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January 12, 2018

Health building could include drug treatment beds

Photo/Lawrence Emerson
The county supervisors suggest a two-story building to replace the mental health clinic on Hospital Hill.
Conceptual drawing for a new mental health clinic building — without a second floor — on the existing site.
Because of the age and construction style of the building . . . it’s just not conducive to a real rehab. It’s better just to get rid of it.
— Brian Duncan, community services board director
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Staff Journalist
Fauquier’s board of supervisors wants to know if plans for a new mental health clinic in Warrenton could expand to provide space for residential addiction recovery and/or psychiatric care.

After a 30-minute work session Thursday, the board postponed action on a consultant’s report related to the demolition and replacement of the Fauquier Behavioral Health Clinic building at 340 Hospital Drive to get an answer to that question.

The county, PATH Foundation and Rappahannock-Rapidan Community Services Board, which operates the clinic, paid Northern Virginia-based SWSG $48,995 to prepare that study.

> Documents at bottom of story

The best solution calls for constructing a new mental health clinic at the site, RRCSB Executive Director Brian Duncan told the board.

“Because of the age and construction style of the building . . . it’s just not conducive to a real rehab,” Mr. Duncan said. “It’s better just to get rid of it.”

Remodeling the existing clinic to include a small addition would require investing about $1 million in a structure that has seen its better days, Mr. Duncan suggested in an interview.

A state agency, RRCSB owns the two-story, 7,800-square-foot building constructed in the mid-1970s. It stands on an acre that the county owns.

The supervisors’ interest in adding a third floor to a new clinic building for a residential addiction recovery program stems from growing concern among a range of organizations and citizens who believe Fauquier desperately lacks that kind of service.

A Richmond-based foundation’s proposal to establish a 14-bed addiction recovery center in downtown Warrenton helped to heighten awareness of the demand for such treatment.

But the town council — citing zoning and the comprehensive plan — Tuesday unanimously denied The McShin Foundation’s special permit application to operate a 28-day addiction recovery program at 30 John Marshall St.

County board Chairman Chris Butler (Lee District) asked during Thursday’s work session whether the SWSG concept for a new mental health clinic building includes a residential addiction recovery component.

That never had been “part of the thinking or part of the goal that we set forth to achieve in the original design of this,” Mr. Duncan said.

Adding that element “really changes the character and the use of the property and any building on it,” he explained. “It would require a completely different assessment” of the project.

As proposed, the concept — a two-story, 9,400-square-foot building with 52 parking spaces — would cost $4 million to complete, according to SWSG, an architectural, engineering and construction management firm.

His agency “is not seeking additional residential beds for addiction treatment,” Mr. Duncan said. “We are not doing that in Fauquier or in the region.”

RRCS has no interest in doing so because it operates a 32-bed addiction recovery center in Culpeper that serves Fauquier and other residents in the area, he said.

The state agency opened Boxwood Recovery Center in the 1980s and replaced it six years ago with a $4 million facility, Mr. Duncan said in an interview.

“We are seeking to expand and indeed are expanding access to out-patient (addiction) services” through the Warrenton clinic, he told the board.

They include “intensive out-patient services, medication-assisted treatment and those components of services that we view as responding more appropriately to the local needs that we see in our community,” Mr. Duncan said.

Recognizing the importance of peer-to-peer recovery programs, his agency prefers the clinic’s outpatient treatment approach “because it keeps people at home, keeps (them) in their community, where rehabilitation needs to take place.”

That led to a discussion — initiated by Supervisor Chris Granger (Center) — about whether a third floor could be added to the proposed building to accommodate a residential addiction recovery or psychiatric care program.

“Our question is not necessarily who runs it, or what kind of program is it,” said Mr. Granger, whose district includes Warrenton.

But rather, “can they add a third floor, can they put 10 or 12 beds” there? he said. “They can be addiction beds; they can be mental health beds.”

The supervisors hope the consultant can determine by their February meeting the feasibility of such a change to the concept.

If a third floor can work, the three parties need to decide if they want to proceed with that change, a decision partly driven by additional cost and whether the site represents the “best location” for a residential program, Mr. Duncan said.

The proposed layout includes about 1,400 square feet of space for a private primary care practice, which would work with the clinic to treat patients holistically, Mr. Duncan said.

Construction bid documents for the proposed clinic concept would cost about $250,000 to prepare.

To design and construct the clinic would take 18 to 24 months. During construction, the clinic’s approximately 25-member staff would occupy rented space in town for up to 12 months.

Adding licensed psychiatric care beds to the new building, would be far more complex. It would require a certificate of public need from the state health department, which would consider regional competitors’ objections. Even if approved, it would prove very difficult financially to operate.

PATH three years ago gave RRCS $16,000 to hire a consultant to study mental health needs in Fauquier and Rappahannock. The 2016 report identified the “significant renovation or replacement” of the clinic as a priority.

The PATH Foundation Behavioral Health Strategy Group last year came to the same conclusion. With assets that soon will exceed $250 million, the foundation ranks addressing community mental health needs as part of its core mission.

Behavioral Center Evaluation Report by Fauquier Now on Scribd

Behavioral Health Facility Sq Footage by Fauquier Now on Scribd

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BJ · January 12, 2018 at 3:16 pm
Now you all are starting to use your heads! Great location close to the hospital.
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