RANTS that there's a need to revisit page 14 of the 8/14/12 FCBHA power point presentation again.
Under the heading of "Other Challenges," FCBHA stated, "...patients were being admitted to out of
county hospitals, including Clarion Hospital, when Highlands was either full or, for other valid reasons,
could not admit a Fayette County patient. Without a contract, (in the case of Uniontown Hospital) or from a
distance (in the case of Clarion Hospital), Fayette and VBH-PA caremanagers could not effectively assess the
need for continued care; nor could they actively participate in arranging quality follow up care in the
community."
From the sound of it, we expected to see a long list of 236 out of county patient hospitalizations at
Clarion Hospital from the targeted period in the RTK information request, from 3/11 through 3/12. This
is the one-year period, of course, before the county approved Uniontown Hospital to serve persons aged
18-55 inpatient for psychiatric treatment.
However, FCBHA's own report shows absolutely no Medicaid-funded hospitalizations at all at Clarion in
the entire one year period prior to Uniontown Hospital receiving the Medicaid insurance provider
number 5 months ago. Not even one.
After comparing FCBHA's list of 236 out of county psychiatric hospitalizations detailed in our RTK
response received 5 days ago to the list obtained today of in-network hospitals with Value Behavioral
Health, we couldn't help notice that FCBHA's list of 236, by their count, of out of county
hospitalizations was incorrect. The number is actually 359.
No kidding!
Of the 359 out of county hospitalizations for psychiatric care from 3/11 through 3/12, a total of 47 of
those 359 were at treatment facilities out of Value's network.
Realistically speaking, we know nothing about the 359 hospitalizations except that the patients have
behavioral health Medicaid through FCBHA. We sincerely doubt, however, that patients are being seen
at a local emergency room and transported to Center County, Altoona, Armstrong County, Butler,
Blair County, Huntington and York because Highlands was full and could not accept patients. As noted
in "Information, Misinformation and Myth," Highlands had to transfer 41 patients from 1/2010 through
6/2012.
Instead, we suspect that a large percentage of the psychiatric hospitalizations at the above mentioned
places might be a result of inpatient medication evaluations needed for county residents who
permanently reside in group homes for the mentally retarded in those geographic areas of the state.
That plus persons traveling, college students, foster care placements, etc., possibly accounting for this
number.
One surprise that Value Behavioral Health's in network hospital list brought was learning that facilities
such as Washington Hospital, Monongahela Valley Hospital, Jefferson Regional Medical Center,
Southwest Regional Medical Center, Westmoreland Regional Hospital and most, if not all of the UPMC
hospitals, are, indeed, all covered for county inpatient behavioral health care.
So, likewise, it would be natural to assume that -- as per Page 14 of FCBHA's power point presentation
-- if Highlands were full and had to transfer someone 100 miles north of Pittsburgh to far away Clarion
before 3/11, all of these neighboring hospitals mentioned above from Washington to Pittsburgh would
have been full as well, right?
Exactly how Fayette leaders plan to keep home the $1.3 Million health care dollars that residents by
choice spend out of county is unknown. That county leaders bring up this subject each time they discuss
the value of having Uniontown Hospital become a behavioral health provider leads one to believe that
they plan on reeling in the behavioral health dollars spent on the 174 psych hospitalizations at
Southwest Regional, the 32 hospitalizations at Westmoreland Regional and 44 hospitalizations at
Monongahela Valley, for starters.
But we have to wonder if they realize that without Highlands Hospital staying in the picture to help
make that a reality, the only other way it can happen is to have Delta Development or another funding
source cut another $8.4 Million dollar check to build another tower in Uniontown to accommodate the
business.
jt
27 Aug 12
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Editor's Note: Part II of this will follow on the second half of FCBHA's Page 14 of the 8-14-12
powerpoint presentation: "Without a contract, (in the case of Uniontown Hospital) or from a distance (in
the case of Clarion Hospital), Fayette and VBH-PA caremanagers could not effectively assess the need for
continued care; nor could they actively participate in arranging quality follow up care in the community."
We've asked some hospital staff how active a part care managers play in the treatment of those
receiving inpatient psychiatric care. How often they visit, that kind of thing.
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