We’ve Come Too Far—Say Yes to CHWs

SB275

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We’ve Come Too Far—Say Yes to CHWs

Email Subject:

Dear [Your Elected Official],

Distinguished Members of the General Assembly and Elected Officials,
Virginia has a critical opportunity to strengthen healthcare delivery, improve Medicaid efficiency, and advance fiscal responsibility through SB275, legislation that formally integrates Community Health Workers (CHWs) into the Medicaid system—without requiring new state spending.
Health outcomes are driven far more by conditions in which people live, work, and age than by clinical care alone. Research consistently shows that only about 20% of health outcomes are driven by medical care, while nearly 80% are shaped by social drivers of health such as housing stability, food access, transportation, and social connection. Yet healthcare spending remains disproportionately focused on the clinical 20%, often responding to preventable crises rather than preventing them.
The result is a costly and familiar cycle  
A patient enters the emergency room, is treated and stabilized, and then discharged. Clinical care ends at the hospital door—but the drivers of health outcomes do not. Providers cannot accompany patients home, where unmet needs frequently lead to missed medications, delayed follow-up care, and avoidable hospital readmissions.
That remaining 80% of health happens in the community—and this is where Community Health Workers play a critical role.
CHWs are trusted frontline public health professionals with lived experience in the communities they serve. They help seniors age in place, support individuals managing chronic illness, assist pregnant mothers, and connect families to essential resources that directly reduce preventable healthcare utilization. Their work strengthens—not replaces—clinical care by ensuring it is effective beyond the exam room.
From a fiscal and systems perspective, this matters. Virginia spent approximately $4.68 billion on Medicaid acute care services in FY2026 Quarter 1 alone, according to the Virginia Department of Medical Assistance Services (DMAS) Medicaid Managed Care Financial Results. A significant portion of these costs is associated with preventable emergency department visits and hospital readmissions driven by unmet social needs after discharge.
SB275 requires no new appropriations: Instead, it leverages existing DMAS–Managed Care Organization contracts already funded for care coordination and addressing social drivers of health. By embedding CHWs into these established contracts, Virginia can improve outcomes, reduce avoidable costs, and maximize the return on current Medicaid investments—within the existing budget framework.
SB275 also supports workforce development by creating training and employment pathways for Medicaid- and SNAP-eligible individuals, strengthening local economies while expanding capacity in high-need communities.
For elected officials tasked with stewarding public resources, SB275 represents responsible governance: aligning healthcare spending with evidence, improving system efficiency, and investing upstream to reduce downstream costs.
As leaders consider SB275, our communities are watching. Healthcare does not begin in an exam room—it begins where people live. Integrating Community Health Workers into Medicaid is a prudent, budget-neutral strategy that advances prevention, equity, and long-term system sustainability.
Thank you for your leadership and your commitment to the health and fiscal well-being of the Commonwealth.
Sincerely,

Sincerely,

[Your Name]

[Your City & State]

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Summary

We’ve Come Too Far—Say Yes to CHWs Community Health Workers (CHWs) are essential bridges between Virginians and the healthcare they rely on. <a href="https://lis.virginia.gov/bill-details/20261/SB275">SB275</a> strengthens an integrated, community-centered approach to care that benefits patients, providers, and taxpayers—without increasing the state budget. Why SB275 Matters For Our Most Vulnerable Neighbors: We often focus on what happens in the exam room, but that is only part of the story. Only about 20% of health outcomes are driven by clinical care. The remaining 80% happens in the community, after the appointment ends. Here’s what that looks like in real life: A patient leaves the hospital with discharge instructions and prescriptions, then returns home to an empty refrigerator, no reliable transportation to the pharmacy, or housing conditions that worsen their illness. A doctor cannot fix those challenges from a clinic. That is where Community Health Workers step in: CHWs help ensure medications are picked up, connect families to food and housing resources, arrange transportation, and provide trusted follow-up that prevents conditions from escalating into emergencies. For seniors, people with disabilities, individuals managing chronic illness, and families navigating complex systems, this support is often the difference between stability and crisis. For Our Healthcare System: Hospitals and clinics are stretched thin managing preventable emergencies rooted in unmet community needs. Integrating CHWs into Medicaid managed care strengthens care beyond clinic walls—reducing ER visits, lowering hospital readmissions, and improving care coordination across the system. For Taxpayers and Payers: Virginia spent approximately $4.68 billion on Medicaid acute care services in FY2026 Quarter 1 alone. Much of this spending is driven by preventable crises that occur after discharge. Source: V<a href="https://www.dmas.virginia.gov/data-reporting/cardinal-care/">irginia Department of Medical Assistance Services (DMAS), FY2026 Medicaid Managed Care Financial Results, Quarter 1.</a> CHWs are a cost-effective public health investment because they address problems early—before they become expensive medical emergencies—saving Medicaid dollars while improving outcomes. SB275 Requires No New Spending <a href="https://lis.virginia.gov/bill-details/20261/SB275">SB275</a> leverages existing DMAS–Managed Care Organization contracts already funded for care coordination and social drivers of health. Embedding CHWs into these contracts allows Virginia to use current Medicaid dollars more efficiently—preventing crises instead of paying for them after they occur. What SB275 Will Do Establish Medicaid reimbursement pathways for CHW services Embed CHWs into care coordination teams across Virginia Create workforce training opportunities for Medicaid and SNAP recipients Deploy CHWs to support high-need populations facing the greatest barriers to care <a href="https://lis.virginia.gov/bill-details/20261/SB275">SB275</a> aligns Medicaid spending with how health actually happens. Vote YES on SB275 and support a smarter, more sustainable healthcare system for Virginia.

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Scott A. Surovell Honorable Senator

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