Health Care Workforce Needs in Wyoming Presented by Tony Glover, Manager, and Michael Moore, Editor, of the Research & Planning section of the Wyoming Department of Workforce Services to the Wyoming Interim Joint Labor, Health, & Social Services Committee, June 13-14, 2019, Cheyenne, WY

Research & Planning http://doe.state.wy.us/LMI OUR ORGANIZATION: R&P is an exclusively statistical entity within DWS. WHAT WE DO: R&P collects, analyzes, and publishes timely and accurate labor market information (LMI) meeting established statistical standards. OUR CUSTOMERS: LMI makes the labor market more efficient by providing the public and the public’s representatives with the basis for informed decision making.

Data Sources U.S. Bureau of Labor Statistics Quarterly Census of Employment and Wages (QCEW) Occupational Employment Statistics (OES) U.S. Census Bureau Population Estimates U.S. Employment and Training Administration Industry and Occupational Projections Guide to Licensed Occupations in Wyoming Research & Planning Wage Records and licensed occupation database linkages Wyoming New Hires Job Skills Survey Special research on CNAs in Wyoming Several sources were used for the data in this presentation. The Quarterly Census of Employment and Wages and Occupational Employment Statistics Survey are both state-federal programs prepared by Research & Planning in cooperation with the U.S. Bureau of Labor Statistics. The U.S. Census Bureau provides population estimates. Industry and occupational projections and the guide to licensed occupations are prepared by R&P in cooperation with the Employment and Training Administration. Several data sources in this publication are exclusive to R&P, such as wage records linked to licensed occupation databases, the Wyoming New Hires Job Skills Survey, and special research on CNAs in Wyoming.

Health Care Workforce Needs in Wyoming Outline Introduction to Health Care in Wyoming Licensed Health Care Occupation Dashboards Frontline Provider Health Care Needs Special Research: Wages of CNAs Health Care Workforce Needs in Wyoming: Update 2017 Mental Health Care in Wyoming There are six parts to this presentation: An introduction to health care in Wyoming Licensed health care occupation dashboards Frontline provider health care needs Special research: wages of CNAs in Wyoming Health Care Workforce Needs in Wyoming: Update 2017 Mental health care in Wyoming

Part I: Introduction to Health Care in Wyoming The first part of this presentation is an introduction to health care in Wyoming

What is Health Care & Social Assistance? Part I: Introduction to Health Care in Wyoming What is Health Care & Social Assistance? Industries defined by the North American Industry Classification System (NAICS) NAICS 62 Establishments providing health care & social assistance for individuals Four subsectors in Health Care & Social Assistance: Ambulatory Health Care Services (621) Hospitals (622) Nursing & Residential Care Facilities (623) Social Assistance (624) Industries are defined by the North American Industry Classification System, or NAICS. The health care & social assistance sector is encompassed within NAICS code 62, and refers to establishments that provide health care and social assistance for individuals Health care & social assistance industries are made up of four subsectors: Ambulatory health care services (NAICS 621) Hospitals (NAICS 622) Nursing & residential care facilities (NAICS 623) And social assistance (NAICS 624) It should be noted that health care workers can also be found in other industries, such as educational services, public administration, retail trade, and insurance industries.

Part I: Introduction to Health Care in Wyoming Figure: Average Monthly Employment in Health Care & Social Assistance in Wyoming by 3-Digit Subsector, 2017 Hospitals (33.7%) and ambulatory health care services (29.7%) made up the greatest proportions of employment in Wyoming’s health care & social assistance industry in 2017. Ambulatory health care services includes offices of physicians, dentists, optometrists, mental health practitioners, therapists, etc.

Drivers of Health Care Workforce Needs Part I: Introduction to Health Care in Wyoming Drivers of Health Care Workforce Needs Factors that influence needs: Economic trends Population changes Workforce demographic changes There are several factors that influence needs for Wyoming’s health care workforce, such as recent economic trends, population changes, and workforce demographic changes. Please note that the most recent calendar year for which employment and wage data from the QCEW were available was 2017.

Drivers of Health Care Workforce Needs: Economic Trends Part I: Introduction to Health Care in Wyoming Drivers of Health Care Workforce Needs: Economic Trends Figure: Over-the-Year Percent Change in Average Monthly Employment and Total Wages Across All Industries in Wyoming, 2007Q1-2017Q4 Wyoming has experienced two periods of economic downturn over the last 10 years. An economic downturn is defined as an over-the-year decline in average monthly employment and total wages for at least two consecutive quarters, based on data from the Quarterly Census of Employment and Wages. The most recent downturn lasted from 2015Q2 to 2016Q4. Both periods were preceded by declining energy prices.

Drivers of Health Care Workforce Needs: Economic Trends Part I: Introduction to Health Care in Wyoming Drivers of Health Care Workforce Needs: Economic Trends Figure: Average Monthly Employment (Number of Jobs Worked) in Wyoming, 2007-2017 This figure shows that average monthly employment (total number of jobs worked) decreased by 4.7% (more than 13,000 jobs) from 2015 to 2017.

Drivers of Health Care Workforce Needs: Economic Trends Part I: Introduction to Health Care in Wyoming Drivers of Health Care Workforce Needs: Economic Trends Figure: Over-the-Year Percent Change in Average Monthly Employment in Health Care & Social Assistance in Wyoming, 2007-2017 This trend line in this figure illustrates that growth in health care & social assistance has slowed over the last 10 years. Health care & social assistance was not immune to the economic downturns brought on by declining energy prices. Wyoming’s health care & social assistance industry increased at an average rate of 3.1% from 2007 to 2012. But from 2013 to 2017, growth slowed to 1.2%.

Drivers of Health Care Workforce Needs: Economic Trends Part I: Introduction to Health Care in Wyoming Drivers of Health Care Workforce Needs: Economic Trends Figure: Average Monthly Employment in Health Care & Social Assistance in Wyoming, 2007-2017 This figure shows average monthly employment in health care & social assistance, and how growth has been much more flat in recent years.

Part I: Introduction to Health Care in Wyoming Figure: Average Monthly Employment in Health Care & Social Assistance by 3-Digit Subsector in Wyoming, 2007-2017 This figure illustrates how employment in all four subsectors has remained flat or decreased slightly since 2015.

Figure: Estimated Wyoming Population, 2008-2018 Part I: Introduction to Health Care in Wyoming Drivers of Health Care Workforce Needs: Population Changes Figure: Estimated Wyoming Population, 2008-2018 This figure shows how population changes differed during the two periods of economic downturn. Wyoming’s population continued to increase during the previous downturn from 2009Q1 to 2010Q1, but has decreased each year since 2015. From 2015 to 2017, Wyoming’s population declined by 1.4%, or nearly 8,000 people. The previous economic downturn coincided with the national Great Recession, when all of Wyoming’s surrounding states had lost jobs. But Wyoming’s most recent economic downturn occurred during a time when many surrounding states were experiencing economic growth. People who lost jobs in Wyoming in 2015 and 2016 were likely able to find work in neighboring states such as Colorado and Utah.

Figure: Estimated Wyoming Population by Age, 2017 Part I: Introduction to Health Care in Wyoming Drivers of Health Care Workforce Needs: Population Changes Figure: Estimated Wyoming Population by Age, 2017 In 2017, there were more than 172,000 persons ages 55 and older in Wyoming, making up nearly one-third of the state’s population.

Drivers of Health Care Workforce Needs: Population Changes Part I: Introduction to Health Care in Wyoming Drivers of Health Care Workforce Needs: Population Changes Figure: Estimated Wyoming Population by Single Year of Age, 2000 and 2017 This graphic shows how the baby boom generation shifted from ages 36-54 in 2000 to 53-71 in 2017. The number of individuals ages 65 and older increased substantially.

Figure: Estimated Wyoming Population Ages 55 and Older, 2000 and 2017 Part I: Introduction to Health Care in Wyoming Drivers of Health Care Workforce Needs: Population Changes Figure: Estimated Wyoming Population Ages 55 and Older, 2000 and 2017 This figure illustrates how the total number of persons 65 and older has grown since 2000.

Figure: Total Persons Working in Wyoming at Any Time by Age, 2018 Part I: Introduction to Health Care in Wyoming Drivers of Health Care Workforce Needs: Workforce Demographics Figure: Total Persons Working in Wyoming at Any Time by Age, 2018 In 2017 there were more workers ages 55 and older (68,723) than any other age group. This large number of older workers indicates that there will be substantial replacement need over the next 10 years as more and more baby boomers reach the traditional retirement age of 55. There were 46,630 nonresident workers in Wyoming, or individuals for whom demographic data are not available; these are typically individuals who commute to Wyoming for work from another state, or are short-term labor working for companies outside of Wyoming.

Drivers of Health Care Workforce Needs: Workforce Demographics Part I: Introduction to Health Care in Wyoming Drivers of Health Care Workforce Needs: Workforce Demographics Figure: Total Persons Working in Health Care & Social Assistance in Wyoming at Any Time by Age, 2018 In 2018 there were nearly 8,000 individuals ages 55 and older working in health care & social assistance in Wyoming, or 21.8% of the total. This demonstrates that there will be increased need for health care workers due to aging of the health care workforce.

Part II: Licensed Health Care Occupation Dashboards

Part II: Licensed Health Care Occupation Dashboards Pages 4-7 of handouts https://doe.state.wy.us/LMI/health/Health_Care_Dashboards_2019.pdf Research & Planning was asked by the Legislative Service Office to prepare dashboards for more than 40 licensed health care occupations, which you should have a copy of. As an example, I will briefly discuss the dashboards for CNAs, which can also be found on pages 4-6 of your handout. The dashboards are available online at the URL shown here and on page 4 of your handouts.

Part II: Licensed Health Care Occupation Dashboards More than 40 licensed health care occupations 6 parts to each dashboard: Occupational Employment Statistics New Hires Long-Term Projections Short-Term Projections Projections and Wages for Surrounding States Education and Licensing Requirements There are six parts to each dashboard: Employment and wages from OES New Hires Job Skills Survey data Long-term occupational projections Short-term occupational projections Projections and wages for surrounding states Education and licensing requirements

Occupational Employment Statistics (OES), March 2019 Part II: Licensed Health Care Occupation Dashboards Occupational Employment Statistics (OES), March 2019 Employment and wages by substate region Employment and wages by industry The first section of the dashboards shows employment and wage data for an occupation by substate region and industry. For example, of the 3,310 CNAs in Wyoming in March 2019, 570 worked in the northwest region, 600 worked in Laramie County, and 550 worked in Natrona County. At the industry level, 2,750 CNAs worked in health care & social assistance, while an additional 490 worked in public administration. Each of these dashboards contains examples of data for the northwest region and Laramie and Natrona Counties at the substate region level, as well as industry-level data for educational services, health care & social assistance, and public administration. You have received a handout that provides employment and wage data for each occupation for all regions and industries.

New Hires Job Skills Survey, 2017 Part II: Licensed Health Care Occupation Dashboards New Hires Job Skills Survey, 2017 Number of hires Average hourly wage Percent offered selected benefits Important job skills Demographics Gender Age The second part of the dashboard includes data from R&P’s New Hires Job Skills Survey, such as the number of hires, the average hourly wage, the percent of new hires offered selected benefits (such as health insurance, retirement, and paid time off), job skills employers have identified as important, and demographics such as age and gender. For example, of the 517 new hire CNAs, 54.5% were offered health insurance, 39.4% were offered retirement, and 51.5% were offered paid time off. All of the employers surveyed (100.0%) identified critical thinking as an important job skill for CNAs.

Long-Term Projections, 2016-2026 Part II: Licensed Health Care Occupation Dashboards Long-Term Projections, 2016-2026 Base employment (2016) Projected employment (2026) Growth Annual openings due to: Exits Transfers Total The third section of the dashboards shows long-term occupational projections for 2016 to 2026, with openings due to growth, exits, and transfers. For example, Wyoming is projected to add 297 new CNAs from 2016 to 2026. There are 389 total openings projected annually, with 30 due to growth, 196 due to persons exiting the workforce, and 163 due to persons transferring jobs.

Short-Term Projections, 2018-2028 Part II: Licensed Health Care Occupation Dashboards Short-Term Projections, 2018-2028 Base employment (2018) Projected employment (2020) Growth Annual openings due to: Exits Transfers Total The fourth section of the dashboards shows short-term projected openings from 2018 to 2020. These were prepared more recently than the long-term openings. Wyoming is projected to add 38 new CNAs from 2018 to 2020. There are a projected 366 total annual openings: 19 due to growth, 189 due to exits, and 158 due to transfers.

Short-Term Projections for WY and Other States, 2018-2028 Part II: Licensed Health Care Occupation Dashboards Short-Term Projections for WY and Other States, 2018-2028 Growth and Annual Openings for: Colorado Idaho Montana Nebraska South Dakota Utah Average Annual Wage The fifth part of the dashboards shows short-term projections and average annual wage for Wyoming and six surrounding states. Wyoming is projected to have the fewest number of openings for CNAs among all states annually. The average annual wage for CNAs in Wyoming ($30,910) was higher than all but one state, Colorado ($32,610).

Education and Licensing Requirements Part II: Licensed Health Care Occupation Dashboards Education and Licensing Requirements Requirements Schools with programs in Wyoming Certificate or degree Examination Fees The sixth and final part of each dashboard shows education and licensing requirements for that occupation, such as: The certificate or degree required Schools located in Wyoming Required examination Fees

Frontline Provider Health Care Needs Part III: Frontline Provider Health Care Needs

What are Frontline Health Care Occupations? Part III: Frontline Provider Health Care Needs What are Frontline Health Care Occupations? Provide routine and essential services Connect families and communities to the health care system First link to health care Relatively inexpensive to train and support Involved in administration, direct care, community & public health, long-term care, mental health, and more Source: The Brookings Institution. Redesigning the Care Team: The Critical Role of Frontline Workers and Models for Success. Retrieved June 7, 2019, from https://www.brookings.edu/wp-content/uploads/2016/06/FINAL-Hitachi-Toolkit-32014.pdf A study by the Brookings Institution in 2014 identified these characteristics for frontline health care occupations They provide routine and essential services Connect families and communities to the health care system For many families, they’re the first link to health care These are occupations that are relatively inexpensive to train and support. In other words, occupations that require a certificate or a two-year associate’s degree. These occupations are involved in administration, direct care, community and public health, long-term care, mental health care, and more

Examples of Frontline Health Care Occupations Part III: Frontline Provider Health Care Needs Examples of Frontline Health Care Occupations   SOC Code Title Page Number 29-2052 Pharmacy Technicians 59-60 29-2061 Licensed Practical & Vocational Nurses (LPN) 9-10 31-1014 Certified Nursing Assistants (CNA) 7-8 31-2021 Physical Therapy Assistants 61-62 31-9092 Medical Assistants 81-82 In the Brookings report from 2014, the authors identified 26 occupations related to frontline health care, many of which are licensed occupations included in R&P’s dashboards. The 5 occupations on this slide are examples of those occupations: Pharmacy technicians, LPNs, CNAs, physical therapy assistants and medical assistants.

Part III: Frontline Provider Health Care Needs Figure: Employment for Selected Frontline Provider Health Care Occupations in Wyoming, 2018 This slide shows the employment for each of those five jobs in 2018. For example, there were an estimated 3,310 CNAs.

Part III: Frontline Provider Health Care Needs Figure: Total Projected Annual Openings for Selected Frontline Provider Health Care Occupations in Wyoming, 2018-2020 This figure shows the number of projected annual openings for each of the five occupations. This includes openings due to growth, workers exiting the labor force, and workers changing occupations. For example, short-term projections show 370 openings for CNAs per year, 15 of which are due to growth. From 2009 to 2018, Wyoming added 320 CNAs, or 32 per year.

Part III: Frontline Provider Health Care Needs Figure: Average Annual Wage for Selected Frontline Provider Health Care Occupations in Wyoming, 2018 This figure shows the average annual wage for the five selected frontline health care occupations. CNAs, which had the greatest number of jobs, also had the lowest annual wage ($30,910).

Part III: Frontline Provider Health Care Needs Figure: Average Annual Wage for Selected Frontline Provider Health Care Occupations in Wyoming and Surrounding States, 2018 This figure compares the average annual wage for the 5 frontline occupations in Wyoming to six surrounding states. Overall, Wyoming’s wages tended to be greater than or equal to most states.

Part IV: Special Research: Wages of CNAs Senior Economist Katelynd Faler recently completed a study that compared employment and wages for Wyoming CNAs to other similar workers.

Part IV: Special Research: Wages of CNAs Pages 12-14 of handouts https://doe.state.wy.us/LMI/ publications.htm Available July 10, 2019 An excerpt of this article from the 2019 Wyoming Workforce Annual Report is provided on pages 12-14 of your handouts. The annual report will be distributed at the 2019 Safety & Workforce Summit July 9 in Cheyenne, and then will be available online at the URL in your handout.

Part IV: Special Research: Wages of CNAs Highlights Purpose: Compare employment and wage outcomes of CNAs to similar individuals matched by age, gender, and education. Conclusion: Female CNAs were more likely to be employed in Wyoming and earned several thousand dollars more in wages in the years following certification. The purpose of the study was to compare employment and wage outcomes of CNAs to similar individuals in a matched to a control group. Matching was done on several variables, including age, gender, and education . The research found that female CNAs were more likely to be employed in Wyoming and earned more than those in the control group.

Part IV: Special Research: Wages of CNAs Figure: Median Annual Wages of Females Before and After Nursing Assistant Certification in Wyoming This figure from the study shows that the median annual wage for CNAs 3 years after certification was much greater than the median wage of the control group. Note that because education was used as a matching factor, the CNAs and control groups in this study were comprised of persons younger than age 30 due to the data available to R&P. Younger workers tend to have less experience, lower wages, more turnover, and less full-time work.

Part IV: Special Research: Wages of CNAs Publication Abstract in 2019 Wyoming Workforce Annual Report Distributed at 2019 Safety & Workforce Summit July 9 in Cheyenne Available in July at https://doe.state.wy.us/LMI Feature article forthcoming in Wyoming Labor Force Trends Research will be available online An abstract of the research was published in R&P’s 2019 Wyoming Workforce Annual Report, which will be available July online and at the 2019 Safety & Workforce Summit in Cheyenne. The article will be published in a forthcoming issue of Trends, and the full results of the study will be available online.

Part V: Health Care Workforce Needs in Wyoming: Update 2017

Part V: Health Care Workforce Needs in Wyoming: Update 2017 Page 15 of handouts Available at https://doe.state.wy.us/LMI/health.htm Published May 2017 Update to Health Care Workforce Needs in Wyoming: Advancing the Study Published Fall 2011 In 2017 R&P published Health Care Workforce Needs in Wyoming: Update 2017, a comprehensive report on the state’s health care needs. It was a follow-up to a 2011 publication that was funded by an Affordable Care Act grant. The cover of the report and the URL are provided on page 15 of your handout.

Part V: Health Care Workforce Needs in Wyoming: Update 2017 Chapter 2: Analysis of Wyoming’s Demographics and the Health Care Workforce Key finding: At mid-decade Wyoming’s population is decreasing and aging. 28.3% of population age 55 or older Higher proportion of older individuals in smaller, rural counties Baby boomers aging, youth leaving Chapter 2 provides an analysis of Wyoming’s demographics and the health care workforce. The key finding of this chapter was that at mid-decade, Wyoming’s population is decreasing and aging. 28.3% of the state’s population at the time was age 55 or older. Smaller, rural counties have an even greater proportion of residents age 55 or older. Baby boomers are aging, and youth are leaving the state.

Part V: Health Care Workforce Needs in Wyoming: Update 2017 Chapter 3: The Impact of Wyoming Postsecondary Graduates on Supply and Demand of Wyoming’s Health Care Workforce Key finding: Young workers from Wyoming tend to leave to work in other states. Figure: Number of 2006/07 Health Care & Related Professions Graduates Working in Wyoming Eight Years After Graduation Chapter 3 presents the impact of Wyoming’s postsecondary graduates on supply and demand of Wyoming’s health care workforce. The key finding from this chapter was that young workers from Wyoming tend to leave to work in other states. For example, there were 879 health care & related profession graduates from Wyoming’s postsecondary institutions in 2006/07. Of those, 61.5% worked in Wyoming the year after graduation. Eight years after graduation, only 43% of those graduates were found working in Wyoming.

Part V: Health Care Workforce Needs in Wyoming: Update 2017 Chapter 4: The Education and Career Pathways of Certified Nursing Assistants Key finding: Fewer than half of all individuals with CNA licensing in Wyoming were still working in a licensed health care occupation in the state five years later. 5,833 licensed CNAs in Wyoming in 2010. In 2015: 57.8% no longer held a certificate or license from any licensing board in WY 30.7% held a CNA certificate as their highest certificate or license 8.6% were licensed as RNs 1.3% became licensed as an LPN or vocational nurse. Chapter 4 discusses the education and career pathways of CNAs. The key finding in this chapter was that fewer than half of all individuals with CNA licenses in Wyoming were still working in a licensed health care occupation in the state five years later. There were 5,833 licensed CNAs in Wyoming in 2010. By 2015: 57.8% no longer held a certificate or license from any licensing board in WY 30.7% held a CNA certificate as their highest certificate or license 8.6% were licensed as RNs 1.3% became licensed as an LPN or vocational nurse

Chapter 5: Analysis of Licensed Health Care Occupations Part V: Health Care Workforce Needs in Wyoming: Update 2017 Chapter 5: Analysis of Licensed Health Care Occupations Key finding: RNs make up a greater proportion of the health care workforce in urban areas, while CNAs account for a greater proportion in rural areas. Figure: Nurses as a Percentage of Individuals Working in All Licensed Health Care Occupations in Health Care & Social Assistance in Wyoming, 2015Q3 Chapter 5 lookes at health care staffing patterns for rural and urban areas in Wyoming. Rural and urban are defined on page 63 of Update 2017. The key finding was that CNAs made up a greater proportion of health care in rural areas, while RNs made up a greater proportion in urban areas. As shown in this figure, CNAs made up 27.5% of all licensed health care occupations in rural areas compared to 21.7% in urban areas.

Chapter 6: State and Local Health Care Shortages Part V: Health Care Workforce Needs in Wyoming: Update 2017 Chapter 6: State and Local Health Care Shortages Identifies potential surpluses and shortages by occupation for U.S., Wyoming, substate regions, and surrounding states Rate per 10,000 people (number working divided by population) Wyoming rate compared to the national average identifies surpluses or shortages Chapter six of the health care 2017 report was designed to look at gaps in health care services. To do this, the number of health care practitioners per 10,000 people in the population were calculated for the U.S. and substate areas in Wyoming and surrounding state MSAs. What was found was that areas such as Casper and Cheyenne were overstaffed and outlying areas were understaffed. This makes sense, as people usually seek care in more populated areas like Casper and Cheyenne.

Chapter 6: State and Local Health Care Shortages Part V: Health Care Workforce Needs in Wyoming: Update 2017 Chapter 6: State and Local Health Care Shortages Figure: Rate of CNAs per 10,000 People, 2015 Number of CNAs per 10,000 people 45.8 national Much higher in most WY regions Could indicate a surplus Casper and Cheyenne are regional destinations treating other counties’ populations For example, this figure shows the number of CNAs per 10,000 people in Wyoming’s substate regions and the Denver and Salt Lake City MSAs. The national average was 45.8 The rate was much higher in most regions This could indicate a surplus of CNAs in those regions The surplus could be due in part to Casper and Cheyenne being regional destinations for health care that service populations from other counties.

Part V: Health Care Workforce Needs in Wyoming: Update 2017 Figure: Surplus or Shortage of Registered Nurses per 10,000 People Figure: Surplus or Shortage of Medical & Clinical Laboratory Technologists per 10,000 People Here are examples of two occupations from Chapter 6. Registered nurses are overstaffed in Casper and Cheyenne, but needed in the central-southeast, northwest, and southwest regions of Wyoming. Lab techs, on the other hand, are needed in Wyoming, Casper, the northeast, and southwest regions. A number of years ago, Casper College and UW built an educational program at Casper College to meet this need.

Mental Health Care in Wyoming Part VI: Mental Health Care in Wyoming

Mental Health Care Industries Average Monthly Employment Part VI: Mental Health Care in Wyoming Mental Health Care Industries Table: Average Monthly Employment and Average Annual Wage for Mental Health Care Industries in Wyoming, 2017 NAICS Code Industry Title Average Monthly Employment Average Annual Wage 621112 Offices Of Mental Health Physicians 21 $61,284 62133 Offices Of Mental Health Practitioners 257 $34,445 62142 Outpatient Mental Health Centers 637 $42,650 6222 Psychiatric & Substance Abuse Hospitals N/D (≈ 500) 6232 Residential Mental Health Facilities 602 $29,885   Total, Selected Mental Health Care Industries 2,000 $36,422 Wyoming’s mental health care is made up of a small number of industries (4-digit NAICS) and detailed industries (5- and 6-digit NAICS). Identifying Wyoming’s mental health care industry proved difficult because of the small number of employers and employees in some cases, making some data nondisclosable due to confidentiality. Although the psychiatric & substance abuse hospitals industry is nondisclosable because of the small number of employers, employment has consistently remained at about 500 with little change over the last 10 years. The combined average monthly employment for these industries in 2017 was approximately 2,000. N/D = Not disclosable due to confidentiality.

Part VI: Mental Health Care in Wyoming Figure: Average Monthly Employment in Mental Health Care Detailed Industries in Wyoming, 2007-2017 Employment in Wyoming’s mental health care industry has been relatively flat for the last 10 years.

Table: Selected Mental Health Care Occupations in Wyoming Part VI: Mental Health Care in Wyoming Mental Health Care Occupations Table: Selected Mental Health Care Occupations in Wyoming SOC Code Title Page Number 19-3031 Clinical, Counseling, & School Psychologists 33-34 19-4099 Life, Physical, & Social Science Technicians, All Other 31-32 21-1013 Marriage & Family Therapists 21-22 21-1018 Substance Abuse, Behavioral Disorder, & Mental Health Counselors 15-16, 29-30 21-1023 Mental Health & Substance Abuse Social Workers 19-20 21-1093 Social & Human Service Assistants 17-18 29-1066 Psychiatrists 27-28 The specific licensed mental health care occupations included in the dashboards prepared by R&P are listed here, along with the page numbers on which they can be found.

Mental Health Care Occupations: Estimated Employment Part VI: Mental Health Care in Wyoming Mental Health Care Occupations: Estimated Employment Figure: Estimated Employment for Selected Mental Health Care Occupations in Wyoming, 2018 This figure shows employment for the mental health care occupations in Wyoming in 2018.

Mental Health Care Occupations: Projected Openings Part VI: Mental Health Care in Wyoming Mental Health Care Occupations: Projected Openings Figure: Total Projected Annual Openings for Selected Mental Health Care Occupations in Wyoming, 2018-2020 This figure shows the total projected number of openings in these licensed mental health care occupations, which includes openings due to growth, workers changing occupations, and workers exiting the labor force. For example, 60 annual openings are projected for substance abuse, behavioral disorder, & mental health counselors, 10 of which are due to growth. Over the last 10 years, Wyoming added 250 of these counselors, or 25 per year.

Mental Health Care Occupations: Average Annual Wage Part VI: Mental Health Care in Wyoming Mental Health Care Occupations: Average Annual Wage Figure: Average Annual Wage for Selected Mental Health Care Occupations in Wyoming, 2018 This figure shows the average annual wage for these occupations in 2018. Wages were not available for marriage & family therapists or psychiatrists.

Mental Health Care Occupations: Wages for WY and Surrounding States Part VI: Mental Health Care in Wyoming Mental Health Care Occupations: Wages for WY and Surrounding States Figure: Average Annual Wage for Selected Mental Health Care Occupations in Wyoming and Surrounding States, 2018 This figure compares the average annual wage for the 5 mental health care occupations in Wyoming to six surrounding states. In most cases, Wyoming’s wages tended to be higher than most states. .