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After decades of administering mental health in Utah's most-populous county, Valley Mental Health will have to surrender that role to someone else.
Salt Lake County announced Thursday that the Minnesota-based health and wellness firm OptumHealth will oversee its mental health programs. While Valley Mental Health may continue providing the actual services - that remains in question - OptumHealth would manage them."The most important aspect of this transition is that there will be no disruption of client services," said Tim Whalen, the county's mental health director. "We will work with both OptumHealth and Valley Mental Health to ensure everything proceeds smoothly."So far, the process is going anything but smoothly.Valley Mental Health CEO Debra Falvo says her agency has had "no discussions" with OptumHealth about continuing clinical care. If the group wants to contract for those services, Valley's board of directors would have to approve it. The agency also is challenging the $50 million-plus OptumHealth contract, accusing the company of not being a "truly viable candidate." Why? Because it doesn't have an established network of mental health providers in Utah. "A lot of assumptions have been made," Valley spokesman Christopher Katis said. "We don't know what the picture is going to look like." OptumHealth officials did not comment directly on Valley's allegation, but said they will work toward a seamless transition. "We have a strong track record of managing behavioral health services for counties," spokesman Brad Lotterman said, "and look forward to working with all of our new partners in Salt Lake County to deliver these programs and ultimately help people in their journey toward recovery and resiliency." The change comes as Valley's contract expires. Instead of renewing that contract, a panel consisting of organizations such as Utah's chapter of the National Alliance on Mental Illness (NAMI) and the state Division of Substance Abuse and Mental Health recommended turning mental health management over to OptumHealth."This is a major change in the mental health system and hopefully will present some new opportunities for a system that has been challenged for a great number of years," said Sherri Wittwer, NAMI's executive director and a member of the review panel. "Hopefully, this change will lead to increased accountability and transparency."The panel suggested that OptumHealth - a for-profit firm that oversees public-sector mental health programs in 38 states - will bring a more innovative and cost-effective approach.It also expects the company to streamline some services and reinvest those savings in crisis-response teams and other community initiatives. OptumHealth, according to the panel, also could better position the county to handle federal health care reform, separate the administrative side of mental health from direct care, and give the county more say in how to distribute Medicaid-related savings each year."It's always important to look at new ways to do business," County Mayor Peter Corroon said. But the decision represents a staggering departure from the status quo. Valley has been overseeing the county's mental health programs since the late 1980s. "I understand saving money," said County Councilman Randy Horiuchi, who plans to raise the issue at next week's council meeting, "But it is difficult to look at a 22-year experience and say that doesn't mean anything."Horiuchi is apprehensive about turning over mental-health management to a for-profit company - can a shareholder-driven company "provide the kind of love that Valley Mental Health has?" he asked - and wonders what the practical implications might be for the county's mental-health priorities.To other council members, change isn't a bad word. County officials haven't always been pleased with Valley Mental Health - namely its handling of leftover Medicaid dollars. It's not that the agency has misused money, officials insist, but that it hasn't consulted with the county about where that extra cash should be spent. Those decisions, Whalen said, have been made internally by Valley Mental Health. Consequently, the agency's spending has sometimes gone "far afield from what their services ought to be," County Councilman David Wilde said. "Shuffling things around once in a while," Wilde said, "can be a good thing."Falvo insists Valley worked in "close partnership" with the county and other stakeholders when making those decisions about Medicaid money. She also challenged the county's notion that hiring OptumHealth - a new layer of administration - would make mental-health services more cost-efficient. Ginger Phillips, a longtime Valley client, looks forward to new management. As someone who had been openly critical about the agency's reorganization last year, Phillips hopes things will improve."I don't think Valley Mental Health has been doing the best job at following up on their clients," she said. "I'm hoping that they bring back more professionals."County Councilman Jim Bradley praised Valley but said a competitive bid for those services makes good financial sense. "This isn't to say that Valley hasn't been a good provider - they have been an excellent provider," he said. "We have to make sure we are getting the best value for the taxpayer dollar." firstname.lastname@example.org email@example.com
Valley Mental Health will no longer oversee Salt Lake County's mental health programs. It still may provide them, but another firm, OptumHealth, will manage them. The county made the switch based on these recommendations from an independent review panel:
The separation of management and money from the direct service provider is a nationally accepted model.
OptumHealth will streamline inpatient, jail and institutional care while reinvesting the savings into community services such as crisis-response teams and receiving centers.
OptumHealth will work directly with the county and mental health stakeholders to decide how Medicaid savings will be spent a determination formerly made by Valley Mental Health.
The removal of Valley from some administrative and financial responsibilities will provide more focus on clinical services.
The change may cause no disruption in client care because Valley still could act as the primary care provider.
The county will be better positioned to address health care reform and Medicaid expansion.
Source: Salt Lake County