As an advanced practice nurse in geriatrics and a proud board member of the impressive Famiky Servicrs of the Roanoke Valley, I agree with their previous comments and especially express concerns for the potential reduction in future counselors and current efforts to decrease wage lists for services.  I agree with one of our counselors: Fewer services in the short term, fewer qualified counselors and fewer credentialed counselors in the long term will result in such a decrease in accessibility of these needed services that it will leave our most vulnerable populations more impaired for longer periods of time further impacting their opportunities for successful outcomes. While these changes may serve to decrease expenditures for mental health services by limiting access, the real life result will be more crisis interventions, more crisis in families, and increased costs to society for dysfunction and repercussions of untreated anxieties and grief, loss, and stress related struggles. 

Please reconsider these changes!