Virginia providers describe mobile opioid-treatment units to expand access in rural and regional areas

Three Virginia behavioral-health providers described efforts to launch or expand mobile opioid-treatment units during a webinar hosted by the Virginia Opioid Abatement Authority. The presentations covered an operating rural unit run by Piedmont Community Services Board, an in-development program at Rappahannock Area Community Services Board, and a five-city regional partnership in Hampton Roads that partners Sentara Community Care with local city-run CSBs.

Panelists said the mobile units are intended to reduce transportation and access barriers, especially in rural localities and parts of the state with limited public transit. Tony McDowell, with the Virginia Opioid Abatement Authority, summarized the OAA’s role: “the Virginia Opioid Abatement Authority makes grants to cities, counties, and state agencies for efforts to fight the opioid crisis and to treat substance use disorders.”

Piedmont Community Services Board (PCS) described an operating unit that serves Franklin, Patrick and Henry counties and Martinsville. Shannon Clark, director of community support services at Piedmont Community Services Board, said the agency applied for and received state grant funding to build its vehicle and has used the unit since the vehicle arrived. Clark said PCS “doesn’t have any medications on board, but we do have an accompanying car that goes with the mobile unit should an immediate need for the Rx or prescription” and that the unit dispenses naloxone, provides medical evaluations, individual therapy, care coordination, peer support and community outreach. PCS staff reported routinely seeing about 6–7 patients per operating day and noted operational costs including roughly $330 per month for diesel fuel and $2,265 in routine maintenance for FY24. PCS also said it developed partnerships with hospitals, food banks and churches to site the unit at community events and distribution points.

Brandy Williams, deputy executive director at Rappahannock Area Community Services Board, said her agency’s service area covers about 1,400 square miles across five localities and that the program is at the launch stage: “we are standing on the starting line of our practice, but we’re really excited to launch our programming.” Rappahannock has received its unit, is hiring a program manager and staff, and plans a conservative rollout: initial inductions will rely on partnering pharmacies or clinic locations rather than carrying medication on the vehicle until policies and licensing logistics are finalized. Williams said the goal is to connect “between 50 and a 100 individuals annually to care” through the mobile response unit and related outlying clinic activity.

In Hampton Roads, city partners and Sentara Community Care described a regional, public–private model spanning Chesapeake, Norfolk, Portsmouth, Suffolk and Virginia Beach. Stacy Smith, division director for adult behavioral health services for the city of Virginia Beach Department of Human Services, said the five-city planning process found access and same-day availability were the most-cited barriers. Heather Strzok, executive director of operations for Sentara Community Care, said Sentara will provide the medical treatment and the CSBs will provide therapy and peer support on the vehicle; she noted, “I run, 6 mobile units today across Virginia and 5 different regions for primary care services.” Sentara’s team said it plans a secured medication room and intends to be able to prescribe and induce on the vehicle once pharmacy and pharmaceutical logistics are in place, with a tentative launch targeted for Q4 2025.

Panelists discussed several recurring startup and operational issues: procurement and vendor selection (one presenter said their vehicle was procured for about $327,000 via a competitive RFP); grant funding that can cover capital and short-term staffing; the need for memoranda of understanding with local partners and pharmacies; secure medication storage and waste disposal; generator, water and sewage logistics; and internet access (units currently rely on cellular hotspots).

Speakers also described data and confidentiality challenges. The Hampton Roads partnership noted multiple electronic health records across partners and said data exchange will require release-of-information agreements and deidentified reporting for program-level metrics. Panelists identified core evaluation metrics including volume served, time from presentation to first service, and ongoing engagement measures to track whether mobile contacts translate into sustained care.

Panelists emphasized program design choices depend on local context: rural providers described using community events and food-bank sites to reach patients, while the regional model aims to tailor staffing and services to each city’s capacity. Funding strategies discussed included using initial OAA or SOAR grants for capital and start-up staffing costs, then billing insurance or Medicaid where appropriate and seeking additional grants for sustainability. Multiple panelists said mobile-unit staff positions are intended as CSB or provider employees rather than short-term grant roles.

The webinar recording, slides and contact information for presenters will be posted on the Virginia Opioid Abatement Authority website, and OAA staff said registrants will receive a link when materials are available.