[{"_1":2,"_87":-5,"_88":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},"mediaId",6368735,"mediaKeyId","2156685-d81a967bd5cdcf94274b310295e5aa69","parentId",2156685,"title","Committee reappoints Dr. Julia Lopez to St. Louis City Mental Health Board","audioSeconds",206,"startMs",1667000,"endMs",1873000,"viewUrl","/Search/View?dp=1&key=2156685-d81a967bd5cdcf94274b310295e5aa69&start=1667&end=1873","thumbnailUrl","https://assets.pipeline.soar.com/2156685-d81a967bd5cdcf94274b310295e5aa69/thumbnail_1667000.jpg","articleUrl","/articles/6368735/St-Louis-City/St-Louis-County/Missouri/Committee-reappoints-Dr-Julia-Lopez-to-St-Louis-City-Mental-Health-Board","mediaUrl","https://secure.pipeline.soar.com/6368735-3a12c05befd44c0ebcebb1571f771db5/orig.mp4?Expires=1770438988&Signature=IJbUqB~i~TH2NOJkyKBjQPvT0IrrMb6sctIEYgUv13jABwSuyOv5U2iTEDFI0bfYjG0lMIVtQ1mHyQ-YzsGHCP0znD3rnlNkjnZvfEFSdARTitH6D06istFd186akhxY-Z5oIhlZ0PCyqP69E3Jf~0VqGvg8496rXKbsy~IMWLT-8CP0H1m0Ye9ElXVN-aRyl8verMAWj35rwsM7xMgx1hyI65evu40YTilyT1U2tWzTezq-92ee7SfzoUHfbKVW1GKCR9x9Dl0sXY4KYT5nL1FnxGna7uqctjSHh-z0VymYt2q-eCB6La2VzmNZE4trypodvKFgnuIUpcyiCoXLXg__&Key-Pair-Id=KUT5TJCACFTXG","author","City Council of St. Louis, MO","date","2025-01-23T22:38:35Z","article","The Health and Human Development Committee of St. Louis City voted to reappoint Dr. Julia Lopez to the city's Mental Health Board after she summarized her experience in community mental health and her prior service on that board.

\"I've been on the mental health board since, I work at WashU School of Medicine and Infectious Diseases,\" Dr. Julia Lopez told the committee, identifying herself as a licensed clinical social worker who has worked for 20 years in community mental health with immigrants, refugees and queer and transgender people affected by severe mental illness and advanced HIV.

Committee members thanked Lopez for her service and said they would support her appointment. Alderwoman Autumn Boyd asked for a motion; the committee made and seconded a motion to appoint Lopez and the chair announced the appointment. The transcript records the motion and second but does not name the motion maker or provide a roll-call tally for this item; the committee chair said, \"Miss Lopez, congratulations. You have been appointed back onto the mental health board.\"

Earlier in the meeting the committee approved its January minutes by roll call. The minutes vote recorded verbal \"aye\" responses from Alderman Farmer, Alderman Taiz and Chair Boyd and the clerk announced \"We have 3 aye votes.\" The committee clerk later confirmed she had the candidates' resumes but no written testimony on the nominees.

Lopez said she has chaired the programmatic committee, served on the executive board as treasurer and secretary, and that she has worked on grant review and program support for grassroots and larger community organizations. Committee members said they appreciated her grassroots perspective and experience evaluating grants.","mediaType","Video","parentTitle","Health and Human Development Committee - January 23, 2025","oneSentenceSummary","The Health and Human Development Committee voted to reappoint Dr. Julia Lopez to the Mental Health Board after brief remarks about her experience in community mental health and grant review work.","taxTitle","St. Louis City, St. Louis County, Missouri","taxId",2587,"location","headline","","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},6368740,"St. Louis City nursing homes shrinking as Medicaid rates, unpaid \"Medicaid pending\" bills squeeze operators",1139,116000,1255000,"/Search/View?dp=1&key=2156685-d81a967bd5cdcf94274b310295e5aa69&start=116&end=1255","https://assets.pipeline.soar.com/2156685-d81a967bd5cdcf94274b310295e5aa69/thumbnail_116000.jpg","/articles/6368740/St-Louis-City/St-Louis-County/Missouri/St-Louis-City-nursing-homes-shrinking-as-Medicaid-rates-unpaid-Medicaid-pending-bills-squeeze-operators","https://secure.pipeline.soar.com/6368740-cfcf0a3bfe0507f8605161f15c7118ad/orig.mp4?Expires=1770438989&Signature=NghYRGvm-7LNoVxRzNL~jK~QbG1mMJQtfHok0VfinZ0LfOcAOZAvo0~elAOvX0LW0GLrzH2QQBj17MsgdVAdwciOrzsq85t-4uzQWwrkWzWumlQ4frJ3meZKr~~yn1yAuDVYB5Z-APGKE8Xv3SsP1HargU13TdnQ689lEw9siaVsO-FmacQEhTJalVJ6d49-XiNC0tMNZ-NCcEkKcHfQU-Mkvj6l22Rah8b8jcrFfirrelmmJCz9fDufvH0mJlsSWL2M3FHB9f4j2~CRmUE9jahX48E8rmCTzOBq6pqHGQM-XwbZfC6l5lH1TQz2GkYLPEVh6ZOXTFMElZwfYcscyA__&Key-Pair-Id=KUT5TJCACFTXG","Nancy Stevens, a representative of Berry City and Community Agencies, told the St. Louis City Health and Human Development Committee that low Medicaid reimbursement and large unpaid Medicaid-pending balances have made it financially untenable for several city nursing homes to continue operating.

Stevens summarized the problem to the committee: Missouri's Medicaid rates use a complex matrix and do not cover the rising costs of care, especially after COVID-19 drove up staffing prices. \"Some of the facilities had Medicaid pending up to and including close to $3,000,000,\" she said, describing how facilities can carry unpaid claims for months while waiting for state adjudication.

The matter matters locally because the closures displace residents and create vacant, unsecured properties that attract vandalism and shelter people experiencing homelessness. Stevens cited recent closures and ownership changes in St. Louis City, including Northview Village, Riverview and Dutchtown, and said those losses strained both long-term care capacity and neighborhood safety.

Stevens described two separate revenue streams for nursing homes: short-term Medicare payments for post-hospital rehabilitation and longer-term Medicaid daily rates for residents who qualify. She said Medicaid daily rates cited in her presentation ranged roughly from $165 to $180 per resident, amounts she said do not cover housing, 24-hour nursing availability, daily care by CNAs or CMTs, medications and other operating costs. At the same time, she said, staffing costs rose substantially; in some cases, hiring an LPN/RN or contract nurse cost 50 to 120 percent more than prior pay scales.

Stevens also described administrative bottlenecks. She said facilities that admit residents not yet enrolled in Medicaid must apply through a layered state-federal process and enter a status known as \"Medicaid pending.\" That application process, she said, runs through an online portal (referred to in the presentation as \"Comru\") and can be months behind, leaving facilities to carry the cost of care without reimbursement.

The combination of lower-than-average Medicaid rates, rising labor costs and large Medicaid-pending receivables has, Stevens said, prompted owners—many family-run—to sell or close facilities rather than subsidize operations. She recommended the committee consider gathering city-level data (including a ward-level breakdown) to show legislators how St. Louis compares with other Missouri localities and neighboring states.

Committee members thanked Stevens for the overview and several members said they would like a follow-up presentation with updated financial figures and a county/city breakdown of the recently released Medicaid rates.

Stevens concluded by stressing the link between nursing home decline and homelessness in some neighborhoods: when a facility closes, displaced residents and staff must find new placements or employment, and vacant multi-story buildings can quickly become security and public-safety concerns for adjacent wards.

Stevens said she would forward updated Medicaid-rate analyses and clarified data for committee review if the committee requests a return visit.","A consultant told the St. Louis City Health and Human Development Committee that low Medicaid rates, rising staffing costs and large unpaid Medicaid-pending balances have forced several local nursing homes to close, increasing housing and safety problems in surrounding neighborhoods.","actionData","errors"]

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Committee reappoints Dr. Julia Lopez to St. Louis City Mental Health Board

St. Louis City nursing homes shrinking as Medicaid rates, unpaid "Medicaid pending" bills squeeze operators