Rich Jurisdictions Vote with Their Feet on the Virginia Department of Health

by James C. Sherlock

M. Norman Oliver M.D., Virginia Health Commissioner

A couple of days ago Antonio Olivo broke a story  in The Washington Post that told of a law permitting Loudoun and Prince William counties to form independent health departments. It awaits Governor Northam’s signature.

Having seen the performance of the Department of Health during COVID, they have decided they cannot depend on their state-run health districts. They are not breaking new ground, as Fairfax and Arlington Counties already made the change in 1995 and 1998 respectively.

We have written much in this space about the dangerous shortcomings of the Virginia Department of Health exposed by COVID, including its planning, exercise, nursing home inspection, testing and vaccination programs.

Now it appears that an increasing number of our wealthier local governments get it and want to take health district matters into their own hands.

It is expensive to do what those Northern Virginia counties are doing or propose to do. They are going that route because VDH failed to meet its responsibilities and the local heath districts could not maintain staff because the state pay scales are too low.

Virginia Beach is also considering the change. What does the rest of the state do? What can other local jurisdictions afford to do?

Letting the rich jurisdictions bail out, though it is hard to blame them, and leaving the others to live with a broken Department of Health is certainly not the answer.  The Governor and General Assembly have to understand that and act.

Virginia needs a 9/11-type commission to examine the Department of Health from top to bottom and help us fix it.

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11 responses to “Rich Jurisdictions Vote with Their Feet on the Virginia Department of Health”

  1. Baconator with extra cheese Avatar
    Baconator with extra cheese

    Come on man… we have a Dr Governor, thus Virginia is all good health-wise.

  2. Dick Hall-Sizemore Avatar
    Dick Hall-Sizemore

    A large part of the problem has been the general neglect of local health departments over the years. We tend to overlook the basics until we urgently need them.

    Part of that neglect has been the failure of the state to keep up with the pay scales of skilled employees. (That is true at all levels of state government.) Another aspect is the disparity between the cost of living in Northern Virginia and in the rest of the state. Even with the Northern Virginia “kicker” that exists for most, if not all, state employees, salaries of local government employees often run higher. I am surprised that either the law or the Department of Health does not authorize local governments to supplement the salaries of local health department employees on the state payroll. I know that happens with probation and parole officers in some Northern Virginia jurisdictions.

    1. James C. Sherlock Avatar
      James C. Sherlock

      That sounds like a good fix for the health district personnel issue. But the major complaints were with VDH itself. That department is fully broken. Needs a Marshall plan.

      1. Dick Hall-Sizemore Avatar
        Dick Hall-Sizemore

        As I read the WP article, the biggest problem was the staffing issue, which was related to the state pay scale. There were some problems with flexibility, but they were related to the pandemic and not a general issue. As far as Virginia Beach is concerned, the comments of the city leaders seemed to indicate they would be satisfied if they could get a health director they would not to share with Norfolk. Again, that is a budget issue.

        1. The lack of enough VDH inspectors is a budget issue too. When did Dr. Oliver demand the GA and the Governor put more into the budget for that? He managed to create a Health Equity Working Group who have met weekly since last March. Hear any calls from them for inspectors to make sure all hospitalized patients and nursing home residents have “equity” in matters such as safety, staffing and care that affect their health?

          1. Dick Hall-Sizemore Avatar
            Dick Hall-Sizemore

            According to VDH, the Licensing and Certification Office is primarily funded by federal funds, with a state match required. VDH requested additional state match this year to qualify for additional federal funds. That request was included in the Governor’s budget.

          2. Remember this story?

            OLC has other responsibilities too.

            “OLC has a single policy analyst responsible for all legislative work, budget requests, and regulatory actions for the 10 state programs that OLC manages. OLC has previously requested additional funding for another policy analyst, and currently has a pending budget request. This budget request is in the process of being reviewed by both the offices of the Secretary of Health and Human Resources and of the Governor.”

            Did they get it?

            And they asked “for funding to support development of an automated online licensing system; these funding requests have been unsuccessful to date. OLC will
            continue to pursue funding for this purpose.”

            Is that in the Governor’s budget?
            How much is their funding being increased?

  3. Eric the half a troll Avatar
    Eric the half a troll

    I suspect it has more to do with having more control over residential development in their own backyard than anything else.

    1. Will you please explain how this relates to residential development? I do not see how changing to a locally-run health district would affect that in any way.

      1. Eric the half a troll Avatar
        Eric the half a troll

        It is the state health department that develops and enforces residential septic and well regulations. If the county has a health department with delegated authority, they can create stricter septic and well regulations which effectively will restrict residential development.

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