VDH implements critical reforms and strengthens financial oversight to support a more efficient and accountable EMS system
On Wednesday, Virginia Department of Health (VDH) Commissioner Dr. Karen Shelton and Chief Operating Officer Christopher Lindsay shared the results of a year-long audit they had requested into VDH’s Office of Emergency Medical Services (OEMS).
The audit identified significant financial irregularities by former OEMS leadership, dating back to 2019. This resulted in $33 million in unpaid debts and over-obligations, including over $4 million in fraudulent charges, and has since led to major reforms and the conviction of a former employee.
In the summer of 2023, Dr. Karen Shelton requested the internal audit after discovering the financial irregularities. The Internal Audit revealed multi-million-dollar contracts that bypassed state procurement rules through the use of Regional EMS Councils, as well as the improper allocation of funds from the mandated Trauma Fund and Rescue Squad Assistance Fund grants to cover the costs for the EMS Symposium, inflated operating expenses, and EMS-related technology.
“Lack of oversight and internal controls within OEMS led to financial irregularities and criminal fraud that had impacts at state, regional, and local EMS levels,” said VDH Commissioner Karen Shelton. “While these findings are difficult to confront, VDH has been taking proactive measures to address these issues which will lead to a well supported EMS system across the Commonwealth.”
The Internal Audit Report outlined 63 key recommendations for VDH Leadership and the OEMS. Dr. Shelton and Mr. Lindsay presented the key findings of the audit, highlighting initiatives that have already been completed or that are planned as part of the effort to bring OEMS into compliance with the audit findings.
The following are some of the significant changes which have been implemented:
- Placement of an interim director of OEMS since the fall 2023
- Reorganization of the OEMS leadership structure, including the permanent placement of a dedicated business operations manager to consult on financial decisions
- Weekly briefings for VDH senior leadership on all aspects of OEMS restructuring and financial status
- Evaluation and restructuring of all OEMS contracts and business relations to ensure compliance with the Commonwealth of Virginia procurement and contracting requirements
- Redesign of the Trauma Fund payout plan to create more transparency and regularity of payment for Virginia’s trauma centers
- Ensuring that all funds committed to the “Return to Locality,” “Rescue Squad Assistance Fund,” and “Trauma Funds” are used in accordance with the Virginia Code
“The changes we have implemented will ensure that the Office of Emergency Medical Services is now in a much stronger financial position, with the right leadership structure and resources in place,” said Chief Operating Officer Christopher Lindsay. “This allows EMS providers across the Commonwealth to be better supported and ready to respond when Virginians need them most.”
Following a review of the audit findings, Fitch & Associates, an EMS consulting firm contracted by VDH, presented on recommendations to improve the strategic direction of the OEMS based on best practices. Proposals included:
- A plan to position OEMS for stronger oversight
- A proposed revised Regional Council structure and oversight model
- A recommended policy and regulatory framework
- Suggested enhancements to the EMS Advisory Board, EMS programs, and their functions
To learn more about the VDH’s OEMS, visit www.vdh.virginia.gov/emergency-medical-services/.