Salt Lake County Mayor Ben McAdams on Wednesday backed a request from patients and advocates for an independent review of the county's mental health services, following budget cuts that prompted provider Valley Mental Health to bounce some 2,200 clients out of its system and into a search for new providers.
Valley Mental Health announced plans to cut the patients on June 28, citing a cut in the funding it gets from Optum, the managed care company with a contract to run the county's Medicaid-funded system.
The county asked providers to take a 5.5 percent cut in the rates they are paid for treatmentafter it calculated that its budget will not cover the costs anticipated in 2014. Valley decided to focus on caring for only those with acute mental illness. Letters directing other patients to contact an Optum-run 800 number for referrals to new physicians or therapists were sent beginning July 1.
County officials learned of Valley's decision through the news media, McAdams said during a meeting with advocates and Valley clients at his office Wednesday.
"I'm outraged at Valley Mental Health," McAdams said, adding that he has told Valley CEO Gary Larcenaire the move was a poor business decision that was "not compassionate to the 2,000 lives that will be affected."
McAdams plans ask the County Council for funds to conduct an audit of Valley's management, service delivery, communications and fiscal responsibilities during the council's July 30 meeting. McAdams anticipated the audit could be done over three months and said he also is open to an examination of the county, Optum and its management of care providers.
The county learned in late May that state and federal funding for Medicaid would be reduced. County officials believed the rate cut would prevent the county from having to cut any services, the mayor said.
"Other providers were willing to work with us," McAdams said.
Valley took a smaller cut 4.9 percent than others because some of the services it provides are tied to specific Medicaid rules, said Tim Whalen, the county's director of mental health. Without the cuts, the county may have had to seek a tax increase.
Both Larcenaire and Richard Elorreaga, Optum's executive director of public sector solutions, said on Wednesday they welcome an audit.
"I don't think that could ever be a bad thing," Larcenaire said.
Ginger Phillips, a Valley client and peer support specialist who was among those lobbying McAdams for an investigation, cheered the mayor's call for an audit that takes a broad look at services.
"Ultimately the county is responsible for the budget cuts," said Phillips. "We want to know what is happening with Valley and how Optum is managing mental health care in the county."
Optum, which was awarded the county contract to manage mental health services two years ago, has promised a seamless transition for Valley's clients.
But Phillips, other clients and advocates fear the disruption could have dire consequences for fragile mental health clients and could leave some without much-needed care.
"I am concerned for my peers because they are vulnerable," said Phillips. "I believe in consistency when it comes to mental health care. If this was a clinic for cancer patients, or diabetes or a pediatrician's office, we would never see 2,200 clients cut and shipped all around the county."
Salt Lake County and Optum contend Valley's decision to cut the patients is part of its planned change to a business model that focuses on those with severe and persistent mental illness.
Phillips said she initially supported the county's decision to contract with Optum. Valley previously held the contract, and the switch was triggered in part by county officials' frustrations with Valley overseeing its own work. But Phillips said she is now disappointed in Optum's management of services.
"We wanted better mental health care, but maybe we didn't get it," she said. "That's why we need this independent review."