Maryland Officials Provide $1M in Funding To Keep Mental Health Clinics in Montgomery County Open

State and county officials in Maryland on Jan. 29 announced a plan to spend $1 million over the next year to prevent mental health clinics in Montgomery County from shutting down, the Washington Post reports. Four of the county's clinics have closed since last year, three more clinics plan to close and eight other clinics are "struggling" financially. Statewide, about 74,000 people could lose access to mental health care with many outpatient clinics refusing to treat underinsured or uninsured individuals because they say reimbursement rates from the state are too low (Becker/Hedgpeth, Washington Post, 1/30). The problem stems from how the state pays for treatment of residents with mental illnesses. Patients who have illnesses severe enough to qualify as a disability are eligible for coverage under Medicare; the program covers only half of a psychiatrist's bill and not medications. Until 1996, Maryland had covered the remaining bills for Medicare beneficiaries who were dually eligible for Medicaid because of their incomes. When the state ended that practice, many patients were unable to pay the portion of their bills that Medicare did not cover (Kaiser Daily Health Policy Report, 1/15).

Raise the Rates
The aid package -- the cost of which will be split by the state and Montgomery County -- is intended to cover services that Medicare beneficiaries in Montgomery County are unable to pay (Washington Times, 1/30). The $1 million also will go toward mental health providers' administrative costs, to help patients whose clinics have closed find new therapists, to expand outreach efforts and to help clinics "better operate" within a managed care setting, the Post reports. Georges Benjamin, secretary of the state Department of Health and Hygiene, said the plan is a "partnership which allows us to make a good system even better by providing an additional safety net" (Washington Post, 1/30). State officials added that the funding solution will "likely be imitated" in other counties, where clinics have been operating without county assistance (Washington Times, 1/30). Providers, however, say the money will not keep clinics from closing (Washington Post, 1/30). Craig Knoll, executive director of Threshold Service, the second largest provider in Montgomery County, said, "This money will get all the clinics through this year. But they need to raise the [reimbursement] rates." The state is considering raising the rates for "specific services," such as rates for psychiatrists, according to Oscar Morgan, director of the state Mental Hygiene Administration (Associated Press, 1/29). However, the state has no plans to raise Medicaid rates, and only the federal government has the authority to raise Medicare rates, the Post reports (Washington Post, 1/30).