East Central Minnesota Health Care Trends

1. East Central Minnesota Health Care Trends Cameron Macht • Minnesota Dept. of Employment and Economic Development (DEED) • Regional Analyst, Central & Southwest Regions • (320) 441-6567 • cameron.macht@state.mn.us • www.PositivelyMinnesota.com

2. A Healthy Economy? How many jobs are in East Central Minnesota? 44,146 covered jobs (DEED QCEW program, 2010 Annual Data) How many of those jobs are in Health Care & Social Assistance? 9,732 covered jobs (22.0% of total employment) How does that rank in East Central Minnesota? Easily the largest employing industry: Retail Trade has 5,431 jobs (12.3% of total jobs) Was Health Care Growing or Declining? Health Care & Social Assistance gained +532 jobs from 2007-2010 Overall, Region 7E lost -2,779 jobs (-5.9%)

3. Industry Employment Statistics • During the 2001 recession, Region 7E still gained jobs • Region 7E averaged gains of +506 net new jobs per year from 2000 to 2007(43,380 jobs to 46,925 jobs) • From 2007 to 2010, Region 7E lost -2,802 jobs (-6.0%) • A return to average growth could mean 5 years to recover… • Or, Region 7E could break even in a couple really good years… (2001-2004) • Perhaps back to where we were in 2007 by 2015? • However, in the past, once back to normal, then job growth really takes off • From 42,705 jobs in Q1 2010 to 43,200 jobs in Q1 2011 (+495 jobs; +1.2%)

4. Industry Employment Statistics • Region 7E has 3,543 establishments & 44,123 covered jobs • Average Annual Wages of $31,460 in 2010 (state = $46,748) • 16 of the 20 major industry sectors lost employment during the recession (2007-2010) – public sector lost -310 jobs • Health Care &Social Assistancegained the mostjobs (+532 jobs) • Administrative &Waste Services sawthe fastest growth(+12.5%; +120 jobs)

5. Industry Employment Statistics • Health care & social assistance is the largest employing industry, with 283 firms and 9,732 jobs (22.0% of total jobs) $35,464 • +532 jobs (+5.8%)from 2007-2010 (state = +5.8%) • Ambulatory Health Care Services (1,393 jobs; +11.1% from 2007-2010) • Nursing & Residential Care Facilities (4,400 jobs; +2.9% from 2007-2010) • Social Assistance (1,374 jobs; higher concentration in the region) • Retail Trade has 479 firms and 5,431 jobs (12.3%) $20,592 • Minnesota = 10.9%; -507 jobs (-8.5%)from 2007-2010 (state = -7.9%) • Educational Services has 82 firms and 4,645 jobs (-59 jobs; -1.3%) • Manufacturing has 236 firms and 4,026 jobs (9.1%) $41,132 • Minnesota = 11.4%;-754 jobs (-15.8%)from 2007-2010 (state = -14.5%) • Fabricated Metal Mfg. (1,041 jobs; -15.4%); Plastics & Rubber Product Mfg. (803 jobs; -6.1%); Machinery Mfg. (346 jobs; -19.3%); Food Mfg. (304 jobs; +22.1%); Wood Product Mfg. (250 jobs)

6. Current Employment Situation • Region 7E has high concentrations of some health care specialties; but very low concentrations of others • Region 7E has high location quotients for: • Nursing & Residential Care Facilities = 2.4 LQ • 74 establishments and 4,400 jobs; $26,988 average annual wage • 3 government establishments with 176 jobs; $44,252 avg. wages (2.2 LQ) • Nursing Care Facilities (Skilled Nursing Homes) = 2.0 LQ • 11 establishments and 1,689 jobs; $23,036 avg. annual wage • Residential Mental Health & Substance Abuse Facilities = 3.7 LQ • 30 establishments and 2,100 jobs; $33,020 avg. annual wages • Community Care Facilities for the Elderly = 1.9 LQ • 25 establishments and 573 jobs; $17,108 avg. annual wages • Offices of Other Health Practitioners = 1.5 LQ • 54 establishments and 307 jobs; $27,560 avg. annual wages • Chiropractors; Optometrists; Mental Health Practitioners; Physical, Occupational and Speech Therapists; Audiologists; All Other Misc. Health Practitioners

7. Current Employment Situation • Region 7E has low location quotients for: • Ambulatory Health Care Services = 0.6 LQ • 130 establishments and 1,394 jobs; $54,340 avg. annual wages • Offices of Physicians = 0.5 LQ • 20 establishments and 553 jobs; $88,088 avg. annual wage • Outpatient Care Centers = 0.8 LQ • 9 establishments and 142 jobs; $31,668 avg. annual wages • Other Ambulatory Health Care Services = 0.9 LQ • 5 establishments and 91 jobs; $40,883 avg. annual wages • Ambulance Services; Blood and Organ Banks; Smoking Cessation Programs • Home Health Care Services = 0.1 LQ • 3 establishments and 25 jobs; $7,884 average annual wage • Other Residential Care Facilities = 0.4 LQ • 7 establishments and 37 jobs; $17,265 avg. annual wages • Boot Camps; Delinquent Youth Halfway Group Homes; Group Foster Homes

8. Current Employment Situation • Region 7E has neutral location quotients for: • Offices of Dentists = 1.0 LQ • 39 establishments and 278 jobs; $36,504 avg. annual wages • Hospitals (government only) = 1.0 LQ • 2 establishments and 310 jobs; $46,280 avg. annual wage • Social Assistance = 1.1 LQ • 74 establishments and 1,374 jobs; $17,108 avg. annual wages • 1 government establishment with 60 jobs; $48,672 avg. wages • Individual & Family Services = 1.1 LQ • 36 establishments and 879 jobs; $18,772 avg. annual wages • Child & Youth Services; Services for the Elderly & Disabled

9. Health Care Employment Trends • Health Care & Social Assistance gained +532 jobs • Total, All Government lost -88 jobs (-13.9%) from 2007-2010 • 6 establishments & 546 jobs • Private Sector gained +22 establishments and +620 jobs (+7.2%) • 277 establishments & 9,186 jobs • Nursing & Residential Care Facilities has 74 firms & 4,400 jobs • Gained +7 establishments & +153 jobs (+3.6%) • Government lost -1 facility & -105 jobs (-37.4%) • Private sector gained +8 facilities & +266 jobs (+6.7%) • Nursing Care Facilities lost -3 facilities & -104 jobs (-5.8%) • Mental Health & Substance Abuse Facilities gained +2 firms & +104 jobs (+5.2%) • Community Care Facilities for the Elderly added +8 firms & +223 jobs (+63.7%) • Other Residential Care Facilities lost -1 firm & -75 jobs (-67.0%) • Ambulatory Health Care Services has 130 firms & 1,394 jobs • Offices of Physicians gained +47 jobs (+9.3%) • Outpatient Care Centers gained +1 firm & +39 jobs (+37.9%) • Social Assistance has 74 firms & 1,374 jobs • Individual & Family Services has 36 firms & 879 jobs (gained +228 jobs; +38.6%)

10. Health Care Employment Trends • Health Care & Social Assistance had 181 job vacancies • Up from 101 job vacancies in Q4 2010; Up from 161 vacancies in Q2 2010 • About 22.3% of total job vacancies in the region • Statewide, there are 9,800 health care job vacancies • About 17.9% of totaljob vacancies inMinnesota • Up from 7,222 jobvacancies in Q4 2010 • Up from 8,407 jobvacancies in Q2 2010 • Down from 21,327vacancies in Q2 2001 • Increased the last 2years (5,350 in 2009)

11. Health Care Employment Trends • Healthcare Practitioners had 67 job vacancies • Up from 29 job vacancies in Q4 2010; Down from 89 vacancies in Q2 2010 • 19 of those were for RNs; 10 were for LPNs; Physical Therapists • Healthcare Support Workers had 54 job vacancies • Up from 47 job vacs. in Q4 2010 • Down from 58 vacs. in Q2 2010 • 29 vacancies forHome Health Aides • 54% required work exp. • $10.25 wage offer • 19 vacancies forNursing Assistants • 95% required certificate • $10.30 wage offer

12. Health Care Employment Projections • Central Minnesota is the fastest growing region • Expected to grow +12.9% from 2009-2019; Minnesota = +8.7% • Health Care & Social Assistance in Central Minnesota is projected to grow +33.6% • Minnesota = +25.5% • 43,119 jobs in 2009; 57,603 jobs in 2019 • +14,484 net new jobs • Ambulatory Health CareSvcs. (+51.3%; +5,635 jobs) • Social Assistance (+55.7%; +3,933 jobs) • Nursing & Residential CareFacilities (+25%; +3,322 jobs)

13. Health Care Employment Projections • Healthcare Practitioners are expected to grow +26.4% • +4,066 net new jobs; 3,300 replacement openings • Healthcare Support workers are expected to grow +33.7% • +3,904 net new jobs; 1,250 replacement openings • All but one health care occupation is expected to see growth • Pharmacy Aides expected to decline -9.3% from 2009 to 2019 • Almost half (20 of 44) ofhealthcare practitioner occupations are expected to grow 25%or more from 2009-2019 • Half (7 of 14) of healthcare support workers are expected to grow 25%or more from 2009-2019

14. Educational Requirements • Based on BLS’s “most significant source of education or training” categories; Central Minnesota will see varied growth • Strangely, the fastest growing category is short-term on-the-job training • Entirely due to Home Health Aides (+50.3%) • Largest growing categories were Postsecondary Voc. Award & Associate • RNs, CNAs, LPNs, EMTs & Paramedics, Dental Hygienists, Health Info. Technicians • Fast growth in Master’s Degrees & Professional Degrees

15. Workforce Demographics • Central Minnesota has a slightly younger – and older – health care workforce than the state • 15.3% of the healthcare workforce is 14 to 24 years of age (state = 12.7%) • 40.8% of theworkforce is25 to 44 years (state = 44.1%) • 43.9% of theworkforce is45 years & over(state = 43.3%) • 83.4% of the workforce isfemale (state = 79.1%)

16. Workforce Demographics • Central Minnesota’s health care workforce has gotten significantly older in the last decade • 14.9% of the healthcare workforce was 14 to 24 years of age (2010 = 15.3%) • 47.6% of theworkforce was25 to 44 years (2010 = 40.8%) • 37.5% of theworkforce was45 years & over(2010 = 43.9%) • 84.8% of the workforce wasfemale (83.4%)

17. Workforce Demographics • Each industry sector has a different workforce • 22.9% of the nursing & residential care facilities workforce was 14 to 24 years of age (state = 21.9%) • 36.6% of theworkforce was25 to 44 years (state = 39.8%) • 40.5% of theworkforce was45 years & over(state = 38.4%) • 83.8% of the workforce wasfemale (state = 79.8%)

18. Workforce Demographics • Each industry sector has a different workforce • 39.6% of the nursing & residential care facilities workforce had a H.S. diploma or less(state = 37.0%) • 60.4% of theworkforce attendedsome college orhad a degree (state = 63%) • 71.5% of the amb.healthcare svcs.workforce had some college orhad a degree(state = 75.2%)

19. Demographic Trends • Central Minnesota has been the fastest growing region • State of Minnesota gained about +385,000peoplefrom 2000-2010 (+7.8%) • Region 7E added +27,545 people (+20.2%) • Chisago Co. (53,887 people) is the 18th largest & 4th fastest growing county in the state (+12,786 people; +31.1%) • Isanti Co. (37,816 people) is the 26th largest county (+6,529 people; +20.9% - 6th fastest) • Pine Co. (29,750 people) is the 36th largest county (+3,220 people; +12.1% - 17th fastest) • Mille Lacs Co. (26,097 people) was the 8th fastest growing (+3,767 people; +16.9%) • Kanabec Co. (16,239 people) was the 28th fastest growing (+1,243 people; +8.3%)

20. Demographic Trends • Minnesota’s population grew +155.5% in the last century • Region 7E grew +176.7% from 1910 to 2010 • Chisago County is nearly 4 times larger (+298%) than it was 100 years ago (13,537 people in 1910; 30,521 in 1990; 53,887 in 2010) • Isanti Co. tripled (+200%)in the last 100 years • Kanabec Co. gained +151% • Mille Lacs Co. jumped+143.8%; +7,427 people • Pine Co. went up & down:from 20,264 in 1930 to 16,821 in 1970 to 21,264in 1990 to 29,750 in 2010

21. Demographic Trends • Region 7E’s population is slightly older than the state’s • 33,459 children aged 0-14 years (20.4%) as compared to 20.0% statewide • 19,434 people aged 15-24 years (11.9%) as compared to 13.6%statewide • No 4-year colleges or universities in the region • 19,851 people aged 25-34 years (12.1%) vs. 13.5% statewide • 22,075 people aged 35-44 years (13.5%) vs. 12.8% statewide • 27,014 people aged 45-54 years (16.5%) vs. 15.2% statewide • Second half of the Baby Boom Generation • 19,308 people aged 55-64 years • 11.8%, as compared to 11.9% • First half of Baby Boomers • 22,648 people are 65 years & over • 13.8%, as compared to 12.9% • More change is coming…

22. Population Projections • Region 7E is projected to increase 40.7% from 2010 to 2030 • Still expected to be one of the fastest growing regions in the state • Faster projected growth in younger age groups than the state • +23.9% in 0-14 years (state = +10.7%) • +31.0% in 15-24 years (state = +5.4%) • +37.0% in 35-44 years (state = +11.7%) • Much faster in older age groups;including +132% in 65 years & over (state = +92%) - Baby Boomers • 19,308 people aged 55-64; which means approximately 2,000 people will be turning 65 each year • By 2030, perhaps 20.4% of theregion’s population will be 65 years & over • 20.6%in the state

23. Labor Force Trends • Region 7E’s labor force expanded 6.8% from 2005 to 2010 • From 81,536 available workers in 2005, with an unemp. rate of 5.7% to84,562 available workers in 2010, but with an unemp. rate of 10.2% • Average of 4,645 unemployed workers in 2005; up to 9,554 in 2009 • Back down to 8,599 unemployed workers in 2010 • Unemployment rate has stayed well above the state during the decade • Region 7E peakedat 11.3% in2009 • Workforce is expectedto grow another 32.3%from 2010 to 2030 • Fastest growth in65 years & over(+171.1%) • +43.1%increase in 45-64 years

24. Labor Force Trends • The 7 counties with the longest travel times to work in the state were all located in Central Minnesota • Anything is bearable for ahalf-hour, right? • Over a five-day work-week,Isanti Co. workers spend332 minutes driving to work • 17,264 minutes in 52 weeks • 288 hoursa year • 12.0fulldaysa year • 7.240-hour work-weeks

25. Commute Times • In 1990, 45.2% of workers spent less than 15 minutes each way • Number of workers with 15 minute commutes rose by +20,000 (+20.5%); thenumber of workers with 45 minutes rose by +35,000 (+118.3%) • Number of workers with long commuteswas increasing sixtimes faster thanshort commutes • Still shorter than thestate and nation; butmuch bigger drops…

26. Wage Levels • There are 22 occupational groups, with median wages ranging from $18,516 (food prep & serving related occupations) to $77,129 (managementoccupations) • Region 7E wageswere 81.3% of Twin Cities wages • Region 7E wagesrange from 68.1%(legal) to 131.1% of Twin Cities wages(farming & forestry) • Four occupationalgroups had higherwages in Region 7E

27. Wage Disparity • In general, the wage gapsare biggest forhigher wage,higher skilledoccupations • In general,jobs requiringlonger tenurewere morecompetitive • Community &Social Svcs.;Protective Svcs.

28. Cameron Macht Minnesota Dept. of Employment& Economic Development Regional Analysis & Outreach Unit 320-441-6567 cameron.macht@state.mn.us RAO Manager: Kyle Uphoff(651)-259-7185 Northeast: Drew Digby (218)-723-4774 Northwest: Nate Dorr (218)-333-8220 Twin Cities: Rachel Vilsack(651)-259-7403  Questions? Thank You!