Onondaga County, NY
Onondaga County
new york
Urban | Population: 467,873Located in the heart of central New York, Onondaga County serves as a vital economic and cultural center for the region, anchored by the city of Syracuse. In response to the rising challenges posed by substance use disorders and the urgent need for effective reentry solutions, the Onondaga County Sheriff’s Office (OCSO) launched a groundbreaking reentry initiative in 2022, supported by the Comprehensive Opioid, Stimulant, and Substance Use Program (COSSUP).
This innovative program provides integrated clinical treatment, peer support, and coordinated care to individuals in custody who are preparing for the critical transition back into their communities. Since an average stay in jail is 28 days, this program is likely to serve over 6,000 people annually. Through a strategic partnership with Crouse Health, participants receive on-site counseling, pre-release case management, and bridge medications to ensure continuity of care post-release. A distinctive feature of the initiative is its 24/7 virtual peer coaching platform, providing ongoing recovery support both during incarceration and after reentry.
Key Components of the Program
Jail-Based Substance Use Disorder Screening and Treatment
The OCSO’s Medication-Assisted Treatment (MAT) program offers all three FDA-approved medications, continuing existing regimens and initiating new protocols for eligible individuals. Designated housing units and close collaboration with local Opioid Treatment Providers ensure a supportive, clinically coordinated environment.
Reentry Services and Discharge Planning
Robust, collaborative discharge planning begins prior to release and extends into the community. The integration of the YouTurn virtual peer support platform and the state-led New York MATTERS initiative provides rapid access to transportation, prescription assistance, and appointment coordination, minimizing barriers to successful reintegration.
System Collaboration
The program’s success is rooted in strong partnerships with local health departments, technical consultants, and community organizations. Comprehensive training for correctional and healthcare staff on MAT and behavioral health ensures a unified, informed approach to care.
Community Partners
Onondaga County Sheriff’s Office
Crouse Health Opioid Treatment Program
Heritage Health Solutions
New York Matters
Syracuse University
YouTurn Health
Program Outcomes
Since its inception, the program has achieved significant milestones:
Maintains a strong and consistent average of 100 participants each month in the Medication-Assisted Treatment (MAT) program, demonstrating both demand for services and the program’s capacity to support sustained recovery.
Enhanced clinical capacity by providing targeted education and training to medical and mental health staff on MAT protocols, equipping the team with the knowledge needed to deliver high-quality, evidence-based care.
Fosters strong system collaboration through bi-monthly meetings with community partners, ensuring a unified approach to treatment, reentry, and long-term support. These regular touchpoints promote shared learning, strengthen referrals, and create a cohesive recovery network.
Looking Ahead
The Onondaga County COSSUP program has laid a strong foundation for recovery and improved public health and safety by delivering measurable impacts one successful transition at a time. Looking ahead, the team is actively exploring new collaborations, including a potential partnership with the County Opioid Response Unit at the District Attorney’s Office, to further integrate system-wide support. Efforts are underway with the program’s research partner to amend and enhance the current data repository and reporting systems, ensuring more accurate evaluation and outcome tracking. Future priorities include expanding post-release support beyond clinical care to encompass employment training, education, and housing, all critical elements of long-term reentry success. While challenges remain, program leaders report feeling increasingly equipped to overcome barriers, thanks to continued support from the Sheriff’s Office and continuously growing community partnerships.
Project Director
Karen Buck, Compliance Administrator
Onondaga County
karenbuck@ongov.net
315-558-9795
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.