Concerns have emerged regarding the state of the Portsmouth Health District, following a column published on November 18 that criticized Virginia’s health leaders for allegedly abandoning the area. The response from the Virginia Department of Health (VDH) highlights ongoing challenges but emphasizes a commitment to improving the district’s operations and support.
The issues facing the Portsmouth Health District are not merely due to political neglect or funding cuts. Instead, they stem from a combination of structural instability, workforce shortages, and high leadership turnover. Over the past decade, the district has experienced the departure of eight different district directors. This high turnover rate is largely attributed to the challenges of attracting qualified candidates, given the complexity of the role and competition from the private sector.
To address these leadership challenges, the VDH is actively supporting the recruitment of a new district director. An acting director is currently assessing the district’s needs and collaborating with both local leadership and the VDH central office to define the qualifications required for a permanent director. The goal is to provide stable leadership that can guide the district in the long term.
Staffing remains a significant issue, with vacancy rates in the Portsmouth Health District ranging from 24% to 38% between July 1, 2024, and November 1, 2025. This marks one of the highest vacancy rates among the VDH’s local health districts, with contract workers comprising 45% of the district’s total staff of 74. The district currently faces substantial shortages in critical clinical and administrative roles, exacerbated by statewide public health staffing shortages.
The VDH is taking steps to mitigate these challenges. A dedicated medical officer for clinical operations, along with another specializing in infectious diseases, has been assigned to bolster clinical services. A human resources business partner is also assisting in improving internal processes and addressing employee feedback related to role ambiguity and communication barriers.
Despite the staffing challenges, essential services such as HIV, STI, maternal-child health, and harm reduction programs continue to operate. The impact on service delivery is largely tied to workforce vacancies rather than funding decisions. The VDH remains committed to these programs, with Portsmouth participating in the Perinatal Health Hub Pilot Program. In November 2024, the district received $200,000 to recruit community health workers aimed at addressing maternal mortality issues, with two already hired as of October 2024.
Claims suggesting that wealthier districts receive disproportionate resources have been countered by the assertion that Portsmouth has underspent its state general fund allocation by an average of $204,000 annually over the past three fiscal years. This underspending is primarily due to the difficulty in utilizing funds effectively when critical positions are unfilled. Simultaneously, state funding has increased by approximately 16% from FY 2020 to the planned FY 2027, while the required local funding percentage for Portsmouth has decreased accordingly.
Dr. Susan Fischer Davis, who has been serving as the chief deputy commissioner for Community Health Services at the VDH since January 2024, emphasized that these efforts reflect a strong commitment to health equity and support for communities in need. The VDH aims to stabilize leadership, rebuild capacity, and enhance collaboration within the Portsmouth Health District.
The narrative of abandonment, as described in the recent column, is considered misleading by the VDH. It undermines the trust necessary for effective public health initiatives and obscures the real barriers faced by the Portsmouth Health District. The VDH and district leadership are dedicated to ensuring that Portsmouth has the necessary stability, talent, and infrastructure to fulfill its public health obligations to all residents.
