St. Louis may have missed out this week on a share of Race to the Top stimulus funds to improve public education, but it is a big winner on the health care front. The federal government announced Thursday that it was extending through 2014 an unusual program that has provided about $25 million a year for funding area community health centers.

Until then, officials were unsure the region would be granted the extension of what’s known as the Gateway to Better Health Demonstration Project. The annual funding represents about 25 percent of the budgets for area health centers. Had the extension been denied, the area would have had to find another way to pick up the health care tab for thousands of low-income residents.

This issue dates back to the start of the decade when Regional Hospital closed its doors and the area faced a potential loss of millions of dollars of federal assistance to provide medical care for St. Louis’ poor.

The development led to creation of the St. Louis Regional Health Commission, which brought all the parties to the table – Republican and Democratic members of the area’s congressional delegation, city and county elected officials, health executives and business leaders – to figure out how to save this pot of money so essential to meeting health needs of the poor.

The solution was to persuade the federal government to grant the region a waiver to allow money that normally was used for hospital care to be transferred instead to health centers. The waiver expired in June. On Tuesday, federal officials sent word that the waiver had been extended to 2014, the year federal health reform laws begin to take full effect.

“This isn’t often done,” Robert Fruend, head of the St. Louis Regional Health Commission, said of the federal decision. “We had been concerned that we wouldn’t be able to convert this money to community health centers. This wasn’t automatic. We had to really earn it.”

He says loss of the funding would have adversely affected the health system in numerous ways. In addition to loss of money to health centers, he pointed to one Barnes-Jewish Hospital study a few years ago projecting an additional 200 to 300 daily emergency room visits in the event the federal funding was lost.

Fruend says the announcement wouldn’t have been possible without a high level of cooperation locally. He said members of the area’s congressional delegation, along with Sen. Claire McCaskill, pitched in to save the program. So did key city and county political, business and civic leaders. Many had done the same a decade ago to persuade the government to allow the old hospital dollars to be shifted to health centers.

“It’s a great story of a community working together to make this happen,” Fruend says.

In a statement, Rep William Lacy Clay, D-St. Louis, praised “our urgent efforts, which included the united support of the entire Missouri congressional delegation.” Had the effort failed, he said, “local emergency rooms would have been overwhelmed with uninsured and underinsured patients.”

The money goes to the Regional Health Commission, the oversight agency that coordinates the funding initiative with Grace Hill Neighborhood Health Centers, Myrtle Hilliard Davis Comprehensive Health Center, St. Louis ConnectCare and the St. Louis Integrated Healthcare network.

Alan O. Freeman, head of Grace Hill centers, said in a statement that his facilities were “breathing a welcome sigh of relief!” He added that denial of the waiver application “would have dealt a devastating blow to the health-care safety net in our city."