Holt made history as the first woman to hold statewide office in West Virginia, serving as Secretary of State in 1957. Though she lost her reelection bid in 1958, she continued her public service as Assistant Commissioner for Public Institutions, improving nursing homes and women's prisons. At the federal level, she contributed to President Eisenhower's Federal Housing Administration, advocating for nursing home construction and nursing administration programs for seniors and people with disabilities.