Dr. Lisonbee Barracco, director of the Central Shenandoah Health District, presented the district's 2024 annual report to Staunton City Council on April 24, outlining sustained clinical and environmental health services in 2024 and recent staffing and funding changes in 2025.

The report, Barracco said, covers a “post-pandemic” 2024 in which the district received more than $3 million in mostly federal grants. In March 2025 the district experienced an “abrupt discontinuation” of some COVID-related grants that resulted in the loss of 12 contract staff — about half focused on population health/community health worker work and the other half on epidemiology for respiratory viruses and related outreach in long-term care settings. Barracco said the district has not yet seen essential functions disrupted and is adjusting workplans with partners while remaining transparent if essential services are threatened.

The 2024 packet shows steady environmental health and WIC services in Staunton. Barracco reported 46 food-service permits and 66 inspections in the city and 2,128 clinic visits for the year. She said the Virginia Department of Health continues school-based immunization work to help families access required vaccines.

Barracco noted a national and local uptick in vaccine-preventable illnesses, specifically varicella (chickenpox) and pertussis (whooping cough). She cited Virginia’s measles vaccination rate around 94% and warned the community’s threshold for herd protection is generally near 95%. “When a measles outbreak comes to Central Shenandoah,” she said, “we want to be prepared,” and she described ongoing partner preparedness work.

Population health services saw 650 referrals and 450 clients assisted in 2024; community health workers connected residents to housing, food, utility and medication assistance and participated in 36 outreach events that year. Barracco said the district will change how it conducts outreach if grant funding reductions continue.

Barracco described harm-reduction programming as “strong,” cited statewide declines in overdose deaths, and said the district partners with community organizations on opioid-abatement efforts. She also announced a mobile clinic now in service; the clinic will be used by the health district and partners to bring care directly to neighborhoods and events.

Barracco also told council she is moving into a new role as a medical officer within the Virginia Department of Health as of the next day; she said she intends to remain engaged with the district and will serve as acting health director until a replacement is identified.

Councilors asked follow-up questions about local TB screening (services are “back to normal”), the harm-reduction network and Narcan trainings, and for quantification of the rise in vaccine-preventable disease; Barracco said she would provide specific case counts following the meeting.

Why it matters: The funding changes and lost contract positions create near-term program risks in community outreach and epidemiologic surveillance. The health district says core clinical and environmental services are intact for now, but continued grant losses could force conversations with local governments about sustaining essential services.