It's imperative we work together to improve our primary goal — appropriate and predictable care to those in need of mental health services. —Bruce Cummings, chairman of VMH's board of directors

SALT LAKE CITY — The number of patients to be transitioned off Valley Mental Health's rolls will stop at 730 under a new agreement among VMH, Salt Lake County and the County's contracted managed care organization, OptumHealth.

Earlier, Valley Mental Health officials said it may have to transition 2,200 clients from its caseload due to financial challenges it has faced in changing from the county's sole provider of mental health services to one of 200 providers in OptumHealth's network.

"What that means (is) it will stop at 730 clients who have received transition letters to date," Salt Lake County Human Services Director Lori Bays told the Salt Lake County Council on Tuesday morning.

Salt Lake County Mayor Ben McAdams said the agreement should preclude more consumers from being dropped from VMH's client rolls.

The agreement will enable 120 people who use VMH's respite program to continue to receive that care, and in most cases stay with the same provider.

The program, offered under the county's Medicaid plan, assists families who have a child under age 18 who receives mental health services through the county's network. The service, which is usually provided in the family's home, gives caregivers a break while the child participates in appropriate supervised activities.

McAdams said the county has two primary concerns — meeting the needs of people who rely on Salt Lake County for mental health services and using taxpayers' resources well.

The agreement, he said, is "a win for the consumer and the taxpayer because we've been able to identify other means to eliminate cuts of other services."

Brian Neilson, a longtime client of Valley Mental Health, said he was pleased that the agreement will curtail further cuts to people served by VMH.

"I think it's really good. I hope they join together and look out for the mental health system as a whole," he said.

Neilson said he has attended recent County Council meetings to learn more about the process and to represent peers in mental health treatment who remain concerned.

"I'm still trying to assure them we're trying to work it out," he said.

VMH, which has been harshly criticized by McAdams and members of the County Council for announcing through the news media its plan to reduce its patient rolls, addressed the council on a number of issues Tuesday.

Bruce Cummings, chairman of VMH's board of directors, said it had been advised by legal counsel from communicating directly with Salt Lake County officials.

"To interfere with your contractual relationship with OptumHealth could be viewed as potential illegal interference. We do not have the financial resources to defend ourselves in a dispute with United Healthcare, Optum's parent company," Cummings said.

Cummings provided the County Council graphs depicting declines in VMH's revenue and employees since 2010. Prior to July 2011, the county contracted directly with VMH to provide behavioral health and crisis services. After that point, the county, through a competitive bidding process, selected OptumHealth to manage the county's mental health resources.

"Our revenue has declined from $102 million to an estimated $59 million, a 42 percent decrease, driven almost entirely by mental health decreases from Salt Lake County. A majority of this funding is still in the system but is no longer available to VMH. The number of our employees has decreased by 28 percent in the same time period," he said.

Cummings said VMH is "committed to getting past this difficult time of policy transition."

"It's imperative we work together to improve our primary goal — appropriate and predictable care to those in need of mental health services," he said.

Gary Larcenaire, president and chief executive officer of Valley Mental Health, said VMH's system of care was built over 25 years under a different funding mechanism. He likened the model to a "highly complicated fleet of engines built to run on a particular type of fuel."

Not only was that the case for its operations, VMH's bonds for facilities such as the expansion of the Carmen B. Pingree Center for Children with Autism were based the previous funding model. That changed when Salt Lake County awarded the contract to manage its mental health resources to OptumHealth. Unlike VMH, it is not a direct service provider.

While VMH has pledged to work cooperatively with OptumHealth and the county, it faces many ongoing challenges, Larcenaire said.

"You're not gong to find one solution that converts this whole fleet over to new fuel," he said.

County Councilman Randy Horiuchi said he was frustrated by the public perception that the county had brought harm to the delivery of mental health services.

Salt Lake County funds mental health at a higher match than any other county in Utah. VMH, a nonprofit entity, spun off from the county, he said.

"The idea of being punitive to you is being punitive to us. It's like taking a gun and shooting my foot. I'd never do that," he said.

Ginger Phillips, a certified peer specialist who advocates for people with mental illnesses, said she was pleased that the County Council gave VMH time on its Tuesday agenda.

"I'm really glad Valley Mental Health got a chance to say their piece. Last week, I felt like they got ripped apart," she said.

VMH counselors and therapists have worked hard to help clients deal with the news of cuts, which Phillips said also impacted people who did not receive letters.

"The providers have tried to help everyone, not just the people who got letters," she said.

Last week, the County Council ordered a performance review of the county's entire mental health system.

Council Chairman Steve DeBry said he looks forward to the completion of an audit, which should provide "crystal clear information" regarding the funding streams and services provided by tax dollars.