The discussion of a CACREP licensure requirement in Virginia is not new and was heavily debated when I was applying for supervision for LPC licensure in 2012/2013 and again in 2015 after I was licensed. I live and work in rural, Southwest Virginia and am currently in a position where I am both providing direct service care and hiring and supervising license-eligible and licensed counselors and social workers. Attempting to find and retain licensed counselors in a rural setting is extremely difficult with vacancies staying open at a minimum of 3 months, but generally much longer due to a lack of licensed professional counselors in the area. Moving the regulation for CACREP-only programs in Virginia would significantly increase the difficulty to hire and retain license-eligible and licensed counselors by further reducing the pool of qualified applicants. In addition to the impact on the workforce, there would be an impact on the ability to provide direct mental health and substance abuse services. Rural, Southwest Virginia has been hit hard by the opioid epidemic and does not have the availability of the resources and supports that more urban areas of Virginia currently have available. It may be better to focus our attention and efforts on how to increase the workforce of qualified mental health and substance abuse providers, as well as how to increase availability of mental health and substance abuse treatment in rural areas affected by the opioid epidemic.