An early look at emergency medicine at the 2026 General Assembly
As the 2026 Virginia General Assembly convenes (day 1 was Wednesday), this annual session carries extra significance: many newly elected legislators are stepping into office following the November 2025 elections, and Governor-elect Abigail Spanberger will officially be sworn in as the 75th and first female governor of Virginia on January 17.
That combination presents a solid opportunity for emergency physicians to educate the Commonwealth’s leadership about the realities of emergency medicine — from patient safety to regulatory fairness.
VACEP has also introduced two pieces of legislation this year that are meant to keep patients safe and make your work less stressful.
Clarifying custody during medical TDOs (HB309, Hope)
VACEP president-elect Joran Sequeira, MD and current president Jesse Spangler, MD at last year’s EM Advocacy Day in Richmond. Sequeira will be sworn in as VACEP’s president in February.
Emergency physicians frequently care for patients who lack decision-making capacity due to intoxication, neurological injury, or other acute conditions.
While a court-ordered medical Temporary Detention Order (TDO) may ultimately be sought, current law does not always clearly define who has custodial authority while a TDO is being obtained.
House Bill 309, carried by Del. Patrick Hope (D-Arlington), provides a practical clarification: during the short period when a medical TDO is pending, a patient who lacks capacity remains in the custody of the facility. This allows hospital security to safely prevent elopement and protects patients at serious risk of harm. The bill does not extend detention authority or change the duration or criteria of a TDO. If a TDO is not issued, the patient must be allowed to leave.
Improving fairness in Board of Medicine disciplinary reviews (HB1139, Downey)
Under current law, physician members of the Virginia Board of Medicine must be appointed from different congressional districts, which can unintentionally limit representation from key specialties, including emergency medicine. HB 309 removes that congressional-district requirement and instead requires that the Board consist of 11 licensed physicians, aligning it with other professional boards and creating flexibility to ensure clinical diversity on the Board.
Importantly, the bill does not expand the Board’s authority or impose specialty quotas — it simply allows appointments that better reflect clinical experience, which can improve fairness and credibility in disciplinary reviews.
Get our 2026 Advocacy One-pager
Download a printable PDF that outlines our 2026 legislation and includes a briefing on other general issues impacting emergency medicine.
Why is VACEP pursuing this change? For physicians in Virginia, receiving notice of a Board complaint can be an overwhelming experience — especially when the complaint is baseless. Complaints to the Board have risen in recent years, but many are unrelated to substandard care. Even so, these complaints often lead to costly, time-consuming in-person investigations that can cause stress, burnout, and even career disruption.
This is a particularly major issue in emergency medicine, which sees hundreds of complaints annually. Separate of the legislation, VACEP is in communication with Board of Medicine leadership and specialty societies like the Medical Society of Virginia to advocate for reforms and reduce the burden of unsubstantiated complaints on physicians.
The Board of Medicine bill is also carried by Mark Downey, M.D., a Williamsburg pediatrician and freshman delegate. Downey is the first physician in the General Assembly since Sen. Siobhan Dunnavant, who was defeated in November 2023.
Why this matters now
The 2026 session is not just about passing bills. With 17 new lawmakers from the November elections and more from special elections, this year is about educating new faces and incoming executive leadership on issues that directly affect emergency care.
Join us to educate lawmakers and support our 2026 legislation.
January 28 is EM Advocacy Day at the Virginia State Capitol, where you can join your Virginia emergency medicine peers to meet with lawmakers and advocate for our specialty and the patients we serve.
VACEP's EM Advocacy Day
7:30 a.m. - 1 p.m.
Starting at Commonwealth Strategy Group
and visiting the General Assembly Building
118 N. 8th St., Richmond
