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Case Study: Community Health and Literacy Center, a first of its kind public-private partnership by The Children’s Hospital of Philadelphia and City of Philadelphia

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Project Overview

The Children's Hospital of Philadelphia (CHOP) is the largest pediatric healthcare network in the United States, consisting of over 50 locations in Pennsylvania and New Jersey. Its campus in West Philadelphia comprises a 535-bed hospital, the Richard D. Wood Pediatric Ambulatory Care Center, the Children's Seashore House, the Ruth and Tristram Colket, Jr. Translational Research Building, the Leonard and Madlyn Abramson Pediatric Research Center and the Buerger Center for Advanced Pediatric Care, a state-of-the-art outpatient facility slated to open in 2015.

As part of its pediatric healthcare network, CHOP operates three primary care offices in Philadelphia, and its newest initiative is the Community Health and Literacy Center in South Philadelphia. The Center is a unique public-private partnership between CHOP and the City of Philadelphia that will provide healthcare, literacy and recreational services in one location for children, individuals and families in a diverse South Philadelphia community. This first-of-its-kind project will serve as a national model for public-private collaboration in efforts to improve health outcomes for children and adults.

Under the agreement, the City is providing a lease on the site at a nominal fee to CHOP along with $2.2 million to support construction. CHOP is expending $42.5 million to develop the land and construct a 96,000-square-foot facility and outdoor playground. The CHOP portion of the funding comes from several sources including: generous support from CHOP donors, hospital operating revenue, and New Market Tax Credits provided through the Chase Community Equity LLC, Chase New Markets Corporation, the Philadelphia Industrial Development Corporation (PIDC), City First Bank of D.C., and Commonwealth Cornerstone Group, Ltd.

When it is completed in late 2015, the Community Health and Literacy Center will encompass four fully integrated components: The Children'€™s Hospital of Philadelphia Care Network, Primary Care, South Philadelphia; The City of Philadelphia'€™s Health Center 2; The Free Library'€™s South Philadelphia Neighborhood Library; and The DiSilvestro Recreation Center. The facility consists of a new three-story building on the eastern side and a new playground on the western side situated on 1.5 acres of land on the city block bordered by South Broad Street, South 15th Street, Morris Street and Castle Avenue.

Impact

The Community Health and Literacy Center will deliver value beyond the sum of its parts. Opportunities for integrated programming will offer the ability for these four services to cross-pollinate so that children, individuals and families can receive one-stop comprehensive care and access to community-based programming and services. Programs reflecting this concept will solidify as construction on the project continues. The construction of the Community Health and Literacy Center will enable each entity to expand its services.

The Children'€™s Hospital of Philadelphia Care Network, Primary Care, South Philadelphia is one of CHOP'€™s fastest-growing primary care practices in Philadelphia, with more than 31,000 patient visits annually. The new facility will provide expanded space and equipment, enhancing the patient and family experience. The new 22,000-square-foot space will provide an additional 6,200 square feet compared to the previous location, and will accommodate six additional exam rooms and a large, inviting waiting area with dedicated space for reading and computer use by patients and families while they wait.

Health Center 2 treats nearly 50,000 patients annually, offering adult and pediatric care, women's healthcare including gynecology, family planning and prenatal care and dental care as well. The new 29,500-square-foot space will include additional exam rooms along with an additional dental operatory and state-of-the-art radiology and mammography services.

The DiSilvestro Playground and Recreation Center'€™s playground area will be renovated utilizing state-of-the-art construction materials to create a soft, smooth surface. The playground will feature substantial green space and a rain garden. The recreation center will double in size, greatly expanding existing programming in both offerings and frequency, using the renovated outdoor space to offer story time in partnership with the library, and other outdoor events such as community movie nights.

The South Philadelphia Neighborhood Library will be one of the Free Library's new 21st-century libraries designed for the evolving way media is consumed. The new facility, which will include an additional day of operation and expanded programming, is expected to draw an additional 35,000 patrons annually and will include a dedicated Makerspace for consumers to embark on creative activities, with access to a new computer lab, 3-D printer and supplies, additional literacy programming and career-development computer education.

In addition to enhanced integrated programming across these City and CHOP functions, the Community Health and Literacy Center is estimated to create a combined increase in new City and CHOP patient visits annually to 183,000, up from 168,000 in 2012. The recreation center will be able to serve as many as 5,000 users, up from 1,000. The project will create more than 200 predevelopment or construction jobs and 9 permanent jobs in addition to the existing 138 jobs from the current CHOP and City centers. The project will also catalyze future investment in the surrounding area.

Innovations and Best Practices

Within its pediatric healthcare network of over 50 locations, CHOP is dedicated to providing top-quality healthcare in the community, with a focus on prevention in underserved communities.

In 2013, CHOP opened the Nicholas and Athena Karabots Pediatric Care Center in West Philadelphia. The 52,000-square-foot Karabots Center includes 35 doctors on staff and serves 64,000 patients visits annually. In addition to 56 exam rooms, radiology services, hearing and vision testing and a phlebotomy laboratory, the Karabots Center also houses community programs such as Early Head Start, Reach Out and Read, Community Asthma Prevention Program, domestic violence education, medical home care coordination and the Home Health Initiative, as well as a dedicated community room for use by neighborhood organizations. With an estimated 78% of children requiring subsidized health coverage such as Medicaid or the state Children'€™s Health Insurance Program, the Karabots Center enables children to obtain full access to high-quality care regardless of their insurance status. By integrating this care with comprehensive on-site programming, CHOP'€™s goal is to improve health outcomes in a way that is efficient and as close to home as possible.

The success of the Karabots Center derives from CHOP'€™s ability to recognize the unique needs within this population and develop comprehensive services and community partnerships that address those needs. This innovative concept serves as a model for the Community Health and Literacy Center.

Now that CHOP has developed a best practice model to address children'€™s healthcare needs, the Community Health and Literacy Center extends the concept through its partnership with the City of Philadelphia. CHOP'€™s experience in constructing a facility that supports the community's current and long-term needs, along with its competence in developing high-quality, high-impact programming to maximize children'€™s well-being, will now benefit the South Philadelphia community through this project.

Lessons Learned

The Community Health and Literacy Center project broke ground on September 18, 2014 and is slated for completion by December 2015. The Center represents a pioneering opportunity for the City and CHOP, given that neither organization had previous experience with developing a public-private partnership of this magnitude. Accordingly, we followed two fundamental principles to maintain the progress needed to advance this project:

The first lesson involves organization. To realize the vision for the Center, the City and CHOP were required to develop infrastructure that would incorporate complex plans, budgets, agreements, regulations and more. Accordingly, a steering committee was developed consisting of executives representing all user groups (CHOP, the Library, the Recreation Center and Health Center 2) €”to manage high-level decisions. This group met regularly, established agreed-upon agendas and goals for each meeting and addressed a list of top issues at each meeting that required immediate deliberation and decision.

The second lesson involved the importance of compromise. This project served as CHOP'€™s first experience in building new facilities in conjunction with other tenants. While CHOP does operate some of its offices within multi-tenant spaces, historically, the organization has relied on a landlord to address building issues. In the case of the Community Health and Literacy Center, CHOP is the developer. As we contemplated the construct of our relationship, it was important to recognize how CHOP'€™s standards for operating facilities aligned with the City'€™s standards. As the developer, CHOP was now required to manage and merge aspects of each individual organizational culture to harmonize the construction process. With regular, appropriate dialogue, this is being accomplished.

Just as this new Community Health and Literacy Center project builds on the lessons of the Karabots Center, we expect future programs to adopt best practices from CHOP's involvement in this innovative multi-service community center.

Acknowledgements

This article included contributions by Peter Grollman Vice President, Government Affairs, Community Relations and Advocacy, The Children's Hospital of Philadelphia