Ambrosini Needs To Recuse Himself From Hospital Contract Talks
That Commission Chairman Al Ambrosini does not see a need to recuse himself from any talks with area
hospitals about their behavioral health contracts is sad news for the county he represents.

In today's Herald Standard article,
"Ambrosini denies helping Uniontown Hospital get contract," we've heard only
for the first time directly from the man his denial in this matter in the two weeks, since the controversy started.
And it was only yesterday, in the same paper's online edition did we hear for the first time in two weeks that no
commissioner had prior knowledge of Uniontown Hospital's second issuance in March of a Value Behavioral
Health provider number, when another commissioner said no commissioner knew.

Since July 16, when Highlands Hospital CEO Michelle P. Cunningham wrote a letter to the commissioners,
questioning Ambrosini's role in Uniontown Hospital's second issuance of a provider number, Ambrosini said
nothing. He should have recused himself from the matter because he received political campaign contributions
from the Uniontown Hospital CEO and a few of its doctors, because he appointed Uniontown Hospital's director
of nursing to the county behavioral health advisory board, and because he is married to Uniontown Hospital's
second in command staff.

Instead of recusing himself, Ambrosini wrote his first of two letters to Cunningham, signed by him and
Commissioner Vince Zapotosky, asking her to meet with them, Uniontown Hospital CEO Paul Bacharach, the
county behavioral health director, and solicitor to talk.

In the meantime, Ambrosini ignored contact from Commissioner Angela Zimmerlink, assuring Cunningham that
the county would investigate her claims and get back to her. Nor did Ambrosini include Zimmerlink in his letter
writing efforts to the Highlands CEO. He foolishly did not stop to think how his personal feelings towards a
commissioner comes off to someone out there who does business with the county.

Ambrosini might be quoting accurate facts in today's paper, but isn't telling the whole story. Highlands and
Uniontown Hospitals are the only Fayette County hospitals, yet he refers to "a lengthy list of other hospitals in the
region that provide inpatient psychiatric services to Fayette County residents. In fact, he added, it (Highlands)
continues to service more patients than any other facility as evidenced in financial reports received by the

True, that other hospitals outside the county can serve Fayette residents, it's only common sense that we would
be able to pay those hospitals, or even hospitals in New Mexico or California -- i.e., if residents travel there and
need care. But they're not Fayette County hospitals, however, as the rest of us know. The lengthy list of Fayette
County hospitals is two. Down one from three, when Brownsville Hospital and its psychiatric unit closed.

Ambrosini in today's paper refers to 2011 pay off statistics, to say that Highlands Hospital received county
medicaid payments of $982,818 while Uniontown Hospital was compensated $40,667 during the same time
frame. Since Uniontown Hospital initially received only geriatric medicaid approval four years ago -- and since
Ambrosini neglects to say that the second issuance it received from Value Behavioral Health 4 months ago cuts
directly into Highlands' 18-55 patient age-range for services -- we certainly hope that Ambrosini is available next
year to quote similar positive earning statistics for Highlands as well.

That is, if Highlands Hospital is still around next year. Yesterday's front page headline newspaper story sent chills
down our spines, seeing the large print headline through the glass for sale in the newspaper box outside an area
resident. Hospital Warns Of Possible Layoffs.

This week, Ambrosini sent Cunningham another letter, accusing her of "standing on the sidelines" and informed
her that she needs to meet with county officials. We do agree with him on this one, but so wish his tone was
nicer. Cunningham needs to meet with two county commissioners, solicitors, and county behavioral health
director, but Ambrosini should not be present. Nor should the Uniontown Hospital CEO.

In Cunningham's two-week old letter to the commissioners, she stated being told by an insurance representative
that the county behavioral health/HealthChoices director was pressured into agreeing to allow Uniontown Hospital
to receive its second insurance provider number. That behavioral health director has been away from work, at
least from the day after Cunningham sent her letter through a few days ago, when Commissioner Zapotosky had
other behavioral health staff attempt to answer this editor's questions in her absence. Zapotosky explained that it
was difficult to obtain answers since the director was out.

While Ambrosini may be correct in today's article, when he says that no commissioner or county representative
needed to approve the issuance of a second provider number to Uniontown Hospital, this column awaits a
response from the county solicitor concerning two sections of the county's contract with Value Behavioral
Health.  Yesterday, the
question was posed at this link, sent to the commissioners and forwarded to the solicitor
by Zapotosky. It is noted that the term Subcontractor refers to Value Behavioral Health. The two sections include:

12.2 County Approval of Subcontracts

(a) COUNTY reserves the right to review and approve all of SUBCONTRACTOR's proposed subcontracts
with Providers as to services and rates. Rates and Providers as recommended by SUBCONTRACTOR will
be approved unless COUNTY determines that such recommendations are inconsistent with Program
objectives or requirements, including objectives or requirements relating to COUNTY's compensation if
its own Providers whether or in the Program or other, non HealthChoice behavioral health programs of

(b) SUBCONTRACTOR agrees to submit the forms of its proposed Provider Agreements to COUNTY
and to cooperate with COUNTY and DPW in its review of the forms of such Provider Agreements, as
further provided in Section 12.2 of the COUNTY-DPW agreement. SUBCONTRACTOR will submit to
COUNTY and DPW for prior approval any material modifications in said forms of agreements.

Should Cupp not find that the insurance agent needed to run this by commissioners first before approving and
issuing a provider number to any new inpatient provider, this editor will accept his opinion. Until then, we note
that the agreement between the county and Value Behavioral Health was signed by 3 commissioners in 1998.

29 Jul 12
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(Editor's Note: Informal, outside legal opinon that this editor yesterday sought was 3-0 unanimous that the
county is at risk of a lawsuit from Highlands, unless the county in a subsequent document waived that right to
review and approve sub-contracts with providers. It is noted that no subsequent waivers were included in
requests from two newspapers to obtain the contract under the Right To Know Law or the contract forwarded
to this editor.)