St. Louis County officials are grappling with a major budgetary hole, one that includes a roughly $20 million deficit for the county’s health department.
But while acknowledging the perilous financial times for the county, Dr. Kanika Cunningham, the county's director of public health, is pushing back against the idea that the county should shutter some of its health clinics as a way to save money.
“This is not a time to discuss closing access to health care,” said Cunningham on an episode of the Politically Speaking Hour on St. Louis on the Air. “We are a partner in the ecosystem of health care in St Louis County and the region. And given what is taking place on the federal level, we cannot close our doors to the most vulnerable in St. Louis County.”
Cunningham was responding to a recent Politically Speaking Hour interview with St. Louis County Councilwoman Rita Days. When asked about specific items that could be cut to alleviate the budget hole, the Bel Nor Democrat pointed to three health clinics that provide a range of primary care services to the working poor.
“It's a good thing to do if you can afford to do it, but at this particular juncture, I don't think we can afford it,” Days said.
St. Louis County is the only county in the state that runs Federally Qualified Health Center Look-a-Likes clinics, which provide services such as pediatric, dental and obstetrics care. They’re located in Berkeley, Pine Lawn and south St. Louis County.
Cunningham said the “look-a-like” designation allows the county to collect better reimbursements from federal government programs like Medicaid and Medicare, adding that it’s “one way to guarantee increased revenue and to sustain the life of the health centers.”
“It speaks to values,” said Cunningham, who added that the clinics cost around $20 million a year. “And historically, the people of St. Louis County have always voted to support public health and maintain access to health care. So I think it comes down to do we care about the constituents of St. Louis County to where we will continue to maintain access to health care or is it truly all about money, and we don't care about the people?”
While there are other health center look-a-likes in St. Louis County and St. Louis that are not run by governmental agencies, Cunningham said those clinics “have their own patient population.”
“When we look at true desert areas in our most vulnerable locations, we don't have access to too many healthcare centers and we can't rely on hospitals,” Cunningham said. “We can't rely on urgent care centers. Primary care serves a purpose. And that purpose is to improve the health and well-being on the individual level.”
St. Louis County Executive Sam Page has backed placing an online sales tax up for a public vote next year, which Cunningham said could go a long way toward closing the budget gap that’s bedeviled county policymakers for nearly a decade.
Focus on animal shelter
Cunningham’s agency also oversees the county’s animal shelter, which has been under intense public scrutiny.
While Page has wanted to invest $20 million of St. Louis Rams settlement funds into the shelter, Days and other members of the council have not been receptive to that idea. Days said during her Politically Speaking Hour interview that the project doesn’t align with the need to spend the Rams money on “one-time expenditures.”
“Let’s say we build a facility for 300 animals, and then we get 300 animals, then do we have to build another facility for that?” Days said.
Cunningham, though, said the shelter needs a lot of structural updates, including a revamped plumbing and HVAC system. She also said the facility needs to accommodate larger dogs.
“We need the money to invest in the animal shelter so that we can improve just the basic living conditions,” Cunningham said.
“St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is produced by Miya Norfleet, Emily Woodbury, Danny Wicentowski, Elaine Cha and Alex Heuer. Darrious Varner is our production assistant. The audio engineer is Aaron Doerr.
