COVID-era federal grants recently terminated by the Trump administration had been helping Southwest Virginians access vaccines, including those required for public school enrollment.
Now the Mount Rogers Health District is trying to figure out how to continue its vaccination outreach clinics that help residents and families access preventative care, track respiratory virus outbreaks and support patients with long-COVID after laying off 13 of its contract staff.
The layoffs were a direct result of the federal cuts to COVID-related funding, according to Meagan Helmick, the district’s director. All of the affected staff were contract workers, employed by other companies but contracted to provide services to the health department.
“We’re trying to think of a new game plan because we really have intended for those people to be out in the community … to ensure that people are up to date and adequately immunized,” Helmick said.
These jobs were part of a statewide wave of cuts to the Virginia Department of Health, an impact from the federal decision to end COVID-related grants. In total, 530 state health department workers were laid off. Of those, 13 were state employees and 517 were contract staff.
The laid-off staff at the Mount Rogers district included community health workers and immunization nurses who had spent the last two years focused on vaccine education and outreach. In rural Southwest Virginia, where access to health care is often limited, the goal of these programs was to meet people where they are, Helmick said.
In the Mount Rogers Health District these efforts included administering COVID and flu vaccines, as well as running summer outreach clinics to help incoming seventh and 12th graders receive school-required vaccinations in time for the school year.
Other staff members had more specialized roles. One worked directly with patients experiencing long-COVID, a condition in which symptoms like extreme fatigue and shortness of breath persist for months after a COVID infection. Another monitored respiratory disease outbreaks.
‘We can’t get transparency’
On April 10, the Virginia Department of Health director of communications, Maria Reppas, released a statement outlining the grants that had been cut and how many positions were eliminated.
These cuts are part of a broader effort by the Trump administration to eliminate $11.4 billion in COVID-related funding by terminating a wide range of Health and Human Services grants.
In Virginia, the terminated grants totaled about $870 million. According to the statement from Reppas, about $219 million in unspent funds remain, though that figure could change as the final expenses are closed out.
The statement from the state department did not clarify whether the remaining funds are still available to the state or if they must be returned to the federal government.
Cardinal News requested a regional breakdown of those layoffs, including how many were based in Southwest Virginia and what roles they held. Neither Reppas nor Linda Scarborough, VDH’s public information officer for the Western region, responded to the questions. Health officials in other Southwest districts said they were instructed to direct all questions about the layoffs to VDH’s central office.
U.S. Sen. Mark Warner commented on the VDH cuts after a roundtable discussion with veterans at the American Legion in Salem on Wednesday.
“This is what I worry about, is that we can’t get transparency about where these cuts are taking place, and that’s just not the way the system is supposed to work. I mean, the administration tries to make these cuts and I feel like a lot of times the criteria is not based on effectiveness,” Warner said.
“In many ways, the cuts have been disproportionately hit in rural communities, which doesn’t seem fair,” he added.
Terminated grants included vaccine initiatives for children
One of the grants that was terminated funded initiatives for immunization and vaccines for children. At the time of the termination, March 25, VDH still had $56 million to spend from that grant.
The state department did not clarify if the remaining funds could still be used for initiatives in Virginia.
Funding also ended for programs aimed at preventing and controlling emerging infectious diseases, as well as for initiatives addressing COVID-19 health disparities in high-risk and underserved communities.
Legislators who represent parts of the health district — Sen. Bill Stanley, R-Franklin County; Sen. Todd Pillion, R-Washington County; Sen. Travis Hackworth, R-Tazewell County; Del. Israel O’Quinn, R-Washington County; Del. Will Morefield, R-Tazewell County; Del. Jed Arnold, R-Smyth County; Del. Wren Williams, R-Patrick County — did not respond to requests for comment in time for publication.
Del. Terry Kilgore, R-Scott County, whose district neighbors the Mount Rogers service area, said Wednesday that neither constituents nor local health departments have contacted him about the cuts.
At this time, he said, he isn’t concerned about further challenges to health care access or respiratory disease outbreaks across Southwest Virginia.
“It’s always good to have those individuals who are out in the communities, especially for the school-aged population doing immunizations or wellness checks, things of that nature. That’s always very important, but I haven’t had any complaints locally yet,” Kilgore said. “I certainly hope we don’t run into any challenges, but it’s hard to tell. We haven’t had any complaints so far.”
Outreach clinics might not be possible in the future
According to Helmick, confusion about the future of the grants began months ago. On Jan. 7, weeks before the presidential inauguration, she received notice that some of the funding had been extended to June 2027, two years beyond the original cut-off date of June 2025. As rumors about cuts began to circulate, she was prepared to lose the funding, but not this early. She thought they’d at least be able to carry out their spring and summer outreach clinics.
“Unfortunately there wasn’t a two-week notice. There wasn’t an offboarding that we could really do with some of our community outreach projects,” Helmick said.
She learned about the federal decision to cut the COVID-era grants on March 25 while attending a conference in Richmond. The cuts took effect at midnight, just hours after the announcement.
Many of the laid-off employees had been scheduled to staff spring vaccination clinics at local schools. Other staff stepped in to fill the gap, but Helmick said those clinics likely won’t continue in the future.
The Mount Rogers district has 115 full-time employees, and now only has three contract staff. Overnight, the department lost about 10% of its workforce, Helmick said.
“We are probably going to have to give up some of the outreach stuff that we really feel is very important. We’ll still try to do it, but it will have to be a scaled back approach,” she said.
Southwest Virginia faces persistent barriers to health care access. Long travel distance to services and a shortage of health care workers in the region make it difficult for some residents to access preventative care. Others may work jobs without paid time off, which keeps them from traveling to a clinic, especially for routine services like vaccinations.
To address those gaps, the Mount Rogers Health District, which serves about 188,000 people over eight localities, is partnering with agencies in the region to bring mobile health clinics to rural areas. These clinics aim to expand services like immunizations, hepatitis C treatment and behavioral health care in some of the region’s most remote areas.
“We are making a concerted effort to go where people are and not make people come to our brick-and-mortar health department all the time. I think there’s a benefit for meeting people where they are,” Helmick said.
