A brownfields-related movement, whose roots are arguably traced to one woman’s foresight and passion in 1997, is beginning to accelerate after years of grassroots and individual program efforts. In hindsight, the initiative that's been billed as “Transforming Brownfields to Healthfields,” makes perfect sense—take abandoned and blighted properties and, using coordinated funding and community-based mechanisms, turn them into thriving economic developments that also improve access to healthy lifestyle choices for all.
Willa Carson, a retired nurse, started simply enough in Clearwater, Fla., providing basic medical assistance to friends and neighbors who lacked health insurance and a means to travel the more than 10 miles to the nearest hospital. Shortly thereafter, beginning in two apartments, Carson founded the North Greenwood Health Resource Center in 1997. When the City of Clearwater designated the Greenwood area Brownfields Redevelopment Area in 1998, it was her vision to take an abandoned gas station site and turn it into the stand-alone facility now called Willa Carson Health & Wellness Center.
The not-for-profit, donation-based health care clinic, credited by many as the pioneer of this movement, provides 4,000 underserved residents with local access to preventive health and dental care, a pharmacy and health education programs. This project also served as the basis for community-driven Highways to Healthcare initiative to turn abandoned properties with underground storage tanks across Florida into health centers and public service facilities. (Go to www.nalgep.org/ewebeditpro/items/O93F24871.pdf for more information.)
This early success did not go unnoticed by public and private brownfields advocates. Addressing the needs of underserved communities seemed to be taking hold. Soon, various other federal and state funding and technical assistance programs began to pop up with many documented victories. Public safety-related developments, housing, health care, transportation, and even emergency preparedness all offered additional opportunities to bundle together funding with transitional brownfields tools.
Studies, statistics and a series of demonstration projects proved that partnerships between governments, nonprofits and private developers bring the most benefit to communities, the lowest cost to government, and the best return on investment to business. Such partnerships help promote the coordination of regulatory programs, the streamlining of administrative procedures, and a multi-stakeholder examination of cleanup solutions and risk sharing.
For instance, using a U.S. Department of Housing and Urban Development (HUD) Safe Neighborhood grant of $224,527 and a $400,000 U.S. Environmental Protection Agency (EPA) assessment grant in 2000, the community of Clearwater, Fla., replaced an abandoned brownfields site with a 5,000 sq. ft. police substation and neighborhood family center that provides after-school care and adult education classes.
The cities of St. Petersburg and Clearwater; Portland, Ore.; and Long Beach, Calif. area were three of many communities that benefited from the 2002 Small Business Liability Relief and Brownfields Revitalization Act (Brownfields Law). The law made petroleum-contaminated properties (estimated at 200,000 sites) eligible for the EPA brownfields program, required 25 percent of the funds be appropriated to them, and allowed up to 10% of a grant to be used to monitor the health of populations near brownfield sites. Now, many states supplement federal cleanup funds with various forms of financial assurance, rebates, tax credits, and instruments similar to private insurance.
In 2003, the Johnnie Ruth Clarke Health Center at Historic Mercy Hospital in St. Petersburg, a national Phoenix Award-winning federally qualified healthcare center, created more than 100 jobs and serves up to 300 patients per day. The facility was funded with a $3.75 million U.S. Department of Health and Human Service (HHS) grant, $463,000 in U.S. Housing & Urban Development (HUD) Community Development Block Grant (CBDG), HUD Economic Development Grant, the state abandoned storage tank program, and other funding sources. Florida A&M University and University of Florida offer an onsite pharmacy and a dentistry program, respectively, and the facility is credited with spurring additional development including a community performing arts center, restoration of the historic casino, and the addition of the new retail plaza.
In 2008, the EPA Office of Underground Storage Tanks (OUST) and the Office of Brownfields and Land Revitalization (OBLR), in collaboration with various levels of government and private industry, developed the Petroleum Brownfields Action Plan (www.epa.gov/oust/pubs/petrobfactionplan.pdf). It improved stakeholder communications, extended technical assistance, and added healthcare options as a potential end use exit strategy for old service station sites.
On June 16, 2009, HUD, U.S. Department of Transportation (DOT), and EPA joined together as the Partnership for Sustainable Communities (PSC) to help neighborhoods nationwide improve access to affordable housing, increase transportation options, and lower transportation costs while protecting the environment. In 2010, it pledged funds to support area-wide planning for brownfield cleanup and community revitalization. That same year, OUST introduced a multi-site planning tool for neighborhood revitalization.
Also in 2010, a joint effort of the U.S. Departments of Agriculture, Treasury, and HHS developed the $400 million Healthy Food Financing Initiative (HFFI). It expands the availability of nutritious food, including developing and equipping grocery stores, small retailers, corner stores, and farmers markets. This effort is focused on reducing childhood obesity and the number of food deserts in the continental U.S, where an estimated 13.6 million people of low income live at least one mile or more from a large grocery store within urban centers (ten miles or more in rural areas).
The Agency for Toxic Substances and Disease Registry (ASTDR), a federal public health agency of the HHS, developed in 2010 the Brownfields/Land Revitalization Action Model, a grass roots, community-level tool designed to foster dialogue, communication, and vision among the diverse members of a community. ATSDR developed Leading Change for Healthy Communities and Successful Land Reuse, (www.atsdr.cdc.gov/sites/brownfields/docs/ASTDR_LandReuse.pdf), a guide for all community members to promote health as part of a redevelopment. The Agency is in the process of developing videos that capture health-based brownfields redevelopment successes in Tampa and Mulberry in Fla. and in Graniteville S.C.
Bundling is good business sense
The Tamiami Trail Petroleum Brownfields Revitalization Initiative in Florida is a good example of the benefits of area-wide planning. The 70-mile highway that connects Tampa to Miami is riddled with more than 500 petroleum brownfield sites, many in economically distressed rural and urban communities.
The initiative, led by the Sarasota/Manatee Metropolitan Planning Organization (MPO), unified the communities, developed a single vision for the corridor, and positioned the effort for maximum funding available. The EPA’s Coalition Assessment grant includes $700,000 for sites with potential petroleum substances and $300,000 for sites with other hazardous substances.
The MPO is currently providing assessment and cleanup planning assistance on the Marion Anderson site, a former dump area to prepare a 3.5 acre portion of this site for a potential healthcare-related end use. The MPO also provided brownfields assessment funding for a new grocery store that will provide affordable, fresh food to a food dessert population cell in Bradenton.
Like many state environmental agencies, the Florida Department of Environmental Protection offers additional incentives including a job bonus refund of up to $2,500 for each new job created; a loan guarantee program for up to 5 years; an expedited permitting process; a sales tax credit on building materials used for construction for certain projects in brownfields areas; a voluntary cleanup tax credit on corporate income of up to 50 percent on annual voluntary cleanup costs, up to $500,000 in tax credits per year; Enterprise Zone Program which provides job creation tax credits, business equipment sales tax refund and electrical energy sales tax exemption; and local option sales surtax exemptions for sales made in urban infill and redevelopment areas.
But the Florida effort goes even further by offering an additional 25 percent of voluntary cleanup tax credit and increases from 50 to 75 percent the Brownfields Loan Guarantee program for health care projects put on brownfields sites.
The 54-mile National Historic Voting Rights Trail in Alabama, which received American Recovery and Reinvestment Act (ARRA), assessment, and cleanup grants, is another example of bundling efforts and funding. The Alabama Department of Environmental Management and EPA, along with a number of state and federal agencies are collaborating with local communities along the Trail to investigate, remediate, and redevelop properties consistent with national historic district and local community goals.
For instance in Montgomery possible developments include daycare centers, a marina, transit services, and health care. HHS and EPA are working together in South Carolina with the Graniteville Community Coalition and Arnold School of Public Health at the University of South Carolina to develop a health clinic to help monitor the health of 650 workers at the mill site of the largest chlorine spill in U.S. history, which occurred in 2005 as a result of a train accident. Funded by a $2.9 million grant from the National Institutes of Health, the Graniteville Recovery and Chlorine Epidemiology (GRACE) project is five-year study that will examine the lung health of community members and workers who were exposed to the dangerous gas.
The HHS Health Resources and Services Administration (HRSA) agency is the primary federal agency providing leadership and funding to improve access to healthcare services for people who are uninsured, isolated or medically vulnerable. According to HHS, more than 1,100 community health centers operate over 8,100 service delivery sites that provide care to approximately 19.5 million patients in the U.S. and its territories.
The Patient Protection and Affordable Care Act (PPACA) was signed into law in March 2010, providing $11 billion to fund the construction and renovation of community health centers and $2 billion to encourage healthcare training. In 2012, HHS and HRSA invested $185 million to improve health care in rural America, and $128.6 million in New Access Point Grants to fund new federally qualified health centers in 219 communities in 41 states to serve more than 1.25 million new patients.
According to the HHS website, “In 2011, health centers employed more than 138,000 staff including: 9,900 physicians, 6,900 nurse practitioners, physicians’ assistants, and certified nurse midwives, 11,800 nurses, 10,300 dental staff, 4,400 behavioral health staff; and more than 12,500 case managers, health education, outreach and transportation staff.”
The city of Mulberry, Fla., working with the Central Florida Health Care and the Central Florida Regional Planning Council, is a great example. It was awarded an $80,000 HRSA health center planning grant and an EPA assessment grant to help develop a federally qualified clinic on a brownfields site, making it eligible for EPA cleanup and HRSA community based healthcare funding. The city is also awaiting word on a HRSA School-based Care Grant and will be seeking additional HRSA and other funding to provide health care to this underserved community.
The city of Manchester, N.H., was able to combine federal and state money with private investment to clean up an old brewery and meat processing plant into its largest development in decades. The new 17-acre mixed-used prime waterfront property, which was two petroleum brownfields sites, was cleaned up and transferred to a developer who built a green urgent care facility, a medical office building, a three-story residential building, a commercial building, and a four-acre riverfront park. The new development created 250-300 permanent jobs, in addition to the construction jobs of which 95% went to New Hampshire residents.
Two of EPA Administrator Lisa Jackson’s Seven Priorities for EPA’s future relate to cleaning up communities and working on environmental justice. The EPA issued a Memorandum of Understanding on Environmental Justice in 2011, supplementing Executive Order 12898—Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations. The memorandum established an Interagency Working Group on Environmental Justice, led by the EPA administrator, and comprised of the heads of departments eight federal agencies.
On the White House blog, HUD Secretary Shaun Donovan, DOT Secretary Ray LaHood, and Jackson highlighted progress from Bridgeport, Conn. to Montgomery, Ala., touting the work through the Partnership for Sustainable Communities. The Partnership has funded 744 projects in all 50 states, the District of Columbia, and Puerto Rico with approximately $3.7 billion in assistance. In addition, building on the success of the EPA traditional funding mechanisms, multi-purpose grants have recently been added to the arsenal of tools to help in redevelopment efforts.
Florida’s East Tampa community is one of the first recipients of the EPA’s multi-purpose pilot grant. According to Ed Johnson, Tampa’s urban development manager, “The funds will be used to assess and clean up a large retail site expected to be anchored by a major grocery store providing fresh food and located next to the large ENCORE redevelopment project.”
Through Johnson’s help, East Tampa has amassed a total of $1.2 million in EPA funding and $400,000 in ARRA assessment grant fund. He is a leader in identifying and combining multi-funding sources. For example, two federally qualified Tampa Family health centers were recently built in the city, which has a large underserved population. The center on North 22nd street in East Tampa cost $3.4 million to build. The city purchased the three parcels, secured the brownfields assessment grant to address lead and asbestos in an old building on the site, searched out indigent care funding through the county, and acquired physicians through HRSA. This facility employs 58 people and offers health, dental and pharmacy services to 37,000 people, mostly low-income residents.
The $6.7 million North Dale Mabry health center, located on a former car dealership, employs 67 medical and office staff. Relying on Johnson and others for information and support, U.S. Representative Kathy Castor was able to secure $2.9 million of ARRA grant money and a $400,000 EPA petroleum grant, in addition to HRSA-supplied physicians.
The EPA Office of Environmental Justice (OEJ) itself offers a variety of grants and cooperative agreements that promote the fair treatment and meaningful involvement of all people. The EPA has committed $1,000,000 to address environmental justice challenges in 10 communities across the nation, providing $100,000 per project over the next two years.
The city of Jacksonville, Fla., has been selected as a Partnership for Sustainable Communities Signature Project, one of 12 Environmental Justice Showcase (EJS) communities, and one of the EPA’s first 10 key Green Infrastructure Partner Communities. Startling health disparities exist within Health Zone #1 (HZ1), in the heart of Jacksonville, where 83 percent of the population are minorities. HZ1 has significantly higher infant mortality, heart disease mortality, asthma and diabetes related emergency room visits than the other health zones. The city will be looking to the OEJ grants to help fund improvements to the health of its severely underserved community.
The Jacksonville Integrated Planning EPA Pilot Project study’s primary purpose, consistent with the EPA EJS project, is to increase access to affordable health services, healthy food, and activities for youth, in addition to increasing job training and employment opportunities, improve air quality, and increase safety.
“The community developed an action plan to address these issues,” said Ken Pinnix, Cardno TBE’s branch office manager in Jacksonville, “and they are determined to establish a health center located on the brownfields site that would provide quality holistic, integrated health care, and related enhancements, such as green building design, public transportation and a local supermarket offering a large variety of fresh foods.”
In the July 22, 2012, Shelterforce journal article titled Better Together: The community development and health sectors can and should work together to reduce health disparities and improve everyone’s health, authors refer to a study in which researchers found that genetic predisposition accounted for just 30 percent of deaths, but 60 percent were explained by social circumstances, environmental conditions, and behavioral patterns—in essence a factor of the conditions in which the individual lived.
The authors strongly suggest that there are many opportunities for the community development sector to work more directly with the health care sector to bring about real change, citing the use of PPACA’s funding as a key tool. That brings us back to the EPA, OEJ, ATSDR, and HRRSA funding that can be used to monitor health and health care outcomes to truly determine which programs effect the best result for all, regardless of their socio-economic status or the neighborhood in which they live.
The community of North Havana, Fla., established the Havana Community Development Corporation (CDC) in 2009, whose first project is to redevelop a historically significant 22-acre former African-American School. The county is one of the lowest ranked in the state in terms of health and wellness outcomes, and poverty, low graduation rates, joblessness and crime are pervasive.
Roger Register, Cardno TBE Tallahassee office manager, explained, “The CDC, based on strong community input and support is looking to redevelop the site into a healthcare center, law enforcement substation, and community center with physical fitness, health education, afterschool computer and homework support, and senior citizen’s daycare operations, as well as an organic farming operation.”
Fert Richardson, CDC board member, said, “We know we desperately need health care in the area, so our very active community group is working with various public agency tools and resources to help us identify possible redevelopment scenarios and to secure funding resources.”
An often-cited success story is the city of Bridgeport, which received $11 million in TIGER multimodal transportation funding from DOT to upgrade roads around the East Side’s Steel Point Peninsula. These funds added to an EPA EJS Community Grant, which helped improve the distressed East End and East Side neighborhoods. Bridgeport is also a partner in the New York-Connecticut Sustainable Communities Consortium, a large stakeholder group that received a 2010 HUD Regional Planning Grant to study the viability of a proposed mixed-use redevelopment anchored by a new rail station in Bridgeport’s East End.
In addition to healthcare, statistics have shown that providing open space/green space encourages physical activity, which brings about social, psychological and motivation benefits, as well as combats obesity and its related chronic conditions of heart disease, diabetes and high cholesterol.
The U.S. Department of Agriculture Forest Service offers grants and technical assistance to preserve open space, and encourages states to do the same. For instance, $9.2 million was appropriated for land protection in four Highland states – New York, New Jersey, Pennsylvania and Connecticut. Florida passed the Rural Lands Stewardship Program, providing economic incentives for stewardship of rural lands to both protect environmental features and beneficial agricultural uses and allow development in appropriate settings.
Florida’s Treasure Coast Regional Planning Council provided assistance to the Village of North Palm Beach through EPA brownfields assessment and revolving loan fund grants for Anchorage Park, which was a former wastewater treatment plant that had petroleum tanks, disposal waste, sludge drying beds, and asbestos. Today there is an expanded open space waterfront park with a marina, playground, dog park, stage and pavilion offering exercise and recreation opportunities to its residents, thanks in large part to brownfields, underground storage tank and other federal and state funding programs.
Economic forces build on healthcare focus
In addition to these public programs, private developers recently have targeted the healthcare industry, simply due to demographics and economics. Statistics boast that the healthcare industry enjoys 10 of the top 20 fastest growing occupations, and it is projected to generate 3.2 million new jobs by 2018, more than any other industry. Driven by the needs of aging baby boomers and advancement in treatment options, health care workers will need increasingly specialized training, snowballing the need for health-related educational programs and facilities.
This movement is taking hold in a big way and was recently noted in the mainstream health care industry. Mel Shipp, OD, DRPH, MPH, president of the American Public Health Association, wrote in an article titled, Bridges between federal agencies can help meet environmental justice goals. In the article, which appeared in the group’s Nation’s Health August, 2012 issue, Shipp supports the federal government’s advancement for healthy, sustainable and equitable communities through the efforts of the IWG, HRSA’s EJ Strategy, and PSC efforts.
A key factor has always been a strong community-led effort with various private and public agency cooperation along with individual leaders who have a passion to make a difference in the lives of the community’s residents and the drive to seek out and piece-together all possible federal, state and local resources.
Going forward, incentivizing cooperation among all the stakeholders will be the key to making a true impact on positive health outcomes for all. The Healthfields concept demonstrates that Brownfields and other related redevelopment funding has and will continue to be a powerful tool to implement environmental justice in underserved communities by replacing environmentally challenged properties with new vibrant opportunities to advance health and healthcare related end uses.
Miles Ballogg, brownfields and economic director for Cardno TBE in Clearwater, FL, is leading with a passion a national initiative that he has termed Brownfields to Healthfields to improve access for all to health and health care. An environmental justice advocate and founding presenter of the Highways to Healthcare concept, Miles previously worked for the Pinellas County Health Department and was the City of Clearwater’s brownfields and redevelopment manager for the Willa Carson Health & Wellness Center. He is past co–chair of the Florida Brownfields Environmental Justice and Public Health Committee and has presented environmental justice and public health related topics on national, regional, state and local levels. He can be reached at 727-431-1555 or email@example.com