County’s managed-care system working pretty well
Salt Lake County’s move to a managed-care system to provide mental health and substance-abuse treatment to county residents received generally favorable marks in an independent, 58-page audit released Tuesday.
"It’s not often I get to share generally positive news," said Denise Callahan, president of TAP International, while presenting her audit to the Salt Lake County Council.
"There’s always challenges, but overall, I was pleasantly surprised," the consultant added. "When I do these kinds of audits, it’s usually one [problem] after another. But in this case, you’re moving in the right direction."
A year ago, the council funded Mayor Ben McAdams’ request for $50,000 to evaluate the system shortly after Valley Behavioral Health announced it was dropping services to 2,200 clients because of budget cuts.
The proposed move of the Olympus Hills subdivision into Holladay will be the subject of a public hearing Aug. 13 at 6 p.m. at Skyline High School.
Salt Lake County Council members will accept public input after formally receiving a report from a Boundary Commission formed to examine the proposed annexation’s financial impacts on the neighborhood, which runs from 3900 South to 4500 South and from 2700 East to Interstate 215.
The Boundary Commission’s review determined the impacts were negligible on all parties.
If the County Council uses that finding to accept the neighborhood’s withdrawal proposal, the 3,600 residents would become Holladay residents as soon as the supportive City Council can act.
Although that number eventually was cut to 730, the crisis called into question the wisdom of former Mayor Peter Corroon’s 2010 decision to replace Valley Behavioral Health (formerly Valley Mental Health) as the sole provider of these services with a managed-care system overseen by OptumHealth.
The change made Valley one of many providers working under the OptumHealth umbrella. While Valley had some financial heartburn as a result, Callahan said the county’s 16,500 recipients of behavioral health services have more choices in this new system, which is also more transparent.
Almost 7,000 of those customers receive services from the 200 service providers other than Valley now in OptumHealth’s system, she said.
Callahan recommended a half dozen improvements, including the collection of more information so the county can know better whether treatments are helping recipients become more socially connected and physically healthy. To coordinate care, she added, more meetings are needed between the county, OptumHealth and providers.
"We’re happy with the results of this audit," McAdams said. "Our highest priority at the county is to ensure consumers of behavioral health and mental health services have reliable care and predictability. That’s the value driving all the decisions we make."
He acknowledged that growing pains accompanied the transition to managed care and predicted that providing these services "will remain a prickly issue in this county for a long time."
Difficulties would diminish, McAdams added, if the Legislature accepted Medicaid expansion or Gov. Gary Herbert’s "Healthy Utah" proposal because it would address the people most likely to need behavioral health treatment — troubled, single, young men living in poverty.
"That would have a dramatically positive impact on our ability to help individuals on the road to recovery," McAdams said.
Brian Miller, president of the National Alliance of Mental Health’s Utah chapter, praised the auditor for including customer advocates’ ideas in the recommendations.
"We concur with the overarching finding that the model has the potential to effectively provide services," he said. "We support the use and improvement of these services and feel [all the groups] are sincerely trying."
Valley Behavioral Health certainly is, said its CEO, Gary Larcenaire.
He felt the audit "clearly affirms our responsible management of client care, stewardship of finances and the responsible transfer of former clients to new service providers."