Lewis and Clark County, MT
Lewis and Clark County Government
montana
Rural & Urban | Population: 75,011Lewis and Clark County, encompassing 3,459 square miles in west-central Montana, is a vital urban-rural hub with a population of 75,011. Anchored by Helena, the state capital and county seat, and East Helena, the county’s communities are tightly knit, with 95% of residents living within 20 miles of Helena. As Montana's sixth most populated county, Lewis and Clark County is a regional economic center and a focal point for public health and safety initiatives.
Addressing Opioid Use Disorder in the Justice System
Prior to 2020, the county faced a critical challenge: frequent interruptions in opioid use disorder (OUD) treatment during incarceration. These disruptions resulted in significant setbacks for individuals on the path to recovery and dramatically elevated the risk of overdose upon release. Data shows that individuals recently released from incarceration are 40 times more likely to experience a fatal opioid overdose than the general population, a stark indicator of the urgent need for intervention.
In response, Lewis and Clark County leveraged federal resources and technical expertise to launch the MAT Bridges Program, a collaborative partnership among Criminal Justice Services, the Sheriff’s Office Detention Center, and local healthcare providers. This initiative exemplifies a comprehensive, evidence-based approach to substance use treatment that expands access to care, reduces overdose fatalities, and supports long-term recovery.
Key Program Components and Impact
Medication-Assisted Treatment
To date, 145 non-unique individuals have received MAT services through the program. The removal of cost barriers has been pivotal in expanding access and engagement.
Continuity of Care
The program ensures that treatment, including MAT and behavioral therapies, continues uninterrupted from incarceration through community reentry.
Discharge Planning and Reentry Support
Upon release, participants benefit from robust case management, coordinated connections to ongoing care, and referrals to essential community services.
Overdose Prevention
The county actively distributes naloxone, a life-saving opioid overdose reversal medication, to at-risk individuals reentering the community—directly addressing the Administration’s priority to reduce overdose fatalities.
Program Overview: A Model of Evidence-Based, Coordinated Care
Screening and Enrollment
Upon entry into the detention center, every individual is screened for substance use disorders by a dedicated medical team. Those identified with OUD are promptly referred to a Behavioral Health Case Manager for further assessment. Eligible individuals may initiate or continue medication-assisted treatment (MAT), ensuring that no one’s recovery is derailed by incarceration.
Comprehensive Care
The program delivers a full continuum of care, including FDA-approved medications (buprenorphine, naltrexone), counseling, behavioral therapies, and ongoing monitoring. By eliminating financial barriers, covering 100% of prescription costs, the program ensures equitable access to life-saving treatment for all participants.
Pre-Release Coordination
Recognizing the high risk of overdose post-release, the program orchestrates seamless transitions to community-based care. The Case Manager coordinates with PureView Health Center, a Federally Qualified Health Clinic, and other community-based providers, to schedule appointments 24-48 hours before release for continuity of care. This “warm handoff” is essential for sustaining recovery and reducing recidivism.
Building Stakeholder Buy-In and Reducing Stigma
“We know what we’re fighting for—it’s the people.”
—Jillian Danesi, behavioral health coordinator
Implementing MAT in a correctional setting required overcoming resistance rooted in longstanding misconceptions about addiction treatment. Program leaders emphasized MAT’s proven benefits through targeted education and outreach, including reduced medical costs and improved behavioral outcomes within the jail environment. Success stories and visible improvements in participant outcomes have galvanized support from staff and community partners.
Collaborative Partners
Lewis and Clark County Sheriff’s Office
Lewis and Clark County Detention Center
Lewis and Clark County Criminal Justice Services
PureView Health Center
Looking Ahead
In the coming year, this program will focus on significantly enhancing services for individuals with substance use or co-occurring disorders. Key initiatives include expanding naloxone distribution and access to MAT, strengthening partnerships with medical services within the Detention Center, and implementing robust data collection methods to accurately measure the long-term effectiveness of behavioral health interventions. These initiatives will ultimately better serve individuals with SUD or co-occurring disorders within the Lewis and Clark County Detention Center and as they transition to the community.
Project Director
Jillian Danesi, Behavioral Health Coordinator
Lewis and Clark County
jdanesi@lccountymt.gov
406-457-8846
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.