State Health Workforce Toolkit

Why this toolkit was created

The health workforce includes the vast array of professions and occupations that contribute to supporting and maintaining the health of the population. This workforce includes entry-level occupations such as Direct Care Workers, as well as highly trained specialist physicians.  States are involved in many activities that directly influence this workforce, from ensuring pipeline sufficiency and establishing public insurance reimbursement policy to regulating individual professionals and/or the settings they work in. The wide range of jobs and complexities associated with financing and regulation of the healthcare sector can make workforce policy and programming challenging.

Although health workforce shortages are not new, the COVID-19 pandemic has worsened existing shortages and created new ones. Preceding the pandemic shortages were documented in many rural and urban underserved communities across the country. As a result of the pandemic, new shortages have emerged. Workforce burnout and increased competition from other sectors are contributing to a “great resignation” from health industry jobs. Shortages are expected to worsen in the coming years.

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Health equity has also been in the forefront of policy discussions at the state level. Diversity and representation challenges in the healthcare workforce have been well-documented for decades. Higher skilled professions, such as medicine, dentistry and nursing, have historically had underrepresentation of minorities, while lower skilled occupations, such as certified nurse assistants and direct support professionals, people from racial and ethnic minority groups are overrepresented in lower skilled, low-wage jobs. These imbalances contribute to healthcare access and equity challenges within minority communities, and perpetuate social disparities. Ensuring health workforce policies support health equity will be critical to advancing population health.

States agencies and Governors are tasked with the challenge of ensuring a sufficiently skilled and robust healthcare workforce to meet the needs of the population. This web-based toolkit has been developed to provide actionable resources to states working to address healthcare workforce issues, such as creating a landscape for direct care workforce stakeholders, aligning pipeline initiatives with population health needs, and reviewing regulatory policies that impact entry requirements. This toolkit was developed to support Governors, Governors’ Policy Advisors, and state agencies involved in health workforce activities (such as licensing, public health, education, Medicaid, and workforce development). States are encouraged to explore and leverage the resources available.

Additional resources are available here for States and Territories.


The NGA Center for Best Practices developed this toolkit in partnership with Veritas Health Solutions and with generous funding from the Health Resources and Services Administration (HRSA).