Category Archives: Government Oversight

Personnel Shortages that Plague Virginia’s Health Facilities Inspection Staff in the Hands of Budget Negotiators

UVa Hospital

by James C. Sherlock

One of the most important responsibilities of Virginia state government is to inspect medical facilities and home care providers to ensure we are safe when we enter their care.

It continues to fail in that responsibility thanks to years of Virginia budgets that have consciously ignored the need for increased inspector staff and increased salaries with which to competitively hire that staff.

I have reported for a long time that the staffing of the Virginia Department of Health (VDH) Office of Licensing and Certification (OLC) is scandalously deficient. Based upon an update today from OLC, it remains so.

That organization has only half of the inspectors it needs to carry out its defined responsibilities.

Those highly skilled and very dedicated people, largely registered nurses, are asked to do every day for Virginians what we cannot do for ourselves and what our elected representatives have refused for decades to properly fund them to do.

Think of that next time you use the facilities and home providers they are required for your safety to inspect.

We hope the current General Assembly budget negotiators keep it in mind for themselves and their families.

Or the Governor sends the budget back until they do. Continue reading

Improving Petersburg Public Health is a State Issue as Well as a Local and Personal Responsibility

By James C. Sherlock

The RTD today published an article “Petersburg is Virginia’s least healthy locality, and money is a big reason why” about one of my favorite subjects – the stubborn health problems in Petersburg and other poor urban areas of Virginia.

The story references the latest annual study from the University of Wisconsin Population Health Institute that ranks localities in Virginia from 1 to 133 in both health outcomes and health factors.

Residents of Petersburg, where the median household income is among the lowest in the state, face a life expectancy of only 66.2 years, the lowest in the state and 10 years worse than the national average, according to a study from the University of Wisconsin Population Health Institute that was circulated by the Virginia Department of Health.

It has ranked as the state’s least healthy locality in eight of the past 10 years.

The RTD headline attibutes those results to lack of money.   But the headline is nonsense.

We can and should do far better with the government assets and funded programs already in place to help Petersburg.

Continue reading

George Orwell Call Home

Nina Jankowitz

by James C. Sherlock

This blog, while proudly based in individual research, often offers controversial ideas.

Uniform agreement is not expected. Debate is encouraged. We learn from one another and even occasionally change a few minds on both sides.

Yesterday the Biden administration announced the establishment of a federal “Disinformation Governance Board” in the Department of Homeland Security to “combat online disinformation in the 2022 midterms.”

Seriously. It was disclosed yesterday afternoon by Secretary Mayorkas in his testimony on Capitol Hill.

You will not be shocked to learn that neither The Washington Post nor The New York Times has yet covered the story. I just checked. Yet it represents a bigger threat to our nation than Russia and China. And it lives within the Department of Homeland Security. Continue reading

Unionize Virginia’s Worst Nursing Home Chains

by James C. Sherlock

If you go back to the series of articles I published here in October of 2021, you can refresh your memory on the dangers represented by Virginia’s worst nursing home chains.

If you look at the complete spreadsheet of every Virginia nursing home from that data sorted by ownership, the bad actors jump off the page. Their business models treat understaffing as a feature, not a problem. The fact that it endangers their employees and kills their patients seems not to matter.

The Commonwealth’s executive and legislative branches have for a very long time absolutely ignored their responsibilities as the state legislature and as the state executive regulator, federal and state inspector and state licensor of nursing homes, respectively. There is as yet no sign that will improve. I have hopes the new administration will step up to those responsibilities, but we’ll have to wait and see.

For now, the only fix that appears viable is unionization of the work forces of the bad actors. I encourage their employees to do it for themselves and their patients. Continue reading

Fix the Virginia Department of Health

Credit: PBS Healthcare Management

by James C. Sherlock

Governor Youngkin and his new administration have an opportunity to fix crucial problems in the Department of Health that have been festering for decades.

The issues:

  • How can Virginia regulate effectively its state-created healthcare monopolies?
  • In a directly related matter, how can we fix the failures, famously demonstrated during COVID, of the Virginia Department of Health (VDH) in its other missions ?

The power of Virginia’s Certificate of Public Need (COPN) to control the business of healthcare in Virginia was the original sin.  Giving that power to the Department of Health made it worse.

From that point VDH was the agent of its own corruption. Never charged by the General Assembly to create regional monopolies in its administration of Virginia’s Certificate of Public Need (COPN) law, VDH did so anyway.

Actions have consequences.

Now those regional healthcare monopolies are each the largest private business in their regions, have achieved political dominance in Richmond, and effectively control VDH. Continue reading

Lies, Damn Lies and Statistics in the Virginia Department of Education – Average Teacher Salaries Edition

by James C. Sherlock

I was in the early stages of researching a column on school salaries in Virginia when I came upon yet another bad report.

In 2021 Special Session I, the General Assembly directed the Superintendent of Public Instruction to provide a report on the status of staff salaries, by local school division, to the Governor and the Chairmen of the Senate Finance and Appropriations and House Appropriations Committees.

The appropriations committees wanted to know how much teachers and others were getting paid so they could raise the state contribution. It would seem to be a report that VDOE would like to get correct.

As with many other reports I have documented, the January salary report on its face cannot possibly be correct. VDOE and thus the Governor and General Assembly have no idea how much teachers and other instructional staff are paid in Virginia.

This report was a parting gift from the Northam administration.

The question itself — average salaries — may prove not to provide information useful for legislation and appropriations however accurately it is answered. Continue reading

Exploding Requirements and Workforce Shortages – An Existential Threat to the Public Schools

by James C. Sherlock

The hottest buzz around many of the public schools, including my home area of Virginia Beach, is around the very real hardships posed by unprecedented staff shortages.

On return from COVID, it seems that our schools faced record shortages of personnel to deal with students that were traumatized and afflicted with massive learning losses.

I said “seems” because there is no accurate count. The new online report VDOE has recently published shows billet vacancies as of October 1 2021 to be 2 1/2 times a similar count it provided me two years ago.

A compelling and disturbing trend. Yet the personnel problem is even worse than we presently have documented.

The new, comprehensive VDOE report of public school personnel shortages is false because some of the inputs were false. The real numbers were higher.  In some cases much higher. Lies were told. I will demonstrate that in this article.

Other well-documented data show both an outsized number of pending retirements from the schools and the ongoing and rapid collapse of the new teacher pipelines.

And we don’t have a sufficient number of professional support specialists — school psychologists, social workers, school counselors and others. That also cannot be quickly remedied.

So the trends are all going in the wrong direction. For the schools, supply is decreasing. Demand, driven by programmatic decisions at VDOE as well as the strain of remediation of COVID learning losses, has been increasing.

This word for the crisis is existential. With a tip of the hat to Herb Stein, things that cannot continue will stop. Continue reading

Secrecy Also Hides Key Solar Energy Data

The well-shaded weeds and untilled earth under a Dominion solar facility. Dominion photo.

by Steve Haner

Perhaps issuing its ruling on the Ides of March by design, Virginia’s State Corporation Commission last week approved another major wave of requests from Dominion Energy Virginia for solar plants it will own, solar plants it will contract with, and a smattering of battery storage facilities added to provide some public relations cover.

In reviewing the massive case file that built up between July and February, without even diving into the long December hearing transcript, some key takeaways appear quickly.

  • The utility proposal received strong pushback from the SCC staff in its analysis, from the Office of the Attorney General on questions of cost, accounting and necessity, and even from the environmental advocates who helped write the controlling Virginia Clean Economy Act. Each might rate an individual report.
  • All the legal brilliance and accounting work were largely in vain, as the Commission has been reduced by law to merely checking boxes on the VCEA approval criteria list Dominion wrote for itself.
  • Secrecy continues to rule, especially on the key issue of the levelized cost of energy (LCOE) used to compare and choose generation sources and related storage. The Cone of Silence was not broken in this case and the utility will fight like a banshee to keep it in place in the pending debate over its offshore wind proposal.
  • While the overall LCOE numbers are secret, the utility is putting two huge thumbs on the scale by including 1) a high social cost of carbon as a financial benefit to offset the consumer cost of the projects and 2) a claimed “avoided cost” because it is meeting its clean energy goals and thus avoiding a VCEA financial penalty for failure. Dominion invents the fine, $45 per megawatt, then counts it as a boon to consumers that it doesn’t have to pay.
  • The opponents did extract a possibly useful stipulation from the utility for future cases, and a careful read opens up the possibility that the VCEA’s rigid dictates may bend after all. I was not imagining things months ago when I sensed pending flexibility, just looking in the wrong place.

Continue reading

Transformation Has a Long Way to Go

Eric Moeller, Chief Transformation Officer

by Dick Hall-Sizemore

Eric Moeller, Governor Youngkin’s Chief Transformation Officer, has his work cut out for him. In Executive Order No. 5, the Governor said that the chief responsiblities of the position would be to “to help build a culture of transparency, accountability, and constructive challenge across our government.”

As for building a “culture of transparency and accountability,” Mr. Moeller should start with the Department of Education and Department of Health. The Virginia Mercury reports that officials in several agencies have turned down numerous FOIA requests it has submitted. DOE and VDH seemed to be erecting the most obstacles.

To be fair, agencies in previous administrations have also freely invoked FOIA exemptions, justifiably or not, in response to requests for information or documents. Contributors to this blog have fought with the University of Virginia. I have had skirmishes with the Dept. of Corrections. On the other hand, some agencies have been very cooperative. James Sherlock has complimented VDH staff on their help and I have had good responses from VCCS, among others.

In summary, agencies invoking the “governor’s working papers and correspondence” exemption is not new; it has been done under governors in the past. But Governor Youngkin promised us things would be different under him.  So, go to it, Eric — start transforming that culture into one of transparency and accountability. The Monroe Building, home of the Dept. of Education and the Madison Building, home of the Dept. of Health, as well as the Patrick Henry Building, home of the Office of the Governor, would be good places to start.

Key Data on Dominion Wind Project Still Secret

Cover page blocking public access to the engineering and cost details for Dominion’s proposed $10 billion plus Coastal Virginia Offshore Wind project.

By David Wojick

A previous article published by Bacon’s Rebellion and the Committee for a Constructive Tomorrow challenged the notion that Dominion Energy Virginia can build a huge amount of wind and solar generating capacity and retire all of its fossil-fueled generators with almost none of the enormous storage capacity that is required to make the renewables viable.

This proposed long-term plan does not work and Dominion knows that, but in the short run it can make billions in profit by building the unreliable wind and solar. The disastrous unreliability shows up only in the long run.   Continue reading

School Threat Assessment Teams Revisited

by James C. Sherlock

I wrote on February 12 of this year about what I consider an indicator of a potential overreach by the Fairfax County Public Schools (FCPS).  FCPS security has published an RFP for corporate support for web search to support its threat assessment team.

Since that article, I have conducted extensive email exchange with Donna Michaelis, Director of the Virginia Center for School and Campus Safety at the Department of Criminal Justice Services (DCJS). She is a dedicated public servant responsible for policy in this area. She gave me a lot of her time. It has proven an informative exchange and I thank her for it.

I see three gaps in current law and policy on school threat assessment teams.

They both set school divisions up to make mistakes that may possibly compromise any case that may be built against an actual threat and can permit them to overreach on matters that they should leave to law enforcement:

  1. Virginia law and policy fail to define roles and responsibilities
    1. on school threat assessment teams between law enforcement and school system personnel on the teams; and
    2. between school systems and law enforcement agencies.
  2. They set no clear limits on what types of “individuals” are within the scope of school investigations.
  3. Finally, there is no requirement that the school division threat assessment oversight teams as currently constituted under Virginia law have the expertise to deal with the legal complexities involved.

Continue reading

State Interest in the Operating Efficiency of Virginia’s Nonprofit Hospitals

Courtesy AP

by James C. Sherlock

Virginia’s nonprofit hospital systems are partially funded with taxpayer money, pay no taxes, and are protected from competition by the state.  

The state, having provided all of those advantages, needs to make sure its citizens reap as much benefit from them as the hospitals do.

Yesterday I wrote that the state has an obligation to regulate the regional monopoly systems it has created to ensure that their prices are kept within reasonable bounds.

One way to do that is by controlling their allowable operating margins.  

That in turn requires the government to see to it that they are operated efficiently. It must ensure that their operating margins, which are operating income divided operating revenue, reflect best practices in controlling operating expenses.  

Optimized operating efficiency has been shown to improve medical performance as well. Continue reading

Virginia Should Regulate Healthcare Monopolies as Public Utilities

Courtesy AP

by James C. Sherlock

I am a capitalist, but we haven’t had capitalism in the healthcare market in Virginia since the Certificate of Public Need (COPN) made its way into the Code of Virginia in 1968.

If we repealed COPN today, we’d still be left with the monopolies it has created and protected.

All that Virginians have gotten from that terrible law are a lack of competition, a lack of hospital capacity (exposed by COVID), few lower-cost ambulatory surgical and imaging centers, exorbitant hospital prices, monopoly control over healthcare labor and scandalously profitable non-profit regional healthcare monopolies.

As a direct result, Virginians paid over $1.5 billion dollars to hospitals in 2020 in excess of what they would have paid if Virginia hospitals had realized national median operating margins. That, of course drove up insurance payouts, on which the insurers based rates to make their own profits.

What the government giveth, the government can taketh away. The best way to lower prices is to lower prices.

Designate Virginia’s COPN-created regional healthcare monopolies as public utilities. Regulate their prices and margins as with the largest electric utilities. Continue reading

Infrastructure Bill, Meet Richmond’s United States Court of Appeals for the Fourth Circuit

United States Court of Appeals for the Fourth Circuit Richmond, Va.

by James C. Sherlock

The President and members of Congress have celebrated the enactment of the Bipartisan Infrastructure Act into law.

In Virginia and the other states (Maryland, North Carolina, South Carolina, West Virginia) of the federal Fourth Circuit, good luck with that.

The United States Court of Appeals for the Fourth Circuit just published two related decisions on January 29th and February 4th, 2022 decided by the same three-judge panel, all appointees of Democratic presidents.

Both decisions remanded to federal agencies for reconsideration years of federal assessments that have supported the Mountain Valley Pipeline. Those agencies are now run by Biden appointees. They won’t be back.

The court is populated with a majority of judges appointed by Democratic presidents. There is a vacancy awaiting a Biden appointment. The Chief Judge faces mandatory retirement next year.

So no relief in sight except the Supreme Court.

The decisions clearly demonstrate what will happen to Virginia public infrastructure projects that are opposed by the greens and/or protected classes or both, which will be nearly all of them.

Roads, bridges, pipelines, large solar panel projects, airport expansions, new rail lines, you name it. Flood control? Forget it. They are headed into the federal and state bureaucracies and then to court and then back again.

For years. Continue reading

COPN’s Regional Monopolies Helped Boost Virginia Hospitals’ Operating Margins to more than 3x National Median in 2020

by James C. Sherlock

Virginians have been assured forever by the hospital lobby that the non-profit regional monopolies established and protected by COPN nearly everywhere but Richmond:

  • are benign public servants with a charitable mission;
  • certainly don’t drive up costs;
  • that competition does not matter;
  • that the State Medical Facilities Plan on which COPN is based, like government 5-year industrial plans everywhere, is both well- managed and prescient; and
  • that limiting capacity is the key to cost containment. (It turned out that limiting capacity was also the key to hospitals being overwhelmed by COVID. Clearly disaster preparedness is not among COPN criteria.)

Well. The median operating margin for Virginia’s 106 hospitals in 2020, the latest year for which data are available, was 9.2%. Nationally, that margin was 2.7%.

Virginians paid over $1.5 billion more for hospital visits than they would have if our hospitals had cumulatively posted a 3% operating margin, which has been at or near the national median  for years. Continue reading