LEONARDTOWN, Md. — For someone struggling with opioid addiction, entering the St. Mary’s County Detention and Rehabilitation Center does not make the illness disappear.
Medication must still be administered. Mental health needs must still be addressed. And when that person prepares to leave the detention center, someone must help connect them with treatment in the community before a fragile path toward recovery is broken.
Those responsibilities are largely carried by a group of contractual nurses, counselors, social workers, care coordinators and peer recovery specialists working both inside the detention center and through community corrections.
On Tuesday, Sept. 1, the Commissioners of St. Mary’s County unanimously approved $736,230 in agreements to continue that work during fiscal 2027. The board also authorized the Sheriff’s Office to pursue a separate $194,229 grant to help sustain its jail-based medication treatment program.
But before the votes were cast, commissioners wanted to understand what the money would mean beyond the numbers printed in their meeting documents.
“What are you going to do with that?” one commissioner asked about the $736,230 award.
The answer revealed a treatment network designed to follow people from incarceration into the community — and, officials hope, toward a more stable life.
Treatment Does Not Stop At The Jail Door
The largest share of the approved funding — $522,536 — comes through the Substance Abuse Treatment Outcomes Partnership, known as the STOP grant.
It supports medication treatment for opioid use disorder, counseling, substance use recovery classes and peer recovery services at the St. Mary’s County Detention and Rehabilitation Center.
“It pays for our medication-assisted treatment program, the counselor that we have for that, the clinician who is required by Maryland law,” a Sheriff’s Office representative told commissioners. “It also pays for substance abuse classes within the detention center.”
Medication for opioid use disorder, or MOUD, can include medications prescribed to help control withdrawal symptoms and cravings. According to the Sheriff’s Office, providing access to the treatment is required under Maryland law and protected under the Americans with Disabilities Act.
The program begins with screenings and clinical assessments to determine whether an incarcerated person has an opioid use disorder and whether medication treatment is appropriate.
Contracted nurses then help administer and coordinate the medication, track required data and ensure patients continue receiving treatment during weekends and holidays.
But medication is only one part of the process.
A “Warm Handoff” Back Into The Community
Recovery can become especially vulnerable when someone leaves incarceration and returns home.
A person may walk out of the detention center needing a treatment provider, medication, counseling and support — all while attempting to find housing, employment and stability.
Care coordinators and peer recovery specialists help bridge that gap. Instead of handing someone a phone number or a list of providers, they directly connect the individual with treatment and community services.
Officials described those connections as “warm handoffs.”
“They hook them with treatment,” the Sheriff’s Office representative said. “They have warm handoffs to make sure that they are getting the services that they need and the treatment that they need for successful recovery.”
Peer recovery specialists bring another layer to that support. Their own experience with recovery can help them establish trust, reduce stigma and encourage people to remain engaged in treatment.
The county’s programs serve people inside the detention center as well as those under pretrial supervision or participating in day reporting through the Community Corrections Center.
One peer recovery specialist also works with parole and probation because, officials explained, the agencies often serve many of the same people.
Mental Health And Addiction Often Intersect
An additional $213,694 will come through the Maryland Community Criminal Justice Treatment Program.
The funding helps pay for care coordinators, peer recovery services and mental health care, including support for a licensed social worker at the detention center. It also helps cover associated services provided by a psychiatrist and nurse practitioner.
“Substance abuse and mental health go hand in hand,” the Sheriff’s Office representative told commissioners.
The program is intended to help people who have, or are at risk of developing, behavioral health disorders. Its services focus on recovery, resiliency, health and wellness.
Of the $213,694 award, $188,694 comes from state grant funding. Another $25,000 in county funding is passed through the St. Mary’s County Health Department.
The commissioners also approved a $144,941 budget amendment. That amount is not an additional grant. Instead, it adjusts the program’s existing $68,753 budget to reflect the full $213,694 award.
The Cost Behind The Care
As the discussion continued, commissioners questioned why the programs required such a substantial investment.
Officials said most of the funding pays for the specialized personnel needed to provide the services.
The nurses, clinicians, social workers, counselors, care coordinators and peer recovery specialists are contractual workers rather than regular Sheriff’s Office personnel. However, they perform work the detention center is legally required or operationally expected to provide.
By the time salaries and benefits are covered, officials said, the available funding is quickly committed.
The services also extend beyond the employee whom an incarcerated person may see face to face. Funding for a licensed social worker, for example, helps support additional care involving a psychiatrist and nurse practitioner.
“We have one licensed social worker that we have through this, and it’s not just the licensed social worker that it pays for,” the representative said. “It’s also the behind-the-scenes for the psychiatrist and the nurse practitioner that goes with it.”
Another Grant Could Keep Nurses And Recovery Specialists In Place
In a separate vote, commissioners authorized the Sheriff’s Office to apply for $194,229 through the fiscal 2027 Residential Substance Abuse Treatment grant program administered by the Governor’s Office of Crime Prevention and Policy.
If awarded, the money would help fund portions of two contracted registered nursing positions and two peer recovery specialist positions supporting the jail-based medication treatment program.
The nurses conduct interviews and clinical evaluations, administer medication, collect legally required program data and help prevent medication from being diverted or misused.
The peer recovery specialists help participants remain engaged in treatment and prepare for life after incarceration.
According to the Sheriff’s Office, the program is designed to reduce relapse, repeat offenses, detoxification-related hospitalizations and fatal overdoses.
The grant funded the program in fiscal 2025 and fiscal 2026, but it is not guaranteed from year to year.
A Program Required by Law — And Dependent On Funding
The requested Residential Substance Abuse Treatment grant carries a 25% nonfederal match requirement.
The county would meet the required $64,743 match using a portion of the salary and benefits already budgeted for a full-time offender reentry case manager. That employee provides aftercare planning and helps people connect with services after leaving the detention center.
Even if the full $194,229 request is awarded, the Sheriff’s Office estimates it will still need approximately $22,000 to cover the remaining cost of the registered nursing positions.
Officials said they will continue seeking other grants to close that gap.
That leaves the county balancing two realities: The programs are required to continue, but many of the people delivering them are supported by grants that must be renewed or pursued each year.
For those passing through the detention center, however, the work behind those funding agreements is far more personal. It can mean receiving medication instead of facing withdrawal alone, meeting with someone who understands recovery or leaving the jail with a treatment appointment already waiting.
The Sheriff’s Office must submit the Residential Substance Abuse Treatment grant application by Sept. 11.
Watch the full meeting below at 31:04.
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