Wake County, NC
Wake County Government
north carolina
Urban | Population: 1,190,275Wake County, North Carolina’s largest and most populous county, has faced a growing challenge: a significant number of individuals entering the jail system with chronic medical, mental health, and substance use disorders. Meeting the complex needs of this population required seamless coordination across multiple systems, a daunting task given the lack of communication that sometimes exists between agencies. Determined to address these systemic gaps, the Wake County Sheriff’s Office launched an ambitious initiative under a 2021 Comprehensive Opioid, Stimulant, and Substance Use (COSSUP) grant to improve care coordination and expand harm reduction efforts for the community.
Identifying the Problem and Adapting the Solution
“It made sense to build on what was already working. Familiar Faces had a strong foundation, and by adding a law enforcement component, we strengthened the system without wasting time or resources duplicating efforts.”
—sheriff william rowe
Initially, the grant funding was allocated to develop an information-sharing system connecting crisis services, law enforcement, jail operations, and community providers. However, as the project began, WCSO identified an opportunity to collaborate with an existing platform called Wake County Familiar Faces. This platform was designed to identify high utilizers of crisis systems and enable health and service providers to create integrated care plans.
1,582
units of naloxone purchased for distribution
This strategic shift allowed Wake County to reallocate grant resources to expand overdose prevention services and improve transitional care services. The result was a broader impact scope that included purchasing 1,582 units of naloxone for distribution in jails, law enforcement agencies, and the community. Additionally, the funding supported developing a Computerized Physician Order Entry and Electronic Prescription Control System, Narcan Vending Machines, and a Medication Bridge Program to ensure continuity of care for individuals leaving the detention centers.
Key Program Components
Wake County’s initiative integrates several innovative components that address both immediate needs and long-term outcomes:
Medication Bridge Program
To support individuals transitioning out of jail, the program will offer short-term prescriptions for medication-assisted treatment. Upon release, participants will pick up their medication at the Wake County Health Department. To support individuals in the jail, Sublocade will be available in the detention center for adults with moderate to severe opioid addiction who meet medical requirements. Within this program, harm reduction supplies consisting of Fentanyl Strips, Xylazine Strips, Emergency CPR Face Shields, Don't Use Alone Cards, Medication Lock Boxes, and Medication Disposal Pouches will be used. In addition to these supplies, a 31-day bus pass, backpack bags, daily medication calendar planners, travel pill organizers, and medication pickup will be available.
Information Sharing via Familiar Faces
By partnering with Familiar Faces, Wake County will facilitate data sharing across hospitals, emergency response teams, housing providers, and criminal justice systems. This integration will enable the development of a data-sharing platform that will share information and support, and provide community care coordination aimed at reducing fatal and non-fatal overdoses, reliance on emergency services, jail time, and jail recidivism rates.
Behavioral Health Technology Enhancements
498+
suspected controlled substances screened
The program will introduce technical solutions such as tablets for behavioral health crisis units and detox centers. Handheld Analyzers (and solutions kits) and a Handheld X-Ray Imaging System to analyze narcotics to reduce the impact of opioids, stimulants, and other substances on individuals and communities by enabling deputies to scan more than 498 suspected controlled substances in a single, definitive test and the X-Ray Imaging System which is designed to detect for traces of illegal natural and synthetic opioids, contamination (visible and non-visible) and/or secondary screening purposes. It will implement a Computerized Physician Order Entry and Electronic Prescription Control System to streamline prescription management.
Collaborative Partnerships
Collaborative partnerships exist with the Wake County Government, the Wake County Health and Human Services Department, and other community partners. These partnerships have been sustained through regular meetings, 79 held to date. These collaborations ensure alignment across agencies while fostering innovative solutions for systemic challenges.
756
individuals reached through naloxone distribution
333
wcso officers trained in naloxone administration
Overdose Prevention
The program has expanded overdose prevention efforts by purchasing and distributing naloxone (Narcan) to law enforcement officers, jail staff, and community partners. Training sessions ensure the effective use of this life-saving tool in overdose prevention efforts.
Impact and Sustainability
The Familiar Faces platform has become a cornerstone of Wake County’s efforts to reduce recidivism and improve outcomes for vulnerable populations. Planning to connect crisis systems with sustained community services aims to decrease reliance on jails and emergency shelters while improving access to healthcare and housing stability.
Medication bridging has also emerged as a critical component in ensuring continuity of care post-jail release.
Key Achievements
WCSO initiatives demonstrate how strategic partnerships and adaptive use of resources can drive meaningful change by:
Improving transitional care via a Medication Bridge Program
Formalizing partnerships, enabling integrated care plans through Familiar Faces
Advancing technical solutions for behavioral health crisis services
Sustaining collaboration through regular interagency meetings
Key Takeaways
WCSO’s innovative approach exemplifies how leveraging existing resources while fostering collaboration can address systemic gaps in care coordination. By prioritizing harm reduction, transitional support, and interagency communication, this initiative transforms individual lives and creates a more resilient system capable of addressing complex public health challenges. WCSO sets a new standard for comprehensive community care integration through sustained partnerships and a commitment to innovation.
Collaborative Partners
Wake County
Wake County Health & Human Services
Wake County Sheriff's Office
Familiar Faces
SouthLight Healthcare
Project Director
Angela Smith, Grants Manager
Wake County
afsmith@wakegov.com
919-856-7538
This project was supported by Grant No. 15PBJA23GK02258COAP awarded by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a component of the Department of Justice's Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime, and the SMART Office. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.