Frederick County officials describe 24/7 walk-in crisis center and early impacts

Frederick County health officials told Baltimore County’s VC Stat meeting that their county-operated walk-in crisis center has expanded to 24/7 service and is reducing unnecessary emergency department visits.

Frederick County Behavioral Health Director Andrea Walker and Susie Borg, director of crisis services at the Mental Health Association, described the center’s timeline, services and outcomes and answered questions about funding and next steps.

The crisis center began with limited hours after a small startup grant and later expanded through state crisis grant funding. "Our vision for this walk in center was to provide crisis focused interventions in a safe environment for anyone," Susie Borg said. She said the center was intended to provide face-to-face, immediate access without barriers such as cost or payment source and to reduce unnecessary ED visits.

Borg summarized the center’s growth: it began with 56 hours per week and two crisis specialists, expanded to 76 hours with state grant funding, added urgent medication evaluations and peer staff, and — after further local investment and a building renovation — moved to a new location that opened in October 2024 and now operates 24/7 with the option for extended care stays.

Program data presented by Borg included more than 8,700 unique individuals served and over 10,000 total visits since opening. "33% of the people who come self report that if they had not come to walk in, they would have gone to the ED," Borg said. She reported an average wait time of just under 12 minutes in fiscal 2024, an average session of roughly 90 minutes, and that 83% of people in fiscal 2024 reported being connected to resources after their visit.

Borg also described client demographics and presenting problems: about 46% of clients in fiscal 2024 had private insurance, 44% reported suicide concerns and 30% reported substance-use concerns. A program prescriber completed 135 urgent medication evaluations in the reported period.

Officials noted lessons learned during the COVID-19 pandemic, when expansion coincided with public-health restrictions and the program added virtual services. Borg said the program emphasizes a written wellness or safety plan for every visitor and proactive follow-up to support connections to continued care.

Looking ahead, presenters said the county plans a phase 2 renovation to add program space and an emergency-vehicle turnaround with a separate entrance for EMS to access the center’s extended-stay area. Borg said the county is "considering the feasibility of implementing the new crisis stabilization regulations to get that specific designation that the state has," but added the staffing requirements in those regulations "are a bit of a heavy lift." Andrea Walker noted Frederick County operates 988 and works closely with a mobile crisis provider (Shepherd Pratt), which officials said helped the walk-in center fit into the county’s broader crisis system.

Baltimore County members asked limited questions about insurance mix and whether a similar model would work here; presenters and Baltimore County staff said Maryland rules issued January 1 require providers to attempt billing across insurance types through the Administrative Service Organization, but it is too early to know whether private insurers will pay consistently.

Presenters closed by inviting follow-up questions and described how the center coordinates with schools to accept referrals and return information to guidance staff with appropriate releases.

The presentation drew brief discussion by Baltimore County members about geographic access and the challenges of siting a single center in a larger county.

Future steps described by Frederick County include pursuing a designated crisis stabilization license if staffing and flow can be adjusted to meet state requirements, negotiating an EMS alternate-destination agreement, and completing a planned second-phase renovation.