As the President and CEO of this historic organization, it is heartbreaking to witness the immense stress and financial strain placed on our community and our health center. I do not take lightly the responsibility of leading an institution built on the dedication and sacrifices of those who came before me. Many of my predecessors served this organization until their last breath, as have several of our employees. Today, our staff continues to give their all to serve this community—and for them, I speak.
I speak to honor the legacy we uphold. I speak to acknowledge the reality we face. And I speak to reaffirm our unwavering commitment to each of you and the patients who depend on us.
Where We Are ….. “living paycheck to paycheck just like many of the employees.” & How We Got Here
Like many healthcare organizations across the country, we are navigating a series of financial and operational challenges that have placed significant strain on our resources. Several key factors have led us to this moment:
- Medicaid Disenrollment & Delays
- Since June 2023, Missouri has experienced a 13% decline in Medicaid enrollment, resulting in approximately 5,000 CareSTL Health patients losing their coverage and becoming uninsured.
- Medicaid application processing delays—often exceeding 90 days—have further strained our ability to provide timely care.
- Missouri leads the nation in delayed Medicaid applications, creating additional burdens for both our patients and our operations.
- Change Healthcare Cyberattack
- The breach significantly disrupted operations, delaying prior authorizations and claims processing, and causing nearly $89 million in current, future, and potential financial losses, including $10 million in actual cash losses in 2024.
- Payroll challenges, vendor suspensions, and increased administrative burdens have compounded the crisis.
- Despite multiple financial assistance requests, no resolution has been reached, leaving us with mounting unpaid balances and service disruptions.
- Federal Funding Freeze
- The January 2025 executive order suspending all federal grants and loans has caused significant delays in critical funding for Federally Qualified Health Centers (FQHCs) nationwide.
- As a result, health centers across the country are experiencing service disruptions and staff reductions due to ongoing funding uncertainties.
- While the release of these funds has been approved, CareSTL Health has yet to receive the allocated funds, further impacting our operations and ability to serve our community.
How We Will Recover
Despite these challenges, we remain steadfast in our commitment to serving our patients and supporting our staff. Our plan for recovery includes:
- Workforce Optimization & Staffing Adjustments
- Strategically realigning staff roles to enhance efficiency while maintaining high-quality patient care.
- Ensuring appropriate patient-to-provider ratios to maximize access and improve service delivery.
- Restructuring leadership to foster greater collaboration, streamline decision-making, and strengthen operational effectiveness.
- Financial Stability & Funding Recovery Efforts
- Actively advocating for policy solutions to restore and expedite funding critical to sustaining our services.
- Addressing delays in receiving federal funds caused by government employee layoffs, restrictions on federal employees communicating with vendors, and agencies closing early, all of which have further disrupted financial operations.
- Strengthening partnerships with philanthropic organizations, grant providers, and community stakeholders to bridge funding gaps.
- Implementing cost-saving measures that maintain the quality of patient care while ensuring long-term financial resilience.
- Prioritizing salary assessments and workforce stability to support and retain our dedicated employees, recognizing their essential role in fulfilling our mission.
Moving Forward Together
We understand the difficulties these challenges present, but we remain committed to transparency, resilience, and long-term sustainability. Your dedication and hard work are the foundation of this organization, and I am deeply grateful for each of you.
We will continue to keep you informed as we navigate this period, and I encourage open dialogue as we work together toward solutions.
Thank you for your perseverance, your passion, and your commitment to the patients and communities we serve. Together, we will overcome these obstacles and emerge stronger.
With gratitude,
Angela Clabon,
President & CEO
