If Angela Clabon would have had her way, she would have retired at age 62 as chief financial officer of Myrtle Hilliard Davis Comprehensive Health Centers following many years of service. After all, she loves finance.
That is not what happened.
The funding mechanism for Federally-Qualified Health Centers (FQHCs) moved from bulk dollars to per-visit payments, putting its three centers in the red – $2.8 million worth. At the beginning of last year, the health center had to lay off 25 workers.
Then longtime Myrtle Hilliard CEO Archie Griffin died unexpectedly in February 2013. Clabon went from CFO to co-CEO during the transition.
Myrtle Hilliard cut supplies by 30 percent. They spruced and painted locations instead of renovating. Myrtle Hilliard began offering urgent care at its main location to fill in a gap after another provider closed its doors.
Yet, in one year’s time, Myrtle Hilliard was turned around from operating in the red to operating in the black. Those 25 laid-off employees were called back to work. Employees received raises.
And in December 2013, Clabon was appointed chief executive officer.
With 50 percent of its clientele being walk-in patients, Myrtle Hilliard is still working through a financial recovery plan. Its most successful strategies were getting its patients to come in more often for care and to enroll for health coverage.
“We were seeing our patients probably twice a year, and we transitioned from twice a year to three to four times a year,” Clabon said.
“And our uninsured patients, we enrolled in Gateway and we enrolled in Medicaid, so we spent a lot of effort getting our uninsured patients enrolled in some type of insurance plan.”
She said while Myrtle Hilliard’s patient numbers stayed the same, the payment mix made all the difference.
“We still have the same number of patients, about 28,000 a year,” Clabon said. “In the past they were 40 percent uninsured and now we are around 22-23 percent uninsured. Insuring at least 10 or 15 percent of our patient mix helped up survive.”
That is why Medicaid expansion is so important, Clabon said. It is an essential funding source for health providers who serve low-income, uninsured and underinsured patients. Without it, urban and rural providers may have to shut down.
“You will see more closures, because the organizations that aren’t FQHCs cannot afford to continue to provide services to uninsured patients,” Clabon said.
U.S. Health and Human Services Secretary Kathleen Sebelius told reporters during a recent visit to St. Louis that Missouri is losing $5 million per day in federal funds because it has not expanded Medicaid.
“Just hearing that number is alarming,” Clabon said. “That’s only a certain portion of health care. That’s just taking care of that gap of patients for Missouri.”
The gap Clabon refers to describes persons with incomes between 100 and 133 percent of the federal poverty guidelines, which in 2014 is an annual income between $11,670 and $15,521 for individuals and between $23,850 and $31,721 for a family of four in the 48 contiguous states and Washington, D.C.
Additionally, persons enrolled in the Gateway to Better Health Program who qualify for Medicaid receive services from a waiver extended through the end of 2014.
“They should receive Medicaid, but they don’t,” Clabon said.
Myrtle Hilliard operates on a $20 million annual budget, of which about $2.5 million is federal dollars. “The rest is earned revenue,” Clabon said.
Clabon’s career has been in health care finance administration, previously working for Grace Hill and People’s health centers and Hopewell behavioral health center. She is a product of St. Louis Public Schools, a graduate of O’Fallon Tech (now Gateway). Clabon attended the University of Missouri – Columbia for two years before earning her bachelor’s degree in accounting from the University of Missouri – St. Louis and an MBA from Webster University. Last year, Clabon graduated from the UCLA Executive Program in Health Care.
Clabon is a member of Central Baptist Church and Sigma Gamma Rho Sorority. She is married to James Clabon, a Mizzou and Vashon High School graduate.
The work ahead for Myrtle Hilliard includes expanding its three locations, integrating behavioral health and expanding pediatric dentistry.
“We have several contracts with Head Start programs. We send a dentist, and a hygienist and a dental assistant,” she said. “We have 12 daycares that we provide services for.”
She said the demand for this service is high. “We are looking to hire additional dentists to treat the daycare programs for preventive services,” she said.
For more information about the services of Myrtle Hilliard Davis Comprehensive Health Centers, call 314-367-5820 or visit www.mhdchc.org.
