The Virginia Department of Health (VDH) is reaffirming its commitment to the Portsmouth Health District amid recent criticism regarding its operational challenges. A column published on November 18 suggested that the state’s health leaders are neglecting Portsmouth, but VDH officials argue that the issues are rooted in structural instability and workforce shortages rather than political neglect or funding cuts.
Over the past decade, the Portsmouth Health District has experienced significant leadership turnover, with eight different district directors. This instability complicates efforts to recruit qualified candidates, as the role is demanding and faces competition from the private sector. VDH is actively working to address these staffing challenges. An acting district director is currently evaluating district needs and collaborating with VDH central office teams to identify the competencies required for a new permanent director.
The staffing situation in Portsmouth is concerning. Between July 1, 2024, and November 1, 2025, the district faced vacancy rates ranging from 24% to 38%, among the highest in VDH’s local health districts. During this same timeframe, contract workers made up 45% of the total staff of 74 employees. Critical clinical, nursing, and administrative roles remain unfilled due to a statewide shortage in public health personnel.
Employee feedback indicates additional challenges, including unclear role definitions and communication barriers. To mitigate these issues, VDH has assigned a dedicated medical officer for clinical operations, another for infectious disease, and a human resources business partner to enhance the district’s clinical services.
Despite the staffing shortages, VDH maintains that key health programs, such as those addressing HIV, sexually transmitted infections (STIs), maternal and child health, and harm reduction, are operational. Any service delivery impacts are attributed to workforce vacancies rather than budgetary decisions. VDH continues to prioritize these essential services, with Portsmouth participating in the Perinatal Health Hub Pilot Program and receiving $200,000 in November 2024 to recruit community health workers focused on reducing maternal mortality. As of October, two community health workers have been hired, with additional funding secured for fiscal year 2026 to support ongoing efforts.
Claims suggesting that wealthier districts receive preferential treatment in resource allocation are incorrect. Portsmouth has underspent its state general fund allocation by an average of $204,000 annually over the past three fiscal years. This underutilization is not due to a lack of interest but reflects challenges in filling critical positions.
In terms of funding, state support for Portsmouth has increased by approximately 16% from fiscal year 2020 to the planned fiscal year 2027. Concurrently, the required local contribution has been reduced by a corresponding amount. VDH remains dedicated to promoting health equity and providing meaningful support to high-need communities like Portsmouth.
Dr. Susan Fischer Davis, who has served as chief deputy commissioner for Community Health Services at VDH since January 2024, emphasizes that the agency is focused on stabilizing leadership and rebuilding capacity. The goal is to recruit a permanent district director, sufficient nursing staff, and other essential clinical personnel. Current rebuilding efforts are designed to foster trust, streamline internal processes, and enhance collaboration.
The narrative suggesting neglect towards Portsmouth is characterized as inaccurate, undermining public trust and obscuring the genuine barriers facing effective public health initiatives in the area. VDH and district leadership are fully engaged in efforts to ensure that Portsmouth has the necessary stability, talent, and infrastructure to fulfill its public health responsibilities.
