Healthcare Delivery Topics Explored at the 2023 Governors’ Health and Human Services Advisors Institute

In October 2023, the National Governors Association Center for Best Practices (NGA Center) hosted the Governors’ Health and Human Services Policy Advisors Institute in Milwaukee, Wisconsin. The institute serves as a forum for Governors’ health and human services advisors to engage in peer-to-peer learning and hear from subject matter experts. The healthcare delivery team at the NGA Center focused this year’s content on the healthcare and human services workforce, aging and health equity. These topics are top of mind for Governors’ health and human services advisors and proved relevant for discussions led at the institute. In addition to the formal sessions, the healthcare delivery team hosted a roundtable to discuss comprehensive topics related to healthcare delivery and to hear directly from states and territories on priorities for the year ahead.

Supporting the Frontline: Strengthening the Health and Human Services Workforce

Dr. Shelby Hockenberry, Program Director for healthcare delivery at the NGA Center, moderated a plenary session focused on the health and human services workforce. Dr. Hockenberry began the session by setting the stage and highlighting the NGA Center’s Next Generation of the Healthcare Workforce Knowledge Exchange Network. The network, comprised of 22 states and territories, serves as a hub for state and territory health and workforce leaders to drive innovation and spur action to support the recruitment and retention of the next generation of the healthcare workforce. A report on outcomes from the first year of the project within the context of broader healthcare workforce efforts underway, titled Preparing the Next Generation of the Healthcare Workforce: State Strategies for Recruitment and Retention, can be found on the NGA website.

After providing an overview of the network’s activity over the past year and a half, Dr. Hockenberry introduced Dr. Sharyl Trail, Regional Administrator for the Health Resources and Services Administration (HRSA) Region 5. Dr. Trail opened her remarks by providing an overview of her lived experience as a healthcare provider and her journey through the Public Health Service Corps. Dr. Trail then highlighted HRSA opportunities for states and territories to take advantage of to support and grow the healthcare workforce, especially as HRSA is the funder for the NGA healthcare workforce project. Following Dr. Trail’s presentation, Dr. Cynthia Persily, Secretary for the West Virginia Department of Human Services, highlighted West Virginia’s investments in both the health and human services workforces. Dr. Persily presented West Virginia’s model of recruiting, growing, retaining and evaluating the healthcare workforce for a number of professions. Additionally, Dr. Persily discussed the state’s success in reducing the child welfare vacancy rate in the state from 38% in January 2023, to 17% in August 2023. Dr. Persily also highlighted West Virginia’s “Appalachian Care Chronicles” podcast, which highlights providers’ lived experience in professions like nursing, social work, emergency medicine technicians and public health, and provided insights on the success of the state’s nursing recruitment program.

Supporting Age-Friendly Healthcare

Moderated by Anna Heard, Senior Policy Analyst for Healthcare Delivery at the NGA Center, the Supporting Age-Friendly Healthcare breakout session focused on aging and the provision of care. Scott Bane, Program Officer at the John A. Hartford Foundation, set the scene for the discussion by providing some background on both the national landscape of aging issues and the John A. Hartford Foundation’s current priorities. Bane highlighted the need for executive leadership on aging and the importance of blending both public and private dollars to support the aging community. Rachel Currans-Henry, Health and Human Services Advisor to Oregon Governor Tina Kotek, then led the discussion from a state perspective, highlighting Oregon’s multi-sector plan on aging. In addition to highlighting Oregon’s work to support aging from multiple lenses, Currans-Henry highlighted the intersection of aging and long-term care workforce shortages. More information on NGA’s work on the direct care workforce that supports the care of older adults is available in the recent reports  State Strategies for Sector Growth and Retention of the Direct Care Health Workforce and Addressing Wages of the Direct Care Workforce Through Medicaid Policies.

State Strategies for Navigating Health Equity

NGA’s Anna Heard also moderated a session on Navigating Health Equity, featuring Colorado, Vermont and Heartland Forward’s approaches to navigating health equity. Edwin Chen, Health Policy Coordinator for Colorado’s Office of Saving People Money on Healthcare within the Office of NGA Vice Chair Colorado Governor Jared Polis and Colorado Lieutenant Governor Dianne Primavera, kicked the session off with a look into the state’s approach to integrating equity in the budget making process. Chen highlighted the administration’s specific focus areas on aging and disability equity in addition to providing a look into how department budget requests are required to evaluate for positive, neutral or negative equity impact. Monica Hutt, Chief Prevention Officer for Vermont Governor Phil Scott, then presented on Vermont’s Impact Assessment Tool. Hutt highlighted how the tool has been implemented in Vermont to support equity evaluation for proposed budget and policy proposals. The tool provides a questionnaire for agency staff to complete to ensure decisions take into account equity and community impact. Finally, Dr. Maria Rodriguez-Alcala, Program Director for Health and Wellness at Heartland Forward, highlighted the organization’s work to improve health equity in rural communities. Dr. Rodriguez-Alcala presented on a 2022 report that outlines health care access and recommendations to improve in rural America, as well as ways that Heartland Forward is currently putting this report into action. To learn more about NGA’s work on intersectional health equity, NGA recently released the commentary Health Equity Roundtable regarding a meeting held in Colorado in  August 2023.

Roundtable Discussion on Comprehensive Healthcare Delivery and Transformation

The healthcare delivery team wrapped up the 2023 institute sessions with three concurrent roundtables focused on different areas of the healthcare delivery portfolio. The first roundtable, led by Elijah McCabe, Policy Analyst for healthcare delivery at NGA,  focused on trauma-informed care and wellness. The second, led by Dr. Shelby Hockenberry, focused on the healthcare workforce. The third roundtable was led by Anna Heard and focused on healthcare cost and coverage. These three roundtables informed ways that the NGA healthcare delivery team can best center their technical assistance and highlight state and territory priorities in the year ahead.

Looking Ahead to 2024

The 2023 Governors’ Health and Human Services Advisors Institute provided a helpful forum for Governors’ health and human services policy advisors to share best practices and learn from one another. The healthcare delivery team remains focused on the topics above, including aging, healthcare workforce, health equity, trauma-informed care, and cost and coverage. For more information about the institute, click here. For technical assistance or more information on any of the aforementioned topics, sessions or resources, please contact Anna Heard at

This article was developed by Eli McCabe.