Change in S.L. County's mental health services 'awkward,' but audit points no fingers

Published: Tuesday, July 15 2014 3:20 p.m. MDT

Former Valley Mental Health client and advocate Ginger Phillips presents a letter to Salt Lake County Mayor Ben McAdams protesting cuts from services in Salt Lake City Wednesday, July 10, 2013. An audit of Salt Lake County's behavioral health system notes an 'awkward' transition from a nonprofit agency as the sole service provider and overseer of the county's resources provider to awarding management services to a for-profit corporation.

Jeffrey D. Allred, Deseret News

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SALT LAKE CITY — The switch to a for-profit company to manage Salt Lake County's mental health resources starting in 2011 has produced benefits and challenges, a new audit reveals.

A larger number of provider networks is available for the more 16,500 Medicaid enrollees and uninsured people eligible to receive mental health and substance abuse treatment paid for by the county and federal government.

New programs such as the countywide crisis services provided by the University Neuropsychiatric Institute and Valley Behavioral Health's school-based programs and early intervention programs for families have further expanded the reach of the county's behavioral health resources, the audit said.

The audit also determined that Valley Behavioral Health "transitioned" 733 clients off its rolls due to financial constraints, far fewer than earlier estimates of up 2,250 individuals, auditors wrote.

Overall, the audit showed "the county is headed in the right direction with this" change, said Denise Callahan, with TAP International Inc., a Carmichael, California, firm hired by the county to conduct an independent audit.

The county spent $48,500 on the audit of the entire behavioral health system, including the county's division of behavioral health services.

Callahan was largely complimentary of the cooperation of the parties during the audit and their professionalism as they interacted on a regular basis.

"I’m not used to seeing that because I’m pretty much a West Coast-based consulting firm," she said.

Last summer, Salt Lake County Mayor Ben McAdams ordered an audit of the county's behavioral health services following Valley's initial announcement that it would no longer provide care to hundreds of mental health consumers. Valley officials said operating revenue was lost when the county awarded OptumHealth the contract to manage the county's mental health and substance abuse resources.

The audit was formally released Tuesday afternoon during a news conference outside McAdams' office, but it had been discussed by the Salt Lake County Council at its work session earlier in the day.

The nonprofit Valley Behavioral Health, formerly Valley Mental Health, had been the sole provider and manager of the county's behavioral health resources for 24 years prior to the change.

"(The) transition process was awkward, but no single entity bears full responsiblity for the issues," the auditors wrote.

McAdams said the audit confirmed that "the managing care model is working out."

"The providers are adapting to this new reality," he said.

The mayor called for the audit roughly a year ago amid great uncertainty regarding Valley's announcement that it was cutting clients due to financial issues and some advocates' perceptions that patients would not fare well if the county's resources were managed by a for-profit company.

As it turned out, the client reductions were not as deep as anticipated and the county had built safeguards into its contract with OptumHealth to ensure clients' care was not sacrificed, Callahan said.

McAdams said, given the events of last summer, elected officials "show leadership and not have uncertainty or finger-pointing rule the day."

That's why he sought the audit, he said.

"What's most encouraging to me about the audit is the conclusion that because of the transition, we are able to provide greater choice for consumers by doubling the number of providers in the network. We reduced the reliance on one primary provider to address the behavioral health needs of the community," McAdams said.

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