro and North Attleboro) are included in this report. Page 2

Population The U.S. Census between 2000 and 2010, reports the total population in the Brockton Workforce Service Area grew by 5,226, an increase of 2.26%, as shown below in Table 1. During this same ten year period, the Massachusetts population increased by 198,532 or 3.13%. The City of Brockton was among 13 cities in Massachusetts whose population decreased. Brockton, the state s seventh (7 th ) largest city, experienced a slight population decrease of 494 or -0.52%. In 2010, the Brockton population stood at 93,810. While the Towns of Avon (-1.96%) and Stoughton (-0.69%) lost population, the other communities in the Brockton Workforce Service Area saw increases in population of between 3.6% to 9.5%. In the other communities listed below in Table 1, Fall River (-3.35%) and Taunton (-0.18%) lost population, while New Bedford, Attleboro and North Attleboro saw increases in population ranging from 1.39% to 5.78%. Table 1 Population of the Brockton Workforce Area City or Town 2010 2000 % Change United States 308,745,538 281,421,908 9.71% Massachusetts 6,547,629 6,349,097 3.13% Brockton Workforce Area 236,196 230,970 2.26% Abington 15,985 14,605 9.45% Avon 4,356 4,443-1.96% Bridgewater 26,563 25,185 5.47% Brockton 93,810 94,304-0.52% East Bridgewater 13,794 12,974 6.32% Easton 23,112 22,299 3.65% Hanson 10,209 9,495 7.52% Stoughton 26,962 27,149-0.69% West Bridgewater 6,916 6,634 4.25% Whitman 14,489 13,882 4.37% Fall River 88,857 91,938-3.35% New Bedford 95,072 93,768 1.39% Attleboro 43,593 42,068 3.63% North Attleboro 28,712 27,143 5.78% Taunton 55,874 55,976-0.18% Source: U.S. Census Bureau Page 3

While the population in the Southeast area is growing at a slower pace than the U.S. and Massachusetts as a whole, Southeastern Massachusetts is one of the fastest growing culturally and linguistically diverse regions in the state. As shown on Table 2 below, the minority population across the region has increased between 2000 and 2010, with a large influx of Hispanic and racially mixed immigrants. The three largest cities in the Southeast area, Brockton, Fall River and New Bedford have large Latino / Hispanic populations which have grown significantly over the last ten years (1,805, 3,522, and 6,340, respectively). This represents an increase of the Hispanic population in Brockton of 19%, Fall River 54% and New Bedford 40%. In the Brockton Workforce Area during the time period of 2000 and 2010, the racial mix of the population has shifted dramatically with a decrease in the white population (-11,978) and an increase in the black and other racially mixed populations (17,198). Table 2 Total Population Population by Race and Hispanic Origin, 2000 to 2010 Change 2010 Change, 2000 to 2010 Race Hispanic Total Race White Black Asian Multiple or Popul- White Black Asian Multiple or Other Latino ation or Other Hispanic or Latino Massachusetts 6,547,629 5,265,236 434,398 349,768 496,004 627,654 198,532 (102,050) 90,944 111,644 98,260 198,925 Brockton Workforce Area 236,196 172,531 35,677 4,768 23,153 12,764 5,226 (11,978) 15,283 1,231 684 3,230 Abington 15,985 14,788 342 284 569 310 1,380 551 231 213 384 207 Avon 4,356 3,660 434 120 142 121 (87) (492) 268 79 58 57 Bridgew ater 26,563 24,163 1,292 328 780 838 1,378 2,181 275 57 (1,130) 145 Brockton 93,810 43,821 29,276 2,151 18,510 9,357 (494) (14,168) 12,465 85 1,106 1,805 East Bridgew ater 13,794 13,139 216 117 322 204 820 566 87 55 116 107 Easton 23,112 21,144 745 563 655 575 813 643 391 254 (478) 223 Hanson 10,209 9,850 104 48 206 95 714 674 (1) 15 25 30 Stoughton 26,962 21,634 2,984 971 1,371 876 (187) (2,383) 1,436 391 380 457 West Bridgew ater 6,916 6,564 104 75 173 121 282 169 41 30 42 54 Whitman 14,489 13,768 180 111 425 267 607 281 90 52 181 145 Attleboro 43,593 37,975 1,299 1,978 2,302 2,765 1,525 (435) 608 611 717 960 Fall River 88,857 77,349 3,466 2,275 5,737 6,562 (3,081) (6,466) 1,183 288 1,909 3,522 North Attleborough 28,712 26,547 427 1,008 723 675 1,569 499 176 545 347 317 Taunton 55,874 48,742 2,773 560 3,774 3,058 (102) (2,573) 1,239 226 999 860 New Bedford 95,072 70,799 6,083 893 17,247 15,916 1,304 (3,151) 1,971 279 2,199 6,340 Source: http://www.massbenchmarks.org/statedata/news.htm#census2010demo Page 4

Table 3 Population by Race and Hispanic Origin, 2000 to 2010 Change Percent of Total Population Race White Black Asian Multiple or Other Hispanic or Latino Massachusetts 80.4% 6.6% 5.3% 7.3% 9.6% Brockton Workforce Area 73.0% 15.1% 2.0% 9.6% 5.4% Abington 92.5% 2.1% 1.8% 3.3% 1.9% Avon 84.0% 10.0% 2.8% 3.1% 2.8% Bridgew ater 91.0% 4.9% 1.2% 2.7% 3.2% Brockton 46.7% 31.2% 2.3% 19.4% 10.0% East Bridgew ater 95.3% 1.6% 0.8% 2.1% 1.5% Easton 91.5% 3.2% 2.4% 2.7% 2.5% Hanson 96.5% 1.0% 0.5% 2.0% 0.9% Stoughton 80.2% 11.1% 3.6% 4.9% 3.2% West Bridgew ater 94.9% 1.5% 1.1% 2.4% 1.7% Whitman 95.0% 1.2% 0.8% 2.7% 1.8% Attleboro 87.1% 3.0% 4.5% 5.1% 6.3% Fall River 87.0% 3.9% 2.6% 6.2% 7.4% North Attleborough 92.5% 1.5% 3.5% 2.3% 2.4% Taunton 87.2% 5.0% 1.0% 6.5% 5.5% New Bedford 74.5% 6.4% 0.9% 16.9% 16.7% Source: http://www.massbenchmarks.org/statedata/news.htm#census2010demo Table 3 above, Population by Race and Hispanic Origin, 2000 to 2010 Change, demonstrates great diversity in the Southeast region by race and Hispanic origin. In the Brockton Workforce Area there is a higher percentage of blacks (15.1%) and multiple/other (9.6%) than reported statewide as a whole (6.6% and 7.3%, respectively). Notably, Hispanics/Latinos make up 10% of the City of Brockton s population, and 16.7% of New Bedford s population. There is also a significant multi racial population in the cities of Brockton (19.4%) and New Bedford (16.9%) which is significantly higher than the statewide average. In the City of Brockton this racial diversity results in a white population that is only 46.7% of the total. Page 5

Diversity in the region manifests itself in the foreign-born/immigrant and foreign speaking population as shown in Table 4 below. In the cities of Brockton, New Bedford and Fall River, a significant number of the population is foreign-born (26.1%, 22.2% and 21%, respectively). These percentages are higher than the statewide average of 14.9%. More than half of this foreign-born population speaks a language other than English at home. Of the total populations in these three cities more than 1/3 speaks a language other than English at home. Of the City of Brockton s total population, 7.5% speak Spanish at home while another 27% speak another foreign language. In New Bedford and Fall River, the Spanish speaking populations are 10.3% and 4.9%, while other foreign languages are spoken by 27.4% and 29.6%. Table 4 Language & Origin Source: 2005-2009 American Community Survey 5-Year Estimates Massa - Subject chusetts By Origin Brockton New Bedford Fall River Total Population 6,125,623 85,999 84,782 85,250 Native Population 85.10% 73.90% 77.80% 79.00% Foreign-born Population 14.90% 26.10% 22.20% 21.00% Naturalized U.S. Citizen 7.10% 12.60% 12.30% 10.70% Non - U.S. Citizen 7.80% 13.50% 9.90% 10.30% Speak English at Home 4,877,834 56,346 52,849 55,854 Native Population 96.30% 94.70% 96.30% 97.30% Foreign-born Population 3.70% 5.30% 3.70% 2.70% Speak Other Language at Home 1,247,789 29,653 31,933 29,396 Native Population 41.30% 34.50% 47.20% 44.20% Foreign-born Population 58.70% 65.50% 52.80% 55.80% Speak Spanish at Home 431,636 6,436 8,743 4,162 Native Population 60.40% 69.10% 70.90% 72.80% Foreign-born Population 39.60% 30.90% 29.10% 27.20% By Language % of Total Population Speak English at Home 79.60% 65.50% 62.30% 65.50% Speak Other Language at Home 20.40% 34.50% 37.70% 34.50% Speak Spanish at Home 7.00% 7.50% 10.30% 4.90% Speak Other Foreign Language at Home 13.40% 27.00% 27.40% 29.60% Page 6

Educational attainment in the area has a direct impact on employment and earnings. As referenced in Table 5 below, 59.6% of the City of Brockton s 18 24 year old population has only a high school degree or equivalent, displaying a much higher rate than the statewide average of 42.9%. This demonstrates that a large portion of this age group are not advancing onto college or beyond. Of the 25 years and over population, 81.4% in Brockton have completed high school as compared to 88.4% statewide. However, only 16.3% have completed a bachelor degree, which is less than half the statewide of 37.8%. In both New Bedford and Fall River, only 13.8% of high school graduates obtained a bachelor degree or higher, which is a rate even lower Brockton. Of the 25 years and over population statewide 11.6% have less than a high school diploma. A significantly larger percentage of this age group in Brockton, New Bedford and Fall River has less than high school diplomas (18.6%, 34.4% and 32.9%, respectively). Table 5 Educational Attainment Source: 2005-2009 American Community Survey 5-Year Estimates Massa - Subject chusetts Brockton New Bedford Fall River Population 18 to 24 years 645,115 8,029 7,890 9,165 Less than high school graduate 12.70% 18.00% 23.80% 26.30% High school graduate (or equivalency) 30.20% 41.60% 38.70% 34.40% Some college or associate's degree 42.60% 35.10% 30.60% 31.00% Bachelor's degree or higher 14.50% 5.30% 6.90% 8.30% Population 25 years and over 4,415,135 59,505 61,138 61,829 Less than high school graduate 11.60% 18.60% 34.40% 32.90% High school graduate (or equivalency) 27.20% 36.30% 32.10% 31.90% Some college, no degree 15.80% 19.80% 13.90% 14.80% Associate's degree 7.60% 9.00% 5.90% 6.60% Total bachelor's degree or higher 37.80% 16.30% 13.80% 13.80% Total high school graduate or higher 88.40% 81.40% 65.60% 67.10% Median Earnings (In 2009 Inflation-Adjusted Dollars) Population 25 years and over $41,716 $32,139 $30,521 $29,914 Less than high school graduate 22,877 25,054 24,408 22,908 High school graduate (or equivalency) 32,053 30,640 27,919 28,178 Some college or associate's degree 37,629 32,912 33,287 30,667 Bachelor's degree 52,544 41,985 41,045 42,939 Graduate or professional degree 66,605 58,569 50,604 55,703 The median earnings across most levels of education are lower in Brockton than the statewide average with the exception of the category of less than high school graduate. Surprisingly, the Page 7

earnings for this group in the City of Brockton is higher than the statewide average possibly showing employer willingness / desperation to hire undereducated people into much needed positions. As shown above in Table 5, a Brockton high school graduate earns approximately $5,000 a year more than those without a high school diploma. By comparison statewide, high school graduates earn nearly $10,000 more than those without a high school diploma. A bachelor degree in Brockton earns $41,985 compared to the statewide average is $52,544 for the same degree working elsewhere. Workforce Employed / Unemployed As shown in Table 6 below, the unemployment rate for the 1 st Qtr. 2010 is higher than the statewide average throughout the Brockton, Bristol County, and New Bedford Workforce Areas. The three largest cities of Brockton, Fall River and New Bedford have the largest number of unemployed and the highest unemployment rates in the region. Table 6 Labor Force Estimates by City And Town Area Labor Force Employed Unemployed 1st Qtr 2010 Unemp Rate Massachusetts 3,463,467 3,121,333 342,133 9.90% Brockton Workforce Area, Total 126,168 112,523 13,645 10.80% Abington 9,716 8,717 999 10.30% Avon 2,352 2,080 272 11.60% Bridgewater 13,492 12,246 1,247 9.20% Brockton 46,186 40,326 5,860 12.70% East Bridgewater 7,841 6,999 842 10.70% Easton 13,508 12,402 1,106 8.20% Hanson 5,772 5,136 635 11.00% Stoughton 15,286 13,840 1,446 9.50% West Bridgewater 3,562 3,204 358 10.10% Whitman 8,453 7,573 880 10.40% Bristol County Workforce Area, Total 200,664 174,755 25,909 12.90% Attleborough 24,396 21,545 2,851 11.70% Fall River 45,910 37,633 8,277 18.00% North Attleborough 16,443 14,616 1,827 11.10% Taunton 31,651 28,048 3,603 11.40% Greater New Bedford Workforce Area, Total 108,518 93,346 15,173 14.00% New Bedford 43,773 36,024 7,749 17.70% Page 8

Employment status in the region is impacted by age, race or origin. In Table 7 below, employment status of the Cities of Brockton, New Bedford, Fall River and the State of Massachusetts are compared. Of the population employed, it is notable that a higher percentage of 16 24 year olds are in the workforce in Brockton, New Bedford, and Fall River than the statewide average. Those of Hispanic or Latino origin in Brockton have a lower unemployment rate (11.2%) than the statewide rate (11.6%) while in the other cities rate are higher (13.4%, 31.1%). Unemployment rates among blacks and multiple or other races are higher than whites. Table 7 Employment Status Source: 2005-2009 American Community Survey 5-Year Estimates Subject Employed New Bedford Fall River Mass. Brockton Unemployment rate New Bedford Fall River Mass. Brockton Population 16 years and over 62.8% 63.0% 55.5% 55.0% 6.7% 10.4% 9.8% 11.4% Age 16 to 19 years 37.1% 43.4% 39.9% 44.9% 19.8% 31.3% 21.0% 28.6% 20 to 24 years 65.4% 67.0% 69.6% 69.3% 11.5% 16.2% 16.7% 12.8% 25 to 44 years 79.4% 79.0% 72.8% 71.0% 5.9% 9.0% 8.5% 11.4% 45 to 54 years 79.6% 74.9% 66.3% 67.6% 5.0% 8.2% 8.6% 7.3% 55 to 64 years 66.4% 61.3% 55.0% 51.7% 5.0% 5.5% 6.8% 9.2% 65 to 74 years 26.6% 24.5% 19.4% 16.1% 4.9% 6.3% 3.2% 5.2% 75 years and over 5.8% 3.9% 4.9% 5.4% 4.1% 7.6% 6.2% 2.9% Race White 62.9% 60.9% 55.6% 55.1% 6.6% 8.6% 8.5% 11.0% Black or African American 63.2% 67.8% 54.5% 56.1% 6.0% 12.0% 18.3% 19.2% Asian 59.2% 64.7% 61.6% 62.9% 12.4% 15.1% 7.9% 9.5% Multiple or Other Races 60.2% 61.1% 54.2% 46.7% 11.5% 13.1% 13.9% 19.3% Hispanic Or Latino Origin Hispanic or Latino (of any race) 59.9% 64.8% 52.4% 44.6% 11.6% 11.2% 13.4% 31.1% White alone, not Hispanic or Latino 61.7% 60.2% 56.0% 55.5% 10.9% 8.7% 8.0% 10.0% Page 9

1st Qtr. 2010 Unemployment Rates for Brockton Workforce Area The unemployment rate in the Brockton Workforce Area (10.8%) is higher than reported in the statewide area (9.9%) with the highest rate in the City of Brockton of 12.7%. The unemployment rates in all other communities in the Brockton Workforce Area are closer to the statewide average. Page 10

Table 8 below shows a profile of unemployment insurance claimants for Massachusetts, Brockton WIA, New Bedford WIA and Bristol WIA, displayed by race, and further separated by Hispanic or Latino classifications. When compared with Table 3, entitled Population by Race and Hispanic Origin, the unemployment claimants generally match the profile of the workforce in their respective regions. Table 8 Profile of Unemployment Insurance Claimants March 2010 Massachusetts Brockton WIA New Bedford WIA Bristol WIA Number % Number % Number % Number % Claimants by Race Total 137,617 100.00% 5,466 100.00% 6,023 100.00% 14,485 100.00% White 113,716 82.60% 4,049 74.10% 5,087 84.50% 12,753 88.00% Black 10,169 7.40% 911 16.70% 405 6.70% 621 4.30% Native American 324 0.20% 9 0.20% 9 0.10% 23 0.20% Asian 3,474 2.50% 68 1.20% 27 0.40% 193 1.30% Hawaiian & Pacific Islanders 105 0.10% 8 0.10% 5 0.10% 10 0.10% INA or Unknown 9,829 7.10% 421 7.70% 490 8.10% 885 6.10% Claimants by Hispanic or Latino Total 137,617 100.00% 5,466 100.00% 6,023 100.00% 14,485 100.00% Hispanic or Latino 13,532 9.80% 316 5.80% 482 8.00% 1,076 7.40% Not Hispanic or Latino 122,966 89.40% 5,121 93.70% 5,507 91.40% 13,330 92.00% INA or Unknown 1,119 0.80% 29 0.50% 34 0.60% 79 0.50% Source: LMI Reports Brockton, New Bedford and Bristol Profiles, May 2010 Page 11

Table 9 below shows a profile of unemployment insurance claimants for Massachusetts, Brockton WIA, New Bedford WIA and Bristol WIA, displayed by average weekly wage, age group and education attainment. The 25-54 age group, as you would expect, represent the highest number of unemployment insurance claimants across the three Workforce Areas, close to the statewide average. A higher percentage of these claimants earn a weekly average below $800 than the statewide average. By education attainment across all three regions, a higher level of claimants are represented by high school graduates than the statewide average. Correspondingly, the claimant rates for those with some college education is lower than the statewide average. Table 9 Profile of Unemployment Insurance Claimants March 2010 Massachusetts Brockton WIA New Bedford WIA Bristol WIA Number % Number % Number % Number % Claimants by Average Weekly Wage Under $300 16,321 11.90% 668 12.20% 903 15.00% 1,669 11.50% $300 - $499 25,294 18.40% 1,036 19.00% 1,231 20.40% 2,742 18.90% $500 - $799 36,636 26.60% 1,532 28.00% 1,539 25.60% 3,895 26.90% $800 - $999 17,123 12.40% 658 12.00% 678 11.30% 1,803 12.40% $1,000 - $1,500 24,518 17.80% 989 18.10% 1,055 17.50% 2,817 19.40% Over $1,500 17,714 12.90% 583 10.70% 616 10.20% 1,558 10.80% Claimants by Age Group Under Age 22 4,563 3.30% 218 4.00% 280 4.60% 542 3.70% 22-24 8,451 6.10% 371 6.80% 393 6.50% 882 6.10% 25-34 31,523 22.90% 1,261 23.10% 1,424 23.60% 3,380 23.30% 35-44 31,701 23.00% 1,315 24.00% 1,315 21.80% 3,490 24.10% 45-54 34,417 25.00% 1,350 24.70% 1,493 24.80% 3,726 25.70% 55-59 12,288 8.90% 402 7.40% 535 8.90% 1,159 8.00% 60-64 8,765 6.40% 314 5.70% 371 6.20% 790 5.50% Over Age 64 5,922 4.30% 238 4.40% 214 3.60% 513 3.50% Claimants by Level of Education Attainment Through Grade 8 4,097 3.60% 202 4.30% 684 12.70% 751 7.80% 9th to 11th Grade 9,256 8.20% 367 7.80% 797 14.80% 1,159 12.10% High School Graduate 49,788 44.20% 2,341 49.70% 2,421 45.00% 4,655 48.40% 1-3 Years of College 24,708 22.00% 1,100 23.30% 993 18.50% 1,888 19.60% 4 or More Years of College 24,710 22.00% 703 14.90% 482 9.00% 1,164 12.10% Source: LMI Reports Brockton, New Bedford and Bristol Profiles, May 2010 Page 12

Table 10 below shows a profile of unemployment insurance claimants for Massachusetts, Brockton WIA, New Bedford WIA and Bristol WIA of healthcare related jobs. Across the regions healthcare related jobs represent only 4.3% - 7.3% of total claimants. Table 10 Profile of Unemployment Insurance Claimants March 2010 Massachusetts Brockton WIA New Bedford WIA Bristol WIA Number % Number % Number % Number % Claimants by North American Industry Classification(NAICS) Total UI Claimants 124,314 100.0% 4,946 100.0% 5,440 100.0% 13,163 100.0% Healthcare Social Assistance (NAICS 62) 7,617 6.10% 362 7.30% 336 6.20% 560 4.30% Source: LMI Reports Brockton, New Bedford and Bristol Profiles, May 2010 Page 13

Section Conclusion Demographics The Brockton Workforce Area and surrounding communities is a culturally and linguistically diverse region. While the population in the region is growing at a slower pace than the State, the minority population has increased. In the Brockton Workforce Area there has been a decrease in the white population and an increase in the black and racially mixed populations, as well as a surge of Hispanic/Latinos. Diversity in the region manifests itself in the population with a high percentage of foreign speaking and foreign-born/immigrants. Of these foreign speakers, a large percentage speak Spanish, an even larger amount speak a mixture of other foreign languages. Educational attainment lags across the area. Notably, a high percentage of the City of Brockton s 18-24 year old population have only a high school diploma suggesting that a large portion of this group are not furthering their education. In the City of Brockton, there are a high number of those with less than a high school diploma. The earnings for this group, however, is surprisingly higher than the statewide average, possibly showing employer willingness / desperation to hire undereducated people into much needed positions. These higher than expected earnings create a smaller premium paid for a high school diploma and provide less incentive for students to remain in school. In the long run, these students without a diploma will miss the opportunity to advance up a career ladder. The unemployment rate in the Brockton Workforce Area is higher than reported in the statewide area with the highest rates in the three cities of Brockton, New Bedford, and Fall River. The unemployment rates in all other communities in the Brockton Workforce Area are closer to the statewide average. While the unemployment rate in the cities of Brockton, New Bedford and Fall River is higher than the statewide average across all age groups, the 16 24 year old age group stands out as significantly higher. This suggests that the 16 24 year olds here represent a larger workforce pool than might be expected as compared to other parts of the state. The profile of unemployment claimants generally match the demographics of the workforce in the region. With generally lower wages and higher number of claims with high school graduates or less. Healthcare related jobs in the region represent a relatively low number of total unemployment claimants suggesting a high demand. Page 14

HEALTHCARE INDUSTRY IN THE REGION Healthcare in the Area The healthcare industry is a vital part of Southeastern Massachusetts economic development. In a report on Employment Projections 2006 2016 by the Executive Office of Labor and Workforce Development (EOLWD), 216,650 net new jobs in Massachusetts are projected during this time period. As shown in Table 11 below, of this projected growth in new jobs, 83,690 (38.6%) are in the area of Healthcare and Social Assistance. This demonstrates that employment in the healthcare industry (18.6%) is expected to grow much faster than statewide overall employment (6.3%) over the same time period. Table 11 Massachusetts Employment by Industry, 2006 and Projected 2016 NAICS Code NAICS Title 2006 2016 Net Change Percent Change Total Employment 3,454,420 3,671,070 216,650 6.3% 62 Health Care and Social Assistance 450,320 534,010 83,690 18.6% 621, 622, and 623 Health Care 387,710 452,340 64,630 16.7% 621 Ambulatory Health Care Services 130,300 154,780 24,480 18.8% 6211, 6212 and 6213 Offices of Health Care Practitioners 80,990 91,500 10,510 13.0% 6216 Home Health Care Services 21,000 30,000 9,000 42.9% 6214, 6215 Outpatient, Laboratory & Other Ambulatory and 6219 Care Services 28,310 33,280 4,970 17.6% 622 Hospitals, Private 165,200 188,730 23,530 14.2% 623 Nursing and Residential Care Facilities 92,210 108,830 16,620 18.0% 6231 Nursing Care Facilities 56,620 61,920 5,300 9.4% 6232, 6233 and 6239 Residential Care Facilities 35,590 46,910 11,320 31.8% 624 Social Assistance 62,610 81,670 19,060 30.4% 6241 Individual and Family Services 27,500 40,370 12,870 46.8% 6242, 6243 Individual, Family, Community and Vocational Rehabilitation Services 12,910 14,300 1,390 10.8% 6244 Child Day Care Services 22,200 27,000 4,800 21.6% HC & SA as % of Total Employment 13.0% 14.5% 38.6% Source: MA Executive Office of Labor & Workforce Development Page 15

As shown in Table 12 below, in 2008, Healthcare & Social Assistance represented 16% of the total employment in the workforce area of Brockton, 17.3% in New Bedford, and 15.3% in Bristol, providing higher than average wages. In the most recent statewide data, June 2010 June 2011, healthcare represents 16% of the total employment and 26% of the job growth over the past year. The 2008 annual average wage in the Brockton Workforce Area of $44,124 was below the statewide figure of $56,759 by $12,635. Healthcare and Social Assistance was among the key sectors whose annual average wages of $45,891 exceeded the overall average in the Brockton Workforce Area. Table 12 Area Employment by NAICS Employment Gross Payroll Average Number % Number % Wage Brockton WIA (Annual Average 2008) Total Employment 90,816 100.00% $4,007,144,961 100.00% $44,124 62 Healthcare & Social Assistance 14,537 16.00% $667,112,989 16.60% $45,891 621 Offices of Doctors & Clinics 5,530 6.10% $294,831,125 7.40% $53,315 622 Hospitals 4,382 4.80% $236,966,118 5.90% $54,077 623 Nursing & Resid. Care Facilities 2,713 3.00% $89,137,946 2.20% $32,856 624 Social Assistance 1,913 2.10% $46,177,800 1.20% $24,139 New Bedford WIA (Annual Average 2008) Total Employment 80,612 100.00% $3,155,636,339 100.00% $39,146 62 Healthcare & Social Assistance 13,985 17.30% $592,607,279 18.80% $42,374 621 Offices of Doctors & Clinics 4,463 5.50% $253,455,158 8.00% $56,790 622 Hospitals C C C C C 623 Nursing & Resid. Care Facilities 4,049 5.00% $120,850,133 3.80% $29,847 624 Social Assistance 2,278 2.80% $54,657,778 1.70% $23,994 C=Confidential Bristol WIA (Annual Average 2008) Total Employment 143,072 100.00% $5,928,179,489 100.00% $41,435 62 Healthcare & Social Assistance 21,870 15.30% $902,291,969 15.20% $41,257 621 Offices of Doctors & Clinics 6,588 4.60% $332,132,061 5.60% $50,415 622 Hospitals 6,262 4.40% $314,980,370 5.30% $50,300 623 Nursing & Resid. Care Facilities 5,521 3.90% $166,957,963 2.80% $30,241 624 Social Assistance 3,499 2.40% $88,221,576 1.50% $25,213 North American Industry Classification System (NAICS) Source: MA Executive Office of Labor & Workforce Development Page 16

Healthcare Careers As displayed below in Table 13, there are many rewarding career opportunities available in the healthcare profession; a sample is displayed below along with average salary in the City of Brockton, MA area as researched as of July, 2011. Table 13 Healthcare Career Title Average Salary Brockton, MA Healthcare Career Title Average Salary Brockton, MA Administrative Assistant, Bilingual $42,000 Medical Billing Clerk $33,000 Adult Basic Education (ABE) Instructor 38,000 Medical Coding Technician 46,000 Anesthesia Technician 36,000 Medical Health Technician 32,000 Animal Technician 34,000 Medical Information Management 68,000 Cardiovascular Technologist 48,000 Mental Interpreter 40,000 First Aid for Healthcare Professionals 45,000 MRI Technologist 53,000 Dental Administrative Assistant 48,000 Nursing Assistant 27,000 Dental Assistant 34,000 Nursing Assistant, Certified 29,000 Dental Hygienist 65,000 Occupational Nursing Asst., Certified 29,000 EKG Technician 42,000 Operating Room Technician 42,000 Emergency Medical Dispatch 31,000 Ophthalmic Assistant, Bilingual 42,000 Emergency Medical Technician (EMT) 31,000 Personal Care Attendant 35,000 ESOL Instructor 43,000 Personal Trainer 49,000 Fitness Instructor 49,000 Pharmacy Technician 34,000 Food Supervision in Healthcare 51,000 Phlebotomy Technician 36,000 Geriatric Nurse, RN 63,000 Physical Therapist Assistant 48,000 Health Claims Analyst 36,000 Polysomnography (Sleep Tech) 61,000 Health Services Administrator 77,000 Radiologic Technology 76,000 Healthcare Business Manager 66,000 Respiratory Therapist, Certified 51,000 Home Health Aide 29,000 Special Needs Instructor 47,000 Human Services Worker 23,000 Staff Nurse, RN 68,000 Licensed Practical Nursing 43,000 Surgical Technologist 41,000 Massage Therapist 44,000 Ultrasound Technologist 68,000 Medical Administrative Assistant 34,000 Veterinary Assistant 28,000 Medical Assistant 31,000 Sources: Indeed Salary Search, July, 2011 Salary.com, July, 2011 Page 17

Employment and Wage Trends As noted previously, the healthcare industry plays a significant role in the economy and employment throughout the Southeastern Massachusetts region. In its report on Employment Projections 2006 2016, the Executive Office of Labor and Workforce Development (EOLWD) estimated a growth of 83,690 new jobs in the area of healthcare and social assistance across the entire state. Southeastern Massachusetts region should anticipate similar growth trends in its healthcare industry. While the focus is often on new job growth, it is important to remember that most job openings will be the result of replacement demand rather than growth. As shown in Table 14 below, 78% of the nearly one million projected net new job openings statewide will occur because of replacement associated with retirement, labor force withdrawal, and occupational changes. For example, total projected net new openings for Registered Nurses are expected to be 29,050, with 12,940 replacement jobs and 16,110 new jobs (as shown in Table 15 on the next page). Table 14 Job Openings 2006 2016 Source: Massachusetts Employment Projections 2006-2016 Table 15 on the following page also shows a sampling of healthcare careers and their projected growth statewide over the 2006 2016 period. The occupations with the largest projected number of net new jobs through 2016 include Registered Nurses (+16,110), Home Health Aides (+5,830), Nursing Aides and Orderlies (+5,590), LPNs (+2,040), Medical Assistants (2,300) and Pharmacy Technicians (+1,660). Among the fastest growing occupations in Healthcare are Home Health Aides (+34%), Pharmacy Technicians (+29%), Physical Therapist Assistants (+27%), Medical Assistants (24%), Dental Assistants (+20%), and Registered Nurse (+21%). Page 18

Table 15 Page Code Massachusetts Employment by Occupation and Education and Training Health Care Careers, Current and Projected, 2006-2016 Occupational Title* 2006 Jobs** 2016 Jobs** Number % Number % Net Change % Change 52 29-2031 Cardiovascular Technologists 970 0.0% 1,180 0.0% 210 22.5% 130 340 $53,540 5 53 31-9091 Dental Assistants 6,430 0.2% 7,740 0.2% 1,310 20.4% 1,120 2,430 $37,550 10 54 29-2021 Dental Hygienists 5,530 0.2% 6,680 0.2% 1,150 20.8% 1,060 2,210 $71,890 6 55 29-2032 Diagnostic Medical Sonographers 1,140 0.0% 1,280 0.0% 140 12.5% 160 300 $69,630 6 56 29-1031 Dietitians and Nutritionists 2,060 0.1% 2,220 0.1% 160 8.0% 520 680 $54,870 5 57 29-2041 Emergency Medical Technicians & Paramedics 4,950 0.1% 5,730 0.2% 780 15.8% 570 1,350 $37,690 7 58 29-2061 Licensed Practical & Licensed Voc. Nurses 17,450 0.5% 19,500 0.5% 2,050 11.7% 4,760 6,810 $48,790 6 59 11-9111 Medical and Health Services Managers 8,210 0.2% 9,320 0.3% 1,110 13.5% 1,530 2,640 $98,050 4 60 31-9092 Medical Assistants 9,630 0.3% 11,930 0.3% 2,300 23.9% 1,200 3,500 $32,940 10 61 29-2012 Medical & Clinical Lab. Technicians 7,220 0.2% 8,180 0.2% 960 13.3% 1,090 2,050 $37,850 6 62 29-2071 Medical Records & Health Info. Technicians 5,640 0.2% 6,400 0.2% 760 13.5% 1,530 2,290 $33,850 6 63 43-6013 Medical Secretaries 18,600 0.5% 20,300 0.6% 1,700 9.1% 2,960 4,660 $34,780 10 64 31-1000 Nursing, Psychiatric & Home Health Aides 67,620 2.0% 78,930 2.2% 11,310 16.7% 6,050 17,360 31-1011 Home Health Aides 17,330 0.5% 23,150 0.6% 5,820 33.6% 1,550 7,370 $25,290 11 31-1012 Nursing Aides, Orderlies, & Attendants 41,620 1.2% 47,210 1.3% 5,590 13.4% 3,730 9,320 $27,920 7 31-1013 Psychiatric p Aides y p 8,670 0.3% 8,570 0.2% -100-1.2% 780 680 $29,480 11 65 31-2000 Assistants & Aides 4,430 0.1% 5,350 0.1% 920 20.8% 600 1,520 31-2011 Occupational Therapist Assistants 1,020 0.0% 1,190 0.0% 170 16.6% 160 330 $43,510 6 31-2012 Occupational Therapist Aides 270 0.0% 300 0.0% 30 13.4% 40 70 $33,210 11 31-2021 Physical Therapist Assistants 2,000 0.1% 2,530 0.1% 530 26.9% 260 790 $47,310 6 31-2022 Physical Therapist Aides 1,150 0.0% 1,330 0.0% 180 15.6% 150 330 $29,030 11 66 29-1122 Occupational Therapists 4,330 0.1% 5,100 0.1% 770 17.7% 640 1,410 $64,600 5 67 29-2052 Pharmacy Technicians 5,740 0.2% 7,400 0.2% 1,660 28.9% 1,750 3,410 $29,480 7 68 29-1123 Physical Therapists 6,580 0.2% 8,060 0.2% 1,480 22.5% 790 2,270 $68,590 5 69 29-1071 Physician Assistants 2,130 0.1% 2,490 0.1% 360 16.9% 300 660 $81,720 5 70 29-1069 Physicians and Surgeons, All Other 9,030 0.3% 9,920 0.3% 890 9.9% 1,630 2,520 $150,470 1 71 29-2034 Radiologic Technicians 5,980 0.2% 6,690 0.2% 710 11.9% 810 1,520 $63,910 6 72 29-1111 Registered Nurses 78,370 2.3% 94,480 2.6% 16,110 20.6% 12,940 29,050 $74,940 5 73 29-1126 Respiratory Therapists 2,190 0.1% 2,640 0.1% 450 20.7% 320 770 $57,520 5 74 29-2055 Surgical Technologists 1,870 0.1% 2,290 0.1% 420 22.1% 570 990 $42,540 7 75 29-2056 Veterinary Technicians 1,840 0.1% 2,450 0.1% 610 33.5% 560 1,170 $33,130 6 Page 19 Replacement Openings~ Net Job^ Openings 2007 Average Wage Education /Training Level***

FOOTNOTES for Table 15 above: *Listed for only those occupations providing 100 or more jobs **Includes self-employed ~Represents the number of job openings expected to arise from the need to replace workers who retire or move up the career ladder ^ Represents the sum of net change and replacements ***Education and Training Level - 1. First Professional Degree 2. Doctorate 3. Master's Degree 4. Work Experience, plus a Bachelor's Degree or Higher 5. Bachelor's Degree 6. Associate's Degree 7. Postsecondary Vocational Training/Certificate 8. Work Experience in a Related Occupation 9. Long-Term On-the-Job Training (1 or more years) 10. Moderate-Term On-the-Job Training (1 to 12 months) 11. Short-Term On-the-Job Training (1 to 4 weeks) Further descriptions of the careers listed above in Table 15, Column one, labeled Page, are available in the Appendix section at the end of this report. Page 20

Employers In order to better assess and accurately predict needs of area healthcare employers in the BAWIB service area, a brief survey by telephone was conducted, July, 2011. Following are the results and comments of these area healthcare employers. Sampling of Healthcare Related Employers in the Brockton Service Area Baypointe Rehabilitation Center, Brockton, MA (508) 580 6800 Kristene Donovan, Staff Development Baypointe has 100 200 full and part-time employees. They currently have no staffing needs and do not see any difficulties filling positions should they arise. They receive many walk-in candidates seeking employment. There are no training needs at this time. Blue Hills Alzheimer s Care Center, Stoughton, MA (781) 344 7300 Peter Callagy, Director Blue Hills Alzheimer s Care Center has 100 150 full-time, part-time, and per diem employees. They have a staffing need for CNA s ( bi-lingual certified nursing assistant), RN s and LPN s, an activity aide, dietary aide and a position open for a cook. They do not foresee any problems filling these positions for they accept walk-in applications. The Director stated there are no language problems at this facility with employees or patients although the laundry workers struggle with the English language. Training needs include CNA 2 & 3 upgrade skills, and customer service training. Visiting Nursing Association, Brockton, MA (508) 587 2121 Suzanne Gerrior, HR Rep. The Visiting Nursing Association is currently seeking a Vice President of HR, Physical Therapists, Occupational Therapists, RN s and pediatric nurses. They do not anticipate problems filling these positions. Many will be filled through an agency. They do not have any training needs at this time. Braemore Rehabilitation/Nursing Center, Brockton, MA (508) 586 3696, Karen, HR The Braemore Rehabilitation/Nursing Center has between 100-150 employees. They have no staffing needs at this time or any projected needs for the coming year. When jobs become available, they do not have any problems filling them. No training needs are required at this time. Caritas Good Samaritan Medical Center, Brockton, MA (508) 427 3000 Jennifer, HR Rep. Caritas Good Samaritan Medical Center staffs between 1,000 1,600 employees. They too have no immediate staffing needs nor foresee any problems meeting these needs when they arise. Good Samaritan uses an agency to assist with job vacancies. Computer training would be helpful for all employees. Page 21

Kindred Hospital, NE, Stoughton, MA (781) 297 8200 Darlene Cunha, Chief Nursing Officer Kindred Hospital, NE has a staff of approximately 700 employees. They are in need of Critical Care RN s and ICU/CCU RN s. Problems they foresee filling these positions is applicant experience level. Experience is not always there. Kindred provides their own training in-house, for life support/cpr, and a critical care refresher program. Life Care Center, W. Bridgewater, MA (508) 580 4400 Alan Richman, Executive Director Life Care Center has 220 full-time and part-time employees. They are a bilingual staff using Portuguese to speak with patients and family members. They do not have any vacancies at this time. This facility recently won an award Employer of Choice and has very little employee turnover. The facility celebrated its 15 th anniversary and 80% of the original employees remain on staff. This is a wonderful milestone, however, it could cause staffing problems in the future as the group retires together leaving a large void in qualified staff. The Executive Director expressed an interest in training programs for LPN to RN and CNA to LPN. Neighborhood Health Center, Brockton, MA (508) 559 6699 Linda Gabrook, Chief Operating Officer The Neighborhood Health Center employees approximately 300 staff. Their staffing needs currently consist of LPN s, secretarial/support help, and a medical assistant. They foresee a shortage of RN s available for their facility in the future because of the low pay Brockton offers their RN s. Many RN s take a short train ride into Boston to receive better wages. To offset this, the facility offers their RN s a steady work schedule, tuition reimbursement and other generous benefits for attraction. Being bi-lingual is a requirement at Neighborhood Health Center. Patients speak Haitian Creole, Cape Verdean Creole, Portuguese and Spanish. As far as training needs, they teach customer service themselves, but would be interested in some training for new supervisors. They promote from within and some new supervisors have never before been in a leadership position. West Acres Rehabilitation & Nursing Center, Brockton, MA (508) 583 6000 Kathy, HR Rep The West Acres Rehabilitation & Nursing Center employees 174 people. Their current staffing needs include two vacancies for CNA s. They do not foresee any problem filling these positions with walk-in and neighborhood applicants. They do not use an agency for staffing needs. They have an on-staff educator for training needs. Most employees are bi-lingual speaking French Creole, Portuguese, and Spanish. Note: For a variety of reasons, the following healthcare employers were unresponsive to the survey: New England Sinai Hospital, Stoughton, MA; Copley Healthcare Partnership, Stoughton, MA; V.A. Medical Center, Brockton, MA; Sachem Nursing/Rehabilitation Center, E. Bridgewater, MA; Signature Healthcare-Brockton Hospital, Brockton, MA; and St. Joseph Manor Healthcare, Inc., Brockton, MA. Page 22

Healthcare Vacancies Healthcare is one of the fastest growing industry sectors and will add the most jobs, expanding by 64,630 jobs during the projection period 2006-2016. There is a growing concern in Southeastern Massachusetts, as expressed by both healthcare employers and trainers, about the current and projected shortages of healthcare workers in the community. According to the 2nd Quarter Job Vacancy Report published by the Department of Workforce Development, healthcare, the state s largest industry, posted an 11% gain in job vacancies over the year. Although this was a lower rate of increase than the statewide average of 45%, Healthcare continues to post more job vacancies than any other major industry, 13,376 as shown below in Table 16. Of these 13,376 statewide vacancies, 86% require related experience and 54% requires an Associate degree or higher. Table 16: Statewide Job Vacancies by Industry, 2 nd Quarter 2010 Job Vacancy Rate * % Private Sector % Requiring Associate's Degree or Higher % Requiring Related Experience % Providing Healthcare Benefits # of Job % Part- Industry Vacancies Time Total, All Industries 71,151 2.5% 95% 41% 41% 65% 52% Healthcare and Social Assistance 13,376 2.7% 99% 47% 54% 86% 66% In the Southeast region, 1,596 or 18% of the total job vacancies were for healthcare related jobs as shown below in Table 17. The higher vacancy rate for healthcare service jobs, both Statewide and in the Southeast region, as shown in Tables 16 and 17, indicates a higher demand which is growing. Table 17: Job Vacancies by Region and Industry, 2nd Quarter 2010 Massachusetts Job Vacancy Rate * Southeast Job Vacancy Rate Industry Title # of Job Vacancies # of Job Vacancies Total, All Industries 71,151 2.5% 8,669 2.5% Healthcare and Social Assistance 13,376 2.7% 1,596 2.6% * Job Vacancy Rate: Calculated by dividing the total number of job vacancies by the total number employed in the occupation Page 23

The New England Public Policy Center released a report in November, 2010 examining the Mismatch in the Labor Market: Measuring the Supply of and Demand for Skilled Labor in New England. Among the healthcare related findings: New England has experienced critical vacancies in a variety of occupations that employ a large share of both middle-skill and high-skill workers. For example, within healthcare, critical vacancies existed in occupations such as registered nurses, radiologic technicians, respiratory therapists, and sonographers. These are jobs that employ a high share of workers with only some college or an associate s degree. New England employers are willing to pay a premium for workers with any educational level past high school. This indicates the demand for such workers outpace the supply. The imbalance between the supply and demand for labor is greatest among middle-skill workers with some college or an associate s degree. Page 24

Section Conclusion Healthcare Industry in the Region Healthcare related jobs represent 16% of the total employment in the Brockton WIA region providing higher than average wages. Healthcare is projected to provide 38% of the new job growth statewide over the 2006-2016 periods. The Southeastern Massachusetts region should anticipate a similar growth trend in its healthcare industry. In the most recent statewide data, June 2010 June 2011, healthcare represents 16% of the total employment and 26% of the job growth over the past year. Overall, Brockton wages are lower than the statewide average, but healthcare wages in Brockton are higher than the Brockton average wage for all employment. There is a wide variety of rewarding healthcare careers in the City of Brockton with an average salary ranging from $23,000 for Human Services Worker to $77,000 for a Health Services Administrator. It is important to remember that most job openings will be the result of replacement demand rather than job growth. These replacements will be associated with retirement, labor force withdrawal, and occupational changes. From a survey of healthcare related employers in the Southeast Service Area, the following conditions seem prevalent: There are very few healthcare job vacancies currently available at many of the facilities in the Brockton Workforce Area who participated in the survey. RNs and LPNs are always in demand, while positions are available for CNAs, physical and occupational therapists, and a medical assistant. All the facilities readily fill vacant positions with qualified people either from walk-in applicants or through an agency. Several facilities have minor training needs, however, most facilities who participated in this survey have in-house trainers for their staff. Some facilities lose their RNs to Boston hospitals where, after a short train ride, higher wages and career paths offer greater rewards than those offered in the Brockton area. Although longevity of dedicated staff is a statistic to be proud of, this may mean the staff will retire together possibly leaving a large replacement need in future staffing. Patient languages in local facilities include Haitian Creole, Cape Verdean Creole, Portuguese and Spanish. Most facilities have bi-lingual staff members to handle language interpreting for patients or family members, and staff members. Some facilities require second language skills for new hires. Many of these facilities promote from within, supporting a career ladder philosophy. There is a growing concern in Southeastern Massachusetts, as expressed by both healthcare employers and trainers, about the current and projected shortages of healthcare workers in the community. Healthcare jobs represent 16% of the employment in the area, while healthcare workers represent only 4%-7% of the total unemployment claims for healthcare workers of total claimants. This suggests a higher demand for healthcare related positions even given current economic conditions. Page 25

New England has experienced critical vacancies in a variety of occupations that employ a large share of both middle-skill and high-skill workers. Notably within the healthcare industry this is especially true. Many of these jobs will employ a high share of workers with some college or an associate s degree. Page 26

HEALTHCARE TRAINING Education Requirements Education and training will play an increasingly prominent role for both current and future job seekers. More than half (60%) of all new jobs related to healthcare growth will require an Associate Degree or higher. While a Bachelor Degree may be preferable, it is important to recognize that some form of postsecondary education will be essential for those seeking a rewarding career in healthcare with good pay and upward mobility. Certificate vs. Degree Programs - Vocational training offer students valuable training in specific areas with a certificate of completion awarded at the conclusion. Training is offered in a variety of formats: technical centers, community colleges, on-line, private schools, and in-house seminars. The emphasis in vocational training is to get a student job-ready. If courses are desired to count toward a future degree, enrollment in a program at a college / community college is recommended. Many institutions are looking into dual enrollment programs which would allow easy transfer of credits between schools. These education and training paths lead to different career ladders and wage earning levels. A sampling of some high-wage healthcare occupations requiring a Bachelor degree or higher, as shown in the last column of Table 15, include: Cardiovascular Technician, Medical and Health Service Managers, Occupational Therapists, Physician and Surgeon Assistants, Physical Therapists, Registered Nurses, and Respiratory Therapists. A sampling of some average to lower-wage healthcare occupations requiring an Associate degree or lower, as shown in the last column of Table 15, include: Dental Assistants, Dental Hygienists, Sonographers, Dieticians, EMT s, LPN s, Medical Assistants, Lab Technicians, Record Technicians, Medical Secretaries, Home Health Aides, Orderlies and Aides, Occupational/Physical Therapy Assistants, Pharmacy Technicians Radiologic Technicians, Surgical Technologists, and Veterinary Technicians. Growth in healthcare jobs will require training and employment programs to prepare individuals for jobs that are currently and will be in demand. Table 18 illustrates that jobs with the largest amount of growth will require an Associate degree (15.3%). Postsecondary Vocational Training / Certificate programs will also see significant growth (9.8%) while traditional on-the-job training positions will decrease in demand. Page 27