Concerns regarding the state of healthcare services in Portsmouth have been raised following the publication of a column on November 18, 2023, titled “How Virginia’s health leaders are abandoning Portsmouth.” The Virginia Department of Health (VDH) has responded, emphasizing that the challenges faced by the Portsmouth Health District are rooted in structural instability and workforce shortages rather than political neglect or funding cuts.
The Portsmouth Health District has experienced significant leadership turnover over the past decade, with eight different district directors. This high turnover rate is attributed to the difficulties in attracting qualified candidates to fill these roles. Factors contributing to this challenge include the extensive responsibilities associated with the position and competition from the private sector. VDH has been proactive in addressing these issues by providing support as the district works to recruit a new permanent director.
A current acting district director is actively assessing the needs of the Portsmouth Health District. This individual is collaborating with district leadership and VDH’s central office to identify the essential skills and qualities for a new director who can provide stable leadership in the long term. Despite concerted recruitment efforts, the district has faced vacancy rates between 24% and 38% for various roles from July 1, 2024, to November 1, 2025, among the highest in the state. During the same timeframe, contract workers represented 45% of the district’s total staff of 74.
These staffing gaps have resulted in significant vacancies in critical clinical, nursing, and administrative positions, largely due to statewide shortages in public health staffing. Feedback from employees indicates additional challenges, including unclear role definitions, communication barriers, and unmet leadership expectations. To address these concerns, VDH has assigned a dedicated medical officer for clinical operations and another for infectious disease specialization, along with a human resources business partner, to enhance the district’s clinical services.
Importantly, VDH has assured the community that essential services, including programs for HIV, sexually transmitted infections (STI), maternal-child health, and harm reduction, have not been diminished. Any impacts on service delivery are attributed to workforce shortages rather than political actions or funding decisions. VDH continues to prioritize these services and remains actively involved in the Perinatal Health Hub Pilot Program. In November 2024, the district received a grant of $200,000 to recruit community health workers aimed at addressing maternal mortality, with two workers already hired as of October.
Claims regarding disproportionate resource allocation have been found to be unfounded. Over the past three fiscal years, Portsmouth has underspent its state general fund allocation by an average of $204,000 annually. This underspending is not indicative of a lack of interest but rather reflects the challenges faced in utilizing funds effectively when key positions remain unfilled. Concurrently, state funding has increased by approximately 16% from fiscal year 2020 to the anticipated fiscal year 2027, while Portsmouth’s required local funding percentage has been correspondingly reduced.
VDH remains committed to promoting health equity and supporting high-need communities like Portsmouth. The department’s goals include stabilizing leadership, rebuilding capacity, and strengthening continuity within the district. Recruitment efforts will focus on securing a permanent district director, qualified nurses, and other essential clinical staff. Ongoing rebuilding efforts aim to foster trust, refine internal processes, and improve collaboration within the health district.
The narrative of abandonment surrounding Portsmouth is deemed inaccurate by VDH, which insists that such perspectives erode trust and obscure the real barriers to effective public health in the area. Dr. Susan Fischer Davis, who has been serving as the chief deputy commissioner for Community Health Services at VDH since January 2024, emphasizes the department’s dedication to ensuring Portsmouth has the necessary stability, talent, and infrastructure to fulfill its public health obligations.
