The Carroll County Board of Commissioners voted Oct. 23 to authorize use of county opioid settlement funds to hire a full-time medication-assisted treatment (MAT) coordinator to manage the county's detention-based MAT program.

The coordinator position will be paid from the county's opioid restitution fund and is intended to support the detention-center MAT program mandated by the state (2019 House Bill 116). County and sheriff's office staff told commissioners the program, which began in January 2023, has expanded rapidly and requires dedicated coordination, reporting and community handoffs when participants are released.

County grants officer Debbie Staniford told the board the MAT coordinator was part of the plan submitted to the state and was discussed by the county work group that prioritized spending from opioid settlement dollars. "As a part of that plan, the coordinator position was always part of the plan," Staniford said.

Vicky McDonald, director of administrative services for the sheriff's office, said the program now runs "7 days a week, 365 days a year." McDonald said the detention center logged roughly 300 individuals through the MAT program during the last fiscal year, with daily participant counts that have ranged as high as about 90. The program includes medication, counseling, and a warm handoff to community providers on release.

Sheriff's office staff told the board they had initially sought to hire a part-time coordinator but were unable to fill that post after several recruitment attempts. With caseloads and administrative requirements growing, the sheriff's office requested a full-time coordinator; the total annual cost including salary, benefits and pension was estimated at about $90,000, staff said. The base salary figure mentioned in the discussion was roughly $46,000.

Budget staff explained the position will be paid from the opioid restitution special revenue fund, a restricted stream of settlement payments from manufacturers and distributors. "These are the settlements with the manufacturers and distributors of opioids. Right now, we will get over the next 17 years about $15,000,000," Staniford said, while noting some settlements and timing remain uncertain. Commissioners and budget staff said the county will have to revisit funding if settlement revenues decline; budget staff said any decision to continue the position without settlement funds would come back before the board.

Commissioners asked whether any insurance or Medicaid billing offsets exist. Staff said medical costs incurred in the detention center cannot be billed to insurance; community providers may bill insurance after release. Heidi Pepin, division manager of budget, said the opioid restitution fund is a special revenue account outside the county's regular operating budget and that the position was not part of the prior operating budget cycle because it was funded separately.

Commissioner [mover not specified] moved to approve use of county opioid settlement funds to add the MAT coordinator; a second was recorded and the motion carried by voice vote.

County and sheriff's office leaders said they will continue to monitor program demand, refine vendor arrangements and return to the board if funding needs change as settlement receipts evolve. Staff also said they plan to reconvene the county work group to re-evaluate priorities once the next phase of settlement allocations (including any Purdue Pharma distributions) is clearer.

The board approved the funding authorization on Oct. 23. The position is to be hired under the terms discussed by the sheriff's office and will remain subject to future budget decisions if opioid restitution revenues change.