At this year's annual Valley Mental Health staff conference on Oct. 12, a motivational speaker gave out pooper scoopers. For staff who see the agency as all but buried under 'poop' created by Valley's leadership, the gift felt painfully appropriate.---

With Valley's future as a provider of clinical services to Salt Lake County's mentally ill overshadowed by the County's recent decision to hand over administration of the contract to OptumHealth, the conference was more than a little surreal. CEO Debra Falvo, according to several staff members who attended, handed out a book called 'Change or die,' which was apparently required reading for all those in leadership roles.

"The time to bring 'Change or Die' is  before you fall apart, not after," said a bewildered Valleyite, who requested anonymity.

Valley's leadership was apparently pushing a "client-orientated" approach at the conference, something of a stark shift in tone from a year ago when Falvo's announced cuts to services and staff positions heralded not only a substantial reduction in client care but also a climate of fear among staff that has yet to completely dissipate.

"The administration under Debra was never about people," says one indignant staffer. While the staffer heard "the hint of an apology" in Falvo's key note speech at the conference, "it's all too little, too late."

Falvo's previous comments to her staff that the organization would fight the county's decision appear to have led to naught. The staffer said Falvo had offered to step down to Valley's board, but had been told "they didn't want her to."    

Whatever behind-the-scenes struggles are presumably going on between Valley's leadership and the county, an Oct. 1 letter from Mayor Peter Corroon's office spelt out in even clearer detail how fundamental the restructuring of Salt Lake valley's mental health services is going to be. "OptumHealth will work directly with the County and Stakeholders to decide how Medicaid savings will be ultized for consumer services," ran the letter. "Historically those decisions were made by VMH outside the County's purview." Not only administration, but also sub-contracting and quality assurance functions are going to OptumHealth, the letter added.

Which begs the question, argue insiders, what will remain of Valley's budget once it no longer controls the state Medicaid funding?