House committee hears plan to direct opioid settlement funds to jail medication programs

Delegate Pena-Melnik, chair of the Health and Government Operations Committee, introduced House Bill 1084 to the Judiciary Committee on March 4, saying the bill would require the State to fund medication assisted treatment (MAT) programs in local detention centers.

Supporters said the bill is intended to bring the State into compliance with an earlier law requiring treatment in local jails and to standardize how funds flow from grants, the opioid restitution fund (ORF), and other appropriations to local jurisdictions. Sarah Sample of the Maryland Association of Counties said the bill would establish “the buckets of money” and a process for local facilities to show costs and apply for reimbursements. Bethany Young, director of policy for the Governor’s Office of Crime Prevention, said agencies support three technical amendments: retain the requirement that jails provide all three FDA‑approved medications for opioid use disorder, require counties to attempt to access grant funding before drawing fully on the opioid restitution fund, and withhold 20% of ORF reimbursement until required reporting is submitted.

Emily Keller, Maryland’s Special Secretary for Overdose Response, told the panel the Office of Overdose Response supports using ORF settlement funds for jail MAT programs but emphasized stewardship rules: settlement funds may not supplant other funding and counties must try to access other grants before ORF. Larry Polsky of the Maryland Association of County Health Officers urged stronger language ensuring pregnant people in custody start MAT quickly, citing medical guidance that treatment begin within 24 hours when practicable.

Local corrections executives told the committee the 2019 Opioid Use Disorder Examinations and Treatment Act (House Bill 116) required local programs but state funding fell short. Christopher Klein, superintendent of Anne Arundel County Department of Detention Facilities, said local jurisdictions combined grants and county dollars to implement MAT but have not received consistent state reimbursement and that program costs vary widely by county. Witnesses referenced a statewide estimate of roughly $11.4 million annually to fund local MAT programs, noting wide county-to-county variation with some smaller counties in the $200,000–$400,000 range and Baltimore County cited at about $2.7 million annually in prior fiscal notes.

Several members pressed presenters for more precise county-by-county cost data and for clarity about how long post-release prescriptions are supported; Anne Arundel’s detention director said people are typically discharged with initial prescriptions and the county works to connect people to community services. Committee members also questioned how ORF use would interact with federal and Medicaid rules on jail care; witnesses said the bill’s amendments would require counties to pursue state grants and other sources first.

The bill’s supporters urged a favorable report with the proposed amendments; committee members requested additional fiscal detail from counties and agencies before final action.