County Council’s delay nearly created a health care crisis 

Two Black elected officials placed health care for nearly 1,300 people — most of them Black — at risk while exposing St. Louis County taxpayers to potentially significant financial liability.

Rita Heard Days chairs the St. Louis County Council, and Shalonda Webb chairs its Budget Committee. Together, they occupy the leadership positions necessary to move forward an appropriations bill, introduced in April, that provides approximately $2.9 million to maintain contracted health care services in the St. Louis County Jail and Juvenile Detention Center.

The council ultimately reached the right decision Wednesday by approving this funding. But it should never have taken this long.

For months, Days and Webb were told repeatedly by Department of Public Health officials that funding for contracted health care professionals would expire June 30. Yet the council failed to approve the funding at its June 16 meeting and again on Tuesday, allowing the deadline to draw dangerously close before finally acting.

Days herself acknowledged that the money existed. The dispute was never whether funds were available. The dispute was whether the council would authorize their use before health care services were disrupted.

County officials warned that without funding, medical staffing at the jail and juvenile detention center would be reduced dramatically. Medication distribution, routine clinic visits, chronic disease management and treatment for substance-use disorders all stood to be affected. Detainees who normally could be treated inside the facilities instead could have required transportation to emergency departments at much greater cost.

The consequences were no longer hypothetical.

The already overworked Corrections Medicine staff was forced to prepare a crisis management plan. County officials notified hospitals and police departments that they might have to absorb the consequences, while the St. Louis Area Police Chiefs Association warned that inadequate jail medical staffing could divert officers from patrol duties.

Webb argued that the council had received only partial information regarding spending audits and fund transfers and that additional questions had to be answered before the funding could be approved.

That explanation did not justify the delay.

The bill had been pending since April. Public health officials repeatedly explained the consequences of inaction. Hospitals, police departments and police chiefs had all been warned.

At some point, scrutiny becomes obstruction.

It is difficult to know what motivated Days and Webb to place these detained individuals and the medical professionals who care for them, led by Dr. Kanika Cunningham, director of the Department of Public Health, in this dangerous and costly position.

Even if Days and Webb have no compassion for people who have been accused of crimes, the United States Constitution requires St. Louis County to provide health care to people in its custody.

This is the opposite of financial prudence.

Had funding lapsed, the county would have had little choice but to send detainees to emergency departments at significantly greater cost and expose taxpayers to costly civil-rights litigation.

If medical staff had become unavailable, incarcerated people would have been much more likely to suffer serious harm without proper care and even to die. Dr. Kanika Cunningham publicly warned that someone could be harmed or die if adequate medical staffing was not maintained.

Many of those affected are people who have been accused of crimes but remained presumed innocent while awaiting the resolution of their cases.

Councilwoman Lisa Clancy described the situation accurately when she called the council’s failure to act “a dereliction of our duties.”

The county came dangerously close to incurring costs far greater than the approximately $2.9 million needed to maintain health care staffing in the jail and juvenile detention center.

Good government is measured not only by the decisions it makes, but by when it makes them. St. Louis County’s elected leaders allowed an avoidable crisis to develop, forced public servants to prepare for a health care emergency that never should have existed, and left detainees, medical professionals, law enforcement officers and taxpayers wondering whether common sense would prevail.

The council ultimately did the right thing. But the weeks of unnecessary delay served no one. They wasted public resources and brought the county to the brink of a health care crisis that was entirely avoidable.

The next time county leaders are warned that lives, constitutional rights and taxpayer dollars are at stake, they should act before a crisis becomes imminent — not after.

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