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Emergency Department Impact Spotlight
Meeting People Where They Are: Howard County’s Peer Support Model Builds Trust Across the Continuum of Care
- Published
- August 31, 2026
- Facility
- Howard County
- Region
- Central Maryland
- Featuring
- Scott and Corey, Peer Recovery Specialists, Howard County
Tagged
- Central Maryland
- Identification and engagement
- Linkage to ongoing SUD care
Inclusion is not an endorsement
The Maryland Department of Health shares this account to highlight practices other facilities may find useful. Appearing in this series is not an endorsement, recommendation, certification, or approval of any hospital, health system, provider, vendor, or program by the Maryland Department of Health or the State of Maryland. Descriptions and figures are provided by the participating facility.
"When you go to look for a job, or apply for a room for rent, people judge you whether they want to or not."
In Howard County, peer support has many homes: the hospital, the jail, recovery court, libraries, motels, the Day Resource Center, and a 24/7 public phone line. For peer recovery specialists Scott Sheldon and Corey Bryce, that's the point. Someone may decline help after an overdose in the emergency department and encounter the same support weeks later at a library or motel. The work is less about waiting for people to arrive and more about building a system that can meet them wherever they are.
Nine peer staff, including two supervisors, are embedded across the county: in the hospital five days a week, libraries three days a week, recovery court, the jail, and the Day Resource Center, with Opioid-Associated Disease Prevention and Outreach Program (OADPOP) hours twice weekly at the health department and twice weekly on outreach. Two peers, Katherine and Juan, are embedded specifically in the hospital, and the team doubles them up to make sure coverage continues without burning either of them out.
That footprint matters in a county where a short trip across Columbia can become a two-hour bus ride, and where residents along the Baltimore-Washington corridor may be taken to hospitals outside the county entirely. A large share of the county's population at risk of overdose near Route 1 is routed to St. Agnes in Baltimore rather than Howard County General, meaning the team's hospital peers never make contact with that portion of their own residents. Scott said, "Part of our biggest problem here is that our public transportation is terrible. We don't have a downtown, per se." So peers go to the places people already are, and the team leans on its 24/7 peer phone line to stay reachable even while spread thin.
Much of the hospital-based work looks different here than elsewhere in the state. Katherine consistently reports that 90 to 95 percent of the patients she and Juan see are there for alcohol-related issues, not opioids. EMS often revives overdoses with naloxone in the field and the patient then declines transport to the emergency department. When someone does arrive at the hospital after an overdose but isn't ready to engage, the team's plan is to station OADPOP services on-site. Their goal is to close that gap by connecting people directly rather than asking them to make a separate trip across town to reach a peer or safer use supplies. That means readiness often arrives later, through a trusted relationship, not in the immediate aftermath of an overdose.
Facing Geographic Challenges
One of the team's ongoing challenges is tracking what happens between hospital contacts. Because peers work across so many settings, a person who talks to Katherine or Juan in the hospital may later run into a different peer at the Day Resource Center weeks or months on, with neither side realizing they're already connected to the same network. The team is working on better ways to capture those repeat contacts so hospital-based conversations don't disappear from view once a patient is discharged. Scott also flagged emergency medical services as an underused piece of that same coordination picture: peers and EMTs "know us, and they're cool," but there's no formal training or collaboration between the two.
Howard County has paired their peer model with case management, giving people a way to stay connected even when they aren't ready for recovery-focused support. Case managers help with documents, appointments, vouchers, and housing, the practical needs that often determine whether someone can stabilize long enough to consider treatment, including for patients whose first real contact with the system was a hospital visit.
By the numbers
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9peer staff embedded across the county, including two supervisors
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5 days / 3 dayspeer presence each week in the hospital and in libraries
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24/7public peer phone line, keeping the team reachable while spread thin
Figures reflect what the interviewee reported and are provided by the participating facility.
What other Maryland hospitals can take away
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Meet people more than one time, in more than one place — whenever they’re ready, and a little before.
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Pair peer support with case management, so people stay connected even when they aren’t ready for recovery-focused support.
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Treat lived experience as a qualification, including for staff with justice-system histories.
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Count practical needs as part of the recovery continuum — documents, appointments, vouchers, housing, and even dental care.
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Still evolving: stronger coordination with emergency medical services, better follow-up tracking, and deeper partnerships with local businesses and motels.
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Questions? Contact the Overdose Data to Action team at
[email protected]. Submitting the form does not guarantee inclusion, and inclusion is not an endorsement by the Maryland Department of Health.
