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Need for Harford Crisis Center, costs to operate it are greater than anticipated

Lyle Sheldon, president and CEO of University of Maryland Upper Chesapeake Health, speaks at the opening of the walk-in/urgent care component of the Klein Family Harford Crisis Center earlier this year.
Lyle Sheldon, president and CEO of University of Maryland Upper Chesapeake Health, speaks at the opening of the walk-in/urgent care component of the Klein Family Harford Crisis Center earlier this year. (Erika Butler/The Aegis / Baltimore Sun)

Harford County officials knew a facility was needed to help treat behavioral health, but they didn’t know how necessary it really was.

Since the walk-in/urgent care facility at the Klein Family Harford Crisis Center opened in June, more than 900 people have sought assistance. Of those, 68 percent had no previous interaction with Upper Chesapeake Health’s behavioral health system in the past two years, Bari Klein, executive director of Healthy Harford/Healthy Cecil, told members of the Harford delegation to the Maryland General Assembly last Wednesday.

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Healthy Harford/Healthy Cecil was among the various groups attending the pre-legislative session meeting at the Bel Air Library to discuss their agendas for the upcoming session that starts in January.

“That says there is a lot more need in the community than we ever even anticipated. And the importance of the center is elevated even more so,” Klein said. “We always knew it was important, and now we are so convinced we made the right decision in putting this forward.”

However, because the majority of people visiting both the walk-in and urgent care center, as well as the residential component, have private insurance, the facility is running a deficit of nearly $3 million, almost double what was expected for the new treatment center, she said.

Upper Chesapeake had anticipated a deficit the first year of about $1.5 million, which it was willing to absorb “as part of doing business,” Klein said.

“And the community needs this,” she said.

She asked the delegation for funding from the state to help bridge the deficit gap so the crisis center can maintain its level of care until the volume of patients increases.

The Klein Family Harford Crisis Center, a partnership between Upper Chesapeake Health, Harford County government, Harford County Health Department, Healthy Harford/Healthy Cecil and the Office on Mental Health-Core Services of Harford County, provides 24-hour-a-day, seven-day-a-week assistance for mental health and addiction issues through its mobile crisis center, urgent care walk-in clinic and residential services.

The goal is to divert clients away from the hospital’s emergency room and to the lower-cost, more appropriate crisis center, she said.

The hotline and mobile crisis team went into service in fall 2018, the walk-in/urgent care center in June and the residential beds opened in September.

More than 5,000 people have called the hotline since it opened. In July and August, the hotline received an average of 500 calls per month, and now that school has opened, the mobile crisis team is responding to an average of 74 visits a month.

The walk-in and urgent care center had had 933 visitors, ranging in age from 8 to 89, since June, Klein said. The average age is 35 ½ and the average stay is 3.4 hours. Of the 67 clients younger than 18, 54 were teenagers.

Approximately 71 percent of all visitors sought help for issues related to depression and/or anxiety.

The residential center has been open since September and 91 clients have visited. They’ve stayed an average of 3.7 days, Klein said.

Because most of the people visiting the walk-in clinic and residential center have private insurance, the crisis center is not being reimbursed as much as anticipated, Klein said. Based on a community needs assessment, operators of the clinic expected a large number of its clients would be using Medicaid.

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“Everyone thinks private insurance offers the best coverage. The reality is it swings wildly,” Klein said. “Medicaid had pretty good coverage for mental health. The private reimbursement rate, in general, is going to be lower. We’re not getting as much money back.”

One of the requests to the delegation from Healthy Harford/Healthy Cecil, on behalf of Upper Chesapeake and the other crisis center partners is to keep abreast of legislation regarding health care bills.

“We need to make sure private and public insurance provide the same level of coverage regarding mental health,” Klein said.

Besides the lack of reimbursement from private insurers, the facility needs more clients.

“When you first open anything, whether it be a fruit stand or a crisis center, you have to get the word out, people have to be comfortable with it,” Klein said. “We’re slowly amping up.”

Another expense is staff, she said. Licensing regulations require a certain level of staffing. “And staffing is expensive,” she said. “Then you have to wait or the people to come in.”

She also asked the legislators to help spread the word about the crisis center, and encourage people to use it to preempt a crisis.

“We don’t want people to come in when they’re in active crisis,” Klein said. “We want them to come before they reach that point so they don’t reach that point.”

Del. Andrew Cassilly, who was attending his last function as a delegate before assuming the role of senior adviser to Gov. Larry Hogan, asked about the crisis center partners’ relationship with the school system.

Cassilly, who also resigned his position with Harford County Public Schools to join Hogan’s staff, suggested putting up posters in schools advertising contact information for the crisis center, 1-800-NEXT-STEP or www.harfordcrisiscenter.org.

“What we’re seeing in this fast-paced, young generation, kids can go from very happy to extreme crisis very quickly. We often think of people who need crisis intervention are involved in substance abuse,” Cassilly said. “But we’re seeing is general populations.”

Students have to be motivated to go to a counselor to get to the mobile crisis center, but often they’ll keep things to themselves rather than do that, Cassilly said. If they see a poster on a wall that has the contact information, they might be more likely to make that first contact.

Del. Susan McComas suggested involving the student government associations at schools, where students are involved and very open about mental health.

“I was really shocked that they were so open about the need for mental health,” McComas said.

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