After delay, planned Henrico treatment and detox center nears reality

When a Henrico resident is struggling with an opioid or substance abuse problem, he or she typically ends up in one of several places: jail, a recovery home, or in the temporary care of Henrico Area Mental Health and Developmental Services or a private behavioral health crisis agency.

Often, though, none of those options is an ideal one, according to Deputy Henrico County Manager for Public Safety Michael Feinmel, since what many people in those situations need is a longer-term, comprehensive treatment plan to help end their dependence and – and that’s why the county is partnering with a private company to create a new solution.

Henrico is planning to fund the construction of a 24-hour, 60-bed treatment and detox facility on 15.3 acres of county-owned land along Nine Mile Road (adjacent to the Eastern Henrico Government Center) and contract with Pennsylvania-based Pyramid Healthcare for its operation. Pending rezoning approval next month from the Henrico Board of Supervisors, construction could get underway by September, and the $10.1-million facility could open by July of next year.

Ten of its beds would be designated for medically managed high-intensity inpatient treatment for patients who need immediate attention, while the other 50 would be geared for people who need clinically managed residential services, a slightly less-intensive, longer-term designation.

The building, to be located on the site that once housed the former Glen Echo School (which until early this century was the home of Henrico School Board meetings) would total about 31,500 square feet in size and include a gymnasium.

The intent is that anyone who needs immediate treatment for substance use disorders will be able to get it at the new center, regardless of their ability to pay, access to insurance or any other factors.

“Nobody’s going to be turned away based on cost,” Feinmel said. “The most exciting part is that this isn’t just a couple days [of treatment], this is developing a long-term plan for the person so that when they leave the facility, they’ve got a plan.”

Despite delays, 'a much better project'

A center of some type been in the works for more than four years, but getting to this point has taken longer than expected, largely because of the expanding scope of what county officials came to believe was possible.

When Henrico County Manager John Vithoulkas announced plans for a detox and recovery center in November 2020, officials envisioned a building with a capacity of 12 to 16 beds that could serve people in crisis for a period of three to five days. With that general concept in mind, they reached a tentative agreement in early 2022 with Pinnacle Rehabilitation Network LLC to operate a facility that would have about 30 beds.

But before that contract was finalized, the county’s concept for the facility changed to one that could offer longer-term stays for more people, prompting officials to shift their focus to Pyramid Healthcare, which had been the second-place bidder on the project initially.

The result is a facility that will offer more than four times the number of beds the county initially sought, each permitting a stay of as long as 28 days, with the option for additional beds or longer-term care to be provided at one of Pyramid’s two other Virginia facilities (a 160-bed location in Radford or a 152-bed facility in Newport News). The Henrico facility will be located just several tenths of a mile from the Henrico Mental Health East center on Nine Mile Road, where many patients also will receive services.

“From where we started to where we ended, we’ve got a much better project,” Henrico Deputy County Manager for Administration Brandon Hinton told the Henrico Planning Commission during a March 13 public hearing on the proposed rezoning for the site, which the commission endorsed by a 5-0 vote.

For Hinton, Feinmel and the other county officials who have worked on the project, there is excitement about what the facility will offer people in need – from Henrico and beyond.

“This is a great, positive step forward in that we are actually developing inpatient drug treatment beds for folks,” Feinmel said. “This isn’t just a couple days [in treatment], this is developing a long-term plan for the person so that when they leave the facility, they’ve got a plan.”

Through the agreement between Henrico and Pyramid, the county will build the facility and then allow Pyramid to staff and operate it. Henrico will incur no recurring costs for its operation, Hinton said.

Although it will be located in Henrico, the facility will accept patients from any locality, Feinmel said – but as part of its contract and lease agreement with Henrico County, it must accept anyone referred by a Henrico governmental agency. If the beds at the Henrico facility are full, Pyramid will transport any new patient – whether referred by Henrico County or not – to one of its other Virginia facilities for treatment and absorb that cost itself, Feinmel said.

“We’re approaching public safety with an outlook that folks have a disease, and if we can provide care to interrupt that disease. . . if the metrics show that that’s working, then we’ve accomplished our goals.”
– Michael Feinmel,
Deputy Henrico County Manger for Public Safety

'Arresting people is not always the answer'

The idea for the facility grew from the Henrico Recovery Roundtable, a group composed of various county officials and stakeholders that met nine times during an 18-month period beginning in 2019, aiming to provide a roadmap for the county as it attempted to deal with the explosion of drug-related offenses and issues.

County officials view the center as an effort that will help solve multiple problems and provide a new option for multiple county agencies.

For example, Feinmel said, in certain instances, a police officer who stops someone for a drug offense could offer that person the chance to get help at the center rather than charging him or her with the violation. In other circumstances when a charge is levied, that person might spend less than 24 hours in jail before being bonded out to get help at the detox center. And in other cases, patients could be referred through Henrico Mental Health.

The opioid epidemic creates an annual economic burden in Henrico County of nearly $275 million, according to a 2023 study by the VCU Center on Society and Health. The county experiences nearly 36 overdose deaths per 100,000 residents annually – higher than the statewide average of 26.1.

For a number of years just prior to the onset of the COVID-19 pandemic, Henrico had witnessed an explosion in the population of its two jails, which reached about 178% of capacity (about 500 more people than they were built to accommodate) – in large part because of drug arrests and other arrests related to addiction, such as larceny, trespassing and fraud.

In 2024, more than 1,550 people went through detox protocol at the county’s jails, Feinmel said – at a cost of $142 per person per day, or more than $700,000 in total.

The cost to build a third jail to house a larger incarcerated population was estimated at $100 million or more, and despite drug court and other programs in the jails designed to help addicts recover, many revert back to their addiction issues once their forced sobriety in jail ends, Feinmel said.

Spending one-tenth of that amount on a recovery facility that can help end those addictions and provide the resources patients need to lead healthy (and employed) lives after they leave makes much more sense, he said.

“Arresting people is not always the answer,” said Feinmel. “We’re approaching public safety with an outlook that folks have a disease, and if we can provide care to interrupt that disease. . . if the metrics show that that’s working, then we’ve accomplished our goals.”

The facility’s existence also will reduce the region’s dependence upon recovery homes – some of which are effective in their efforts to help addicts transition back to productive lives, some of which are (out of necessity) attempting to care for people who are still in the midst of their addictions, and others of which are not actually qualified to do either, Feinmel said.

“Really, there’s been a vacuum of inpatient treatment beds, and as a result, people have been pushed into different settings that probably weren’t the ideal settings,” Feinmel told the Citizen. “[Recovery homes] are being forced sometimes into serving a need beyond what they should be. They should be more for after the person is stabilized, as opposed to someone who is actively using drugs five times a day. But right now, that’s where they’re going.”

There also are a number of private mental health crisis agencies that bill Medicaid for recovery treatment provided to people in need, Feinmel said, but that actually are providing no treatment at all – only stays in motel and hotel rooms that do nothing to help those people recover.

“They are just dumping them in hotel rooms,” he said. “People are not getting services, they’ve just gone from the street and back to a hotel. It really is nefarious, and that’s something that we’re trying to cut off.”

Henrico to maintain oversight of facility

Pyramid, a 26-year-old company, currently serves about 14,000 active clients in eight states across its more than 50 outpatient care locations and 2,000 inpatient beds. Its services range from detox to structured outpatient offerings “with the hopes of keeping someone engaged in treatment long enough to ensure they engage in long-term recovery,” according to Pyramid Vice President of Business Development Dan Gellman.

In addition to its two active locations in Virginia, it’s also building an 80-bed facility in King George County, just east of Fredericksburg.

Pyramid’s business model primarily relies upon Medicaid reimbursements to fund the work it does, according to Gellman, who said that it is able to get the vast majority of its patients covered under the program.

If someone comes to the facility seeking treatment for a condition that Pyramid is not equipped to handle there or at one of its other state facilities, Gellman told the board of supervisors that the company would transport that person to another facility that could help.

“That particular scenario happens very, very rarely that someone calls us and we're not able to figure something out,” Gellman said.

Henrico will form a board to maintain oversight of Pyramid’s operations and ensure that it is meeting the requirements of its contract, according to Feinmel.

County officials still are working out some details related to the facility, such as how the intake screening process will work. They expect, though, that Henrico Mental Health employees will be involved with that process, and Feinmel said that no new hires will be necessary.

The county currently has two positions within its Division of Fire and five Police mobile response team members who are involved with similar types of efforts currently, he said.