The partitions of Devdutta Sangvai’s workplace have been largely naked on his third day as North Carolina’s high well being official.
A doctor, professor and former president of Duke Regional Hospital, Sangvai had been far too busy settling into his new position as secretary of the state Division of Well being and Human Providers to embellish.
“It appears like Month Three based mostly on how busy it’s been, nevertheless it’s been outstanding,” he mentioned in an unique interview with NC Well being Information. “I entered into this house as a result of I had such a robust affinity for what the division does […]. After which if you’re really right here and also you get to see the folks doing the work — it truly is a particular place.”
Sangvai was tapped in December by newly elected Gov. Josh Stein to steer the division. As soon as he’s confirmed, he would be the first Indian-American cupboard secretary in North Carolina historical past. He’ll oversee a posh, multi-faceted company with greater than 18,000 staff and an annual price range of about $38 billion.
His appointment follows the departure of Kody Kinsley, whose three-year run as secretary coincided with the state’s growth of Medicaid in 2023. That decade-in-the-making measure has allowed greater than 600,000 low-income adults to affix the government-funded medical insurance program, swelling the state’s complete enrollment to greater than 3 million.
Kinsley succeeded Mandy Cohen, who was secretary from 2017 to 2021. She spearheaded North Carolina’s Medicaid transition from a standard fee-for-service system to at least one run by giant managed care insurance coverage corporations. Cohen additionally led the state’s response to the COVID-19 pandemic earlier than being chosen by President Joe Biden to function director of the federal Facilities for Illness Management and Prevention.
“My two predecessors on this position did such a unbelievable job — not simply in really doing the work, however with the ability to talk the imaginative and prescient of the division,” mentioned Sangvai, including that he has been repeatedly reminded he has “huge sneakers to fill.”
Sangvai believes he’s as much as the duty. He hopes to construct on his forerunners’ successes by enhancing entry to companies for Medicaid beneficiaries and rising “effectivity across the work we do.”
“Before everything, we’re going to proceed the work that’s already been laid ahead however ask ourselves alongside the way in which: ‘Are there issues we will do otherwise? Are there issues we’d be capable to do extra creatively?’” he mentioned. “This concept round ‘how will we get extra environment friendly’ might require us to consider creativity. Are there any know-how instruments that we’d be capable to use to assist us obtain these outcomes?”
One other precedence, he mentioned, is addressing the continuing scarcity of well being care professionals throughout the state. Demand for registered nurses, specifically, is anticipated to exceed North Carolina’s provide by almost 12,500 positions by 2033, in keeping with projections from UNC Chapel Hill’s Cecil G. Sheps Heart for Well being Providers Analysis.
“We all know that we now have a chance to essentially prepare up a workforce that North Carolina wants sooner or later,” Sangvai mentioned. “Not solely within the division, however actually all through well being care.”
‘Good man’
A graduate of what was then the Medical Faculty of Ohio, Sangvai has been licensed to apply medication in North Carolina since 2001 — the identical yr he joined the Duke College Well being System as a household doctor.
He led a number of divisions and departments throughout his two-decade rise by the Duke system’s ranks, and in 2023 he turned president of Duke Regional Hospital in Durham.
His profession at Duke, which additionally included stints on the helm of a hospice program, a nursing faculty and an workplace that seeks to enhance affected person outcomes by population-focused well being initiatives, gave him a “sense of the enormity of a posh group,” he mentioned.
“I felt that a lot of that translated to the kind of complexity that we see right here at HHS,” Sangvai mentioned. “However extra importantly, each a kind of [positions] had a touchpoint with the type of work we do right here.”
Mary Martin, chief working officer for Duke College Hospital, labored intently with Sangvai when he was answerable for Duke Regional. She described him as a collaborative, inclusive chief who “understands the challenges dealing with the residents of North Carolina from a well being care perspective in a approach that most individuals don’t.”
“Selfishly, I’m excited that he understands the hospital aspect of the enterprise, as a result of the necessities to proceed to be sure that we maintain our people nicely, which is the fitting factor to do, usually include an unfunded mandate,” Martin mentioned. “Him understanding the stability of constructing positive we have to maintain our sufferers nicely whereas additionally with the ability to present the workers to be sure that occurs, I believe, goes to be so invaluable.”
She added that Sangvai is a “very personable” collaborator who believes in optimistic reinforcement.
“He was all the time a colleague that after I did one thing nicely, he’d be the primary one to achieve out and say, ‘Nice job. Congrats,’” she mentioned. “I’d simply classify him within the ‘Good Man’ class. He’s one of many good folks, and I believe that the state of North Carolina and Governor Stein are very fortunate to have him on board.”
His appointment was additionally praised by Chip Baggett, CEO of the North Carolina Medical Society. Sangvai was president of the group in 2013 and has served on its board of administrators.
“Having labored with Dr. Sangvai for a few years, I’m thrilled at his choice to steer the Division of Well being and Human Providers,” Baggett mentioned in a press release on the society’s web site. “He brings a wealth of information and management expertise to this position. I’m assured he’ll uphold North Carolina’s robust custom of offering glorious well being companies to residents, with a give attention to susceptible populations equivalent to kids, the aged, people with disabilities, and low-income households.”
Bracing for change
Sangvai is taking the reins at a time of uncertainty for DHHS’ largest program: Medicaid.
The incoming Republican majorities in Washington, D.C., have signaled curiosity in slicing Medicaid funding throughout President Donald Trump’s second time period. This system facilitates look after low-income kids and lots of of their dad and mom, low-income seniors and folks with disabilities.
There have additionally been calls to implement stricter eligibility necessities to qualify for care. Undertaking 2025, the controversial coverage blueprint whose Heritage Basis suppose tank authors have been elevated to key roles in Trump’s administration, features a proposal that might drive unemployed Medicaid members to seek out work to be able to maintain their advantages.
The division, Sangvai mentioned, is bracing itself for potential adjustments.
“I believe our duty now will probably be simply to give attention to what the federal authorities might or might not suggest, after which attempt to perceive what the affect could be right here,” he mentioned. “However clearly it’s one thing that we might have to even give attention to as early as [Trump’s first day in office].”
Further uncertainty surrounds North Carolina’s first-in-the-nation Wholesome Alternatives Pilots, which use Medicaid {dollars} to deal with nonmedical well being wants like meals, transportation and housing in three rural areas of the state.
The federal Facilities for Medicare and Medicaid Providers lately accredited a request that provides DHHS the choice to take HOP statewide, however its growth should first be accredited — and supported financially — by lawmakers within the Normal Meeting.
“We now have to consider how we train the choices that CMS has given us, so it’ll positively require partnership with the Normal Meeting to grasp the place these priorities are,” Sangvai mentioned. “We’re not going to have the ability to do every little thing all of sudden, and we’re not going to have the ability to do it at 100% all of sudden.”
Studying the ropes
Sangvai, who’s serving as interim secretary till his appointment is confirmed by the state Senate, mentioned his predecessors have given him a couple of pointers for navigating North Carolina’s political panorama.
“Dr. Cohen shared with me some issues to do and a few issues to be cautious about,” he mentioned. “And equally, with Secretary Kinsley, I really had a chance to hold round right here somewhat bit [with him] earlier than I really took workplace.”
He mentioned the previous secretaries instructed him to do “quite a lot of listening” and “be ready for lengthy hours,” amongst different recommendation.
Nonetheless, Sangvai acknowledged one of many largest challenges he’ll face within the months forward is taking his “expertise on the particular person degree and speaking it up on the coverage degree.”
“I believe I’ve a extremely good expertise because it pertains to lots of the issues the division does and the way it impacts people,” he mentioned. “However then taking that and with the ability to talk it at a coverage degree or talk that at a division initiative degree — that’s one of many issues that I’m going to give attention to.”
On the similar time, Sangvai mentioned he feels nicely positioned to succeed because of the executive groundwork laid by Cohen and Kinsley.
“I believe that I’m most likely one of many luckiest secretaries to be on this position as a result of a lot of that basis has already been constructed,” he mentioned. “That imaginative and prescient that’s already there may be a lot of what resonates with me.”
This text first appeared on North Carolina Well being Information and is republished right here underneath a Artistic Commons license.
