County to close mental health services clinic after nearly 90 years of operation

The Frederick County Health Department’s Mental Health Services Clinic will close its doors on Aug. 1 after struggling to cover its expenses using financial reimbursements from public health insurance.

The clinic opened in 1937 and has sought to address mental health needs for individuals who can’t afford private health insurance, closing off many providers who don’t accept public health insurance.

It is within the Frederick County Health Department’s main location at 350 Montevue Lane in Frederick.

The clinic offers services to adults including diagnostic evaluations; family, individual and group therapy; psychiatric evaluations; and medication management.

It sees nearly 300 clients in a year and has five staff members: Joyce May, director of the county’s mental health services, who has a part-time case load; two full-time therapists; an administrative staff person and a psychiatric nurse practitioner.

In fiscal year 2024, there were 3,472 visits made to the county’s outpatient mental health service, according to the most recent annual report for the Frederick County Health Department.

The clinic previously offered services to children and adolescents, until around 2017, according to May.

As the health care landscape has evolved, so has the clinic and the services it offers, she said.

May said the clinic has had various clinicians, psychiatrists, psychologists, nurses, social workers and licensed counselors work there.

The county also has provided mental health services in partnership with other organizations, including Frederick County Public Schools and the Frederick County Adult Detention Center.

Over the last 20 years, there have been multiple times when the clinic couldn’t cover its expenses using public health insurance reimbursements and was in danger of closing, according to the county’s health officer, Dr. Barbara Brookmyer.

Health care reimbursement is the payment health care providers receive for providing a medical service, according to Definitive Healthcare, a healthcare analytics company.

The clinic has had to whittle down its services and has had trouble recruiting additional staff, she said.

With more than 80% of the clinic’s clients using Medicare, “the reimbursement rate just hasn’t kept up with the increase in salary and fringe benefits for state employees,” Brookmyer said.

“The reimbursement does not cover the cost of providing the service anymore,” Brookmyer said.

“... The structural deficit is just too great. We’ve looked at optimizing everything administratively that we can, and even with it, if it was possible to have everything at 100%, the reimbursement rate from Medicare will not cover the cost of providing the service.”

May said the county’s Local Behavioral Health Authority, which plans and manages the county’s public behavioral health system, carefully monitors if there are enough mental health services providers in the area to meet people’s needs.

She said the clinic gave its clients a list of agencies in Frederick County that provide services for patients enrolled in Medicare or Medicaid.

“I’m hopeful, based on the extensiveness of that list, that everyone will find a provider of their choice in the Frederick community and in the amount of time that we are able to continue to serve them,” May said.

Both Brookmyer and May said the clinic’s clients are at the forefront of their minds, and so are the employees.

Although the clinic closure will be a loss to Frederick County, Brookmyer said, there may be other opportunities in the future for the health department to work on systemic issues within the public behavioral health system.

“With this one door closing — I’m not sure what a year or five years from now will look like ... we’ll continue to work to expand the capacity in the private sector to serve more individuals with Medicaid, more with Medicare, and work on trying to improve that system capacity, but also taking a look at what can be done to reduce the need,” she said.

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