LA PLATA — The Charles County office that oversees the public mental health system, the overdose response program and substance use prevention has been told to plan for life with 12% less money.
Charles County Health Department staff disclosed the planning exercise Oct. 27 during the department’s biannual report to the Board of County Commissioners, who also sit as the county’s ex officio Board of Health under state law. The group running the department’s Local Behavioral Health Authority has been asked to lay out what its work would look like under a cut of that size, and what it could still keep.
The answer matters well beyond the Health Department’s walls. The authority is the piece of local government that coordinates publicly funded mental health care in Charles County, and it is the source of the outreach workers residents see handing out overdose-reversal kits at community events. Staff said reductions would most likely land on that community work and on staffing, in a department that already runs on what one presenter called bare bones.
“We learn how to make a dime out of a penny,” a Health Department presenter told commissioners.
Not a clinic, but the system’s hub
The question surfaced when a commissioner pointed to a slide on the behavioral health authority and asked staff to explain it. The authority is not a clinic, the presenter said. It is a regulatory office inside the Health Department that oversees the county’s public mental health system and runs programs including overdose response and substance use prevention.
Its outreach team tries to be at as many community events as possible. That team ran the department’s Save a Life Day effort this fall, part of a national campaign to put naloxone, the opioid overdose-reversal drug, into as many hands as possible.
The results were the strongest numbers in the briefing. The department distributed 450 naloxone kits, or 900 doses. Staff said that was about four times last year’s total. Residents can also walk into the department’s behavioral health services division to pick up kits, with virtual training available.
The doses themselves cost the county nothing. Asked whether the giveaway was grant-funded, staff said the state supplies the naloxone. The goal, the presenter said, is to saturate the community so that anyone at risk has a kit nearby, reducing overdose deaths.
What the state does not cover is the people who carry that message into neighborhoods. That staff time is exactly where a 12% cut would bite.
Pressure from Annapolis and Washington
The commissioner who raised the issue noted that the county’s health officer, Dr. Dianna Abney, had already reached out to the board about possible reductions in state general funds and grants. A slide in the department’s presentation addressed those decreases.
Staff tied the planning to cuts to public health at both the federal and state levels, which they said many of the department’s programs are now seeing. They also stressed that the Health Department does not live on government appropriations alone. Much of its money comes from grants, leaving it with what staff described as very limited sources to cover the work it believes it should be doing.
The state picture explains the warning. Gov. Wes Moore’s proposed fiscal 2027 budget called for cutting the Maryland Department of Health’s Behavioral Health Administration by $155.8 million, a 3.8% reduction, Maryland Matters reported in March. A year earlier, the governor’s fiscal 2026 plan included a $12 million reduction to the core public health formula that funds local health departments, according to the Department of Legislative Services budget analysis.
The next budget looks tighter still. Earlier the same day, the Maryland Association of Counties told commissioners the state faces a roughly $2.5 billion gap for fiscal 2028, with agencies told to sketch budgets at 97 and 90 cents on the dollar, as the Chronicle detailed in its coverage of the MACo briefing. MACo Executive Director Michael Sanderson told the board he did not expect the state to zero out its aid to local health departments, but warned that counties nearly always absorb some of the squeeze. He also pointed to the 2025 federal budget law shifting Medicaid and nutrition costs onto states.
Commissioners point to the delegation
The commissioner who asked about the cuts said the issue should go before the county’s state legislators. The commissioner said the full board would likely support efforts to maintain the department’s funding, particularly for behavioral health, calling it “critical in our community right now.”
No vote was taken; the item was a briefing. Staff did not say how much money a 12% reduction would represent in dollars, which programs or positions would be first in line, or when the plan would be finished.
The department’s state funding warnings also spilled into the board’s biggest fight of the afternoon. During debate over introducing a new county employee collective bargaining bill, Commissioner Bowling cited the Health Department’s testimony about state cuts as he argued the county cannot take on new long-term costs. The bill advanced 3-2 anyway, as the Chronicle reported in its story on the bargaining vote.
Behavioral health has been a recurring budget question for the board. A year ago, commissioners weighed a county-specific mobile crisis team carrying a $1.05 million annual price tag rather than continuing to share a regional unit with St. Mary’s County, the Chronicle reported in its October 2025 coverage.
Other services on the books
The rest of the briefing showed how much the department is carrying as the money tightens. Its school-based health center in Indian Head, open since March, is close to earning official state designation, which staff said would open the door to more grants as the center works toward sustaining itself. It sees students during the school day and opens to families, school employees and others in the school system after classes until 5 p.m.
A full-time Spanish interpreter added this year has assisted more than 470 clients since July, staff said. The department also reported five confirmed animal rabies cases in the county this year and an earlier-than-usual flu season, with walk-in flu shots available weekdays from 8:30 a.m. to 4:30 p.m.
The fiscal 2028 state budget the governor submits in January will show how deep the reductions go. For the behavioral health authority, the plan it is now drafting is the clearest preview of what Charles County residents could lose.
