Board of Health update: mobile health clinic launches; county reports substance‑use declines but flags fentanyl, kratom and Medicaid risks

The County Council convened as the Board of Health June 24 for a biannual update from the Department of Health and Human Services. Dr. Keisha Davis and DHHS staff reviewed recent program rollouts and public-health trends.

Mobile clinic and access: DHHS said the new mobile health clinic is operational and visits Poolesville, Wheaton and multiple county service-consolidation hubs; services include routine and diagnostic care, behavioral-health screenings, STI/HIV testing, dental screenings and connections to primary-care “medical homes.” The mobile van visits most sites monthly and Poolesville three times a month because of limited local access.

Substance use and harm reduction: Ben Stevenson (Acting Manager, Prevention & Harm Reduction Services) reported that polysubstance use and fentanyl remain drivers of fatal overdoses; the county recorded 20 fatal overdoses in the first four months of 2025, 13 involving opioids and 12 involving fentanyl (some overlap among categories). DHHS reported year‑over‑year reductions from 2023 to 2024 in several overdose metrics (e.g., 23% fewer total fatal overdoses in one comparison) and reductions in some youth ER visits tied to opioid overdoses; DHHS credited prevention, Narcan distribution (9,762 doses distributed in FY24) and expanded outreach and treatment referrals.

Prevention programs and crisis responses: DHHS described programs including STEER, crisis stabilization room admissions, jail-based medication-assisted treatment with Narcan provision at release, community grants for youth prevention, and training of new Botvin life‑skills trainers for school settings. DHHS is expanding distribution of Narcan and fentanyl-test supplies and planning vending or kiosk options for harm-reduction supplies.

Kratom: DHHS raised kratom as an emerging concern—describing its stimulant effects at low doses and opioid-like effects at high doses, withdrawal risks and documented adverse outcomes (seizures, liver damage, psychosis). Maryland recently restricted sales to those 21 and older and added labeling/testing requirements; the county health department is monitoring enforcement and potential local roles but noted enforcement resources and tracking mechanisms are limited for unregulated products.

County health rankings and disparities: DHHS presented county health ranking data (most recent covering through 2021) showing Montgomery County ranks among the healthiest counties but continues to experience racial and ethnic health disparities; the department plans a focused initiative on the state of Black health and additional community‑centered interventions.

Respiratory disease and vaccinations: Deputy Health Officer Sean O’Donnell said influenza was the main driver of recent respiratory hospitalizations and that respiratory illness levels were low at the time of the report; federal vaccine guidance for the next COVID season remains pending.

Maternal and child health: DHHS recapped a maternal-health convening and follow-up work to reduce racial disparities, including home‑visiting programs and a plan to form a steering committee to develop recommendations and pursue grant funding. DHHS noted that Medicaid expansion adults (about 46,000 county residents) are a key budget risk if federal policy changes reduce coverage, potentially increasing demand on county safety-net programs such as Montgomery Cares and Care for Kids.

Council members asked follow-up questions about kratom enforcement, survey response rates for TDM earlier in the agenda, mobile-clinic scheduling and prioritization, Narcan distribution to schools and libraries, outreach to Hispanic communities for alcohol-related intoxication spikes, and preparedness for heat emergencies. DHHS and agencies committed to follow-up and coordination with county emergency management, police and community partners.