Source: New York Times Online, December 11, 2012
Posted on: http://envfpn.advisen.com
The community health center rising on a derelict corner here in West Philadelphia never would have broken ground if not for the asbestos inside the building that was demolished to make way for it. Because of the contamination, Spectrum Health Services received a $2 million federal cleanup grant, the first piece of a $14 million construction financing puzzle.
When complete, the 36,000-square-foot building will provide a new home for a health center that has been squeezed into a deteriorating strip mall nearby for decades. It will also be the latest in a nationwide trend to replace contaminated tracts in distressed neighborhoods with health centers, in essence taking a potential source of health problems for a community and turning it into a place for health care. In recent years, health care facilities have been built on cleaned-up sites in Florida, Colorado, New Hampshire, Minnesota, Oregon and California.
“These health care providers are getting good at it,” said Elizabeth Schilling, policy manager for Smart Growth America, an advocacy group. “They have internalized the idea that this is an opportunity for them.”
Because these sites are contaminated, many qualify for government tax credits and grants, providing health centers with vital seed money to build. Community health centers, by design, exist to serve populations in poor neighborhoods, where there also tend to be available but contaminated properties like old gas stations, repair shops and industrial sites.
In fact, many of the country’s 450,000 contaminated sites, known as brownfields, are in poor neighborhoods, according to the Environmental Protection Agency. These tracts are disproportionately concentrated in poor communities because contaminated sites are more difficult to redevelop if property values are depressed. Banks are often reluctant to finance construction on a property that might require a costly cleanup.
“In communities where the real estate market isn’t working that well, you end up with a brownfield,” said Jody Kass, executive director of New Partners for Community Revitalization, a brownfield advocacy group.
“It’s a Catch-22,” said Phyllis B. Cater, chief executive of Spectrum Health Services. “The environmental issues are significant and yet there are scarce resources for communities to do the cleanup and remediation that’s required.”
But if the state or federal government provides the first piece of financing, other funders are more likely to fall into step.
Community health centers, in particular, are under pressure to grow. By 2015, the number of Americans who rely on community health centers for care is expected to double to 40 million from the 20 million who relied on the centers in 2010, according to the National Association of Community Health Centers. The Affordable Care Act allocated $11 billion to expand these centers. Of that, $1.5 billion was allotted to construction.
But finding a viable site is not always easy. It took Spectrum 15 years to find its new home on Haverford Avenue. The original building, an aging medical office, went up for auction in 2007 after the owner was arrested on a tax evasion charge. Spectrum bought the property for $650,000. Ms. Cater speculated that if Spectrum hadn’t bought the site, it most likely would have fallen into disrepair like the decaying row houses and the dilapidated bodega across the street that Spectrum hopes to redevelop eventually.
Spectrum currently occupies 10,000 square feet in a rundown strip mall four blocks away. The center is divided among three crowded spaces, so employees must walk outside to get from the medical offices to the billing department. The treatment rooms are dreary and cramped, with holes in the drywall and collapsing ceiling panels.
“I’ve seen better centers in rural Mississippi. This is not how you support a community,” Ms. Cater said.
When it opens next summer, the new, three-story center will have 34 exam rooms, eight dental rooms, a spacious community center and a full-service laboratory. It will also employ twice as many people as the current facility, adding 66 jobs to Spectrum’s payroll.
The 50-year-old building was in poor shape, but it was the presence of asbestos that allowed Spectrum to qualify for the critical first piece of financing: a $2 million brownfield redevelopment grant from the federal Department of Housing and Urban Development. The organization also received an additional $2 million H.U.D. loan that was tied to the brownfield grant, a $1.7 million redevelopment grant from Pennsylvania and $3.45 million in other loans.
“Brownfield cleanup dollars tend not to be very big dollars, but they’re important dollars as a funding mix,” said Allison Coleman, chief executive of Capital Link, a nonprofit group that helped Spectrum secure financing for the development.
There is no data on how many health centers sit on cleaned brownfields. The effort is gaining traction, however, particularly in Florida, where local government officials, environmental advocates and health center developers have led an ad hoc movement. As an incentive, the state provides developers who redevelop a brownfield into a health center with tax credits of up to $500,000.
Supporters in Florida have toyed with various names for the concept, like Doc in a Box, healthfields and Highway to Healthcare.
“The concept in Florida has proven to be not only needed, but viable,” said Michael R. Goldstein, an environmental lawyer in Florida who specializes in brownfield redevelopment. “We are just at the beginning of the journey here. I predict that in the next two years we’ll have close to two dozen across the state.”
The first of these centers to open in Florida was a tiny clinic in Clearwater on a redeveloped abandoned gas station in 2001. Since then, other health center organizations have opened similar facilities around the state.
In 2010, Tampa Family Health Centers opened an 18,000-square-foot facility on the site of a former Saturn dealership that had underground fuel storage tanks, hydraulic lifts in its service center and oil disposal tanks. The $6.7 million project was partly financed with federal stimulus money.
The new center, in a working-class neighborhood, serves about 10,000 patients a year. Situated on a busy commercial strip, the location was critical for the organization, which has 12 other centers in the area.
“This was an ideal location for us in so many respects,” said P. David Bonham, chief operating officer of Tampa Family Health Centers. “We simply knew that we had the need here.”
In some cases, the cleanup involved is extensive. In 2011, Elliot Hospital opened a 240,000-square-foot ambulatory care facility on the site of a former Tyson meatpacking plant in Manchester, N.H. The plant, which dated to the 19th century, had at one time been a slaughterhouse. Among the contaminants was a 10,000-gallon concrete tank that had stored the blood of slaughtered animals.
“We had to assure ourselves that we would be able to appropriately clean the site,” said Doug Dean, president and chief executive of Elliot Hospital. As part of the demolition, the original building was crushed and used as gravel fill for the parking lot.
The former plant had been shut for five years and added to the blight of what had become a red light district. The new $100 million ambulatory center is the first phase of a 17-acre redevelopment plan that will include an 111,000-square-foot medical office building, a three-story residential building, 13,000 square feet of commercial space and a four-acre riverfront park.
“When you look at revitalizing a community, these kinds of uses tend to be the first anchors,” said Mathy Stanislaus, an assistant administrator for the Environmental Protection Agency.
For the Centennial Mental Health Center in rural Sterling, Colo., the neighborhood eyesore, a 1920s coal processing plant, has been sitting across from Centennial’s main clinic for decades. But a local development team has begun to clean the site and Centennial hopes it will be able to expand onto part of the site, using it for patient parking.
Elizabeth Hickman, Centennial’s executive director, said: “If all goes well we will feel pretty privileged to have a piece of that corner of Sterling that nobody wanted or knew what to do with.”