Building Ambrosini's Legacy
How ironic that the most recent outside legal opinions on the Highlands Hospital inpatient county Medicaid psych
contract recommend that hospital staff put their concerns and private financial information to the county
in writing.

Ironic, that is, to me because the whole relationship between Highlands and the county really fell apart when the
hospital CEO last July asked
in writing for the county commissioners to investigate and provide feedback to her
in writing why or how another hospital became a county behavioral health Medicaid provider so quietly and why
a top county department head concealed the information from her and the commissioners.

Specifically, the hospital CEO
in writing last July to the commissioners asked the commissioners to investigate
concerns that provider professionals reported to her that the county behavioral health director falsely claimed the
Connellsville psych unit was at capacity when it was not.

And way back in July, when Highlands' CEO first learned that Uniontown Hospital had become a Medicaid
behavioral health provider five months earlier, the hospital CEO, as per, in writing to the
commissioners said she was advised "that the county VBH (Value Behavioral Health) was "pressured by the
commissioners' to award the contract to Uniontown Hospital."

She asked for an explanation, comment, feedback
in writing. However, about ten or so days later, Fayette
County Commission Chairman Al Ambrosini took to the press to show off his written response to the hospital
CEO. He wrote to her that he would not provide
in writing the explanation that she requested to receive.

Instead, he told that his goal "is to form a panel that would include both hospitals and others
knowledgeable of pending health care changes and related issues to work together to improve in-place services
and expand the offerings of the two hospitals."

With his response, Ambrosini sure said
quite a mouthful.

We can't help think that there
had to have been more than a few private meetings and agreements between
county and Uniontown Hospital brass for our guy Ambrosini to feel comfortable enough to say that he and
Uniontown Hospital were on the same page and wanted to make Highlands an offer that the Connellsville facility
shouldn't refuse.

That said, nobody here can really fault Highlands' staff for throwing around the words "selective Sunshine Act"
in recent press statements, when referring to the county's actions. The hospital staff hit the nail right on the
head. The more Ambrosini talked back then to the press and later spoke at the August public meeting at Fayette
County Behavioral Health Administration, the more it was apparent that there had to have been
quite a lot of
private talks all along that excluded Highlands.   

In the past year since Uniontown Hospital has become a county Medicaid behavioral health provider, we here are
curious if that facility's opening has curbed or decreased that significant $1.2 Million health care dollars that
leave Fayette for treatment out of county.

More specifically, we're curious whether Uniontown Hospital's psych unit has influenced any of the multitude of
Fayette patients, who see one specific out of county psychiatrist to stay inpatient at Uniontown, instead of being
treated inpatient in Washington, Westmoreland or Greene counties.

We bet not, but we will still try to get those numbers. After all, getting Dr. R. Mehta's Fayette County patients to
be treated inpatient in Fayette County was always Ambrosini's goal. The real kicker of irony is that Highlands
staff reported here that their CEO at one time could have had that very doctor on staff, but the county  
behavioral health director reportedly stopped the hospital from hiring him.

As per the last referenced story from, "Ambrosini said that he was "very disappointed" in the
methods used and allegations made by" the hospital CEO in her statements made to the county in writing.

what exactly did she say that pissed Ambrosini off so much? Or did the Highlands CEO piss him off more
so because she told others and the media about the issue? The Highlands CEO wasn't alone in her thinking that
Ambrosini needed to recuse himself last summer from hospital discussions. A majority of his fellow
commissioners also felt that he needed to recuse himself from any talks with Highlands since his wife was
employed at the time -- though no more -- by Uniontown Hospital in a top professional role. Ambrosini was
wrong to have taken Highlands' opinion on that count so personally.

Highlands' CEO was merely relaying information in writing  to the commissioners that reputable professionals in
the field had relayed to her -- i.e., that someone in a county department felt pressured to approve the new psych
hospital contract. The hospital CEO did exactly the right thing when she wrote to commissioners asking for the
truth. Her complaint, after all, concerned one of the county's largest departments.

Ambrosini was wrong to have taken that personally, too. If it were untrue that anyone felt pressured, one would
think that he should have been eager very quickly to say so in person to Highlands' staff.

Very eager.

In later statements to the media, Ambrosini said that the Highlands CEO should be made to face those who -- in
his opinion -- she accused of wrongdoing in her mid-July letter. In spite of his repeated public comments that he
wants to help Highlands stay afloat, Ambrosini still gives us the uneasy impression that he wants a public
lynching to retaliate against the hospital CEO for daring to inform the public of what had happened.

We still can't quite figure Ambrosini out, why he's so hell-bent on placing blame on the Highlands CEO.

Nor will we ever understand why he has yet to accept a sense of responsibility to apologize to Highlands on
behalf of the county. It was, of course, one of his own county department heads, who, reportedly, told that
hospital CEO and his fellow majority commissioner on a phone conference call in July that the county did not
approve the Uniontown contract five months earlier.

It didn't seem to phase Ambrosini that his staff did not acknowledge the truth to commissioners or the public for
another 7 weeks. It certainly should have phased him.

At this point in time, we also do not understand why the Highlands CEO won't attend a public meeting. A former
chief legal counsel for the state's Department of Public Welfare agreed with Highlands' claim -- and, more
importantly, strongly disagreed with county lawyers -- about how the county inpatient psych contracts should
have been approved.

The Highlands CEO has nothing to fear by attending a public meeting, as far as we're concerned. All she did was
ask commissioners to investigate whether someone in the county behavioral health insurance department actually
felt pressured to allow Uniontown Hospital to become an inpatient psych provider. She did present a very valid
and reasonable concern. Any reasonable mind would have known that from the start.

County residents and taxpayers have a right to know all the facts whether Highlands participates in a public
forum or not. Highlands deserved the truth in a private forum 8 months ago when the hospital CEO wrote her
letter mid-July to the commissioners.

The rest of us shouldn't have to feel that it will be a very cold day in Hell before we all know the complete truth.

4 Mar 13
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