Department of Medical Assistance Services
Board of Medical Assistance Services
General Notice: Notice of Public Comment Period: Community Psychiatric Support and Treatment (CPST)
CLOSED Opened on 9/8/2025 and Ended on 9/21/2025
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189 comments
| Comment Title | Commenter | |
|---|---|---|
| Public Comment on Proposed Community Psychiatric Support and Treatment (CPST) Service | Anonymous (237341) | 9/21/25 11:59 pm |
| Case Management | Sowker | 9/21/25 11:58 pm |
| Clubhouse | Sowker | 9/21/25 11:55 pm |
| Financial Impact on Providers and Staff | Anonymous (237338) | 9/21/25 11:45 pm |
| Recommendations | Anonymous (237337) | 9/21/25 11:37 pm |
| Risks to Continuum of Care | Anonymous (237336) | 9/21/25 11:34 pm |
| Reimbursement and Rate Conflicts | Anonymous (237335) | 9/21/25 11:33 pm |
| Exclusion of PRS and CSAC Workforce | Anonymous (237334) | 9/21/25 11:32 pm |
| Duplication with Intensive In-Home (IIH, H2012) | Anonymous (237333) | 9/21/25 11:31 pm |
| Duplication with Mental Health Skill-Building (MHSS, H0046) | Anonymous (237332) | 9/21/25 11:30 pm |
| Conflict with Existing Crisis Services (Appendix G / DBHDS Licensing) | Anonymous (237331) | 9/21/25 11:29 pm |
| A Draft That Costs Dollars and Childhoods | Anonymous (237330) | 9/21/25 10:30 pm |
| Summary -- issues identified as top concerns | Mindy Carlin, VACBP | 9/21/25 9:17 pm |
| Summary of other general feedback | Mindy Carlin, VACBP | 9/21/25 9:16 pm |
| Specific section-by-section feedback | Mindy Carlin, VACBP | 9/21/25 9:15 pm |
| CPST Billing Requirements | Mindy Carlin, VACBP | 9/21/25 9:13 pm |
| Additional Documentation Requirements and Utilization Review | Mindy Carlin, VACBP | 9/21/25 9:12 pm |
| Service Aurthorization | Mindy Carlin, VACBP | 9/21/25 9:10 pm |
| Exclusions and Service Limitations | Mindy Carlin, VACBP | 9/21/25 9:09 pm |
| CPST Medical Necessity Criteria | Mindy Carlin, VACBP | 9/21/25 9:08 pm |
| Provider Qualification Requirements | Mindy Carlin, VACBP | 9/21/25 9:07 pm |
| Required Service Components | Mindy Carlin, VACBP | 9/21/25 9:05 pm |
| Required Service Oversight and Supervision | Mindy Carlin, VACBP | 9/21/25 9:04 pm |
| Required Evidence-Based Practices | Mindy Carlin, VACBP | 9/21/25 9:03 pm |
| Service Definitions/Critical Features | Mindy Carlin, VACBP | 9/21/25 9:01 pm |
| Definitions | Mindy Carlin, VACBP | 9/21/25 8:57 pm |
| Summary of all member feedback | Mindy Carlin, VACBP | 9/21/25 8:55 pm |
| Feedback on CPST manual at this point | Harvest Outreach Center | 9/21/25 7:45 pm |
| CPST proposed regulations | Henrico Area Mantal Health & Developmental Services. | 9/21/25 6:47 pm |
| CPST proposed regulations | Henrico Area Mantal Health & Developmental Services. | 9/21/25 6:46 pm |
| CPST proposed regulations | Henrico Area Mantal Health & Developmental Services. | 9/21/25 6:45 pm |
| CPST proposed regulations | Henrico Area Mantal Health & Developmental Services. | 9/21/25 6:44 pm |
| CPST proposed regulations | Henrico Area Mantal Health & Developmental Services. | 9/21/25 6:42 pm |
| Section 3 Onboarding and Training Concerns | Gretchen Wilhelm, PhD, LPC, LSATP. VNPP, Compass | 9/21/25 5:44 pm |
| Section 4: Supervision | Gretchen Wilhelm, PhD, LPC, LSATP | 9/21/25 5:31 pm |
| 2.1, 4.1, 4.3, 4.5, 4.6 Staffing Concerns | Gretchen Wilhelm, PhD, LPC, LSATP, VNPP, Compass | 9/21/25 5:02 pm |
| CPST proposed regulations | Henrico Area Mantal Health & Developmental Services. | 9/21/25 4:49 pm |
| CPST proposed regulations | Henrico Area Mental Health & Developmental Services | 9/21/25 4:48 pm |
| CPST proposed regulations | Henrico Area Mantal Health & Developmental Services. | 9/21/25 4:47 pm |
| CPST proposed regulations | Henrico Area Mantal Health & Developmental Services. | 9/21/25 4:46 pm |
| CPST proposed regulations | Henrico Area Mantal Health & Developmental Services. | 9/21/25 4:44 pm |
| CPST proposed regulations | Henrico Area Mantal Health & Developmental Services. | 9/21/25 4:43 pm |
| What an insult for QMHPs | Anonymous (237299) | 9/21/25 3:53 pm |
| Grave Concerns | Dr. Claire Curcio, LPC, RACSB Board Director | 9/21/25 3:49 pm |
| Too Many Changes, Too Little Time | Daphne Cunningham, Hampton-Newport News Community Services Board | 9/21/25 1:33 pm |
| Assertive Community Treatment | Anonymous (237295) | 9/21/25 1:12 pm |
| Significant Concerns | Kelli Jones, LPC-Middle Peninsula Northern Neck Behavioral Health | 9/21/25 8:31 am |
| The Good, Concerning, and Recommendations for CPST | HopeTree Family Services | 9/21/25 8:10 am |
| Removing TDT will be detrimental to student mental health and well-being | Anonymous (237292) | 9/21/25 12:44 am |
| referrals to standalone services | Amy Jinddra LPC, RACSB | 9/21/25 12:12 am |
| service reduction | Amy Jindra LPC, RACSB | 9/21/25 12:08 am |
| questions about the CANS lifetime | Amy Jindra LPC, RACSB | 9/20/25 11:58 pm |
| supervision burdens | Amy Jindra LPC, RACSB | 9/20/25 11:52 pm |
| dual dx but not able to utilize clinically appropriate tx | Amy Jindra LPC, RACSB | 9/20/25 11:44 pm |
| chronic nature of SMI | Amy Jindra LPC, RACSB | 9/20/25 11:37 pm |
| not the right help, if not right now | Amy Jindra, LPC, RACSB | 9/20/25 11:27 pm |
| Child-based services impacts | Matthew Zurasky, RACSB BOD | 9/20/25 9:42 pm |
| Financial impacts to Planning District 16 | Matthew Zurasky, RACSB BOD | 9/20/25 9:41 pm |
| Continuum of care interruption | Matthew Zurasky, RACSB BOD | 9/20/25 9:39 pm |
| Not enough time to adequately review | Matthew Zurasky, RACSB BOD | 9/20/25 9:36 pm |
| I am curious | Matthew Zurasky, RACSB BOD | 9/20/25 9:35 pm |
| I am confused | Matthew Zurasky, RACSB BOD | 9/20/25 9:33 pm |
| Improve functioning of current regulations. | Anonymous (237278) | 9/20/25 9:24 pm |
| CPST Concerns | Dana Dewing, HRCSB | 9/20/25 6:13 pm |
| Big Picture | Virginia Network of Private Providers. Inc | 9/20/25 12:48 pm |
| Section 10 Additional Documentation Requirements and Utilization Review | Allison Meyer, GPCS | 9/20/25 12:14 pm |
| Section 9 Service Authorization | Allison Meyer, GPCS | 9/20/25 12:06 pm |
| Section 8 Exclusions and Service Limitations | Allison Meyer, GPCS | 9/20/25 11:53 am |
| Section 7 CPST Medical Necessity Criteria | Allison Meyer, GPCS | 9/20/25 11:48 am |
| Section 6 Provider Qualification Requirements | Allison Meyer, GPCS | 9/20/25 11:44 am |
| Section 5 Required Service Components | Allison Meyer, GPCS | 9/20/25 11:41 am |
| Section 4 Required Oversight and Supervision | Allison Meyer, GPCS | 9/20/25 11:32 am |
| Section 3 Required Evidence-Based Practices | Allison Meyer, GPCS | 9/20/25 11:24 am |
| Section 2 Service Definition/Critical Features | Allison Meyer, GPCS | 9/20/25 11:08 am |
| Section 1 Definitions | Allison Meyer, GPCS | 9/20/25 11:05 am |
| Section 10 | Shenee McCray, RBHA | 9/20/25 8:12 am |
| Section 8 | Shenee McCray, RBHA | 9/20/25 8:11 am |
| Section 7 | Shenee McCray, RBHA | 9/20/25 8:10 am |
| Section 5 | Shenee McCray, RBHA | 9/20/25 8:09 am |
| Section 4 | Shenee McCray, RBHA | 9/20/25 8:08 am |
| Section 3 concerns | Shenee McCray, RBHA | 9/20/25 8:07 am |
| Section 2 | Shenee McCray, RBHA | 9/20/25 8:04 am |
| General Concerns | Shenee McCray, RBHA | 9/20/25 8:02 am |
| Directly impacted LMHP staff perspective | Anonymous (237257) | 9/19/25 6:04 pm |
| Peer Specialist | George Hiter Davis IV | 9/19/25 6:03 pm |
| My services | Anonymous (237255) | 9/19/25 5:56 pm |
| Services Concerns | JayShawn White | 9/19/25 5:54 pm |
| Questions/Comments | Zewditu Tadesse, health Connect America | 9/19/25 5:15 pm |
| CPST Concerns | Michelle Blumling, Harrisonburg-Rockingham Community Services Board | 9/19/25 5:11 pm |
| Concerns with Proposed Behavioral Health Service Redesign | Virginia Beach Human Services | 9/19/25 5:03 pm |
| CPST | Loudoun County MHSADS | 9/19/25 4:44 pm |
| Concerns | Nicole Ocheltree, Harrisonburg-Rockingham Community Services Board | 9/19/25 3:48 pm |
| Concurrent Services | Anonymous (237248) | 9/19/25 3:47 pm |
| concerns | Dianna Sloat, RACSB | 9/19/25 3:46 pm |
| Concerns | Lexy Muskett | 9/19/25 3:37 pm |
| Concerns with Draft Proposal | Private Provider | 9/19/25 3:25 pm |
| The proposed redesign from CMHRS to CPST creates serious risks for SMI adults | Sarah McClelland, LCSW | 9/19/25 3:15 pm |
| Concerns re CPST proposed regulations | Ryan Hite RBHA | 9/19/25 3:07 pm |
| Response to the redesign | clarvida | 9/19/25 3:07 pm |
| CPST model | E C Spangler | 9/19/25 3:06 pm |
| CANS Lifetime | Rappahannock Area Community Services Board | 9/19/25 2:58 pm |
| Section 9: Service Authorization | Rappahannock Area Community Services Board | 9/19/25 2:55 pm |
| Section 8: Exclusions and Service Limitations | Rappahannock Area Community Services Board | 9/19/25 2:54 pm |
| Section 7: CPST Medical Necessity Criteria | Rappahannock Area Community Services Board | 9/19/25 2:50 pm |
| Increased Administrative Burden to an already high demand position | Harrisonburg-Rockingham CSB | 9/19/25 2:49 pm |
| Section 5: Required Service Components | Rappahannock Area Community Services Board | 9/19/25 2:48 pm |
| Section 4. Required Service Oversight and Supervision | Rappahannock Area Community Services Board | 9/19/25 2:47 pm |
| Section 3. Required Evidence-Based Practices | Rappahannock Area Community Services Board | 9/19/25 2:45 pm |
| 2. Service Definition/Critical Features | Rappahannock Area Community Services Board | 9/19/25 2:44 pm |
| Section 1 Definitions | Rappahannock Area Community Services Board | 9/19/25 2:43 pm |
| RACSB Top 6 Concerns: | Rappahannock Area Community Services Board | 9/19/25 2:42 pm |
| Comments & Questions | Anonymous (237229) | 9/19/25 2:39 pm |
| Concerns about requirement changes | Laura Davis, MRCS | 9/19/25 2:30 pm |
| Concerns related to CPST and It's Impacts | Anonymous (237227) | 9/19/25 2:19 pm |
| DMAS changes with CPST/Clubhouse International | Brandy Rushing, LPC (RBHA) | 9/19/25 1:57 pm |
| Concerns | Whitney Girten | 9/19/25 1:44 pm |
| concerns | Anonymous (237221) | 9/19/25 1:00 pm |
| This policy will negatively impact the people we are supposed to be helping | AL, LCSW | 9/19/25 12:40 pm |
| Effects of this will also be drastic for Virginians without SMI. | sharon span | 9/19/25 11:41 am |
| Assessment | Western Tidewater CSB | 9/19/25 11:04 am |
| Timeline | Western Tidewater CSB | 9/19/25 10:56 am |
| Conflict with Crisis Services | Western Tidewater CSB | 9/19/25 10:47 am |
| Redesign Concerns | NRVCS | 9/19/25 9:30 am |
| significant concerns regarding impact on consumers and workforce | Region Ten CSB | 9/19/25 8:18 am |
| Concerns | Anonymous (237211) | 9/18/25 10:58 pm |
| concerns regarding | Anonymous (237210) | 9/18/25 5:56 pm |
| Skillbuilding is a Critical Part of Recovery | Carrie Beard, RACSB Home Road Supervised Apartments | 9/18/25 5:29 pm |
| Concerns with CPST | Katy Bradshaw, DPCS | 9/18/25 4:55 pm |
| Serious concerns and questions | Jodie Burton, DPCS | 9/18/25 4:46 pm |
| Please don't eliminate skill building services and replace with CPST | Jennifer Beall | 9/18/25 3:40 pm |
| TDT | Mandy Patton | 9/18/25 3:06 pm |
| Section 3.3.3 - Transitional Youth Age | Helen Holz, Compass | 9/18/25 2:21 pm |
| Top Concerns | Emily Hollidge, HopeLink Behavioral Health | 9/18/25 2:07 pm |
| Concerns regarding CPST | Pulaski FAPT/CSA Team | 9/18/25 1:52 pm |
| Intensive In-Home Services | Dr. Laura Boyd | 9/18/25 1:44 pm |
| Recommendations for Sustainable EBP Implementation | FCTF Tim Wood | 9/18/25 1:29 pm |
| CPST will decimate services in schools and our communities and pass costs to our localities | Melanie Adkins | 9/18/25 11:41 am |
| Positives and Concerns | Abbey Roff | 9/18/25 11:12 am |
| EBP Sustainability | Janet L. Fuller-Holden | 9/18/25 10:52 am |
| Section 11 Billing Requirements | Anonymous (237193) | 9/18/25 10:34 am |
| Exclusions and Limitations | Dominion Care | 9/18/25 10:30 am |
| Section 8.2 | Anonymous (237191) | 9/18/25 10:27 am |
| Section 7.7 | Dominion Care | 9/18/25 10:24 am |
| Section 7.6 | Anonymous (237189) | 9/18/25 10:22 am |
| Tier 1 Standards | Dominion Care | 9/18/25 10:14 am |
| Care Coordination | Dominion Care | 9/18/25 10:09 am |
| Crisis Support Concerns | Dominion Care | 9/18/25 10:08 am |
| Section 5.2.8 | Dominion Care | 9/18/25 9:56 am |
| Section 5.1 | Dominion Care | 9/18/25 9:50 am |
| Section 4.6 | Dominion Care | 9/18/25 9:47 am |
| Training Mandates | Dominion Care | 9/18/25 9:40 am |
| Section 3.1.2 | Dominion Care | 9/18/25 9:38 am |
| Clarity Needed | Dominion Care | 9/18/25 9:35 am |
| QMPH | Dominion Care | 9/18/25 9:31 am |
| Supervision Requirements Contradict Board of Counseling | Dominion Care | 9/18/25 9:30 am |
| This is wrong | Anonymous (237177) | 9/17/25 7:17 pm |
| Need more clarity and thought | Anonymous (237176) | 9/17/25 3:46 pm |
| Supervision requirements | Anonymous (237175) | 9/17/25 3:41 pm |
| Training Barriers | Anonymous (237174) | 9/17/25 3:36 pm |
| Service duplication and restrictions | Anonymous (237173) | 9/17/25 3:32 pm |
| Workforce Support Challenges | Anonymous (237172) | 9/17/25 3:28 pm |
| High administrative and documentation burdens | Anonymous (237171) | 9/17/25 3:22 pm |
| Telehealth vs. In-Person Confusion | Anonymous (237170) | 9/17/25 3:13 pm |
| unclear boundaries for natural supports and caregiver involvement | Anonymous (237169) | 9/17/25 3:12 pm |
| rigid structure and does not support staffing plans | Anonymous (237168) | 9/17/25 3:09 pm |
| Significant challenges across the board | JB | 9/17/25 2:40 pm |
| concerns | Megan McGregor | 9/17/25 10:28 am |
| Why Keeping TDT in Schools is Necessary | Anonymous (237162) | 9/16/25 5:18 pm |
| Concerns | Michael Price | 9/16/25 3:23 pm |
| CPST Concerns | Caryl Allen | 9/16/25 2:06 pm |
| Community Mental Health functioned best around 2017. It's been a steady decline since 2018. | Andrew Peddy | 9/16/25 1:50 pm |
| Serious Concerns | Elizabeth Webb | 9/16/25 1:08 pm |
| If It Ain't Broke, Don't Fix It | Anonymous (237154) | 9/16/25 11:58 am |
| Concerns | Robert Graham | 9/16/25 11:56 am |
| Concerns | Mary Cheverton | 9/16/25 11:46 am |
| Concerns About CPST as a Replacement for Therapeutic Day Treatment in Schools | Anonymous (237151) | 9/15/25 9:06 pm |
| Maximum Hours Authorized per month is not enough on any tier! | Turning Point Interventions | 9/15/25 9:38 am |
| Services do not compare to TDT, Hurts children | Gina Miano | 9/15/25 8:50 am |
| Travel time and Cost | Virginia Network of Private Providers | 9/15/25 8:44 am |
| Travel time and Cost | Jennifer Fidura | 9/15/25 8:40 am |
| Not a sustainable staffing option | Anonymous (237143) | 9/14/25 8:20 am |
| CPST is not a responsible financial decision | Anonymous (237142) | 9/14/25 7:59 am |
| idk guys | Anonymous (237138) | 9/12/25 6:17 pm |
| Policy on Paper, Chaos in Practice | Anonymous (237137) | 9/12/25 5:46 pm |
| Who will be left to offer the right help, right now? | Anonymous (237136) | 9/12/25 5:12 pm |
| Concerns with Service Definition | HopeLink Behavioral Health | 9/11/25 10:38 am |
| CPST/TDT | Anonymous (237118) | 9/10/25 6:06 pm |
| SBIRTs | LeVar Bowers | 9/10/25 3:58 pm |
| Section 3.2 | Virginia Network of Private Providers. Inc | 9/10/25 9:02 am |
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