Highlands' Performance From The State's Perspective
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    In 2008, when Value Behavioral Health, Fayette County's Medicaid behavioral health provider,
    started granting special considerations based on quality review performances to its 39 in-network
    hospitals, VBH launched a prestigious Value Select Provider (VSP) program. The VSP program
    monitors the performance of psychiatric hospitals for average length of stay and readmission rates
    within 30 days of discharge.

    These criteria, after all, are how quality psychiatric hospitals earn their reputations.

    To be granted VSP status, facilities have to be known to diagnose accurately, treat effectively and
    discharge quickly and to be able to be trusted to continue to do so without Medicaid managed care
    looking over its shoulder to make sure all factors about the admission and treatment are kosher.
    VSP status gives hospitals a 5-day coveted pre-authorization window of clearance to admit and
    treat without bartering daily to the insurance provider for a second, third, fourth and fifth day of
    coverage.



    To date, in four years across 13 counties, only Highlands Hospital and Jameson Hospital in
    Lawrence County are the only two such noted hospitals in the eyes of VBH for it and the state to
    be allowed to be labeled as VSP providers.

    Considering that the list of 39 VBH in-network hospitals (obtained 8/27/12 from VBH) also
    includes power house facilities such as UPMC and WPIC, and smaller neighboring county hospitals
    such as Mon Valley, Washington, Westmoreland Regional, Jefferson, Uniontown and West Penn
    Hospitals that are NOT on the VSP list, Highlands and Jameson blow the others away in credibility.



    In the "Commonwealth of Pennsylvania Department of Public Welfare Office of Mental Health
    and Substance Abuse Services 2011 External Quality Review Report on Value Behavioral Health,
    Final Report Completed on April 6, 2012," Fayette County met full compliance in only two areas of
    several reviewed for annual performance.

    Fayette was within full compliance in the areas of Readmission Report and Consumer Detail
    Readmission Reports that are reviewed by the hospital behavioral health clinical teams and the
    county over-sight team to insure that all consumers have appropriate follow up. Highlands received
    a stand-out mention as a VSP provider on page 50 of the 77 page state audit of VBH and Fayette's
    2011 perfomance mentioned in the above link.

    It is noted that VBH overall, with respect to the other 12 county programs, did not meet the
    OMHSAS standards for favorable standards for psychiatric hospital re-admissions within 30 days
    of inpatient discharge. Highlands got Fayette the honor of being one of the few VBH counties to
    meet state standards.


    Meanwhile, in audited areas of administrative (or non hospital) functions more directly between
    VBH and consumers, such as grievances, enrolee rights, appeals, record keeping, record keeping
    requirements, quality assessment and performance improvement regulations, federal and state
    grievance standards regulations, etc., VBH and Fayette performed just OK. Once we stopped
    looking at hospitalizations, Fayette had full compliance on an administrative level only in regard to
    its level 2 grievances.

    Highlands, essentially, gave Fayette its only strong mention in the state program audit released
    4/6/12.



    jt
    22 Sept 12
    copyright protected




    Editor's Note: This editor graciously thanks the state official reading here for forwarding the link
    mentioned above to the 4/12 report referenced in this commentary and for this comment. "Your
    county leaders are a bunch of arses if they force Highlands to close. It is a proven leader in the
    field of behavioral health. They know what they're doing there. It's in the county's best interest to
    make sure Highlands does not close or lose its behavioral psychiatric units."



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