Summer 2006 Newsletter

Yaroslavsky Champions Joint-Use Health Clinic in Sun Valley

Zev YaroslavskyRecognizing the natural connection between education and health care, L.A. County and LAUSD, in conjunction with supporting agencies, broke ground on a revolutionary community health clinic on the campus of Sun Valley Middle School. Designed not only to bring health care to a badly under-served community but also to leverage scarce real estate, the clinic brings services close to those who need it most: the children and families of Sun Valley. NSBN was pleased to speak with L.A. County Supervisor Zev Yaroslavsky about the vision behind this crucial community resource.

The new Sun Valley Health center, located on the campus of the Sun Valley Middle School, recently broke ground. Elaborate on why you were so supportive of and involved in this joint-use school and health clinic.

Sun Valley is ground zero for the health care crisis in Los Angeles County. One-third of Sun Valley residents are uninsured. Over 80 percent of its children are living in families at or below 200 percent of poverty. The Sun Valley Middle School is federally designated as a health professional shortage area for primary care, and it's also designated as a medically under-served area.

For all of those reasons, when we looked at the possibility of leveraging county resources with school district property to bring ambulatory health care to a campus, this was the spot where we thought we could make the most impact. Fortunately, the school had several acres of under-utilized land, and we made a deal with the school district to build this clinic there.

You, along with other civic leaders, have been very supportive of joint-use schools being neighborhood centers. Is this Sun Valley project a prototype for what you hope will happen in other neighborhoods and on other school sites?

Yes. This whole idea really mirrors what NSBN has been talking about for a number of years. In fact, we took great strength from the NSBN philosophy and we implemented it at this location.

The Sun Valley Health Center is a partnership between L.A. County, the LAUSD, the Northeast Valley Health Corporation, and the UCLA Geffen School of Medicine. The school district is giving us the land gratis for 40 years or more. The county agreed to build a clinic at its own expense, for about $7 million. Northeast Valley Health Corporation, which is a nonprofit health care provider based in the San Fernando Valley, will provide the health care services in the clinic; they are a "federally qualified provider," which is a term of art that means they can draw from federal funds that even the County cannot access. And the UCLA Geffen School of Medicine will provide expanded asthma screening for the kids and families in the Sun Valley area, where asthma is a particularly acute problem.

We've really leveraged everybody's resources here in an unprecedented way. It is the first time that this kind of partnership has been done in the County of Los Angeles. At 11,000 square feet, we understand that it will be the largest school-based health clinic in the United States, and it certainly will be the most comprehensive.

The level of service provided to the community – and this will be a community clinic; it happens to be at a school, and it will target the school's 3,000 students – but we will also provide services to anybody else who walks in the door. For years the school has operated with only one full-time nurse, and now they and the rest of the community will have a full-fledged clinic. It is a real prototype, not only for the County, but for beyond as well.

As NSBN has experienced throughout the county, joint-use collaborative planning between jurisdictions – school districts, cities, counties, nonprofits, housing developers – is not easy. What's the lesson from this success for others who want to engage in this kind of collaborative shared-use planning?

The lesson is that when there's a will, there's a way. When something makes sense, just do it. We had been cooking it up for five to seven years. We looked around, finally settled on the Sun Valley Middle School; UCLA and Patrick Dowling helped us identify the site and the most needy community, but it languished in the bureaucracy of both the county and the school district.

Finally I called Superintendent Roy Romer, and I said, "Roy, I'm prepared to build you a clinic on your campus for $7 million. Providers are ready to provide medical care – doctors, nurses, the whole nine yards – at the clinic, and UCLA is ready to expand their activity in the community. All I need is for you to give us the rights to build on this acreage, which you're not using. If you just give us the go ahead, we can move."

To his credit, Superintendent Romer did not call in a battery of attorneys and real estate experts. He just ruminated for about 30 seconds and then said, "Let's do it."

So principal to principal, more or less, and with the backing of his school board members, once he said yes, we moved. The district put out an RFP, Northeast Valley Health Corporation was selected, and we designed the clinic. What's really exciting about it – and I believe, as NSBN does, that as long as you're building something in a community, you might as well make it an architectural amenity as well – is that we've created a beautiful mission-style design, which will be the nicest building anywhere within walking distance of the Sun Valley Middle School, and it will hopefully be a magnet for people to come in and get preventative health care.

As you have long noted, the health crises that threaten America are in L.A. County in epidemic form, in terms of diabetes and obesity among children. With $19 billion in school bonds and billions in parks, libraries, police stations, and other facility bonds, what can we do between jurisdictions to leverage those capital investments in the most needy neighborhoods?

I think there needs to be, at the principals level—whether it's county supervisors, school board members, superintendents, mayors, whoever they are—a cross-jurisdictional conversation about the needs of the community. Whether it's a health center or a library, whatever the need is—with the kind of building program the school district is engaged in you can sometimes do both—there is no limit to what can be done.

The limiting factor for us was the real estate; it wasn't the money. The money to build is a one-time cost for the county. It's substantial, but it's worth it. The operational money is largely going to come from drawing on federal money through the Northeast Valley Health Corporation. UCLA is going to contribute a portion, and LA Care donated the first year's operational cost.

So it's a real partnership, and the opportunities are manifold throughout the County of Los Angeles. It works economically, it works physically, it meets a need in the East San Fernando Valley, and there are other areas of the county where this can be replicated. But it requires a vision and a goal, which is to leverage dollars and assets, assets such as real estate and community-based assets, such as federally qualified health centers, which can bring quite a bit to the table.

In the case of libraries or other facilities for which there is bond money, the assets are there. So as long as you're in the business of acquiring land and building schools, it doesn't take that much more effort—and not even that much more money—to make the school site a broader community-based site with all kinds of community-based assets. And in this community, no asset is more valuable than this health clinic.

We have all the health problems that the rest of the county has – in terms of diabetes and obesity and the growing epidemic of adult-onset diabetes in teens, and on top of that we have air quality issues that are unique to certain parts of Los Angeles County, including Sun Valley.

So we have an opportunity here that is second to none, and there's no community in the LAUSD's jurisdiction where this can't be done, but it requires decision-makers who can say what Roy Romer said —"Let's do it."