A Special 3-Part Series by The Narrative Matters
Part 1 of 3 | Part 2 | Part 3
SSM Health Shortfall: Demanding Accountability: What Needs to Change
When a promise worth millions of dollars to a community is broken, silence is not an option. The $74 million shortfall in minority business participation for the SSM Health Cardinal Glennon Children’s Hospital project is more than a missed target—it is a wake-up call. We have examined the scope of the problem and the human cost of these failures. Now, we must turn our attention to the solution. How do we move from disappointment to action?
The path forward requires a shift from passive observation to active enforcement. It demands that we stop treating equity goals as suggestions and start treating them as what they are: binding contractual obligations that define the integrity of our city’s development.
The Pillars of Accountability
Accountability is not a vague concept; it is a mechanism built on transparency, enforcement, and consequence. For SSM Health to realign with its commitments to the St. Louis community, three specific pillars must be strengthened immediately.
1. Radical Transparency
Currently, the flow of information regarding the Cardinal Glennon project has been opaque. Generalized reports and “good faith” assurances are no longer sufficient. To fix a problem of this magnitude, we need granular data.
The NAACP St. Louis City Branch has rightly called for itemized reporting. This means moving beyond broad percentage estimates and providing specific details:
- Trade-by-Trade Breakdown: Which specific trades (electrical, plumbing, drywall, etc.) are meeting their goals, and which are failing?
- Contract Values: What is the exact dollar amount of contracts awarded to Minority Business Enterprises (MBEs) versus the total spend?
- Vendor Identification: Who are the specific minority and women-owned firms receiving these contracts? This prevents “pass-through” schemes where a minority firm is listed on paper but a larger non-minority firm does the actual work.
Without this level of detail, it is impossible to identify where the bottlenecks are. Is it a lack of bidding from minority firms, or is it a procurement process that filters them out before they even have a chance? Transparency answers these questions.
2. Strict Enforcement of the CBA
The Community Benefits Agreement (CBA) signed by SSM Health, Saint Louis University, and the NAACP was designed to be the enforcement mechanism for equitable development. However, agreements are only as strong as the will to enforce them.
SSM Health has recently argued that the CBA is merely a “framework” rather than a binding contract, a stance that threatens to unravel the entire premise of the Midtown Redevelopment Plan. This interpretation must be challenged. If developers can treat signed community agreements as non-binding whenever budgets get tight, the entire system of public-private partnership in St. Louis collapses.
The City of St. Louis, specifically the St. Louis Development Corporation (SLDC), holds the keys here. Ordinance 70428 provides the legal foundation for these requirements. City officials must step in to clarify that compliance is mandatory, not optional. If a developer accepts the benefits of being in a redevelopment district, they must accept the responsibilities that come with it.
3. Corrective Measures and Outreach
Identifying the problem is only half the battle. We need a concrete plan to fix it. The project is ongoing, which means there is still time to course-correct, but the window is closing.
SSM Health needs to implement immediate corrective measures, including:
- Unbundling Large Contracts: Breaking massive bid packages into smaller, more manageable scopes of work allows smaller minority firms to bid directly as prime contractors rather than just subcontractors.
- Targeted Outreach: Partnering with MOKAN Construction Contractors Assistance Center to identify “project-ready” minority firms that have been overlooked.
- Prompt Payment Guarantees: Ensuring that small minority businesses are paid quickly (e.g., within 15 days) so they have the cash flow to sustain operations on a large job site.
The Role of Public Pressure
Institutions move when the public demands it. SSM Health is a mission-driven organization that relies on the trust and goodwill of the community. When that trust is jeopardized, they listen—but only if the community speaks with a unified voice.
We have seen this dynamic play out in cities across the country. When residents, clergy, business leaders, and activists stand together to demand equity, the calculus changes. The cost of ignoring the community becomes higher than the cost of compliance.
This is not about being anti-development or anti-healthcare. We all want a world-class children’s hospital. But we also want a St. Louis where the people building that hospital can afford to live in the neighborhoods surrounding it. We want a city where economic justice is woven into the brick and mortar of our institutions.
A Blueprint for the Future
The outcome of this dispute will set a precedent for the next decade of development in St. Louis. If we allow a $74 million gap to slide today, we are giving a green light for every future developer to underdeliver on their diversity promises.
Conversely, if we hold the line here—if we force a course correction that results in millions of dollars flowing to Black and Brown businesses—we prove that the system can work. We prove that St. Louis is a city where growth is inclusive and where a handshake agreement still means something.
Call to Action: Your Voice Matters
The NAACP and MOKAN are leading the charge, but they cannot do it alone. They need the weight of the entire community behind them. Here is how you can get involved and demand the change we need:
Support The Orgs Fighting For Community Benefit
Join the NAACP and MOKAN to show your support and hear directly from the leaders fighting for equity.
- Visit their websites or offices in St. Louis to learn more about this issue.
Contact City Leadership
Reach out to your Alderman and the St. Louis Development Corporation. Ask them specifically: “How are you enforcing the Community Benefits Agreement for the Midtown Redevelopment?” Remind them that they are the stewards of the public trust.
Spread the Word
Share this article series. Talk to your neighbors. Use social media to amplify the message using hashtags like #EquityInAction and #SSMAccountability.
The gap between promise and reality is $74 million wide. It is up to us to close it. Let’s stand together and demand that when St. Louis builds, we build for everyone.
Follow The Conversation
For Your Review:
Laura S. Kaiser, Presdient, CEO SSM Health, letter dated 09.09.25
SSM Letter Response dated 10.2.25
Otis Williams, Interim President/CEO St. Louis Development Corporation, letter dated 10.15.25
#EconomicJustice #SSMHealth #CommunityImpact
