A Proposed Methadone Clinic Raises Concerns, Meets Needs – Part I

Last week, the Stafford County Planning Commission voted unanimously to recommend approval of an amendment to county zoning codes that expands the definition of “hospital” to include facilities that provide “opioid treatment services.”

If this amendment is approved by the Board of Supervisors, it will require a facility intending to provide intervention to people with substance use disorder—as well as people with mental illness or developmental disabilities—go through the process of obtaining a conditional use permit.

Following the Commission’s unanimous vote to approve the amendment, audience members in attendance wearing purple shirts applauded. Many of them are neighbors of the Woodlawn Shopping Center off Deacon Road, where a methadone clinic operated by Maryland-based Concerted Care Group is expected to open after it receives its state license.

Methadone is a medication approved by the U.S. Food and Drug Administration to treat opioid use disorder. It’s an opioid agonist, meaning it activates the same receptors in the brain as heroin and synthetic opioids like fentanyl, but because it’s long-acting, it reduces cravings and prevents debilitating withdrawal symptoms.

This allows patients to stabilize, break the cycle of seeking drugs to prevent sickness and focus on other aspects of their recovery, such as therapy, counseling and peer support, which the facility also plans to offer.

Concerted Care’s application was approved by the county zoning director early last year. It did not require further approval because the use is permitted by-right under current zoning.

However, Stafford County ordinance does require that neighboring property owners be notified of the application. This did not happen until July, more than three months after the clinic was approved.

Concerned neighbors of the proposed location and their supporters formed a group called 22405 Neighborhood Watch and have spent significant amounts of time and funds over the past eight months attempting to stop the clinic from opening.

The group has filed an appeal of the county’s approval of Concerted Care’s application, arguing that because the company has to obtain a medical license through Virginia, the proposed clinic should have counted as a hospital and should not have been considered a by-right use.

A Stafford Circuit Court judge in September dismissed this case and two other related ones, but the matters are now with the Virginia Court of Appeals.

The message of the 22405 Neighborhood Group has been that clinics providing medication assisted treatment for opioid use disorder are needed in Stafford, but not in a location near neighborhoods and a daycare center with limited access to public transportation and poor walkability.

They are also distressed by the lack of notification from the county or opportunity for public input into the process.

“The way this methadone clinic has come to be so far has been very, very under the radar,” said Linda Winans during a public hearing on the proposed amendments at the Planning Commission’s January 10 meeting. “It’s a thing that’s needed, but it needs to be put in its proper place. If this passes, there will be more control over where places like this can go … You all have the ability to shape the way this county is going to look now and into the future. It’s a very, very smart move to be more responsive and responsible, not only for residents but people who need the help.”

‘Legal Nonconforming Uses’

As Kathy Baker, the county’s acting director of planning, told the Commission at the meeting, the amendments broaden the definition of hospital to include any facility that provides certain “service or services” as defined by Virginia Code Section 37.2-403.

The Code defines services as “interventions intended to reduce or ameliorate mental illness, developmental disabilities, or substance abuse through care, treatment, training, habilitation, or other supports that are delivered by a provider to persons with mental illness, developmental disabilities, or substance abuse.”

It continues, “Services include outpatient services, intensive in-home services, opioid treatment services, inpatient psychiatric hospitalization, community gero-psychiatric residential services, assertive community treatment, and other clinical services; day support, day treatment, partial hospitalization, psychosocial rehabilitation, and habilitation services; case management services; and supportive residential, special school, halfway house, in-home services, crisis stabilization, and other residential services.”

The county’s current zoning permits hospitals only by conditional use permit in certain zoning districts.

Hospital use is one of three medical uses permitted by the county’s zoning. The other two are “medical/dental office” and “clinic, medical and dental.”

Baker explained that the main difference between these two uses has to do with the number of providers permitted. Medical and dental offices can have a total of two principal providers, while clinics do not have a limitation.

If approved by the Board of Supervisors, the amendment would render all existing facilities that meet the new definition of hospital “legal nonconforming uses,” meaning they would not be able to expand without seeking a conditional use permit.

22405 Neighborhood Group

Stafford’s zoning administrator notified Concerted Care that its proposal could proceed by-right on March 3, 2023, just two months after legislation went into effect eliminating the requirement that methadone treatment facilities be located more than one-half mile from a public or private licensed daycare or K-12 school.

Kristin Halstead, a member of the 22405 Neighborhood group, said the Woodlawn location is 500 feet from a daycare center.

She said the group has evidence that Concerted Care was inquiring about opening a treatment facility in the Woodlawn location as early as 2022 and was ready to move forward as soon as the new legislation went into effect on January 1, 2023.

The group feels the location isn’t accessible for its patients and also isn’t safe for them or for the surrounding community. The clinic would open at 5:30 a.m., but bus service doesn’t begin until 8:30 a.m.

“The public school bus stops in front of the shopping center,” Halstead said. “The school recreational bus stops in the shopping center parking lot. There are no sidewalks for people who need to walk to the clinic.”

“It takes about 10 minutes for public safety to arrive in that location if somebody has a major health issue after getting their medication,” she continued. “They will not receive the help they need in a timely manner. It’s just a huge safety concern for everybody involved.”

Halstead said the group has tried to engage with Concerted Care and has received no response.

“We were hoping there would be more community engagement if they are coming here to help the community,” she said.

The group is determined to keep fighting the facility and is seeking funding to continue its legal efforts “to protect the local community,” Halstead said.

And it’s hoping that the Board of Supervisors will pass the hospital definition amendment so that the county will have more control over where future treatment facilities will go.

“They need to go somewhere closer to the hospital where patients might need to receive emergency treatment,” Halstead said. “Not right next door to a local grocery store that everybody is going in and out of, and definitely not right next door to a daycare center. Not in a neighborhood. It doesn’t need to be in a neighborhood.”

It’s not yet clear when the Board of Supervisors will take up the matter.

In Part II, coming at 5 p.m., we look at how methadone has help one local resident and business owner recover his life.

by Adele Uphaus