[HISTORY: Adopted by the Board of Supervisors
of Buchanan County 10-5-2006.
Amendments noted where applicable.]
GENERAL REFERENCES
[In regard to statutory provisions, unless the
County specifically amends the statutory provisions to the contrary
or repeals the statutory provisions, future amendments to said statute
shall take effect as provided by law.]
A.
Purpose. The Buchanan County Board of Supervisors
has determined that it shall regulate the licensing of methadone clinics
in Buchanan County, Virginia. The purpose of this chapter is to provide
the citizens of Buchanan County, Virginia, proper, adequate and necessary
medical care.
B.
Title. This chapter is identified and may be cited
as the "Licensing Regulations for Methadone Clinics."
It is required that the methadone clinic requesting
a license to practice business in the County of Buchanan first apply
by application to the Virginia Department of Mental Health, Mental
Retardation and Substance Abuse Services. By § 37.2-406
of the Code of Virginia, the Virginia Department of Mental Health,
Mental Retardation and Substance Abuse Services shall notify the Buchanan
County Board of Supervisors of said application. By § 37.2-406,
the Buchanan County Board of Supervisors shall, within 30 days of
receipt of said notice, submit to the Commissioner of the Virginia
Department of Mental Health, Mental Retardation and Substance Abuse
Services our comments and a copy of the ordinances concerning the
regulation of licensing of methadone clinics in Buchanan County, Virginia.
No license shall be issued by Buchanan County until the conditions
contained herein and those required by § 37.2-406 and the
regulations of the Virginia Department of Mental Health, Mental Retardation
and Substance Abuse Services shall have been met.
In addition to the application and approval
of the application by the Virginia Department of Mental Health, Mental
Retardation and Substance Abuse Services, an application to practice
business in Buchanan County, Virginia will be required. This application
must be submitted to the Buchanan County Board of Supervisors within
five days after approval of the Commissioner of the Virginia Department
of Mental Health, Mental Retardation and Substance Abuse Services
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 Buchanan 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 the physicians' offices;
(8)
Data provided from local law enforcement officials
(including law enforcement officials for the counties of Tazewell,
Washington, Russell, Dickenson, Buchanan and Wise) 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 Buchanan County 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 Buchanan 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 Buchanan 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.
[Added 9-14-2020]
The provisions of this chapter shall apply to methadone clinics
requesting a license to practice business in Buchanan County, Virginia.
[Added 9-14-2020]
A.
Office-based
opioid treatment (OBOT) services, as defined by the Department of
Medical Assistance Services (DMAS) in 12 VAC 30-130-5020, approved
and located within Buchanan County, shall be exempt from this chapter,
provided that such services otherwise comply with applicable state
and federal regulations.
B.
Limitations.
(1)
The exemption provided in Subsection A shall not apply to OBOT services, unless such services:
(a)
Meet
the criteria and regulations set forth in 12 VAC 30-130-5060, entitled
"Covered Services: Clinic Services — Preferred Office-Based
Opioid Treatment;" and
(b)
The
applicant requesting a license to practice business in Buchanan County
demonstrates to the Buchanan County Board of Supervisors that its
OBOT services meet the criteria and regulations set forth in 12 VAC
30-130-5060.
(2)
All
future exemptions from this chapter for OBOT services not presently
in existence in Buchanan County shall be applied for and granted upon
proper notice and proof that such application qualifies for exemption
hereunder.
(3)
OBOT
services provided on the property of a hospital facility shall receive
automatic exemption hereunder, provided that such services otherwise
comply with applicable state and federal regulations.
C.
The provisions
of 12 VAC 30-130-5020 and 12 VAC 30-13-5-60, and all of the provisions
and standards referenced therein, are hereby adopted and incorporated
as if fully set forth at length herein. All future amendments to such
sections and provisions are hereby automatically incorporated into
this chapter.
