Education Required for Addiction Counselor Credentialing

Virginia credentials three types of addiction counselors. A Certified Substance Abuse Counselor Assistant must hold a high school diploma, complete 300 hours of relevant education courses and have 180 hours of experience. A Certified Substance Abuse Counselor requires a bachelor’s degree, 400 hours of relevant education courses and training and 2,000 hours of experience. A Licensed Substance Abuse Treatment Practitioner requires a master’s degree related to substance abuse or counseling, a 600-hour internship and 4,000 hours of a supervised residency. Va. Code §54.1-3507 and Virginia Board of Counseling

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Licensed Professional Counselor Ability to Diagnose

Licensed professional counselors (LPCs) conduct assessments and diagnoses for the purpose of establishing treatment goals and objectives for patients. LPCs plan, implement and evaluate treatment plans using treatment interventions to facilitate human development. Va. Code §54.1-3500

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Number of Nurse Practitioners Prescribing Buprenorphine

As of August 2018, 71 NPs in Virginia have received a federal waiver to treat opioid dependency with buprenorphine-containing products. Consistent with their prescriptive authority and with proper training or appropriate experience an NP in independent practice can receive a federal waiver to dispense buprenorphine-containing products. An NP who is prescribing while supervised by a physician may be able to receive a federal waiver with proper training or experience and as long as the supervising physician is certified, trained, or permitted to treat and manage patients with opioid use disorder. Certain NPs who complete 5 years of full time clinical experience as a licensed nurse practitioner under practice agreement with a physician can practice independently.  Va. Code §54.1-2957.01(A)

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Number of Physician Assistants Prescribing Buprenorphine

As of August 2018, 15 PAs in Virginia have received a federal waiver to treat opioid dependency with buprenorphine-containing products. A PA in Virginia may prescribe controlled substances as authorized by practice agreement with a supervising physician. With proper training or appropriate experience a PA in Virginia can receive a federal waiver to dispense buprenorphine-containing products, as long as the supervising physician is certified, trained, or permitted to treat and manage patients with opioid use disorder. Va. Code §54.1-2952.1

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Peer Support Specialist Certification or Credentialing Authority

The Department of Behavioral Health and Developmental Services is tasked with establishing the qualifications, education and experience of peer recovery specialists. . The standards and requirements for certification of a peer recovery specialists are administered through a collaborative effort between the state and a third-party, non-profit certification provider. 12 Va. Admin. Code § 30-130-5190

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Authority to Sign POLST Forms

NPs are authorized to sign physician orders for scope of treatment forms as qualified emergency services personnel. Va. Code §54.1-2987.1

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Practice Authority

Before allowed full independent practice authority, NPs must complete two years of full time clinical experience as a licensed nurse practitioner under practice agreement with a physician. Va. Code §54.1-2957

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Prescriptive Authority

Nurse practitioners may prescribe Schedule II-VI controlled substances without a collaborative agreement if certain conditions are met. Va. Code §54.1-2957.01(A)

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Nurse Practitioner as a Primary Care Provider

NPs are not recognized in state policy as primary care providers.

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Authority to perform ophthalmic procedures

Optometrists may only perform procedures related to foreign body removal and the examination, evaluation, diagnosis and treatment of the human eye. Additional allowable procedures may be authorized by statute and/or rule. Va. Code §54.1-3200

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Injectable Authority

Optometrists may use epinephrine for treatment of emergency cases of anaphylactic shock as well as administer the COVID-19 vaccine. Va. Code §54.1-3200

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Prescription of controlled substances

Optometrists may prescribe Schedule III-V controlled substances and Schedule II controlled substances containing hydrocodone combinations. Va. Code §54.1-3200

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Dental Hygienists with Direct Access

Dental hygienists employed by the Virginia Department of Health can enter into a remote supervision agreement with a dentist allowing the dental hygienist to provide dental hygiene services outside the dentist’s presence and without an initial patient examination by the dentist at a community health center, charitable safety net facility, free clinic, long-term care facility, elementary or secondary school, Head Start program, or women, infants, and children program. Local anesthesia or nitrous oxide may not be administered under remote supervision. The dental hygienist must have two years of experience and regular, periodic communications with the dentist. Virginia Code §54.1-2722

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Dental Therapists

Dental therapists are not recognized in state policy as an oral health provider.

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Practice of Teledentistry

Virginia allows for the practice of teledentistry. (Recently passed; statute not updated)

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Administration of COVID-19 Vaccine

Pharmacists may administer vaccines included on the Immunization Schedule published by the Centers for Disease Control and Prevention or that have a current emergency use authorization from the U.S. Food and Drug Administration. (Bill enacted March 18, 2021. Statute not yet updated.)

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Prescription Adaptation

Virginia does not allow pharmacists to modify prescriptions.

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Prescription of Hormonal Contraceptives

A pharmacist may initiate treatment with, dispense, or administer injectable or self-administered hormonal contraceptives if the patient completes a self-assessment. A pharmacist must notify the patient’s primary health care provider as long as the patient consents to such notification. If the patient does not have a primary health care provider, the pharmacist must counsel the patient regarding the benefits of establishing a relationship with a primary health care provider. A pharmacist must counsel the patient regarding seeking preventative care, including routine well-woman visits, testing for sexually transmitted infections and pap smears. Va. Code §54.1-3303.1

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Prescription of Tobacco Cessation Aids

Virginia does not allow pharmacists to prescribe tobacco cessation aids.

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Supervision Requirements

A patient care team physician or patient care team podiatrist may serve on a patient care team with physician assistants and shall provide collaboration and consultation to such physician assistants.  Each patient care team shall identify the relevant physician assistant’s scope of practice and an evaluation process for the physician assistant’s performance. A physician or podiatrist shall not supervise more than six physician assistants at a time. Va. Code §54.1-2952

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Prescriptive Authority for Physician Assistants

A PA may prescribe drugs, devices and controlled substances if authorized through a practice agreement and under the supervision of a physician. Va. Code §54.1-2952.1

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Scope of Practice Determination

The supervising physician and the PA identify the PA’s scope of practice, including the delegation of medical tasks as appropriate to the PA’s level of competence. Tasks are outlined in policy and must be set forth in a practice agreement. Va. Code §54.1-2952

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