Missouri Gateway to Better Health

Under the Demonstration, the State will spend up to $30 million (total computable) annually to preserve and improve primary and specialty care in the St. Louis region. To maintain budget neutrality, the State will ensure that these amounts, when added to payments to disproportionate share hospitals (DSHs) will not exceed the DSH allotment calculated in accordance with section 1923 of the Social Security Act (the Act). From July 28, 2010 (the date of the award letter) through June 30, 2012, as the State works to devise strategies to ensure the financial sustainability of the area's safety net system, the State will have authority to divert DSH funds to pay for otherwise uncompensated ambulatory care at specific facilities for the approved Demonstration period. These entities include St. Louis ConnectCare, Grace Hill Neighborhood Health Center, and Myrtle Hilliard Davis Health Center. By July 1, 2012, the State must implement a pilot program, subject to review and approval by CMS, to provide health insurance coverage to uninsured individuals residing in St. Louis City and St. Louis County with family income at or below 133 percent of FPL.