Health Institutions as Economic and Community Anchors: Case Studies and Practical Strategies

1. Health Institutions as Economic and Community Anchors: Case Studies and Practical Strategies Jen Kauper-Brown, CCPH Debra Wesley-Freeman, Sinai George Kleb, Bon Secours Community Health Solutions Tampa, FL March 5, 2005

2. Workshop Overview • Introductions • Project Overview/Strategic Framework • Case Study: Sinai Health System • Case Study: Bon Secours Baltimore Health System • Small Group Discussion • Question and Answer Period

3. CCPH Mission To foster partnerships between communities and educational institutions that build on each other’s strengths and develop their roles as change agents for improving health professions education, civic responsibility and the overall health of communities

4. Health Institutions as Economic and Community Anchors How do health institutions serve as instruments of economic andcommunitydevelopment? What are examples of health institutions that have targeted their own substantial investments to directly improve economic conditions in their local communities? Project funding from the Annie E. Casey Foundation and CEOs for Cities

5. Economic Impact of Health Institutions • Health care services ▲ from 7% of GDP in ‘70 to 15% in ‘02 (Hospitals- 33%: $486.5 bil) • Employment in health sector ▲ 331% from ‘70 to ‘00 • Hospitals: 2nd largest employer in private sector- 5 mil • Medical schools/teaching hospitals (2002) • Employ 1 out of 54 wage earners • Purchases totaled over $81 bil • Produce total of $14.7 bil in revenues for state govt. • NIH awards (2003): Hospitals: > $1.5 bil, Medical schools: > $10 bil, Other health prof schools: > $15 bil

6. Context for Decision Making • Changing Healthcare Market Place/Cost Pressures • Tax Exemption Debate/Community Benefit Laws • Community Perception

7. Why do health institutions invest in economic and community development? • Mission, values and leadership • Enlightened self-interest • Community, Political, Financial Support • Community/Economy Attractiveness • Operational Efficiency & Effectiveness/Economic Bottom Line • Community Perception • Tax/Public responsibility • Improved community health

8. Strategic Framework for Leveraging Health Institution Assets for Community Economic Revitalization Purchaser Redirecting institutional purchasing toward local business Employer Offering employment opportunities to local residents Real Estate Developer Using real estate development to anchor local economic growth Workforce Developer Addressing local and regional workforce needs Operating Community/ Neighborhood Developer Contributing to the quality of the local physical environment Serving/ Learning Investing Advisor/ Network Builder Channeling expertise to increase local capacity Incubator Offering services to support start-up businesses and/or non-profits Service Provider Providing health care and social services Funder Providing resources to support local community development Note: This figure adapted from “Leveraging Colleges and Universities for Urban Economic Revitalization: An Action Agenda” A Joint Study by Initiative for a Competitive Inner City and CEOs for Cities, 2003.

9. Anchor Roles: Operating • Employer • Employee training/education • Model workplace (insurance coverage, living wage) • Policies/procedures for local recruitment/hiring • Partner w/community orgs • Purchaser • Policies/procedures for local/environmentally-preferable purchasing • Support/training for local businesses • Joint ventures btwn national/local suppliers

10. Anchor Roles: Investing • Real Estate developer • Consider/participate in local community planning efforts • Building on empty/abandoned properties • Waste management programs • Community/Neighborhood developer • Collaborate w/community development corps • Socially responsible investing • Support community quality-of-life activities • Support home ownership/rehabilitation programs

11. Anchor Roles: Investing • Incubator • Establish community development corp • Assistance to research commercialization • Technical assistance/expertise • Funder • Operate foundations/endowments/grant making/ tithing programs • Resources: personnel, space/facilities, materials/ equipment • Conduit for philanthropy • Leverage local financial institutions

12. Anchor Roles: Serving/Learning • Workforce developer • Partner w/ K-12 schools/colleges • Welfare to Work programs • Scholarships education/training • Service provider • Uncompensated medical care • Filling service gaps • Support paid time for employees to volunteer • Advisor/Network builder • Leadership/facilitating role • Leveraged engagement • Research activities • Advocate locally/nationally for supportive policies

13. Mission Statement Our Mission is to improve the health of the individuals and the communities we serve. Vision Statement Sinai Health System will become the national model for the delivery of urban healthcare. Chicago Community Area Map

14. Improving Community Health Survey • Report 1- January 2004, Eleven Key Findings • Purpose • Interventions to improve health work best at the community level where they can be tailored and sensitive to local needs; • Community-level data on most health issues- prevalence of diseases (e.g., diabetes, asthma) or risk factor information (e.g., obesity, cancer screening)- do not exist. • Only a community survey can deliver such data to us, and in almost real time. • Information like this offers an opportunity for us to develop interventions that can improve community health http://www.sinai.org/urban/publications/FINAL_Report_1.pdf

15. Mission Statement Sinai Community Institute offers a comprehensive array of public health, referral and social services programs designed to meet its community’s most pressing needs. Vision Statement Sinai Community Institute works to improve the lives of families by providing direct services and establishing partnerships and collaborations that will address the public, health, social and economic needs of the community. A Place for New Beginnings: “Builds community by strengthening families, showing compassion for those in need and maintaining a place where people of every background can create a new beginning”

16. Guiding tenets used in meeting the vision: • Asset Model: SCI helps our community/clients recognize their strengths and identify untapped human resources. • Partnership Model: SCI works in cooperation with Sinai Health System and other community organizations to offer resources that benefit the community/clients. • Solution Focused: Services are created from an understanding of the community environment and designed to address community need. • Family Based: Programs and services focus on families.

17. Health Care Housing Education Clothing Employment Community Needs Recreation Food Safety

18. Range of Services • Enhancing economic opportunities for community residents • Improving community health outcomes • Supportingstrong, healthy families • Buildingstrong communication within the community • Developingpotential of children and youth

19. North Lawndale Employment Network Partnership, Collaboration, Incubation VISION North Lawndale is a strong, economically thriving, diverse community connected to high quality job opportunities and serves as a replicable model for communities nationwide. MISSION To improve the earnings potential of the North Lawndale community through innovative employment initiatives that lead to economic advancement and an improved quality of life for residents. Creating a Community That Works

20. Our Foundation: Linkages with over 50 partner agencies Early Headstart Headstart Early Intervention Hospitals Daycares Kidcare Sankofa Hull House Community Residents Elected officials Chicago Police Department CDPH WIC SCI DCFS North Lawndale FCM Social Service Agencies IL DSCC

21. Supporting strong healthy families • Sinai Parenting Institute • Family Development Initiative • Family Case Management • WIC

22. Building strong communication within the community “Voices From The Community”

23. Developing potential of children and youth • POWER Violence Prevention Program • Mentoring • Balanced and Restorative Justice Program (BARJ)

24. Outcomes: • SCI services/resources currently provided to over 22,000 individuals/year • Opened $ 7 mil Center for Families and Neighbors facility (a former sausage factory) in ‘98 on Sinai Health System campus • Referred 2,685 unique patients to SHS, generating 20,433 visits, resulting in over $11 mil in charges for medical services (1/00-5/04) • NLSSCCtracked & linked 900 newborns to community resources (6/02-9/04) • NLEN has created model ex-offender re-entry programs: U-Turn Permitted, Resource Center Building Beyond Sweet Beginning • Participated in the planning, design and success of: Legacy Elementary Charter School Local Community Development Initiatives North Lawndale Immunization Campaigns Racial and Ethnic Disparities Initiatives Health Career Clubs Youth Mentoring Programs Healthy Fit Programs

25. Our Challenges: • Sustaining and Building Capacity • Incubation Model: Developing a Realistic Plan • Quantifying Value to System • Succession Planning

26. The Sisters of Bon Secours arrived in Baltimore from France in 1881 to care for the poor, the sick and the dying. In 1919, they established a hospital in West Baltimore and in the decades since, the Sisters have continued to expand and adapt their mission To address the community’s needs.

27. The Bon Secours of Maryland Foundation (BSMF)is a nonprofit organization that sponsors housing and community development initiatives in collaboration with the people of West Baltimore. A division of the Bon Secours Baltimore Health System, BSMF adheres to the 120- year-old mission of the Sisters of Bon Secours to improve the health of area residents.

28. The Foundation secures resources and operates successful, innovative programs that include: • Developing and managing safe and affordable housing • Providing needed community services that complement the healthcare services of the local system • Initiating and supporting neighborhood development, economic development and community capacity-building ventures

29. Through these partnerships, the Foundation and resident leaders build on neighborhood and individual assets by: • Increasing resident and neighborhood wealth; fostering its creation • Helping residents identify and reach their educational and career goals • Improving the physical infrastructure of our neighborhoods • Strengthening the physical and emotional health of our residents • Fostering pride in our community

30. In all of its activities, the Foundation develops enduring community partnerships marked by collaboration, a comprehensive approach to community development and the ability to leverage additional resources – financial and programmatic -- for the community.

31. We have learned that successful initiatives are resident led and community driven - through the OROSW coalition we have set up a decision making infrastructure that ensures meaningful resident participation in planningand implementation

32. Operation ReachOut Southwest Vision Statement: “By the year 2018, the neighborhoods of Operation ReachOut Southwest will be known city-wide as a desirable place to live. All houses will be occupied, the majority by homeowners. The streets will be clean, safe, attractive, drug-free, lined with trees and well-kept gardens. There will be parenting, individual and family support services for those who need them. All residents will be educated. There will be recreational activities for all. There will be a variety of fulfilling business and employment opportunities for all people. All community groups, businesses, churches, institutions, government, and individuals will continue to maintain the quality of life in our neighborhoods.”

33. We have also learned that success is more certain when you reverse thinking from addressing deficits in the community to building upon assets. A major part of what we do is to attract resources and then leverage that investment to attract more resources.

35. Small Group Discussion Share and discuss experiences in your own setting • What challenges have you encountered? • What strategies/advice do you have for addressing these challenges? • What benefits have been achieved? • How can more health institutions be engaged to serve in these anchor roles?

36. Resources • CCPH www.ccph.info • Project webpage: http://depts.washington.edu/ccph/anchors.html • Electronic Discussion Group: https://mailman1.u.washington.edu/mailman/listinfo/anchors • Sinai Community Institute www.sinai.org • Bon Secours of Maryland Foundation http://www.bonsecours.org/baltimore/

37. Debra Wesley-Freeman Sinai Community Institute (773) 257-6936 wesd@sinai.org George Kleb Bon Secours of Maryland Foundation (410) 362-3199 George_Kleb@bshsi.com Jen Kauper-Brown Community-Campus Partnerships for Health (206) 543-7954 jenbr@u.washington.edu Contact Information