Senate subcommittee advances multiple health-related bills; several moved to budget or tabled

A Senate Education and Health subcommittee in Richmond handled a package of health-related bills on the docket, recommending several for further consideration, approving amendments to others and tabling a handful for additional study.

The panel recommended reporting bills that would direct the Department of Medical Assistance Services (DMAS) to select a single pharmacy benefit manager (PBM) administrator for the state Medicaid program (SB 875), create an advisory council for breakthrough therapies aimed at veteran suicide prevention (SB 1101), and require reporting or program design work for certified community health workers (SB 980 and SB 981). Lawmakers also amended and reported legislation on recovery residences (SB 838) and restored prior-year language for donor human milk coverage (SB 1186). Several other bills drew fiscal concerns and were passed by indefinite (PBI) — effectively tabled — including a supplemental Medicaid transportation payment measure (SB 1451), an initiative to expand a TANF-funded education-work incentive (SB 1273) and a bill changing hour limits for consumer-directed services (SB 1480).

Why it matters: The bills affect Medicaid program design, access to pharmacy services in underserved “pharmacy desert” areas, support for community health workers and reimbursement or reporting requirements that shape how state agencies seek federal approval and spend state or TANF funds. Several measures include budget amendments or uncertain fiscal impacts that will be resolved in the upcoming budget process or require federal signoff.

Key actions and context

SB 875 — single PBM for DMAS: The committee discussed an amendment that would allow DMAS to negotiate additional savings and provide for affordable dispensing fees under a state-run PBM, and a second amendment striking a conflict-of-interest provision in the bill. The committee recorded the bill as coming from the Education and Health Committee with a prior committee vote of 14 yes, 1 abstain and noted a fiscal note showing a potential cost up to $51,100,000 and potential savings up to $35,000,000. The committee recommended reporting the bill with the adopted amendments.

SB 1101 — Breakthrough Therapies for Veteran Suicide Prevention Act: Senator Hashmi (introducing) said the bill is familiar to members and that this session’s substitute would focus on establishing an advisory council; a budget amendment of roughly $60,000 was filed to cover council costs (fiscal impact estimate cited around $66,100). The committee adopted a substitute limiting the bill to the advisory council and recommended reporting (it was noted the bill previously came from Education and Health, 13–1).

SB 980 and SB 981 — Certified community health workers: The subcommittee heard that the Joint Commission on Health Care (JCHC) recommended directing DMAS to convene stakeholders to design a state plan amendment to reimburse certified community health workers (SB 980) and directing the Virginia Department of Health (VDH) to report annually on community health workers employed by VDH and local health departments (SB 981). The sponsor said JCHC research showed value in community health workers; SB 980 included a budget amendment of $100,000 (DMAS fiscal estimate $125,000). For SB 981 the committee amended the requirement to a one-time report in year one (fiscal note cited $90,000) and reported the bill as amended.

SB 838 — Recovery residence certification: Senator Van Valkenburgh moved a one-line drafting amendment to remove a sentence about provisional certification applying only to residences established on or after July 1, 2025; the committee adopted the amendment and reported the bill as amended. The bill includes a work group provision to address recovery residence regulation.

SB 1451 — Medicaid supplemental transportation payment: Sponsor Senator Srinivasan said SB 1451 would direct DMAS to seek federal authority to allow supplemental payments for nonemergency transportation when other options are unavailable. Committee members raised fiscal concerns, noting DMAS has large projected shortfalls and federal approval is not guaranteed; the panel voted to pass the bill by indefinite (PBI), effectively tabling it while exploring options such as sending a letter to federal authorities or applying for a waiver.

SB 1186 — Health insurance coverage for donor human milk: Senator Carol Foy asked the committee to restore last year’s language in a substitute; the panel adopted the substitute and reported the bill (previously reported 15–0 from Education and Health). The measure would create a regulatory/licensure scheme for donor human milk banks and allow donor milk for medically eligible infants under 12 months when ordered by a physician.

SB 1273 — Virginia Initiative for Education Work (TANF-funded): The bill, reported from the Rehabilitation and Social Services committee, would increase a stipend tied to the initiative to boost participation by connecting training and employers with TANF recipients. Sponsor said initial implementation would use TANF (non-general fund) dollars; the bill was passed by indefinite (PBI) amid concerns about TANF balances and competing priorities.

SB 1480 — Consumer-directed services hours: The bill would remove a 16-hour-per-day limit on consumer-directed services employees under DMAS regulations for individuals with developmental and intellectual disabilities. The fiscal impact estimate was revised downward (committee cited roughly $4 million annually, down from earlier estimates of $8–9 million). Members expressed sympathy for affected families but, citing fiscal constraints, moved to pass the bill by indefinite (PBI).

Votes at a glance

- SB 875 (single PBM / DMAS) — amendments adopted; recommended for reporting; prior committee vote noted 14–1 with 1 abstention; fiscal note: potential cost up to $51,100,000, potential savings up to $35,000,000. - SB 1101 (Breakthrough Therapies for Veteran Suicide Prevention Act) — substitute adopted to focus on advisory council; recommended for reporting; prior committee vote recorded 13–1; budget amendment ~ $60,000 (FISC ~ $66,100). - SB 980 (community health worker reimbursement work group) — reported; sponsor and chair signaled intent to pursue inclusion in the budget; budget amendment $100,000 (FISC $125,000). - SB 981 (VDH community health worker reporting) — amended to one-time report and reported; FISC cited $90,000. - SB 838 (recovery residence certification/work group) — drafting amendment adopted; reported. - SB 1451 (supplemental transportation payment) — motion passed to PBI (tabled) amid fiscal uncertainty and need for federal approvals. - SB 1186 (donor human milk coverage/licensure) — substitute adopted to restore previous-year language; reported (previously 15–0 out of Education and Health). - SB 1273 (Virginia initiative for education-work — TANF-funded stipend increase) — passed by indefinite (PBI) due to TANF funding concerns; noted non-general fund/TANF figures (~$440,000 first year, ~$240,000 second year) cited by sponsor. - SB 1480 (consumer-directed services hour limit removal) — motion to PBI passed after debate on fiscal impact (FISC cited ~ $4 million annual estimate).

How the committee handled fiscal and federal-dependency issues

Members repeatedly flagged fiscal risk and the limits of state authority where federal approval is required. SB 1451’s sponsor emphasized CMS must approve any state plan amendment; several members warned that, without federal signoff, costs could fall solely on the state. For bills with budget amendments (SB 1101, SB 980, SB 981) members noted the committee may seek to address funding in the biennial budget rather than through standalone, immediate implementation.

Next steps

Bills recommended for report will move to the full Senate or to subsequent steps in the legislative process; items passed by indefinite (PBI) may be revived if funding or federal approvals are secured or if sponsors amend them to reduce fiscal exposure.

Speakers quoted or referred to in the transcript included senators who sponsored or introduced bills and the committee chair; procedural comments (for example, “All in favor say aye”) reflect recorded voice votes without full roll-call tallies in the transcript.

Ending: The subcommittee concluded its docket and rose; the transcript ends with the procedural close of the Senate of Virginia session in Richmond.