Information, Misinformation and Myth
One unforgettable comment made in the July 13th letter that the Highlands CEO wrote to commissioners and that
again was repeated in the subsequent newspaper articles desperately needs addressed. This piece of the puzzle
concerns if, or then why, the county thought a second psychiatric unit serving persons over the age of 18 was
needed because Highlands reportedly was full too often or was reaching capacity.

At the public information meeting held at FCBHA 10 days ago, staff presented a power point explanation of how
the contract with Uniontown Hospital came to be. When staff got to page 14 of the presentation, there it was
again, the inference that Highlands being full was a challenge that caused patients to be treated out of county.
Just how big an issue or challenge was it really?

While nobody disputes the fact that persons needing inpatient care sometimes have been transferred out of
county for treatment because Highlands was full, this editor was floored when the FCBHA speaker was stumped
when Highlands staff in attendance disputed the statement. The FCBHA behavioral health department director
said she had no documentation to support her claim, but passed the buck by saying that that vague information
came from Value Behavioral Health, the Medicaid insurance provider.

Nobody at FCBHA asked for that in writing?
Nobody wrote down or documented such an important piece of
information? Nope! Why not?

As stated here previously, FCBHA should not have had to pass the buck and rely on VBH or any other entity for
statistics that FCBHA itself generates, tracks and owns. FCBHA delegates, who approve all county mental health
court orders, approve all voluntary and involuntary psychiatric admissions of persons physically in the county at
the time the court order petitions are written and approved. Their phones ring for each and every psychiatric
admission around the clock, holidays included.

Each work-day morning, a unit of FCBHA casemanagers pick up delegate logs and then track the patients in
hospitals. Those competent folks track the hospitalization stays on computers at each of their desks. Some of the
data is then shared with or forwarded to Chestnut Ridge Counseling Services, Inc. for outpatient aftercare
intakes and/or appointments.

But back at the August 14th public information meeting, page 14 of the power point presentation and the FCBHA
staff comments didn't sit well with the Highlands staff in attendance -- or with any of us who worked in the
field. Why FCBHA would even need to confer with VBH about Highlands being full or nearing capacity seemed
odd, since FCBHA delegates approve mental health court orders for persons with all kinds of insurances. In
contrast, VBH deals only with Medicaid, while we've maintained that FCBHA's own in house counts covering
patients with all insurances would be more accurate.

As readers recall, the day following the meeting, email was sent to the county office hosting the previous
evening's meeting asking for clarification on that piece of the presentation. To date, nope, no response.

So a week ago, a RTK request was sent to FCBHA to obtain their count of the number of times persons were
seen at Highlands emergency room for medical clearance and transferred to another hospital for inpatient
psychiatric care because Highlands was full.

Yesterday, the RTK response that the county clerk relayed stated:

"For the issue of “FCBHA/HealthChoices total number of Fayette County Residents who were medically
cleared at Highlands ER and transferred out of county for inpatient psychiatric care because Highlands was full
and could not admit them,� I cannot provide the information because according to FCBHA, there is no means
to report or provide the information. Because FCBHA cannot provide the records, I am denying your request."

What was included, however, was a list of all 236 admissions of county Medicaid consumers inpatient for
psychiatric care in the state from 3/11 through 3/12 -- which was not exactly what we wanted, but appreciated
information, nonetheless.

Meanwhile, as county staff sitting on Highlands' transfer statistics that they generate and own but possibly don't
care to compile, even under a RTK request, Highlands staff quickly knew their numbers.

In 2010, Highlands' inpatient psychiatric units had 960 admissions and transferred 10 patients elsewhere because
the hospital was full. In 2011, the hospital psychiatric units admitted 810 patients and transferred 31 elsewhere
because there were no beds. Through January and July of 2012, the hospital has had only 310 admissions and
transfered no patients because there were no beds available.

Other key reasons why Highlands has transferred psychiatric patients for treatment are a moot point, since
Uniontown Hospital will also have to transfer young children and, in all probability, have to transfer pregnant
women due to high risks of treating them. All hospitals, too, expect to experience patients who want transferred,
due to relationships with employees or others patients.

Missing from this story of statistics are the known numbers of children involved and an explanation of where
patients physically were when petitioned and admitted 236 times to out of county hospitals from 3/11 through
3/12. This is a one-year span of time targeted in the RTK request before Uniontown Hospital became eligible to
admit adults over 18 with Medicaid for psychiatric treatment.

Considering Highlands has turned away no patient in 2012 and had no bed available for only 31 persons in the
whole calendar year of 2011 while treating 810, we're confident to say that Highlands did not create the need for
205 or more of the 236 people to receive treatment out of county during the one-year period before Uniontown
Hospital became eligible to receive Medicaid behavioral health reimbursement to treat adults age 18 and older.

To blame Highlands or include that facility as a "challenge" on page 14 of FCBHA's  power point presentation
was rather pointless and unfair.

23 Aug 12
Copyright Protected                                                                                                   August 14 FCBHA Presentation