NUR 303 Module 5 Advocacy Letter Example

[Your Name], BSN Student, RN

[Street Address]

[City, State ZIP]

[Email Address]

[Date]

The Honorable [Legislator's Name]

[State] House of Representatives

[State House Address]

[City, State ZIP]

Dear Representative [Last Name]:

I am a registered nurse, a resident of your district and a student in a bachelor's nursing program. I am writing to ask you to support [House Bill number], which would let our state's Medicaid program reimburse the work of trained community health workers. I would also be glad to speak with your staff about what I have seen in our district.

This spring, as part of a service-learning course, I have staffed a free health table once a month at a laundromat on the east side of our district, working with a small neighborhood nonprofit. I expected most people to want their blood pressure checked, and many did. But the most common requests were different. People asked for help reading an insurance letter, understanding a prescription label, finding out why a benefit had stopped or figuring out how to get to an appointment on a weekday when they could not leave work. One woman showed me three unopened letters from her health plan because she was afraid of what they said. None of these problems needed a nurse. They needed someone trusted, trained and available, which is what a community health worker is.

Community health workers are frontline public health workers who usually come from the communities they serve. They help people navigate care and benefits, connect them to food, housing and transportation resources and support them in managing chronic conditions. The evidence that this work pays off is stronger than many people realize. Kangovi et al. (2020) analyzed a randomized controlled trial of a standardized community health worker program that addressed unmet social needs for low-income patients and estimated that a state Medicaid payer would get back about $2.47 for each dollar spent, and would see that return inside a single fiscal year. Because the estimate came from a randomized trial rather than a before-and-after comparison, it is less likely to overstate the benefit.

The federal government has already moved in this direction. Beginning in 2024, Medicare created payment for community health integration services, which include helping patients address unmet social needs and navigate the health system, and it allowed community health workers employed by community-based organizations to provide those services under a billing practitioner's supervision (Centers for Medicare & Medicaid Services [CMS], 2023). Our state's Medicaid program serves many of the same families I met at the laundromat, but without a clear payment pathway, clinics and nonprofits have to rely on short-term grants to employ community health workers, and the positions disappear when the grants end.

As a nurse, I also see this as a matter of professional responsibility. The profession's code of ethics describes nurses' obligations as extending to the health of communities and to advancing social justice through policy (American Nurses Association, 2025). Supporting a stable workforce of community health workers is one of the most practical ways I know to act on that obligation. It would not replace nurses. It would allow nurses, physicians and clinics to spend their time on clinical care while trusted neighbors help people with everything that happens between visits.

Two features would make the bill work for districts like ours. First, payment should reach community health workers employed by small community organizations, not only those employed by hospitals, because the people who most need this help often trust a neighborhood group more than a large institution. Second, the program should pay for time spent outside clinic walls, in homes, laundromats, churches and libraries, since that is where the conversations I have described actually happen. A payment rule written only for office visits would miss the point of the workforce it is meant to support.

I respectfully ask you to vote for [House Bill number] and to support an amendment, if one is offered, that would require community health worker training standards so that services are consistent across the state. I am grateful that you took the time to read this. I can be reached at the email address above and would welcome a call from your office.

Respectfully,

[Your Name], RN

Registered nurse and constituent, [District Number]

References

American Nurses Association. (2025). Code of ethics for nurses. https://codeofethics.ana.org/

Centers for Medicare & Medicaid Services. (2023, November 2). Calendar year (CY) 2024 Medicare physician fee schedule final rule [Fact sheet]. https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2024-medicare-physician-fee-schedule-final-rule

Kangovi, S., Mitra, N., Grande, D., Long, J. A., & Asch, D. A. (2020). Evidence-based community health worker program addresses unmet social needs and generates positive return on investment. Health Affairs, 39(2), 207-213. https://doi.org/10.1377/hlthaff.2019.00981