LEONARDTOWN — Children waiting months to see a counselor at St. Mary’s County’s two school-based health centers should see that wait shrink, as the county health department prepares to double its behavioral health staff at both sites with federal rural health money.
Health Officer Dr. Meena Brewster told the Commissioners of St. Mary’s County, sitting as the Board of Health on Oct. 27, that each center now has one full-time behavioral health clinician and still keeps a waiting list of a few months. The plan is to put two clinicians in each, add exam rooms and primary care staff, and eventually open on evenings and weekends.
The expansion is one piece of St. Mary’s 360, the health department’s name for how it will spend a $3,530,907 Maryland Rural Health Transformation Program award announced Aug. 31. Brewster’s presentation was the most detailed public look yet at where that money goes, and it reaches well beyond the school clinics: a second doctor and dentist for the county’s federally qualified health center, paramedics paired with social workers for people who lean on 911, coaching to help residents use patient portals and telehealth, and a new grant round for community gardens and food programs.
Brewster described the effort as a coordinated strategy rather than a collection of separate projects, built on five pillars: connecting residents to care, expanding primary, behavioral and oral health care, bringing care closer to where people are, prevention and wellness, and building the local health workforce.
School clinics are the front door
The county’s school-based health centers sit at Margaret Brent Middle School and Spring Ridge Middle School. During school hours they serve any St. Mary’s County public school student or staff member; after dismissal and when school is out, they are open to anyone in the community.
Brewster said the centers have logged more than 4,300 enrollments since opening. Counseling for children, added last year because community waits were so long, filled almost immediately. She also cited an 86% return-to-class rate for students from the host schools who are seen at the clinics, meaning most go back to class instead of going home, and parents do not have to leave work for an urgent care trip.
The health department also wants a third center, on the Leonardtown campus, which would serve the largest group of schools yet. Brewster said grant money is available to put the unit in place, but the school system would own it and has to be able to cover repairs and upkeep, and that annual operating cost has not been worked out.
Asked by a commissioner whether the behavioral health expansion would help the centers pay for themselves, Brewster said the department is only now starting to bill insurers for those services. Local health departments get lower reimbursement rates than large health systems and cannot contract with every insurer residents use, she said, so a gap will remain that grants and county support have to cover. She added that the Garrett County Health Department is leading a statewide look, on behalf of all local health departments, at how they might negotiate better rates.
A doctor, a dentist and a team for frequent 911 callers
Through its partnership with Greater Baden Medical Services, the county’s federally qualified health center, the grant will add a primary care clinician and a dentist at Greater Baden’s Lexington Park clinics. Brewster said that would let Greater Baden double the number of residents its clinics can take. Greater Baden recently opened a dental clinic in Lexington Park alongside the primary care site.
The money will also launch a mobile integrated health program, a model several Maryland communities already use, built with the county Department of Emergency Services and the volunteer EMS association. An EMS provider and a health department care coordinator, ideally with a social work or behavioral health background, would visit people referred for heavy use of 911 or the emergency room for problems that could be handled elsewhere. Brewster said long emergency department waits affect everyone, not just frequent users.
One commissioner was blunter, calling 911 misuse a real problem that wears out volunteers and ties up crews needed elsewhere. He recalled hearing a busy Friday-night call on his scanner from someone who had run out of diabetes medication, which he said is not a 911 call, and said the program would be a major help if it works.
Technology, with coaching
At the center of St. Mary’s 360 is a care coordination network: coordinators placed around the county who work with community health workers and peer recovery specialists on a shared platform, so residents with several health and social needs are not left to navigate a dozen agencies alone. The plan also covers support for people re-entering the community after incarceration.
Participants will receive wearable devices and remote patient monitoring tools, and the county’s online health and wellness resource directory will gain online scheduling and case management features for nonprofits. Brewster said technology only helps if people can use it, so the department will train partner groups, coordinators and community health workers to coach residents on devices, patient portals and telehealth. She called the digital health literacy piece innovative and said it is drawing attention around the state and the country. The University of Maryland’s Horowitz Center for Health Literacy is among the partners, according to the Maryland Association of Counties.
Other pieces include a mobile pediatric prevention effort that builds on hearing and vision screening for young children, partner mobile programs for homebound seniors, maternal health and behavioral health, and nutrition work through community health workers, healthy food kits and farm-share distributions. The health department will issue a competitive request for proposals to local groups that want to run community gardens or food distribution, and Brewster said a press release will announce it. For the long term, the Southern Maryland Area Health Education Center will introduce students as young as elementary school to health careers.
Demand already high
Brewster’s numbers showed why the department is pushing access. The Health Hub has logged nearly 13,000 encounters since opening, and its crisis walk-in team keeps seeing steady use. Reports of human rabies exposures are up 15% this year through most of October compared with 2025, and Brewster urged residents to vaccinate pets, avoid wildlife and call the health department after any bite, scratch or bat found in a bedroom.
The same meeting brought an update on the county’s measles outbreak, and Brewster told the board the health department’s new agency strategic plan is complete and ready for review.
Carrying St. Mary’s 360 forward will fall largely to her successor. Brewster leaves the health officer post Dec. 8. The St. Mary’s grant was part of a larger first round in which seven Southern Maryland health organizations shared more than $11.6 million.
