I read with concern the Nov. 18 column, “How Virginia’s health leaders are abandoning Portsmouth,” which is misleading and fails to acknowledge the work of the dedicated Portsmouth Health District staff. The core issues affecting the Portsmouth Health District do not stem from political neglect or deliberate program defunding. They arise from structural instability, workforce shortages and recurrent leadership turnover.
During the past decade, the Portsmouth Health District has had eight different district directors. That high rate of turnover reflects the difficulty of recruiting qualified candidates due to many factors, including the breadth of responsibility, complexity of the role and competition from the private sector. The Virginia Department of Health (VDH) is providing robust support as the district prepares to recruit a new director. An acting district director is assessing district needs and working with district leadership and VDH central office teams to identify the qualities and skills of a new director who will set up the district for long-term stable leadership.
Despite focused recruitment efforts, between July 1, 2024, and Nov. 1, 2025, the Portsmouth Health District faced staff vacancy rates from 24-38%, among the highest of VDH’s local health districts. During the same period, contract workers comprised 45% of the district’s total staff of 74. Portsmouth continues to face significant vacancies in critical clinical, nursing and administrative roles. These gaps are the result of statewide shortages in public health staffing. Employee feedback highlights additional issues: ambiguity in role definitions, communication barriers and unmet leadership expectations. To help address these issues, a dedicated medical officer for clinical operations, another for infectious disease specialization, and a human resources business partner are currently assigned to strengthen all aspects of district clinical services.
VDH’s central office remains deeply engaged, providing multi-year interim leadership, recruitment support and technical expertise across programs. Services such as HIV, STI, maternal-child health and harm reduction have not been scaled back. These programs remain operational. Any impact on service delivery is attributable to workforce vacancies, not political or funding decisions.
VDH continues to prioritize these services. Portsmouth is an active partner in the Perinatal Health Hub Pilot Program. In addition, in November 2024 the district was awarded $200,000 to recruit community health workers to address maternal mortality. As of October, two community health workers have been hired. Additional funding for FY 2026 ensures continuity of this effort.
Claims of disproportionate resource allocation — implying that wealthier districts receive preferential treatment — are wrong. Over the past three fiscal years, Portsmouth has underspent its state general fund allocation by an average of $204,000 annually. This is not due to lack of interest or intent but reflects the difficulty of expending funds when critical positions remain unfilled.
In parallel, state funding has increased by approximately 16% (from FY 2020 to the planned FY 2027) while Portsmouth’s required local percentage has been decreased by a commensurate amount.
VDH remains committed to health equity, evidence-based public health and meaningful support for high-need communities such as Portsmouth. Our goal is to stabilize leadership, rebuild capacity and strengthen continuity.
We will recruit a permanent district director, qualified nurses and other essential clinical staff. Rebuilding efforts currently underway will guide interventions to rebuild trust, refine internal processes and improve collaboration. The narrative of abandonment is inaccurate, erodes trust and obscures the real barriers to effective public health in Portsmouth.
VDH and district leadership are fully engaged to ensure that Portsmouth has the stability, talent and infrastructure required to deliver on the promise of public health for all residents.
Dr. Susan Fischer Davis of Richmond has served as chief deputy commissioner for Community Health Services at the Virginia Department of Health since January 2024. She has worked in public health at the local, state and federal level.
https://www.pilotonline.com/2025/12/25/column-vdh-remains-committed-to-serving-portsmouth/
