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Anti-Crime | Youth | Seniors | Economy | Planning | Codes | Preservation | Energy  TRANSPORTATION SERVICES An effective transportation system is an integral aspect to the continued revitalization of St. Louis City. Proper and well-developed systems of transportation help the business community prosper and enhance the quality of life for residents. Transportation planners at Bi-State Development Agency and East-West Gateway Coordinating Council are continuously working to create a transportation system that will continue to be safe and that will make employment and services more easily accessible. A proposed multi-modal center connecting the City's bus line, light rail (MetroLink), AMTRAK Station, and Lambert International Airport will be an important improvement to the City's transportation needs. Current Services Bi-State Development Agency: Bi-State has been serving Missouri and Illinois since 1949. The Agency is responsible for planning, building, maintaining, owning and operating public transportation systems, bridges, docks, and airports. Bi-State operates three services throughout the regional area: bus, MetroLink, and Paratransit. Bus service runs across 114 regularly scheduled routes and 46 special event routes annually. Buses serve approximately 36.6 million passengers each year. MetroLink has a 17-mile route serving two states and 14.4 million passengers in a single year. The table below shows the number of passengers using public transit during the past 10 years. [ Table III-F-1, Transit Ridership - 10 Year Trend ] MetroLink offers convenience and accessibility while assisting the bus lines with the transportation of passengers. Since the opening of MetroLink, the number of people using mass-transit has risen. MetroLink provides its service from St. Louis' International Airport, through Downtown, ending in East St. Louis, Illinois. An extension has been approved connecting more of St. Louis County with the City.
Bi-State Call-A-Ride/Call-A-Ride Plus, ACT, Care Cab, OATS are considered High-Level Trip Providers by EWGCC. This foursome accounted for 310 vehicles, 149 of which were lift-equipped vehicles. The following table includes information on the four High-Level Trip Providers. [ Table III-F-2, High-Level Trip Providers ] Needs and Challenges The Bi-State Development Agency, EWGCC, and Downtown Now! are all working on long-range transportation planning for the expanded Downtown St. Louis Core. Efficient and convenient transportation is a considerable problem for the City as well as for its revitalization efforts. Efforts are currently in progress to make transportation in St. Louis safe and pedestrian friendly, but much work is needed to reach the ultimate goal of a well-connected City easily accessible from its suburbs. The approved expansion of MetroLink to extend further west into the county has brought about various ideas of expansion north and south of the City. Ideally, all transportation would use Downtown as its hub, and this is the thought of two studies performed by EWGCC. The Major Transportation Investment Analysis (MTIA) is a group of studies concerned with three different areas, but only two of these areas directly relate to the City of St. Louis, the Northside and Southside Study Areas that would emanate transportation services from the City outward. Northside Study Area: There are seven recommended alternatives for developing a transportation system that would connect North St. Louis County and the City. Suggested alternatives consist of maintaining the status quo, expanding several MetroLink routes, developing a route exclusively for public buses, and considering two new options for new road construction. Excluding the option of doing nothing, the options all cater to the same goals and objectives. These goals are listed below.
Southside Study Area: The Southside Study Area is designed to connect south St. Louis County to the City through one of five different recommendations. The options are similar to those proposed in the Northside Study. They consist of maintaining the status quo, adding two MetroLink routes, creating a rapid transit option for buses, and modifying an existing roadway. The Southside Study has goals and objectives it wishes to meet via one of the above alternatives. These goals are listed below.
One of the toughest challenges facing the City of St. Louis is the development of the new Mississippi River Bridge. St. Louis has the opportunity to avoid detrimental construction that took place in cities such as Boston and San Francisco. The City needs to ensure the new bridge serves as a freeway across states and to Downtown. The new structure must not degrade existing neighborhoods, it must maintain the local street network, support and build economic activity for Downtown and surrounding neighborhoods, and maintain or improve the social equity of its users, neighborhoods and districts. Mayor Clarence Harmon and St. Clair County, IL Board Chairman John Baricevic signed a resolution on June 17, 1999 to move forward the Environmental Impact Statement for the new bridge. EWGCC, in cooperation with organizations in the St. Louis region, is working to try to eliminate the barrier of transportation for low-income adults seeking employment. This has developed through a report done by EWGCC in 1990 entitled, "Employment Accessibility: A Study of the Transportation Needs of the Economically Disadvantaged in the St. Louis Region." With less than 25 percent of the region's employment opportunities accessible via the current public transit system, residents without private transportation are at a considerable disadvantage when it comes to obtaining employment. Therefore, EWGCC is proposing two projects for funding to improve on these situations. The first proposed project is to coordinate transportation services to connect low-income job seekers from six separate service delivery areas with employment opportunities throughout the community which are not serviced by existing transit. The second project calls for a GIS-based transit/job information service to connect urban core residents with jobs accessible by existing transit but unknown to them. Another challenge for the City of St. Louis continues to be transporting people, specifically tourists, to the major Downtown attractions. Downtown Now! has put forth a proposal to develop a shuttle that will connect some of the most popular attractions in downtown St. Louis. The route will link the Arch and hotel district to Union Station, St. Louis Centre, and the Kiel Center. Bicycling and walking are two forms of transportation that are continually growing throughout the country as well as St. Louis. In order to make the City a more pedestrian and cyclist friendly environment, a plan has been developed by Downtown Now! to improve sidewalks. This plan includes making sidewalks ADA compatible, eliminating of poor pavement conditions throughout the City, providing clear wayfinding devices, maintaining cleanliness, and providing properly functioning pedestrian signals. Recommendations St. Louis City, Bi-State, EWGCC, and Downtown Now! are all working towards the common goal of improving transportation services for the City of St. Louis. Although plans have begun for an improved system of transportation, costs and other related problems are hindering progress. The following recommendations attempt to alleviate these problems while developing transportation in the most efficient manner available. a) Explore nontraditional methods of obtaining revenue, as a supplement to existing revenue sources, for highway and transit system projects.
b) Continue precise planning guidelines for development.
c) Continue efforts to design and build the multi-modal center.
d) Begin to link transit with development and vice-versa.
Resources Currently, St. Louis' transit system is extremely underfunded, thereby hindering the possibility of major expansion. Non-traditional allocation of revenue funds may be an option for future progress of transportation issues. Agencies most involved in these types of issues are Bi-State Development Agency, EWGCC, and Downtown Now!. These three agencies currently implement federal transportation grants and programs. Programs that are developed through non-traditional means will be supplementary to existing programs. The proposed Multi-Modal Center can be funded in a number of ways: tax revenues that are designated for transportation development, and TEA-21 utilization. This federal policy has changed transportation planning by giving states and cities flexibility in planning and funding. SUBSTANCE ABUSE SERVICES According to the Missouri Division of Alcohol and Drug Abuse, alcohol and other drug abuse affects more than 259,000 Missourians directly as substance abusers and another 800,000 Missourians who are family members of substance abusers. The toll is measured in both human and economic terms. Substance abuse contributes to domestic violence, the break-up of marriages and families, and lost productivity on the job and in school. It afflicts more than half of all persons incarcerated for committing crimes in Missouri. Alcohol intoxication is a cause in a large portion of deaths from burns, fires, homicides, assaults, drownings, suicides, and traffic crashes. Current Services St. Louis Drug Court. A single Circuit Court Judge is dedicated to this program that works with non-violent, first-time, drug dependant offenders. The judge monitors the defendant's progress in remaining clean and sober. This service now operates in both the Juvenile and Adult Courts. Enhanced Probation Monitoring. Random checks are performed on juvenile who are on probation and parole. The goal is that each team (consisting of a deputy juvenile officer and a police officer) visit an average of 10 individuals every four hour shift. Life Skills/Conflict Resolution Training. The New Haven Social Development Program's Life Skills curriculum is being learned by staff of the Department of Human Services Mentoring, Instruction, Nutrition and Education (MINE) program. In concert with the law related education programs at the Board of Education, the intent is to work with juveniles who are on probation or under the jurisdiction of the court. Juveniles and the Law. This program will be held for juveniles who are in residential detention. The intent is to help kids understand the law, especially the system of graduated sanctions to which they may be subject. Literacy/Tutoring. This program uses college students to tutor juveniles who are on probation or sentenced to residential detention. The assumption is that young people who can read are more likely to stay in school and avoid recidivism. Multi-Systemic Therapy and In-Home Visit Follow-Up. This program attempts to understand and build on the strengths and assets of a particular youth and his or her family. It is geared to juveniles on probation and typically a condition of that probation. Job Readiness/Job Training. A four week program is designed to help juveniles understand how to get and keep a job, and how to build employable skills that will lead to longer term success. Missouri Division of Alcohol and Drug Abuse. The division plans and funds prevention, treatment, and rehabilitation programs. Established within the department in 1975, it became a statutory entity with passage of the Omnibus Mental Health Act in 1980. It provides funding for prevention, outpatient, residential, and detoxification services to community-based programs that work with communities to develop and implement comprehensive coordinated plans. The division provides technical assistance to these agencies and operates a certification program that sets standards for treatment programs, qualified professionals, and alcohol and drug related educational programs. Three of its largest programs are: CSTAR (Comprehensive Substance Treatment and Rehabilitation) Started in 1991, the Comprehensive Substance Treatment and Rehabilitation Program (CSTAR) is a unique approach to substance abuse treatment. It expands outcome expectations by offering a flexible combination of clinical services and living arrangements that are individually tailored for each client. CSTAR provides community-based treatment through an array of intensive services and programs. Each CSTAR Program is targeted to one of the following groups: pregnant women and women with children, adolescents, or the general adult population. The program was developed by the division and is funded by Missouri's Medicaid system and the division's purchase-of-service system. In FY 1997, CSTAR's appropriation was $26,632,644. There are approximately 42 CSTAR Programs, 6,000 Medicaid-eligible clients, and 5,800 non-Medicaid-eligible clients. Average cost per client is $2,224. In addition to treatment, CSTAR services can include transportation to treatment, day care, tutoring, assistance with education and job search, and access to medical care for mothers and their children. One of the reasons CSTAR has been successful is that it makes provisions for clients with children. In the past, many women were reluctant to seek treatment when no effort was made to care for their children. CSTAR has been so successful that during a four-year period, 522 babies were born drug-free to mothers enrolled in the program, resulting in substantial savings in hospital costs of treating each newborn impaired by drugs. In addition, there have been more than 690 children returned to their mothers from foster care after CSTAR treatment. That saves the state about $24,000 per child—the amount it costs to have a child in foster care. In the City of St. Louis there are seven organizations affiliated with the state program. They are:
The Missouri Community 2000 Program. The Missouri Community 2000 Program is the primary substance abuse prevention effort of the Division of Alcohol and Drug Abuse. It is designed to be easily adopted and flexible to meet each area's needs. Currently, there are more than 200 Community 2000 teams throughout the state. The initiative blends the resources of federal, state, and local governments with those of community groups, schools, and families to focus efforts on specific community needs. The program's greatest asset is that a cross section of community residents come together to address the problem of substance abuse. The teams consist of area leaders in business, education, and other civic organizations. Members receive an orientation training course covering the prevalence of alcohol and drug abuse, coalition building, volunteerism, and prevention planning. A key to the program's success is that the residents themselves decide how they want to go about correcting their area's problems. The program uses all aspects of prevention, intervention treatment, and aftercare to devise strategies to combat substance abuse. The National Council on Alcoholism and Drug Abuse-St. Louis City Office is the local Community 2000 Support Center. There are currently three active Community teams in the City. They are:
According to the Missouri Department of Mental Health statistics, 227 St. Louis City residents were served by Community 2000 programs in FY 1995 and 3,220 in FY 1997 (the only two years available). SATOP (The Substance Abuse Traffic Offender Program). This program served more than 26,000 DWI offenders in 1998 who were referred as a result of an administrative suspension or revocation of their driver's licenses, court order, condition of probation, or plea bargain. Approximately 3,000 of these were young people who attended programs as a result of Minor In Possession, Abuse and Lose, or Zero Tolerance Laws. SATOP is, by law, a required element in driver's license reinstatement. All SATOP offenders enter the system via an Offender Management Unit, where a screening protocol (review of driving record, breath alcohol content analysis at time of arrest, and computer-interpreted assessment) is done and appropriate referral is made to one of four types of SATOP programs, including an Alcohol and Drug Education Program for minors. In St. Louis City, the Safety Council of Greater St. Louis handles the SATOP program. According to the Missouri Department of Mental Health statistics, 705 St. Louis City residents were referred to SATOP programs in FY 1997, 1,056 in FY 1996, and 40 in FY 1995. National Council on Alcoholism and Drug Abuse-St. Louis Area. NCADA is a private, nonprofit, community health agency serving the St. Louis metropolitan area as a central resource and information clearinghouse on alcohol and other drug use, abuse, and addiction. They provide information, education, assessment, referral, prevention, and intervention services. NCADA is an affiliate of the National Council on Alcoholism and Drug Dependence, a member agency of the United Way of Greater St. Louis, a certified prevention agency and Community 2000 Support Center of the Missouri Department of Mental Health. NCADA receives funding from the United Way, St. Louis Mental Health Board of Trustees Department of Mental Health, Department of Economic Development, and Youth Opportunities Program. NCADA's prevention staff serves more than 75,000 people annually. Specific services provided by NCADA-St. Louis include information and referral services, crisis intervention, individualized assessments, and programs for juvenile offenders and other youth at-risk; community access to videos, films, audio cassettes, pamphlets, articles, books, manuals, posters, speaking and training services; school-based prevention programs for parents, faculty and students. Programs For Communities:
Involving Community Groups in Prevention. NCADA trains and provides consultation to any community groups interested in prevention. The staff networks with task forces, advisory councils, youth groups, civic, religious organizations, and businesses. For Elementary Age Children. NCADA provides a six volume substance abuse prevention series called WINNERS, a 6-week peaceful problem solving training series called WINNING FRIENDSHIPS, mentoring groups, classroom presentations, and school assemblies. For Junior and Senior High School and College Student. Programs include Peers as Role Models, Teen Leadership, classroom presentations and assemblies, and a national peer leadership program, called TREND, which trains teens to offer alcohol/drug free social and educational activities, and service projects for their communities. For School Teachers, Counselors and Administrators. Offers faculty in-service training, assistance with drug-free schools programming, training and assistance for facilitation of support groups, school and community based mentoring programs, development and training of Care Teams, and assessment. For Parents. Provides programs for parent meetings and parenting classes, and helps create and network parenting groups wanting to discuss concerns, provide education, and implement action plans for community involvement. Department of Corrections. The Department of Corrections, in partnership with 20 communities including St. Louis city, has developed drug courts, day report centers and other substance-abuse treatment and shock-incarceration initiatives to target drug-involved offenders at risk for revocation and recidivism. As examples, prior to 1993, only 562 short-term institutional substance-abuse treatment beds were available at three institutions for men. No long-term drug programs were available in the department for men or women. Also, needs assessments and drug education programs were not available for any general population inmate. In 1999, there are 2,837 institutional treatment beds providing short and long-term treatment to both men and women in prison at 10 facilities across the state. Another 735 offenders are currently enrolled in drug education courses. Opportunity to Succeed in St. Louis is a specialized program targeting substance abusers developed through grants from the Center for Addiction and Substance Abuse at Columbia University in New York. The department has also worked with the General Assembly to craft enabling legislation. In 1994 Senate Bill 763 enacted both short- and long-term shock programs for acutely afflicted and chronically addicted nonviolent offenders. The Offenders Under Treatment Program, the long-term Cocaine Addiction Program, and the Post Conviction Drug Program are currently in operation for male and female offenders. Offenders Under Treatment is a 180-day treatment program for those whose drug problem was a participating factor in their offense. The Cocaine Addiction Program lasts up to 18 months for offenders who are in need of long-term drug treatment for long-term addictions. The Post Conviction Drug Treatment Program is designed for probationers who have failed to complete treatment within the community. In 1995, House Bill 424 was passed. As a result, all general population offenders are now required to pursue school, work and substance abuse treatment on a full-time basis throughout their confinement. In 1998, House Bill 1147 established the Required Educational Assessment and Community Treatment program (REACT). Now, all felony drug offenders on probation complete a substance-abuse assessment and, as necessary, drug education or treatment in the community as a condition of probation. In 1999, House Bill 355 expanded REACT to include all alcohol-related offenses as well. Since 1993, the availability of treatment and the mandate for sobriety has made a measurable difference. The number of offenders returning to the Department of Corrections with a new felony offense has dropped to 21 percent from 34 percent. The following are statistics concerning City residents and drug offenders developed by the Missouri Department of Corrections for FY 1999. This is the only year such statistics are available: St. Louis City Residents-Assessment Screening: During FY 1999, 16,593 Missouri offenders received the Multidimensional Addictions and Personality Profile (MAPP) screening test. Of those offenders, 1,768 (10.7 percent) claim St. Louis City as their place of residence when not in jail or prison. The following information refers to those offenders who claim St. Louis City as home:
St. Louis Probation and Parole Drug Testing: In FY 1999, 4,279 probationers and parolees were tested for drugs in St. Louis City. The urinalysis results had 1,509 positive results from those tests. Thirty-five percent of the tests done in St. Louis City were positive for illegal drugs. The following chart shows the average percent testing positive. [ Table III-F-3, St. Louis City Positive Drug Tests FY 1999 ] Arrestee Drug Abuse Monitoring Report 1998
Oxford Houses. Missouri's Oxford House program is a private, not-for-profit effort to provide "good houses in good neighborhoods" for people recovering from alcoholism and/or other drug dependence. In addition to safe, substance-free living, Oxford Houses also provide important psychological supports, such as fellowship and opportunities to enhance self-reliance and self-respect. Each Oxford House is a separate, self-sustaining, resident-managed, independent entity, closely aligned with Alcoholics/Narcotics Anonymous and coordinated with the Missouri Division of Alcohol and Drug Abuse. There are separate houses for men, women, and women with children. Oxford House residents must have at least 30 days of sobriety and be financially able to pay their share of house upkeep. There are currently 11 Oxford Houses in St. Louis City. Grace Hill Neighborhood Services. Grace Hill works with Basic Black Alcohol Service Information Center to provide shelter for women who are afflicted with substance abuse and their children. The work with the Department of Social Services to help stabilize women in order to participate in the Welfare to Work program. The Division of Family Services will fund Grace Hill $16,500 per family. With an average stay of six months, Grace Hill has the capacity for 15-16 women and their children. DART (Drug Alcohol Rehabilitation and Treatment). DART is a non-profit agency for the treatment of substance abusers and their significant others. They began providing substance abuse services in 1969 as the first drug abuse hotline in the country. Today DART provides comprehensive inpatient-outpatient drug and alcohol treatment along with a 24-hour hotline run by professional staff. DART Inpatient opened in October 1990. This therapeutic community provides intensive detoxification and residential treatment services for abuse of any drug including alcohol, cocaine, opiates, depressants, and hallucinogens. Inpatient services are available for both men and women. The structured 12-step based program provides group, individual, and family counseling as well as recreational activities. Clients are required to do daily chores to keep their living environment clean and homelike. An on-site tutor helps clients earn their GED. Life skills classes are also available to help clients achieve employment. DART Inpatient is staffed by qualified LPNs and detoxification technicians, who work together to address the medical needs of the clients. The key to DART's services is to place clients in the least restrictive level of service, thereby maintaining the client's optimal level of functioning in the community. DART operates two outpatient counseling centers, one in St. Louis City and the other in St. Louis County. Some specific programs are as follows:
Federal Probation and Parole. DART provides substance abuse treatment services to Federal Probation and Parole clients from the Eastern District of Missouri. Services are available for both males and females. Each client is given a comprehensive intake assessment and an individual treatment plan is developed. DART staff provide individual substance abuse counseling, urine drug screens, and individual mental health counseling if needed. The program provides aftercare services for ex-offenders as well as pretrial supervision for clients awaiting trial. They also provide transitional care for United States Bureau of Prisons' clients. Children Uniting with Parents (CUP) Program. The CUP program is a collaboration between DART, Employment Connection, Lutheran Family and Children's Services, and the State of Missouri Department of Probation and Parole. CUP is building on the thriving Opportunity to Succeed (OPTS) Program, which is a substance abuse recidivism prevention program for ex-offenders. The program cooperatively assists ex-offenders with housing and employment and provides counseling and support services. The goal is to facilitate the positive reintegration of the ex-offender into the community, with the expectation that the individual will achieve and maintain a drug and alcohol free lifestyle within a supportive community. HIV Services. They offer HIV and STD counseling and testing free of charge for clients and their partners. Through Health Education/Risk Reduction (HERR) funding, they have a full-time HIV specialist on staff. The HIV Specialist uses the Holistic Harm Reduction concept to help educate our outpatient and methadone clients and their partners on how to reduce high risk behavior to prevent the spread of HIV and other sexually transmitted diseases Pathways Program. Pathways is a program for youth for the education, prevention and rehabilitation of substance abuse. They are working with the young men at Hogan Street Regional Youth Center. At least 80 percent of these youth have a history of using and/or distributing drugs. They are at high risk for resuming these behaviors upon release. Their ultimate goal is to not only prevent future substance abuse but also to help these youth envision a hopeful future, keep them from re-entering a life of crime, and increase their probability of becoming productive members of our community. DART collaborates with the Division of Youth Services on this program. DART is funded by the federal government, Missouri Department of Mental Health, Mental Health Board and private patients. Faith House. Faith House is the first child care agency in the State of Missouri to care for children prenatally exposed to drugs, or the children of substance abusing parents, ages newborn to eight. They have cared for over 550 children since 1991. Originally there were 12 beds but has grown to accommodate 54 children St. Louis Comprehensive Neighborhood Health Services. Methadone treatment center for persons recovering from chemical dependency. St. Patrick Center. Alcohol and drug abuse program designed to reach out to chemically dependent. Offers advice, education, treatment, and fellowship. United Methodist Metro Ministry. Transitional shelter for up to 24 months for single, chemically dependent women. Youth & Family Center. Sponsors a Just Say No to Drugs program through the St. Louis Public School System with the Optimist Club. Harris House. A residential recovery facility that serves 31 men and 12 women in separate facilities with the same basic 12-step recovery program as Alcoholics Anonymous. Magdala Foundation. Originally a residential treatment center for female offenders, it is now a broad-based agency that serves men, women and children with a variety of social service needs. Its substance abuse program emphasizes helping the client and family to identify and resolve problems through constructive alternatives. Needs and Challenges Statistics comparing the City of St. Louis with the rest of the nation in the area of drug use are as follows (according to the Missouri Department of Corrections-Division of Offender Rehabilitative Services):
The following statistics are available from the Eastern Region Office of the Missouri Department of Mental Health-Division of Alcohol and Drug Abuse: [ Table III-F-4, Substance Abuse Consequences, 1995-1998 ] Recommendations a) Increase funds available for treatment.
b) Expand educational programs for tobacco and alcohol.
c) Initiate educational programs concerning heroin.
d) Expand support for drug courts.
e) Explore the feasibility of community courts.
f) Focus on truants and "drop outs" before they get in trouble.
g) Explore the feasibility of truancy court.
h) Expand collaboration especially among first line supervisors.
i) Expand cooperation between police and deputy juvenile officers.
Resources Funding for substance abuse programs come from many sources. Examples include: United Way Fiscal 1999 Funding. Continual funding programs (in which at least 90 percent will be funded in future years) specifically for substance abuse treatment and prevention programs total more than $800,000 annually. Programs include:
In addition there were one time grants of $103,087. Eight agencies received grants ranging from $1,200 to $28,000 in Fiscal year 1999. There are many other organizations that receive funding that offer substance abuse treatment and program as part of their services, but not as the main focus, such as Provident Counseling and St. Patrick Center. Funding for these programs is not included: Mental Health Board 1998 Funding.
Department of Mental Health: Total funding for Fiscal Year 1999 for City of St Louis programs was $8,475,792. Substance Abuse Resources Missouri Division of Alcohol and Drug Abuse: www.modmh.state.mo.us/ada Karen Korenburg
Pam Cannon
Randy Smith
Connie Otto (replaced in 7/99 by Harriet Kopolow)
Drug Alcohol Rehabilitation and Treatment: www.dartinc.org Oxford Houses
Kari McAvoy
Gary Campbell
Mental Health Board of Trustees 1998 Annual Report-funding information Missouri Legislature Alcohol and Drug Abuse pending bills:
EMPLOYMENT TRAINING The relative strength of the economy in the past seven years has revealed systematic weaknesses in the workforce development arena in the City of St. Louis and the MSA. While unemployment and poverty prove exceptionally resilient in the City, many employers are straining to find skilled and available workers. Traditionally, not-for-profit and other training service providers must deploy job developers to identify job openings or persuade employers to consider their program graduates. In 1999, employers were calling these agencies asking for referrals and help in recruitment. Agencies are focusing renewed attention on recruitment and outreach to meet employer needs. Even though unemployment remains relatively high for City residents, rarely have more opportunities been present. Economic and demographic projections suggest this situation will continue. These trends underscore weaknesses which have long been present and provide opportunities for new levels of cooperation. Among the employment sectors with substantial and continuing demand for workers are:
As evident in the employment forecasts made by the State Workforce Development Division, many other jobs will also be available at lesser volumes. Welfare reform, the new federal Workforce Investment Act and the Regional Jobs Initiatives are all stimulating new thinking and new approaches to workforce issues. In similar fashion, the "One Stop Service" delivery system are stimulating new configurations for services and marketing and outreach efforts. These can benefit both citizens and employers. An emerging awareness of the needs of working poor, and the inefficiencies caused by inadequate wages and benefits for entry level workers, may lead to improvements in basic working conditions which will benefit those entering the workforce. Current Services St. Louis Agency on Training and Employment. Access to employment, training, and education programs for residents of the City of St. Louis are primarily offered through the St. Louis Agency on Training and Employment (SLATE). SLATE receives input from the St. Louis Private Industry Council, which is comprised of leaders from business, education, labor, and civic organizations. SLATE, through its administration of Department of Labor workforce development funds, provides on-the-job training, vocational skills training, direct job placement, combination training/academic programs, job search assistance, customized training, and supportive services for youth and adults. It subcontracts with private and public entities to implement these programs. SLATE participates in numerous collaborations such as the Workforce Partners of Metropolitan St. Louis, a group comprised of service providers from around the metropolitan area; Workable (which assesses skills for employers); and participates in the regional planning and implementation of numerous employment training projects. The Workforce Partners develop business-to-business relationships with employers to better address the human resource needs of industry. The group's goal is to have satisfied employers and satisfied employees. SLATE's Department of Labor-funded Welfare to Work activities specifically target individuals who have been on the TANF list for 30 months. Their strategy ensures that those who are the hardest to employ will be the first to receive employment assistance. In addition to the aforementioned criteria, about 70 percent of SLATE Welfare to Work funding is targeted towards helping those with two of the following barriers: no high school diploma or GED; reading or math levels below 8th-grade level; substance abuse problems; and poor work history. More than 1,300 people were served through the Welfare to Work program under SLATE in its first year (1998-1999). Under SLATE administration, the Workforce Investment Act will soon replace the Job Training Partnership Act. The act requires 14 new partners to join the One-Stop partnership. The Private Industry Council, which advises SLATE, is being replaced by the Workforce Investment Board, the majority of whom are representatives from business. This board will craft a local strategy for the One-Stop facility which must offer core intensive and training service to a universal population of job seekers. Businesses receiving city tax abatement or other economic development incentives must use SLATE as a "first source of employment referrals." Under a city ordinance employment generating process, SLATE assists area businesses with job fairs, screening and assessment of potential employees, transporting interviewees to employers, and providing appropriate work attire to job seekers. The United Way. The United Way provides a major source of funds for local service providers. In 1999, the Agency sponsored A series of Welfare to Work job fairs. At the first two job fairs, there were 715 job seekers and165 placements (with wages at an average of approximately $8.30 per hour). Approximately 24 percent of attendees found placement versus 10 percent at a normal job fair. The United Way also makes a concerted effort to strengthen ties between the service providers and private industry. Approximately $2.8 million in wages and benefits were generated by the first two fairs. The East-West Gateway Coordinating Council (EWGCC). The council of governments and metropolitan planning organization for the St. Louis region sponsors various employment and training initiatives. Currently EWGCC has four pilot employment training programs; three of these programs are fully or partially contracted to service providers. Bridges to Work provides work training and employment related transportation to Earth City and Chesterfield. The other pilot programs address the industries of health care (SSM Health Care System), business services (Clayton Business School), and construction (St. Louis Works Partnership). Average starting hourly wages for the first three programs are $8.79, $8.74, and $9.85 respectively. Contractors are paid on a performance basis. Work Force Partners. In 1998, the Enterprise Community's Employment Partnership was revitalized and expanded. Renamed the Work Force Partners of Metro St. Louis, this working collaborative of 18 employment and training service providers is focusing on strengthening ties with employers (some of whom will become official Partners), and service quality improvement. With funding from the Enterprise Foundation, the Partners are establishing a Customer Service Career Initiative to serve hospitality, banking, retail and health care employers committed to progressive employment practices and career advancement. Employment Collaboratives. Within the past 18 months, two new groupings of employers have emerged to address workforce issues. A local chapter of the national Welfare to Work Partnership has been active in educating employers and co-sponsoring Job Fairs with local service providers. A Business Leaders Network has formed to educate employers on employment of persons with disabilities. These two groups coordinate some of their efforts and may serve as a nucleus for organizing focused employer representation on larger workforce policy issues. Area Resources for Community and Human Services. Area Resources for Community & Human Services (ARCHS) facilitates a community based governance process for the state in the St. Louis area. This Missouri state-funded initiative, counts among its many strategies an active Welfare to Work component to support services provided by state and local efforts. The ARCHS' Welfare to Work initiatives encompass the City of St. Louis and St. Louis County. Cornerstone Partnership. This partnership of industry and service providers offers technical vocation training (precision manufacturing and computer aided design) to disadvantaged and dislocated workers. Students use state-of-the-art technology, much of which has been donated by corporate sponsors such as Unigraphics, Southwestern Bell, and Boeing. Pre-training is provided for those who do not immediately qualify. Students in pre-training use computer programs that allow them to progress at their own pace. Recently, the Computer Aided Design in Manufacturing program added a co-op option with the Boeing Corp. All curricula are prioritized to meet industry needs. Students use machines and programs identical to those used by major employer sponsors. The partnership is housed at the former Wagner Electric Plant in Wellston. Clayton Business School. This organization was recently awarded a grant from the Department of Labor to prepare a program that combines employment training and fathering skills for unemployed, non-custodial fathers. The intent of the program is to help these men contribute not only financially, but also help stabilize the family units. Needs and Challenges In some respects, schools and the community colleges are not addressing the training needs of employers. Many of the programs offered are defined in two-year prep cycles, requiring far more time to complete than is necessary for the skill development, and require more investment of time than low income persons can afford to commit. Many entry level jobs, which require few technical skills, do require "soft skills" (defined as inter-personal and work ethic attitudes) that are not addressed in most preparatory programs. Most federal and state funded programs place severe limitations on paid "work experience" opportunities where these skills can best and most quickly be mastered and documented. Although the Community Colleges provide customized training to employers, they still lag behind in the development of industry specific, customized, and "fast track" skill development programs. The St. Louis Public Schools lack a full scale vocational education program of its own, and the public school system is burdened with many other problems, pushing this further down the priority list. One of the main challenges facing SLATE and the network of service providers is maintaining efficient lines of communication. Training providers are not uniformly evaluated, thus there are currently no standardized measures of job readiness and training effectiveness. Convincing welfare recipients they will be removed from the welfare rolls is a major problem facing service providers. There is confusion as to how this issue is handled by the Department of Social Services. Are warnings being sent out to recipients as to the amount of time they will continue to receive benefits? How can a more coordinated partnership be built between the Department of Social Services and service providing entities? All these questions need addressing to ensure the effectiveness of employment training services. The current structure of welfare offices begs the question: How will staff be used as the great majority of the rolls are eliminated? How can this staff play a greater role in assisting the multitude of training efforts? Many job opportunities exist outside the city boundaries, however transportation to many of these are limited. Entry level workers without private cars are severely disadvantaged by the lack of adequate public transportation or affordable alternatives. Workers have complained that many jobs are located in distant suburbs. This is especially problematic because many of these jobs are offered for second and third shifts when public transportation is unavailable. Compounding this problem is a lack of childcare service, especially for single parents. SLATE, in conjunction with St. Louis County and St. Charles County, MoDOT and the Federal Department of Transportation, has received funds that will provide transportation for a limited number of Welfare to Work recipients and their children. The program is scheduled to begin in the near future. However, the more effective long-term solution is providing better job opportunities in the neighborhoods of the City of St. Louis, where workers live. Recommendations a) Identify industries and areas locally where there are shortages of workers.
b) Leverage local competitive advantages.
c) Institute local training guidelines and standards for all service providers with employer input.
d) Continue to engage and foster relationships with business, working towards Federal programs and conditional acceptance.
e) Place new emphasis on education and career advancement post-employment.
f) Subsidize and expand transportation for Welfare to Work recipients.
Resources Currently, SLATE receives its primary funding through the Department of Labor. ARCHS is funded primarily through the Department of Health and Human Services and State appropriations. Numerous foundations and government agencies support local service providers. As stated in this report, there is a significant need for contribution from private interests, especially employers facing labor shortages. Funding from all sources exceeds $30 million per year. Welfare reform has increased the money available for workforce development by approximately $7 million per year, but it is unclear how long these funds will be available. HEALTH SERVICES Although the City of St. Louis has some of the finest health-care institutions in the country, the availability of services is not uniform. When compared with other metropolitan areas, St. Louis ranks among the highest in medical care resources—including more than 35 hospitals, two teaching medical centers, an abundance of community health centers, approximately 5,000 physicians, and hundreds of health services and voluntary agencies and associations. Access to health care, however, is not evenly distributed. Many areas of the City, for example, have no physicians or fewer than one physician for every 5,000 residents.[see footnote 1] In areas of high need and medical underservice (based on rates of poverty, fertility, and infant mortality), a minimum of one physician for every 3,000 residents is considered essential to meet basic health care needs. Moreover, this would be a very low standard compared to the norms of traditional physician staffing state planning, or in terms of the panel size assigned a physician in a staff model health-maintenance organization. The St. Louis region's only quasi-public hospital, St. Louis Regional Medical Center, served the health care needs of the indigent, uninsured, and underinsured residents since 1985. In 1996, however, it lost its major sources of funding and closed. [see footnote 2] In 1997, a consortium of St. Louis' health systems and medical schools joined with St. Louis Regional and the community to consider new ways to collaborate in meeting the health needs of the region. BJC Health System—the area's biggest health care provider—took over management of the ConnectCare health care plan for uninsured St. Louisans. The five-year agreement calls for the City to pay a maximum of $5 million annually to help run ConnectCare. Overall, its costs are expected to total about $38 million annually, with the state government committing about $26 million in state and federal aid. [see footnote 3] ConnectCare now serves about 80,000 area residents, approximately 40 percent of whom have no insurance. [see footnote 4] Current Services The City of St. Louis provides services that help protect the community from unsafe food or beverages, unhealthy living or lifestyles, and spread of infectious disease. An overriding goal is to teach people to live longer and healthier lives. Services can be described in terms of preventing diseases, helping families, controlling health hazards, and promoting healthy living. Preventing Disease
Helping Families
Controlling Health Hazards
Promoting Healthy Living
Other Services
A variety of nonprofit, state and federally assisted programs complement the health services offered by the City of St. Louis. CDBG funds have traditionally been offered to assist the Family Care Center of Carondelet and the Community Health in Partnership programs which have assisted low-income individuals with a mix of health, mental health, child service and nutrition services. Needs and Challenges Managed care is having an effect on the health care of the poor. The more doctors depend on managed care for their income, the less likely they are to fill their role of providing free care to the uninsured. Doctors who get at least 85 percent of their income from managed care provide 40 percent less charity care than those who get no more than one-fifth of the income from managed care.[see footnote 5] There are an estimated 45 million Americans without health insurance, and their ranks are growing by one million per year. At the same time, doctors are struggling with radical changes in how they practice and how they are paid. Under the old system, it was easy for a provider to provide service to an uninsured patient and make up the lost income by charging an insured patient more. [see footnote 6] That cost-shifting is harder to do under managed care; therefore fewer uninsured patients get treatment since providers are competing in the discounts they offer the private market, and less charity care money is available. In the St. Louis region, it is estimated that approximately 25 percent of the population are uninsured, many of them poor or near poor, and others are on Medicare, Medicaid or Medicaid MC+. Since the poor lack the resources to pay for medical services, much less the means to get to the source of care, they are more likely to suffer from a variety of health problems that are very different from those faced by the rest of society. Drug abuse, mental health, violence related injuries, higher rates of diabetes, hypertension, and heart disease affect the poor and uninsured at higher rates than with other classes. [see footnote 7] The traditional sources of indigent care-free clinics, and the emergency and outpatient departments of public and teaching hospitals—also have limits and have declined in numbers because of reduced federal funding. They could not serve everyone before and are even more burdened now. A study has found that the uninsured are less likely to get free care if they live in communities where the number of people without insurance is relatively high. [see footnote 8] Other trends in health care are summarized below. Many of these topics are explored in greater detail in the following pages.
Information from the Dartmouth Atlas of Health Care indicates that St. Louis has a higher rate of coronary artery bypass surgery and angiography than the average for the U.S. or other large cities. The procedure rate for coronary artery bypass surgery in St. Louis is 6.1, compared to the U.S. average of 5.2. In other large cities such as Los Angeles and New York, the rates are 4.7 and 4.4, respectively. Similarly, the rate for angiography in St. Louis is 18.0 while the average for the U.S. is 16.1, for Los Angeles is 14.7, and for New York is 12.3. These rates are some of the most important indicators of physicians recommending surgery. Cardiology as a specialty is notably more aggressive in St. Louis than in other major cities. [see footnote 15] As the BJC and Tenet integrated delivery systems in the City began the process of consolidating their services, the city's inpatient hospital bed capacity declined by 600 beds between 1995 and 1998, and the City-wide occupancy rate began to improve a bit. Despite the suburban contribution to the region's historically "overbedded" status, St. Louis County hospital collectively reduced their cumulative bed total during that period only a small amount (5.3 percent), and their occupancy rate appears actually to have worsened a little. The following statistics show this trend: [ Table III-F-5, Hospital Trends - City and County ] Lead Poisoning
The City is full of old housing stock containing lead paint, which has been banned for more than 20 years. At the same time, some absentee landlords ignore their properties and fail to keep them up. When the paint starts to chip, it is easily ingested by children. [see footnote 17] The following table shows the ZIP codes in the City that have the highest percentage of children with high lead levels in their blood. [see footnote 18] Since the majority of City residents are African-American, it is likely that the majority of children with lead poisoning are also African-American. [ Table III-F-6, Cases of Lead Poisoning and % Lead Poisoned ] Maternal and Infant Care
Approximately 60 percent of all infants who die before their first birthdays have low birth weights. The low birth weight rate has increased since the mid-1980s. This factor contributes to the poor numbers. From 1988 to 1992, the low birth weight rate for the city of St. Louis was 11.4 percent. For the period 1993 to 1997, the rate increased to 11.9 percent. Statewide, the low birth weight rate for minority babies was 12.6 percent, almost twice the Caucasian rate of 6.5 percent. The rate for Caucasian infants in Missouri worsened between 1993 and 1997, while the rate for minority infants improved slightly. The following tables show the percentages of late or no pre-natal care, low birth-weight babies, and teen pregnancies. [see footnote 19] [ Table III-F-7, Percentage of Late or No Prenatal Care ] [ Table III-F-8, Percentage of Babies with Low Birth Weights ] [ Table III-F-9, Percentage of Teen Births ] Infant Mortality
Medical technology has improved the prevention of Sudden Infant Death Syndrome (SIDS) and deaths of premature babies. The infant death rate for the city of St. Louis has improved in recent years. For the period 1988 to 1992 the infant death rate was 14.5 per 1,000 births; for the period 1993 to 1997, the rate was 12.6 per 1,000 births. Infant mortality remains unusually high in many ZIP codes in the St. Louis area, as shown in the following table. [see footnote 20] [ Table III-F-10, Infant Mortality per 1,000 Births ] Sexually Transmitted Diseases
In 1997, St. Louis had one of the nation's highest rates of gonorrhea, chlamydia, and syphilis. An epidemic of syphilis in the St. Louis area that began in 1993 continues to be a major concern. Up to 40 percent of the pregnancies in mothers with untreated syphilis will result in still birth or perinatal death. In 1998, the number of gonorrhea cases jumped 30 percent in the city and the number of chlamydia cases increased by 10 percent. In St. Louis City, nearly 2,500 teen-agers contracted gonorrhea or chlamydia. [see footnote 22] Nearly one-third of the gonorrhea cases and almost half of the chlamydia cases were in people under age 20. However, according to a national survey by the Kaiser Family Foundation, about half the young people don't believe they have any chance of getting the diseases. [see footnote 23] Although the diseases can be cured with antibiotics, many infected people don't know they are infected because the symptoms are subtle or in some cases absent. Thus, the diseases are spread and/or increase in severity. [see footnote 24] The following table shows the rates of syphilis in the City by ZIP code. [see footnote 25] [ Table III-F-11, Syphilis Cases Per 10,000 Persons ] Recommendations a) Accelerate health education activities.
b) Concentrate on improving child immunizations.
c) Continue pre and post natal care programs.
d) Expand programs that advise youth about the dangers of tobacco and alcohol.
e) Monitor and disseminate health indicators.
Resources Major changes have occurred in the health care field over the last five years. The advent of ConnectCare to replace Regional Hospital, the state's Medicaid managed care program, and changes at the national level all make for an uncertain environment. The current FY 2000 budget of almost $19 million ($8.2 million in general revenue and $10.6 in grants and other funds) is approximately the same as five years ago. But the components are different, especially given changes such as the shift of Emergency Medical Service to the Fire Department. General Health Care Needs: The Next Five Years
Additional needs include:
ENDNOTES 1. St. Louis Currents, Missouri Historical Society Press, 1994, 111. 2. St. Louis Currents, Missouri Historical Society Press, 1997, 177. 3. Mark Schlinkmann, "BJC Agrees to Manage ConnectCare," St. Louis Post-Dispatch, April 21, 1998. 4. Larry Fields, "ConnectCare Makes Strides to Improve Care," St. Louis Post-Dispatch, July 6, 1999, B15. 5. Joseph P. Shapiro, "No Time for the Poor," U.S. News and World Report, April 5, 1999, 57. 6. Ibid. 7. Richard Mark, "The System Doesn't Work for All," St. Louis Currents, Missouri Historical Society Press, 1997, 121. 8. Ibid. 9. The Children of Metropolitan St. Louis, Project Respond/Vision for Children at Risk, 1993 and 1997 issues. 10. Ibid. 11. Ibid. 12. No author, "Finding Ways to Provide Access to Health Care for all Citizens," St. Louis Post-Dispatch, May 30, 1999, B1. 13. John G. Carlton, "As Student Battles TB, Search is on for Others who Might Be Infected," St. Louis Post-Dispatch, December 24, 1998, B1. 14. http://stlouis.missouri.org/resources/stldhh.htm 15. Www.dartmouth.edu/~atlas/proctab.html 16. Norm Parish, "Clinic Grapples with the Effects of Lead," St. Louis Post-Dispatch, May 2, 1999, D1. 17. Ibid. 18. The Children of Metropolitan St. Louis, Project Respond/Vision for Children at Risk, 1993 and 1997 issues. 19. Ibid. 20. Ibid. 21. www.intelihealth.com 22. John G. Carlton, "Sexually Transmitted Diseases are Rising Among Teens Here," St. Louis Post-Dispatch, March 23, 1999. 23. Ibid. 24. Ibid. 25.The Children of Metropolitan St. Louis, Project Respond/Vision for Children at Risk, 1993 and 1997 issues. 26. Associated Press, "AIDS Cases are Declining but HIV Infections Are Not," St. Louis Post-Dispatch, April 24, 1998. 27. Associated Press, Conference Focuses on AIDS Among African-Americans, February 28, 1999. 28. No author, "Finding Ways to Provide Access to Health Care for All Citizens," St. Louis Post-Dispatch, May 30, 1999, B1. 29. John G. Carlton, "A Health Center's Simple Solutions Remove Barriers to Health Care," St. Louis Post-Dispatch, June 6, 1999, B1. 30. No author, "Finding Ways to Provide Access to Health Care for All Citizens," St. Louis Post-Dispatch, May 30, 1999, B1. 31. National Association of Community Action Agencies, "National Dialogue on Poverty: What Does America Want?" 1996 | |||||
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PUBLIC SERVICE NEEDS
Thirty-one cars operate along the track, which has 18 stations throughout the area. Paratransit operates 63 demand-response vans that serve over 360,000 passengers annually.
The shuttle service will run from 10:30 a.m. until 10:30 p.m., Monday through Saturday, with plans to add Sunday service if the need is demonstrated.
