Dear DBHDS:

BrightView Health would like to express our appreciation for considering feedback from providers and making amendments that will allow us to better provide appropriate substance use disorder treatment services. BrightView concurs with the comments submitted by the Virginia Association of Medication Assisted Recovery Programs. Please find that BrightView submits the following additional comments.

12VAC35-109-250 Service Operation Schedule

Section B.2. States, "The provider receives prior approval from the state opioid treatment authority (SOTA) for Sunday closings. Each program must have a policy that addresses medication for the newly inducted patients and those who are deemed at risk, i.e., still actively using illicit substances or medical issues that may warrant closer monitoring of medication. This policy must include openings on Sundays for the population described above."

BrightView recommends changing the wording of the first sentence to read, "Provider will follow federal guidelines for Sunday closings."

• The SOTA oversees and ensures the programs follow federal guidelines, and prior approval is not necessary.

12VAC35-109-280. Counseling sessions

Section A.1. States, "The provider shall conduct face-to-face counseling sessions (either individual, group, or family) of one hour minimum. The provider shall document details of each session including the length within the individual's service record. The counseling sessions shall occur:                                                                                                                     1. Every week for the first six months of the first year of the individual's treatment."

BrightView recommends the counseling sessions are only required to be offered to the individual twice per month for the first twelve months of treatment.                   

• The provider cannot control the frequency of the counseling sessions the patient chooses to attend. It is counterproductive to deem a patient ineligible for the program for noncompliance with inflexible therapy requirements.
• Federal regulations require counseling sessions to be provided to patients as clinically necessary (42 CFR 8.12(f)(5)(i)). The frequency of attendance that is clinically necessary should be left to the professional judgement of the provider.

Thank you for this opportunity to provide input on these proposed amendments. Please feel free to contact BrightView with any questions or if we can be of assistance in any way.