VDH outlines plan to clear nursing‑home inspection backlog, flags Ryan White cuts and EHR costs

Cameron Webb, Virginia's new secretary of Health and Human Resources, told the Senate Finance and Appropriations subcommittee on Health and Human Resources that the Virginia Department of Health intends to eliminate a backlog of long‑term care recertifications within 12 months and is seeking added staff and funding to do so.

Webb said the Office of Licensure and Certification is working to address recertification shortfalls across 289 long‑term care facilities, noting that 74% remain out of compliance on the stated recertification metric. "We wanna address that entire backlog over the next 12 months," Webb said, describing a target monthly completion rate of at least 18 recertifications and a prioritization of facilities with the longest overdue status or prior enforcement history.

Why it matters: Webb told the panel the backlog is driven by capacity constraints and gaps in workforce certification for medical facility inspectors (MFIs). He reported 46 MFIs statewide—with 4 certified supervisors, 21 certified MFIs and 21 still requiring SMQT certification—and said the agency lowered vacancy rates from around 40% to 7% through recent hiring.

Budget and staffing request: Webb said the governor's introduced budget included funding for 2 additional MFIs but that VDH estimates the department needs 8 MFIs total to meet demand. That change would increase the general‑fund request from roughly $291,000 to a little more than $1.1 million, he said, and he asked the committee to consider adding six MFIs beyond the current proposal.

EHR rollout and ongoing costs: Webb also updated the subcommittee on VDH's long‑planned electronic health record. He said the department contracted with Oracle Health after a $30 million ARPA appropriation in 2022 and is in testing and go‑live readiness. "We contracted with Oracle Health," Webb said, adding that the agency will pilot the system in select sites before rolling it out in waves across health districts and local health departments. Webb noted ARPA funds expire in December and described the governor's request for $8.2 million in FY27 and an ongoing $6.8 million estimate for FY28 to cover software licensing, hardware, IT support and staffing.

Ryan White funding shortfall: On the federal Ryan White Part B program, Webb told the subcommittee that voluntary rebates from pharmaceutical companies—one of the funding streams that supports services—have been lower than projected over the past two grant years. As a result, VDH reduced the number of direct service providers from 27 to 14 and pared back covered services from 21 to 7, prioritizing outpatient ambulatory care and several core supports. Webb said the department secured approximately $3.8 million in supplemental funding for the drug program and is pursuing emergency ADAP relief, improved rebate recovery with manufacturers and potential Medicaid strategies to mitigate gaps.

What Webb said the department will do next: Webb described a phased approach to clearing complaints and recertifications—addressing immediate jeopardy and high‑risk complaints in the next 30 days and medium/low risk items over 30–90 days—and promised weekly progress reports to the committee. He also agreed to follow up with senators about the status of specific drinking water appropriations and other local matches.

For the record: Webb introduced members of his VDH team for follow‑up questions, including John Ringer (finance lead), Joe Hilbert (regulatory lead), Susan Fisher Davis (community health services), Armand Latif (CIO), Stephanie Dunkel (population health and preparedness) and Lori (Dr.) Filano (state epidemiologist). The presentation did not include a formal vote; Webb asked the committee to consider adding staffing in the budget to meet the operational targets he outlined.

Next steps: Webb said VDH will provide the committee with requested follow‑up details on drinking water grant drawdowns, specific facility recertification timelines and additional breakdowns of Ryan White supplemental funding requests.