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For Del. Mark Sickles, representing part of eastern Fairfax County in Virginia’s House of Delegates means confronting an almost continuous stream of problems—and hearing just as many proposed solutions.

On a recent Wednesday in Richmond, Sickles began at 7 a.m. with House Speaker Don Scott’s prayer breakfast. Later that morning, he squeezed eight consecutive meetings with professional and citizen lobbyists into a little more than two hours.

His first visitor was Allan Coukell, Civica’s chief of governmental affairs. The pharmaceutical company operates a manufacturing facility in Petersburg, and Coukell sought $5 million in state funding to produce insulin.

“I’m happy to help,” Sickles said.

A team from Children’s National Hospital followed. Its representatives supported legislation barring baby food with toxic heavy metals above Food and Drug Administration limits. They also backed a bill requiring school districts to use federal funding to provide free breakfast and lunch to students.

Dr. Danielle Dooley said nutritious meals improve learning. She also said Children’s National cared for 45,000 children across eight Virginia localities in 2024, including Fairfax and Arlington counties.

“Thank you for taking care of our children,” Sickles told the group.

Officials from Lifepoint Care hospitals in Richlands then made their case for rural hospitals, where patients may travel considerable distances for treatment. Asked about their most difficult challenge, they cited recruiting and retaining employees. The hospitals work with high schools and community colleges to develop a pipeline of future staff.

Hospital pharmacists arrived next, seeking greater authority to compound medications and distribute them throughout their health systems. They argued that the change could help address drug shortages.

“It’s common sense,” Sickles said.

Representatives of the Virginia Association of State Parks advocated for additional park funding and opposed placing data centers near state parks. Sickles said those facilities should instead be located in industrial parks.

Between scheduled meetings, he accepted a flashlight from the Virginia Health Care Foundation.

Equifax officials then opposed legislation that would require Virginia to solicit competitive bids for the company’s existing service verifying income eligibility for state programs.

Members of Muslims for Just Futures discussed several priorities, including fee-based lending as an alternative to traditional interest-bearing loans that conflict with Islamic law. They also supported creating affordable housing on properties owned by faith organizations.

The morning’s final group consisted of emergency dispatchers seeking access to the state disability and retirement system. Sickles expressed sympathy before leaving for the tunnel to the Capitol as the Democrats’ daily 11 a.m. caucus meeting approached.

The activity extends throughout the 14-story General Assembly building, where lobbyists crowd the hallways, elevators and café.

“Lobbying is a thriving industry,” Sickles quipped.

During the rush, Sickles also darted downstairs for a slice of cake marking state Sen. Louise Lucas’ 81st birthday, joining a gathering filled with attentive lobbyists.

From the House floor to evening receptions

The House of Delegates convenes at noon each day. Members begin by recognizing constituents watching from the gallery before moving through formal legislative procedures, including readings, committee substitutes and engrossing bills.

Sickles’ afternoons are frequently dominated by Appropriations Committee hearings and votes. Decisions can involve funding for everything from colleges and railroads to civil aviation, accompanied by still more appeals from advocates.

His work often continues into the evening as he prepares for the following day, meets with constituents and lobbyists, and attends receptions hosted by lobbying groups. He usually finishes around 9 or 10 p.m.

Sickles said the work rewards curiosity.

“If you’re curious about how things work, this is the place to be,” he said. “The more you learn, the more you need to learn.”

Virginia delegates receive $17,600 annually, and Sickles describes the role as public service rather than a lucrative pursuit.

The institution itself also carries historical weight. The House traces its roots back 405 years to the colonial House of Burgesses.

“When you return after a long absence, you feel a sense of history and realize you are a very small part of it,” Sickles said.

A focus on health care

Now in his 22nd year representing eastern Fairfax County, Sickles has developed a legislative specialty in health care. He chairs the Health and Human Services Committee and the Appropriations Subcommittee on Health and Human Resources. He also sits on the Privileges and Elections and Rules committees.

He identifies three health care initiatives among his leading accomplishments. One measure, now law, prevents a hospital from billing an insured patient beyond the amount covered by the insurance plan, aside from the patient’s deductible and co-payment.

Another initiative would increase transparency in drug pricing by requiring participants throughout the supply chain—from manufacturers to pharmacies—to report prices. The state would then publish that information annually.

Sickles also successfully established Virginia’s health insurance exchange to implement the federal Affordable Care Act. The state agency gives uninsured residents a place to purchase coverage instead of relying on a federal exchange.

Originally from Arlington, Sickles spent 18 years working for the marine services company Weeks Marine. Outside his responsibilities as a delegate, he works on federal legislation with Moran Global Strategies.