Concerns regarding the operational effectiveness of the Portsmouth Health District have been addressed by the Virginia Department of Health (VDH) in response to a recent column titled “How Virginia’s health leaders are abandoning Portsmouth.” The VDH emphasized that the challenges facing the district are rooted in structural instability, workforce shortages, and frequent leadership changes, rather than neglect or funding cuts.
The Portsmouth Health District has experienced significant leadership turnover, with eight different district directors in the past decade. This turnover reflects the difficulties in attracting qualified candidates, a challenge exacerbated by the complexity and breadth of responsibilities involved in the role. The VDH has stepped up efforts to support the district as it seeks to recruit a new director. An acting district director is currently evaluating the district’s needs and collaborating with district leadership to identify the necessary skills for a suitable permanent replacement.
Staff vacancy rates within the Portsmouth Health District have been notably high, ranging from 24% to 38% between July 1, 2024, and November 1, 2025, marking some of the highest rates among local health districts in Virginia. During this period, contract workers constituted 45% of the district’s total staff of 74. The district continues to face critical vacancies in clinical, nursing, and administrative roles due to statewide public health staffing shortages.
Employee feedback has highlighted issues including unclear role definitions, communication barriers, and unmet leadership expectations. To address these concerns, the VDH has assigned dedicated personnel, including a medical officer for clinical operations and a human resources business partner, to strengthen clinical services within the district.
Despite these challenges, essential programs such as HIV and sexually transmitted infection (STI) prevention, maternal-child health, and harm reduction services have remained operational. “Any impact on service delivery is attributable to workforce vacancies, not political or funding decisions,” a VDH spokesperson stated. The department continues to prioritize these vital health services.
The Portsmouth Health District is actively involved in the Perinatal Health Hub Pilot Program. Additionally, in November 2024, the district received a grant of $200,000 to recruit community health workers to tackle maternal mortality. As of October, two community health workers have already been hired, with further funding for fiscal year 2026 secured to ensure the continuation of these efforts.
Claims regarding disproportionate resource allocation have been countered by VDH data showing 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 attributed to challenges in utilizing funds effectively, particularly when key positions remain unfilled. Concurrently, state funding for the district has increased by approximately 16% from fiscal year 2020 to the planned fiscal year 2027, as the required local funding percentage has been reduced accordingly.
The VDH remains devoted to promoting health equity and providing meaningful support to communities with high needs, such as Portsmouth. The agency’s goals include stabilizing leadership, rebuilding staff capacity, and ensuring continuity of services. Efforts are underway to recruit a permanent district director, along with qualified nurses and other essential clinical staff.
Dr. Susan Fischer Davis, the chief deputy commissioner for Community Health Services at the Virginia Department of Health since January 2024, has extensive experience in public health at all levels of government. She emphasized that the narrative of abandonment is misleading and detrimental to trust, obscuring the real barriers to effective public health in Portsmouth.
The VDH and district leadership are committed to ensuring that Portsmouth has the stability, talent, and infrastructure necessary to fulfill its public health mission for all residents.
