Planning Commission tables drug treatment clinic’s expansion request

The Pulaski Planning Commission on Tuesday tabled a request by Pulaski Medical for approval of a special exception to allow for a 6,099-square foot expansion of its facility at 1006 East Main Street.

The action came following a joint public hearing between the commission and Pulaski Town Council during council’s legislative session – its only meeting scheduled for December.

The commission’s job is to make a recommendation to council whether or not to approve the special exception. Council takes the commission’s recommendation into consideration when it makes the final decision on the request.

Deputy Town Manager Nicole Hair told council Pulaski Medical’s facility – an outpatient mental health and substance abuse clinic – lies in the town’s B-2 General Business District. Hair explained such a clinic is permitted in the B-2 District with an “approved special exception.”

However, the clinic is considered “non-conforming” since Pulaski Medical went into operation prior to a change in the town’s zoning ordinance requiring an approved special exception. Because it is non-conforming, the requested expansion cannot be approved until Pulaski Medical’s request for a special exception is approved.

Pulaski Medical’s planned expansion would create two additional spaces to provide its services. One space would be used to expand current services and includes additional waiting areas, reception facilities, lab spaces, restrooms and medication area. The second space would expand office space and include additional conference rooms, reception and waiting areas as well as restroom facilities.

Often referred to as a methadone clinic, Pulaski Medical is a certified opioid treatment program, providing detoxification and substance abuse treatment. Patients of the clinic receive daily doses of medications prescribed for them – one of which might be methadone. As part of their treatment, patients are also required to attend counseling sessions at the facility, which is highly regulated by the DEA (Drug Enforcement Administration) and the Virginia Pharmacy Board.

Following Hair’s presentation, Pulaski Medical Executive Director Cherie Adams faced council and the commission – briefly describing the work of the clinic, then answering a barrage of questions from commission and council members.

Adams reported that Pulaski Medical’s current patient count stands at 600, but that number is expected to grow by another 200 to 300 patients after the first of the year – partly due to Medicaid expansion.

Adams said the current facility is over capacity, which she said explains why patients are seen standing in line outside the clinic. Adams said the planned expansion would provide the space needed for the expected increase in patient count.

Adams responded to questions on a variety of issues, including concerns over reported problems with patients staying in the area of the clinic following their treatment, and about patients being brought to the clinic from other jurisdictions.

Adams said of the 600 patients, about 480 live in the Pulaski area and most of the rest live elsewhere in the county. She added that five patients live in West Virginia, two in Grundy and the rest in Giles and Wythe counties.

Adams acknowledged some problems had been reported but defended the need for the clinic.

“I am from here,” Adams said, noting she was born and raised in the Shiloh area. “What happens here means a lot to me.”

Adams said she doesn’t think there is anyone here who isn’t touched by substance abuse in some way.

“Substance abuse as a whole is overwhelming our town. It is a nationwide epidemic,” Adams exclaimed. She said the clinic primarily treats opioid addictions – including pain killers and heroin. She noted the use of heroin is “rampant in this area.”

She said getting patients off opiates is a long process, and for most it happens over years, not months.

According to Adams, about 150 of the clinic’s patients are in its “work pass group.” Those patients receive their dose of medication before reporting to work at area companies, such as Volvo and James Hardie. The patients are provided required counseling sessions later in the evening to accommodate their work schedules.

During the public hearing council and the commission heard from two other representatives of the clinic and its parent company, Pinnacle Treatment Centers.

After over an hour of Q&A, Mayor David Clark opened the floor for citizens comments.

The only citizen coming forward was David Hagan of the Shelor Group, which operates a used car dealership in Pulaski next to the clinic.

Hagan told council and the commission that when his company built the dealership, they never dreamed the clinic would be expanded.

He said a gentleman’s agreement existed between he and the owner of the Pulaski Medical property, Bob Strenz, that Shelor would possibly buy that property if Strenz would re-locate the clinic elsewhere – opening the door for the dealership to expand.

Hagan said his company chose to spend $2.5 million on the dealership beside the clinic and he could not support an expansion of it partly because of concerns over economic development. Hagan said he sees the area as being a vital part of the town’s economic growth.

Hagan said he also is concerned about the clinic’s patients.

“I am the father of a son who died a year ago from a prescription overdose. I get it. I understand it. It is a very needed program,” Hagan said of the clinic’s work.

He said he understands that patients of the clinic have pride and “they don’t need to be lined up like cattle outside. They don’t need to be in the rain.”

Hagan said he realizes the planned expansion is for more waiting room in an attempt to accommodate 900 patients, however, he said, “I think we all know 900 will go up to 1,200 and 1,200 will go bigger.”

Hagan said there are lots of places in Pulaski where the clinic can be located, but its present location isn’t the place for it.

“I don’t know about anyone else, but I haven’t had any problem finding a building to buy in Pulaski,” Hagan stated. “There are plenty of facilities that are private and better for customers, better for the patients and better for the community.”

Hagan said one example is the Pulaski Medical Center – next to LewisGale Pulaski Hospital – that had been for sale the past year or two.

“I bought that building yesterday,” Hagan stated. He added the 17,000-square foot building was, in his opinion, a great bargain. “There are a lot of places that could serve their customers and the community better.”

Hagan asked council to consider his points, but if it chose to approve the special exception and allow the expansion that he would like some buffer between the clinic and his company’s dealership. Although, he noted, the dealership had had “very little trouble” with the clinic’s operation.

Council does not meet again until Jan. 2, so it would appear a final decision on the special exception request won’t happen at least until then.


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