[HISTORY: Adopted by the Board of Supervisors of Carroll
County 3-22-2022; amended in its entirety 5-9-2022. Subsequent amendments noted where applicable.]
A.
Purpose. The Carroll County Board of Supervisors has determined that
it shall regulate the licensing of methadone clinics in Carroll County,
Virginia. The purpose of this chapter is to provide the citizens of
Carroll County, Virginia, proper, adequate and necessary medical care.
B.
Title. This chapter is identified and may be cited as the "Licensing
Regulations for Methadone or Other Opioid Replacement Clinics."
As used in this chapter, the following terms shall have the
meanings indicated:
The Carroll County Board of Supervisors.
The Commissioner of the Virginia Department of Behavioral
Health and Developmental Services.
The County of Carroll, Virginia.
The Virginia Department of Behavioral Health and Developmental
Services.
A clinic regulated pursuant to § 37.2-406 of the
Code of Virginia, 1950, as amended.
It is required that the methadone clinic requesting a license
to practice or conduct business in the County of Carroll first apply
by application to the Department. By virtue of § 37.2-406
of the Code of Virginia, the Department shall notify the Carroll County
Board of Supervisors of said application. In accordance with § 37.2-406
of the Code of Virginia, the Carroll County Board of Supervisors shall,
within 30 days of receipt of said notice, submit to the Commissioner
the County's comments and a copy of the ordinances concerning
the regulation of licensing of methadone clinics in Carroll County,
Virginia. No license shall be issued by Carroll County until the conditions
contained herein and those required by § 37.2-406 and the
regulations of the Department shall have been met.
In addition to the application and approval of the application
by the Department, an application to practice business in Carroll
County, Virginia will be required. This application must be submitted
to the Carroll County Board of Supervisors within five days after
approval of the Commissioner and shall contain the following:
A.
Applicants requesting an initial license to provide services for
the treatment of opioid addiction through the use of methadone or
any other controlled substance shall supply information to demonstrate
the need for, and appropriateness of, the proposed service.
B.
Applicants shall demonstrate that the geographic and demographic
parameters of the service area for the proposed service are reasonable,
and the proposed service is expected to obtain sufficient patients
to justify the service. The applicant shall also define the service
area and it shall not exceed 100 miles from the proposed location
of the service. The applicant shall also identify the number of individuals
it seeks to be licensed to serve.
C.
Applicants shall demonstrate that there are no other facilities located in the service area set forth in Subsection B above that provide the same or similar service.
D.
Applicants shall demonstrate that there are persons residing in the
proposed service area who have an opioid addiction and would benefit
from the proposed service. The following information may be used by
the applicant to document that individuals in the service area are
known or could reasonably be expected to be in need of the proposed
service:
(1)
Numbers of persons on waiting lists for admission to any existing
opioid addiction or other public substance abuse treatment program
in the service area for the most recent twelve-month period;
(2)
Numbers of opioid use disorder cases (e.g., overdoses) originating
from the proposed service area that have been treated in hospital
emergency rooms for the most recent available twelve-month period;
(3)
Projections of the number of persons in the service area who are
likely to seek services for opioid addiction based on drug-use forecasting
data, citing the source of the data;
(4)
Data reported on suicidal and accidental deaths related to opioid
use in the proposed service area for the most recent available twelve-month
period, citing the source of the data;
(5)
Data from law enforcement officials for the County of Carroll regarding
arrests in the proposed service area related to illicit opioid activities,
citing the source of the data;
(6)
Data on communicable diseases for the proposed service area related
to injection drug abuse (e.g., HIV, AIDS, T.E. and Hepatitis B and
C);
(7)
Data on the availability of any evidence-based alternative services
or services that have been proven effective in the treatment of opioid
addiction, and that are accessible to persons with the proposed service
area, including services provided by physicians' offices;
(8)
Data provided from local law enforcement officials (including law
enforcement officials for the counties of Grayson, Wythe, Pulaski,
Floyd, Patrick and Carroll) regarding arrests for the illegal sale
of methadone obtained by patients through a licensed methadone clinic;
(9)
Data proving that the use of methadone as a medical treatment provides
patients with the tools needed to end their drug dependence; and
(10)
Letters from citizens, governmental officials, or health care
providers, which indicate there are conditions or problems associated
with substance abuse in the community that demonstrated a need for
the applicant's proposed opioid treatment services in the service
area.
E.
The Board of Supervisors shall determine whether a need exists for the proposed service based on the documentation provided in accordance with Subsection D, and the consideration of the following factors:
(1)
Whether there are a sufficient number of persons in the proposed
service area who are likely to need the specific opioid treatment
service that the applicant proposes to provide.
(2)
Whether the data indicate that evidence-based service capacity in
the proposed service area is responsive to or sufficient enough to
meet the needs of persons with opioid addiction.
(3)
Whether there is documentation of support to confirm the need for
the proposed service in the identified service area.
The proposed site of the service shall comply with Virginia
Code § 37.2-406 and shall not be located within 1/2 mile
of a public or private licensed day-care center or a public or private
K-12 school.
A.
In addition, it is required that the building or space to be used
by the proposed service shall be located within 1,000 feet of a medical
facility providing emergency medical treatment and care for patients
of the methadone clinic.
B.
It is required that the building or space to be used by the proposed
service is suitable for the treatment of opioid addiction by submitting
documentation of the following:
(1)
Compliance with the requirements of the local building codes;
(2)
Compliance with all required business licenses;
(3)
That the building is suitable for and compatible with use as offices
and the delivery of health care services;
(4)
Existence of sufficient off-street parking to accommodate the projected
caseload of the service without disrupting traffic flow or adversely
impacting neighborhood residences or businesses;
(5)
Existence of accommodations necessary to protect individuals during
periods of inclement weather;
(6)
Compliance with the Virginia Statewide Fire Prevention Code; and
(7)
A written plan to ensure security for storage of methadone at the
site, which complies with regulations of the Drug Enforcement Agency
(DEA), and the Virginia Board of Pharmacy.
C.
The Board of Supervisors will make its decision based on the documentation
provided by the applicant if the proposed facilities are suitable.
Applicants for licensing to provide the treatment of opioid
addiction through the practice of methadone distribution in Carroll
County, Virginia, shall also submit information to demonstrate the
number of qualified personnel available to meet the needs of individuals
whom the applicant proposes to serve. Also, the Carroll County Board
of Supervisors requires that the personnel meet certain criteria,
as follows:
A.
A program director with relevant training and proven experience in
the treatment of persons with opioid addiction;
B.
A medical director who is a board-certified addictionologist or has
successfully completed or will complete (within one year) a course
of study in opiate addiction that is approved by the Department of
Mental Health, Mental Retardation and Substance Abuse Services;
C.
A minimum of one pharmacist must be on duty at all times the proposed
clinic is open for business;
D.
Licensed registered or licensed practical nurses;
E.
Counselors who are licensed, license-eligible or certified by the
applicable Virginia health regulatory board or by a nationally recognized
certification board, or eligible for this license or certification;
and
F.
Personnel to provide support services.
A.
The applicant shall also submit a description for the proposed service
that includes:
(1)
Proposed mission, philosophy, and goals of the provider;
(2)
Care, treatment and services to be provided;
(3)
Proposed hours and days of operation;
(4)
Plans for on-site security; and
(5)
A diversion control plan for dispensed medications.
(6)
In addition to the requirements of 12 VAC 35-105-580.C(2), applicants
shall provide documentation of their capability to provide the following
services and supports, directly or by arrangement with other specified
providers, which such services and supports are (a) requested by an
individual being served; or (b) identified as an individual need based
on the assessment conducted in accordance with 12 VAC 35-105-60.B
and included in the individualized services plan.
(7)
A plan showing how each individual served shall be assessed by the
medical director to determine if that individual is appropriate for
safe and voluntary medically supervised withdrawal or continued federally
approved pharmacotherapy treatment for opioid addiction and what conditions
the medical director is using to assess the individual for continued
treatment.
(8)
The applicant must also provide the Board of Supervisors with a plan
on how the provider shall provide or arrange for the provision of
continuing supportive services for individuals who voluntarily withdraw
from opioid treatment.
B.
The applicant shall also provide a written plan to the Board of Supervisors
on the applicant's liaison and its plans to have a developing
and maintaining cooperative relationships with community organizations,
other service providers, local law enforcement, local government officials,
and the community at large.
