ST. LOUIS (AP) - One of the St. Louis area's largest providers of outpatient specialty medical services for the poor is firing more than half its staff and reducing services.
Officials with St. Louis ConnectCare announced Wednesday that 88 employees will be laid off in the next 60 days. Eleven other employees were let go last week.
CEO Melody Eskridge said some doctors will no longer provide services to ConnectCare patients at its center.
Eskridge said the nonprofit company will not offer outpatient specialty appointments but will continue its urgent care center, radiology services and community health visits. She said the changes came partly because of federal and state budget cuts for health care for the uninsured, and the Missouri Legislature's decision not to expand the state's Medicaid program.
ConnectCare is located on the former Delmar campus of the St. Louis Regional Medical Center. The company has provided outpatient specialty services for the past 15 years to a disproportionate share of the St. Louis area's uninsured and underinsured. Sixty percent of its patients in the most recent fiscal year lacked insurance, and another 23 percent received Medicaid, according to Eskridge.
"For me personally, it hurts," she said. "I've seen the good work that was done. I've talked to patients over and over who told us, "If you weren't here we don't know what we'd do.' In that respect, I pray that everyone has a place to get the care that they need."
By sheer percentages, the nonprofit's focus on the city's poor is far greater than at the area's two largest safety net providers, Washington University and SLUCare physicians groups. According to the St. Louis Regional Health Commission, only 3 percent of specialty care appointments at WashU involve the uninsured, with those cases accounting for about 5 percent at SLUCare.
Advocates of Medicaid expansion said the cuts portend similar reductions ahead.
"This is the day the rhetoric becomes real," said Robert Fruend, the regional health commission's executive director. "Without Medicaid expansion, we will start losing capacity in our medical institutions particularly in those that serve our most vulnerable populations. We will continue to see layoffs and access reductions in the rural areas, the urban areas and institutions that serve the mentally ill, until we expand Medicaid."
Missouri lawmakers rejected Medicaid expansion after the U.S. Supreme Court gave states the right to decline participation. An estimated 877,000 Missourians don't' have health insurance.
St. Louis Mayor Francis Slay said the ConnectCare cuts show that the state's "failure to improve, reform and expand Medicaid (has) real consequences for real people."
"Unfortunately, it is coming true. Hospitals have started to lay people off," he said in a statement. "Now, this from ConnectCare. It will mean sick people will have less access to specialty health care."