by James C. Sherlock
Virginians of every political stripe have grown very tired of watching the Northam administration obfuscate repeated, very public failures to carry out its role in protecting the health of its citizens since the onset of COVID.
But that is an effect, not a cause, of the massive and continuing failures at the state level to protect the public health.
A parade of failures
The bigger problems — incompetence in the Virginia Department of Health (VDH), lack of management oversight by the Governor and his appointees and political indifference driven in part by political corruption — go back as far as I can remember.
The very latest is COVID vaccinations. VDH has known for 9 months that it would have to lead the internal distribution within the state of vaccines and oversee a program to make sure they get into peoples arms. That is going so well that we are 48th in efficiency of vaccinations.
Before that it was the state’s failure to read much less practice the state emergency pandemic plan that was written at federal expense by federal contractors more than a decade ago; failure to maintain the state emergency stockpile that it called for; failure to effectively inspect for hospital and nursing home pandemic readiness prior to COVID; failure to appropriately manage COVID personal protection equipment distribution; delays and corruption in the program for COVID testing in nursing homes; failure to even acknowledge the attempted hostile takeover of EVMS; failure to support Health Enterprise Zones to improve access by the poor to primary care; VDH’s use of its role in COPN to create regional hospital monopolies and restrict the number of beds; severe and very costly restriction of the establishment ambulatory surgical centers under COPN; the list goes on.
Remember the embarrassed removal of the pandemic emergency operations plan from state websites the day after I wrote about it? VDH and the Virginia Department of Emergency Management (VDEM) were at least efficient at that.
The Virginia Department of Emergency Management
While VDEM itself is no better in a health emergency than the quality of VDH staffers, VDEM needs a thorough review by an outside agency to determine the quality and effectiveness of its exercise and training programs, not only overall but specifically in pandemic emergency plans, and its performance in the COVID emergency.
The Virginia Department of Health
VDH is another matter. It had a direct role and responsibilities in all of the failures listed above.
It’s perhaps most important Division, the Office of Licensure and Inspection, has been deliberately starved of the staff needed for competent and timely hospital, nursing home, home healthcare and other inspections by a Governor and General Assembly corrupted by campaign donations and a Board of Health that does not like inspections.
That failure had the expected consequences. VDH, lacking competent internal inspection data and sufficient staff, either failed to see or ignored federal data that showed unequivocally that more than half of Virginia’s nursing homes were understaffed prior to COVID onset. Either way, it failed to correct those deficiencies, which it had the authority to do.
We seldom if ever heard from the Virginia’s appointed Health Commissioner, the head of VDH, about the nursing home COVID crisis. In the endless press conferences, he seldom spoke and even less often took questions.
VDH needs a total overhaul, and the Health Commissioner should resign or be fired as the first steps in accountability and repair of a failed bureaucracy.
Health Commissioner Oliver has failed utterly as the manager of VDH. =His own self respect should cause him to resign.
His organization has been bad at so many things for so long that it will take a management overhaul specialist and the cooperation of the Governor and General Assembly to fix it.
The Virginia Board of Health
The current members of the Virginia Board of Health (VBOH) have failed at nearly everything important for which they are responsible.
That Board is by design unserious about the health of Virginians. It is populated by political appointees and dominated by industry stakeholders. Those stakeholders professionally have one thing in common — they are unfavorably disposed to state oversight.
The Chair of the VBOH, Faye Prichard, is at least not an industry stakeholder. Indeed she does not appear to have any health care qualifications at all. She is a Hanover local politician and “the Director of Writing for the Honors College at Virginia Commonwealth University where she has been teaching for over fifteen years and previously earned a bachelor’s degree in English and a master’s degree in Literature.”
Good to know.
She is a reliable Northam contributor, which apparently qualified her for consideration for an appointment to the Board of Health. Virginia doesn’t have a Board of Writing. At least not yet.
One look at the resumes of the members of the Maryland Healthcare Commission and then the Virginia Board of Health shows which state is serious about health care. The comparison is profoundly embarrassing to Virginia and a key reason that Virginia has failed in plain sight at everything related to COVID preparation and response.
Its VBOH mission statement includes the words: “The Board serves as the primary advocate and representative of the citizens of the Commonwealth in achieving optimal health.” In a pig’s eye it does.
The current Board, like the Health Commissioner, should resign or be fired.
Code of Virginia Title 32.1. Health » Chapter 1. Administration Generally » Article 2. State Board of Health » § 32.1-5. Appointment of members; terms and vacancies must be completely rewritten. It must redesign the Board with a membership of top-flight healthcare professionals likely to be focused primarily on the health of Virginians rather that their own business interests.
The Governor and General Assembly
The Governor has never indicated publicly an interest in how well the VDH was doing its job. He consistently looked like a deer in the headlights at his press conferences when asked specific questions on any subject related to its responsibilities and performance.
That combined with the campaign donation-fueled passivity of the General Assembly and the incompetence and antipathy to inspections of the Governor’s appointees to the Virginia Board of Health killed a lot of people in nursing homes and more Virginians that were not efficiently and effectively tested and vaccinated.
Directly and traceably killed them.
Yet even with the November 30th, 2020 expose of what the VDH itself readily admits is a critical shortage of health facilities inspectors, I can find as yet no 2021 bill or budget amendment to fund the increase.
These chronic and deadly failures contain both political and bureaucratic components. It will take political and bureaucratic accountability and reform to ensure they are not repeated.
Virginians deserve accountability for the deadly management disaster that has been the state health system in preparation for and reaction to COVID. So far there has been absolutely none and Virginia’s corrupt political system is unlikely to generate either accountability or reform without serious prodding.
There are two things I hope each Virginian will do to prevent deadly failures from continuing to happen:
- Write or email your elected officials and demand action. Link to this essay and ask them to respond.
- Ask candidates for your gubernatorial and General Assembly votes going forward what their positions are on these issues. And demand specific answers, not vague generalizations.