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Loudoun weighs expanded psychiatry and medication‑assisted treatment at county jail; price tag could triple current contract
Summary
County staff and the sheriff’s office presented options to expand psychiatric services and add a medical director and MAT coordinator at the Adult Detention Center. Scenarios in the packet showed the next contract could range from about $8.8 million to $9.9 million, up from roughly $3 million under current agreements.
County staff and the Loudoun County Sheriff’s Office outlined proposals on Jan. 21 to expand medical and psychiatric services in the Adult Detention Center (ADC), including a recommendation to increase psychiatric hours, contract for a full‑time psychiatrist and add a medically‑assisted‑treatment (MAT) coordinator.
"Mental health is health. Substance abuse is a disease," Chair and board members said during discussion, urging the board to consider the long‑term care and cost implications of expanded services (SEG 2017–2036).
Staff presented three cost scenarios. The current contracted spend is roughly $3 million; proposed scenarios for increased psychiatric services and MAT initiation ranged from about $8.8 million to $9.9 million depending on the operating model. Staff said the RFP will include more psychiatric hours, a full‑time psychiatrist, and a MAT coordinator; the county is also considering adding a civilian medical director position in the Sheriff's Office for oversight and contract management (SEG 1879–1888, 1919–1925).
Sheriff's office representatives said the preferred model is continued contracted services supervised by a medical director in county employment, which they believe gives strongest liability protection and consistent quality assurance (SEG 1921–1936). Board members expressed support for strengthening mental‑health care in the ADC and asked staff to carry the proposal forward into the FY27 budget discussion.
No formal budget decision was made during the Jan. 21 meeting; staff were asked to include the position and model in their FY27 proposed budget and return with more detailed cost and operational information.
