State Service

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The Program on Health Workforce Research and Policy (PHWRP) provides objectively and timely health workforce research and data to inform state health policy. Each year, the Program dedicates significant time to state service to the North Carolina legislature, the Department of Health and Human Services, the UNC system, the North Carolina Community College System, and other educational and state policy makers. Below is a select list of recent state service activities.


Health Workforce Data and Policy Briefs Series

The Program on Health Workforce Research and Policy compiled a series of four policy briefs on North Carolina’s experience collecting and using health workforce data to answer policy questions, inform decisions, and determine the need for health professions education programs. The series aims to demonstrate the value of investing in systems to reliably gather health workforce data to support policy.


Providing data to policy makers for administrative, education and regulatory decisions

Our workforce team provides expertise to the NC General Assembly (NCGA)  regarding anticipated changes in the availability of and demand for health providers. In a span of three months in 2013-14, Erin Fraher and her colleagues gave five presentations to NCGA subcommittees relating to trends, opportunities and challenges in the education and deployment of physicians, nurses, optometrists, certified nurse midwives and other health care workers.


Trends in the Supply and Distribution of Obstetric Delivery Providers in North Carolina (2/26/14)

Trends in the Supply and Distribution of the Health Workforce in North Carolina (1/21/14)

Trends in the Supply and Distribution of Optometrists in North Carolina (1/21/14)

Health Workforce Supply in North Carolina: Future Trends, Opportunities and Challenges (12/16/13)

Residency Training in North Carolina: Needs for the Future, Opportunities for Expansion (12/16/13)


Does North Carolina need a school of optometry?

In 2014, the North Carolina General Assembly directed the Board of Governors of the University of North Carolina to evaluate the feasibility of establishing a school of optometry in the state [link to legislation]. As part of their response, the UNC General Administration commissioned the Program to produce a report describing the supply and distribution of optometrists in the state. Based on these data, the Board of Governors, in November 2014, recommended not developing a new school, a recommendation that, if adopted by the General Assembly, will save the state an estimated $12-$40 million in initial start-up costs and an estimated $8-19 million in annual operation costs.

Final Report: Envisioning the Future Optometry Workforce in North Carolina


Should Certified Nurse Midwives be allowed to practice midwifery in collaboration with, rather than under the supervision of, a physician?

In 2014, the North Carolina Legislature’s Joint Legislative Committee on Health and Human Services appointed a Subcommittee on Certified Nurse Midwives (CNMs) to determine whether CNMs should be allowed to practice midwifery in collaboration with, rather than under the supervision of, a physician. In response to a legislative request, the Program on Health Workforce Research and Policy conducted a CNM workforce analysis using data from the state nursing and medical licensure boards. Data indicated that although the CNM workforce grew by 20% between 2006 and 2011, there was no growth in the number of physicians who supervised CNMs. Hospital discharge data indicated that the average distance to care for childbirth was greater than 19 miles for 31 counties in the state. A proposed bill drafted in the committee sought to change the law from requiring physician supervision to requiring a collaborative practice agreement with an obstetric delivery provider for a new CNM’s first 2,400 hours of practice. Concerns about access to care with a specific mention of the Program’s data were cited in this bill. The bill was not passed during the 2014 legislative session.

Slides: Trends in the Supply and Distribution of Obstetric Delivery Providers in North Carolina

Manuscript under development


GovernorsWebsiteServing the state’s Medicaid population through better health workforce planning (2014-15)

The Program worked with the National Governors’ Association (NGA) health workforce policy academy to identify strategies and form a plan to ensure the workforce is in place to meet the diverse health care needs of the Medicaid population in North Carolina. Erin Fraher and Katie Gaul were expert faculty for the NGA policy academy, and Tom Ricketts worked staff from the Governor’s office, the Division of Mental Health, Developmental Disabilities and Substance Abuse Services, the NC Institute of Medicine, and other partners on our state’s action plan.

States to Focus on Health Care Workforce


Previous work:

Dental – Trends in the Supply of Dentists in North Carolina, 1996-2005;

Pharmacy – Pharmacists in North Carolina: Steady Numbers, Changing Roles (2014), Trends in the Supply of Pharmacists in North Carolina (2010)