Friday, May 6, 2011

Valley clients concerned over future of mental health care

Posted By on May 6, 2011, 2:36 PM

Two Valley Mental Health long-term clients visited City Weekly's office today, expressing concern and anger over the direction they felt Salt Lake County mental health care was being taken. ---

Their concerns have been prompted in part by what some argue has been Valley's failure to communicate fulsomely with its clients about the changes that are taking place in the wake of Salt Lake County's decision to hire OptumHealth to manage its $55 million care contract for the mentally ill.

Last month, Valley's CEO Debra Falvo announced 100 layoffs of its 1,000-odd staff as part of a restructuring in preparation for the tougher times the private nonprofit treatment provider faces in the wake of Optum taking over its contract.

Bud Day, 56, is bipolar and says he has been a Valley client since 1995. Donna Gunn, 36, is autistic and has been a Valley client since 2004. Both spoke passionately about their fears about, and frustrations over, mental health care in Salt Lake County. They felt information was being kept from clients about the future of Valley, which now faces having to compete in the marketplace if Optum decides its services are too expensive. "I'm tired of [Valley's clients] cowering," Gunn says. "We need to stand up for our rights."

While Gunn feared that the highly successful and admired Alliance House might be closed -- something Valley has said will not happen -- they both expressed concern over the representative payee office closing at the end of June. That office helps administer clients' financial affairs, ensuring, for example, that checks for rent are paid on time.

"We have to find another payee," Day says, but his therapist won't sign papers, "so I can become my own payee," he continues, leaving him uncertain about how his finances will be managed in the future.

In an April 13, 2011, dated communique from Salt Lake County to Valley clients, entitled OptumHealth, stated Fresh Start would continue. "Most people who attend Fresh Start find it very helpful." No mention was made of Wellness and Recovery, which provides group therapy sessions. Fresh Start and Wellness were Valley's much trumpeted replacement for Pathways, which some saw as a "red-headed step child" that Valley management didn't like.

City Weekly last year ran a cover story, Valley Mental Hell, about the demise of Pathways as part of sweeping changes introduced by CEO Debra Falvo. Those threatened changes irked County officials to the point where they eventually took control of their contract away from Valley. Day said that issues of  City Weekly that featured the cover story were removed by either a Valley employee or client from the stand outside the North Valley building minutes after they had been delivered.

Several weeks ago, following Falvo's announcement of a new wave of cuts, City Weekly submitted questions to Valley's communications director, Christopher Katis. Below are the questions and his responses.

CW: Are clients being informed of changes? How?

VMH: Yes, clients are being informed. Information for them is being coordinated with a client group, SLCo, Optum, NAMI, and Valley.

CW: Representative payee is closing? If true, why? What does it do? My understanding is it serves almost 1,000 clients by monitoring SSI and disability funding, paying bills etc. If correct, won't loss of rep payee impact clients who struggle to maintain finances? Possibly lead to evictions?

VMH: Representative Payee is an important service. It is Valley's hope that the new administrative structure with Optum will be successful in finding a way to provide this service.

CW: Changes in admin staff? Was anyone let go from management?

VMH: There are and will be changes at every level of the organization central and local administration along with clinical.

CW: Why not dispose of real estate assets rather than cut staff on the front line?

VMH: Managing real estate assets and ongoing funding are entirely different management issues. To continue to provide actual services ongoing, reimbursement of services must occur. One time money cannot sustain service delivery.

CW: A new operations manager was appointed? Why?

VMH: No position has been appointed. However, a COO position is very common in organizations like ours, and indeed has been a position at Valley in the past. We tried it without having a dedicated COO for a few years, and recently made a management decision to reinstate this role to better position us for the future.

CW: Did VMH board approve changes? Any votes against? Has to be unanimous or not?

VMH: Valley's Board members have been very involved at every stage in the changes. State and local authorities and NAMI have as well. We are making the changes to position ourselves to successfully compete for a contract with Optum.

CW: Optum is supposedly hiring 30 management staff, effectively setting up mirror of Valley's admin structure. Any comment?

VMH: You would need to speak with Optum about its hiring needs. However, it's important to remember that Optum will be administering only the Salt Lake County mental health contract, not running Valley. Valley has other business besides the Salt Lake County contract, and our management is necessary for that business.

CW: Optum contract up for review in 18 months apparently. What expectation does Valley have of regaining contract?

VMH: Our current focus is to work with Optum so we can continue providing services to this important population.
CW: How is morale at Valley with further round of cuts?

VMH: Change is always difficult. It is especially difficult to lose great staff. But it's important to remember that these changes were made simply to match our staffing needs with our future revenue.

CW: Who is Valley bidding against for Optum contract?

CW: Staff complain of cuts being made to services yet expected to increase productivity to 70 percent?

VMH: Productivity expectations being asked of staff in both the administrative and clinical areas meet community standards for our industry across the nation. They are necessary to successfully provide services at the future revenue expectations.

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