The floor of the Virginia House of Delegates. (Ned Oliver/ Virginia Mercury)
Virginia legislators want to expand the potential pool of candidates who can take charge of local health departments — a position that’s become increasingly central amid the ongoing COVID-19 pandemic.
After a Tuesday vote, both chambers of the General Assembly have approved legislation from Sen. Monty Mason, D-Williamsburg, that would allow applicants with master’s or doctoral degrees in public health to serve as directors of Virginia’s 35 local health departments. Currently, state law only allows licensed physicians to serve in the role.
But recruitment has become increasingly challenging amid the worst public health crisis in a century. Seven of the state’s health districts are combined, which means Virginia — at full staffing — would hire 28 local directors to oversee them.
Currently, though, five of those positions are unfilled —an 18 percent vacancy rate, Mason pointed out in multiple hearings for the bill.
“We’re just trying to open it up to find other people and other opportunities to hire qualified folks,” he told House lawmakers in a committee meeting earlier this month. In Southwest Virginia, for example, three of the region’s local health departments have been without a full-time director for months as the state’s Department of Health has struggled to fill vacancies left by retiring or departing officials.
In November, Cardinal News reported that a single physician, Dr. Noelle Bissell, is currently overseeing those three departments in addition to her primary role as director of the New River Health District. That leaves her more than 150 miles away from constituents in some of the region’s westernmost areas, including the Lenowisco Health District.
Mason’s bill still has to be signed by Gov. Glenn Youngkin to become law. But the legislation as drafted would allow individuals with master’s or doctoral degrees in public health to oversee local health districts as long as they had at least three years of professional experience with a public health agency or public health-related position. If a local department didn’t have a licensed physician on staff, it would be required to enter into a consulting agreement with a doctor for certain clinical duties, including prescribing.
The bill would also allow the commissioner of the Virginia Department of Health to appoint directors deemed “otherwise qualified for the position,” a caveat Mason said was directed at Jon Richardson, chief operating officer for the Eastern Shore Health District, who serves in a key leadership role despite currently being unable to take the title of director.
“But he’s doing just an outstanding job, so we thought we’d give the commissioner the discretion on folks like that in the profession,” Mason said in a hearing earlier this month.
The bill passed both chambers with broad bipartisan support despite some concerns among House legislators.
Del. Kathy Tran, D-Fairfax, questioned whether there would be equity concerns if local departments were led by directors with varying experience levels. And Del. Sally Hudson, D-Charlottesville, opposed the measure because she said it would disincentivize legislators from better funding the department in order to hire licensed physicians at competitive salaries.
One former job advertisement for an open position in Suffolk listed a salary range between $165,000 and $175,000. The median salary for doctors in Virginia is between $225,000 and $250,000, according to the most recent physician workforce survey by the state Department of Health Physicians. And while not all doctors graduate with debt, when they do, they median is between $110,000 and $120,000.
“I worry that functionally, what will happen — given we’ve left this completely wide open back door — is that the state won’t feel the necessary pressure to continue to compensate these people well enough to recruit really top-notch folks,” Hudson said earlier this month.
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