The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
A bipartisan group of state health policymakers from both the executive and legislative branches who are focused on improving population health.
Supporting networks of state officials, advocates, and others aiming to invest in and transform primary care.
Advancing state-based efforts to make health care more affordable for residents, employers, and states.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
A leadership development program for early and mid-career state government officials who are committed to improving the health of all people in their communities.
A leadership program for senior state government officials who are committed to improving population health.
The Fund focuses on creating an affordable health care system built on strong primary care and partnerships that improve health outcomes for all.
Improving state leaders ability to enact and implement evidence-based health policies.
Advancing policies that create a more prevention- and primary care-oriented health system.
Improving population health through policies that contain health care cost growth.
Our state health policy resources provide relevant data analysis and best practices.
The Fund publishes reports, issues briefs, and case studies on state health policy issues.
Short takes on health policy issues from Milbank staff and guest authors.
Insights from Milbank President Debra Lubar on state health policymaking.
Reported articles and Q&As on timely health policy issues, as well as foundation updates.
Upcoming and past Milbank Memorial Fund and Milbank Quarterly webinars featuring state health policymakers and researchers.
Updates and expert contact information for reporters.
The Milbank Memorial Fund is a private foundation that works to improve population health and health equity.
September 15, 2020
Blog Post
Lauren Moran
Erica Brown
Hilary Kennedy
Sep 16, 2026
Aug 28, 2026
Aug 18, 2026
Back to The States of Health
Today’s public sector leaders are navigating an unprecedented public health emergency, a deepening economic recession, and, at the same time, a historic opportunity to address racial disparities in the United States. As the backbone of state government, public sector leaders—including Medicaid, public health, social services, legislative staff, among others—are charged with maintaining the economic stability, health, and well-being of state residents and must be ready to face the inevitability of unforeseen challenges. They are responsible for administering billions of state and federal dollars, setting and managing strategic direction, and navigating the complex web of state government and community relationships. Yet, despite the significant role that they play and challenges they face, scant attention is typically given to the professional leadership development of the nation’s public sector workforce.
Recognizing the need to better support public sector leaders in their challenging roles, the Center for Health Care Strategies, the Milbank Memorial Fund, and the National Association of Medicaid Directors launched the Public Sector Leadership Consortium in late 2019. Through this effort, we are seeking to align our collective work focused on strengthening the capacity of public sector leaders, particularly those in state government. Drawing from our combined experience working with state leaders across the country, we created the Framework for Public Sector Leadership to provide a foundational tool to bolster state leadership capacity.
The competency framework aims to strengthen the leadership capacity of public leaders and their teams to work effectively. Drawn from both academic research and insights from leaders across the field, the framework can serve as a guide for both established public sector leaders and their teams, as well as for rising leaders. The framework is built on a core belief that leadership does not necessarily refer to an individual’s formal position, as one can rise to the occasion as a leader regardless of stature within an organization. The framework includes five domains that are critical to the success of public sector leaders:
When crisis hits, it can be challenging to find time to focus on professional leadership and capacity building. But this is perhaps the most important time to strengthen leadership skills. Now, more than ever, solid leadership skills are invaluable to public sector leaders as they navigate the impacts of COVID-19 and seek opportunities to address disparities and promote equity within public policies and programs. When reflecting on public sector leadership, Michelle Alletto, Texas Health and Human Services Chief Program and Services Officer, said, “An aspect of the leadership framework that really resonated with me is resiliency. This has been particularly important during the COVID-19 pandemic, not just for myself but for my team and for the community we serve.” We hope the framework will foster new and creative strategies for supporting those who commit themselves to the essential work of public service.
Conversations on Building Leadership: Look for a new series of blog posts and podcast episodes from the Consortium that will explore the application of the leadership framework through the perspectives of state leaders offering a wide range of experiences in public sector leadership. The first podcast—What Makes a Successful Public Sector Leader?—features Michelle Alletto, Texas Health and Human Services Chief Program and Services Officer and Beth Kidder, Deputy Secretary for Medicaid at Florida’s Agency for Health Care Administration discussing how they’ve used the domains, competencies, and associated skills and behavior during their leadership tenures.