MetroHealth offers updates on its planning and development projects

by Chuck Hoven

(Plain Press, November 2020)           At a September 30^th virtual community meeting MetroHealth Medical Center offered an update on progress of construction of the new hospital building on its main campus, a progress report on the Institute for Health Opportunity Partnership and Empowerment (HOPE), and updates on development projects and neighborhood planning efforts.

   MetroHealth System Director of Economic and Community Development Gregory Zucca said MetroHealth’s Transformation plan calls for building a community of health. He said MetroHealth is undertaking a number of community development projects working with community partners.

Main Campus

   Zucca said the hospital was formed in 1837 as a response to a cholera epidemic in the City of Cleveland. MetroHealth reported $1.2 billion in operating revenue for the 2019 fiscal year, said Zucca. The hospital was now investing $1 billion in its main campus to be able to provide better care. Zucca said the hospital has called the main campus its home for over 150 years. Many of the facilities are now functionally obsolete, said Zucca.

   Zucca said currently the main campus sits on 52 acres of hospital property. He said MetroHealth plans to stay within this 52-acre footprint as it transforms the main campus. When complete, Zucca said plans call for approximately 25-acres of green space within the main campus.

   In its planning process, Zucca said MetroHealth is looking to the future from the “perspective of, how do we provide wellness, not just on the main campus, but throughout the community that we serve?”

   Zucca said the building of the new main campus tower is on schedule. He expects the exterior façade to be complete by April of 2021. The interior work which includes plumbing, HVAC, electrical and framing of the walls should be completed by May of 2022, he said. Zucca said the new building should be ready to receive its first patient by the fall of 2022. MetroHealth is financing the entire project without any taxpayer assistance, said Zucca.

   MetroHealth’s mission “to service the health needs of the community” involves much more than four walls, or the doctor’s office, or the campus itself,” said Zucca. To that end, MetroHealth has been looking at the social determinants of health – social and economic factors that contribute to an individual’s well-being. These non-clinical factors include job security, income, the physical environment one lives in, and healthy behaviors.

   Some of MetroHealth’s efforts to do community outreach involve a $160 million investment to help address some of the social determinants of health, said Zucca. Health and wellness programs include School Health Clinics in partnership with the Cleveland Metropolitan School District and other school systems, Project DAWN (Deaths Avoided With Naloxone), Breast Amigas – breast cancer education, and a Nurse Family Partnership Program to help improve pregnancy outcomes.

Institute for HOPE

   Following Zucca’s update and overview of the MetroHealth Transformation Plan, he introduced the Principal for Clinical Transformation for the Institute for Health, Opportunity, Partnership and Empowerment (H.O.P.E.)) Brant Silvers. Zucca said the Institute for H.O.P.E. takes the lead on many of MetroHealth’s efforts to address the social determinants of health.

   Silvers said the goal of the Institute for H.O.P.E. was to improve health through opportunity, partnership and empowerment. He said the social determinants of health have a big impact on how healthy people are and how long they live. For example, he said there is a difference in life expectancy of 23 years between two neighborhoods just 2 miles apart in Northeast, Ohio.

   One initial goal of the Institute of H.O.P.E. involves data gathering on all 300,000 MetroHealth patients registered on MyChart, said Silvers. The Institute of HOPE has already begun to screen the patients asking eighteen questions concerning such issues as food insecurity, social connections, intimate partner violence, financial resource strain, stress levels, transportation availability, and internet connectivity. Silvers said, so far, they have completed screening of 30,000 patients and employees.

   Statistics gathered to date give a picture of some of the factors that influence the health of people in Greater Cleveland. Silvers said 42% of those surveyed said they had a high degree of social isolation; 26% a medium degree of social isolation; and 32% experienced no social isolation.

   Food Insecurity and low levels of physical activity also weighed in as issues for large numbers of participants in the survey.

Unite Ohio

   Silvers then described a new resource referral network called Unite Ohio that he personally worked on and had just got up and running the week prior to the September 30^th meeting. He said Unite Ohio is designed to “build a community of partners across Cuyahoga County equipped with the tools they need to collaborate across sectors and create a more equitable community.” 

   He talked about how the referral network will work. He said if a patient filled out a survey on MyChart or talked to their doctor about a social determinant of health such as food insecurity, then the health care provider could, with the patient’s consent, put their social need into the referral network.

   Silvers offered a diabetic person with food insecurity as an example. Putting their concern about food into the referral network would result in the Greater Cleveland Food Bank giving them a call and helping them to access resources that will help the patient meet food needs. The next time the person comes in for a medical appointment, the doctor can ask about their experience with the Food Bank and if their needs were met. If the Food Bank, in helping provide food, discovers the family has another need, for example, they may be facing eviction, the Food Bank can use Unite Ohio to make another referral to Legal Aid Society, which will offer assistance to the family to help prevent eviction.

   Silvers said Unite Ohio can be accessed at: https://ohio.uniteus.com. He said the referral network created by MetroHealth Medical Center is free to any community-based organization to join. Silvers said he hopes other hospital systems will join the network as well.

Digital Inclusion

   Silvers talked about the efforts of the Institute for HOPE to address digital inclusion and connectivity in the neighborhood surrounding the hospital. He said MetroHealth found through its data gathering that up to 50% of residents have no broad band access. He said sometimes this is an issue of affordability of an internet plan and sometimes internet companies simply don’t offer broad band service in certain neighborhoods because it isn’t profitable. 

   In order to provide internet services to the neighborhood, Silvers said, MetroHealth installed antennas on its towers and on Cuyahoga Metropolitan Housing Authority’s (CMHA) Scranton Castle building. They also partnered with DigitalC in a new program called EmpowerCLE to offer low cost or free internet service to the neighborhood. EmpowerCLE is able to offer Clark Fulton residents internet access for $20 a month, or $10 a month for those that qualify. Through a partnership with the Cleveland Metropolitan School District that is citywide, families with children in the school system will get free high-speed internet access. Clark Fulton neighborhood residents wishing to sign up for the internet service can contact EmpowerCLE at 216-777-3859 or  visit them online at EmpowerCLE.org.

Scranton Castle

   Scranton Castle has become a pilot project in the Institute for H.O.P.E.’s efforts to address the social determinants of health.  Silvers said all 161 apartments have been wired for internet access and many residents have signed up. He said in a partnership with CMHA, Metro Health has joined with other partners such as the Greater Cleveland Food Bank, Medworks, and Digital C to do intensive outreach at Scranton Castle to address the needs and concerns of residents.

School Health Plan

   Silvers noted the success of the existing School Health Plan which has not only experienced good clinical outcomes for students increasing their immunization rates and overall health, but has also resulted in increased school attendance and increases in Grade Point Averages for students. He said the program, already in a number of Cleveland Metropolitan School District Schools and in Cleveland Heights schools, is looking to expand.

COVID Hotline

   In response to the corona virus COVID-19 pandemic, Silvers said MetroHealth’s immediate response was to set up a COVID-19 Hotline. He said anyone could call the hotline at 440-592-6843 and talk to a doctor or nurse. Silvers said the hotline has received over 32,000 calls from 17 counties. The calls have resulted in 16,000 provider visits with follow ups by call care coordinators who do wellness and resource checks. The Institute of HOPE partners with the Food Bank, Drug Mart, Lubrizol, Care Source and other organizations to provide home delivery of food, toiletries and other resources to help patients who are recovering at home, said Silvers.

Local Innovator

   While there are other organizations in other cities such as Toledo and Chicago doing similar evidence-based health care to address the social determinants of health, Silvers said “We are in the forefront in Cleveland in addressing the social determinants of health. In order to move the needle on improving public health, you have to address the social determinants of health.” Silvers said the Institute for H.O.P.E. plans to be very transparent in offering quarterly reports to the community on the outputs and outcomes that result in improvements in public health from the partnerships and referral network.

Community Transformation

   Following Silvers presentation, Greg Zucca talked about MetroHealth’s efforts to improve the built environment in the neighborhood by connecting with community partners to contribute to economic and community development in the neighborhood surrounding the Main Campus of the hospital.

   He talked about an effort to address housing insecurity. He said families moving every five months may interfere with their ability to schedule follow up visits with doctors. Lead paint in older houses may result in children becoming victims of lead poisoning.

   Zucca said MetroHealth as the largest employer on the West Side of Cleveland has the ability to hire locally to increase the number of neighborhood residents working for the hospital system. He also said the buying power of the MetroHealth System and its employees could be used to support businesses in the community. 

   Zucca said MetroHealth hopes to use this comprehensive system level approach from an EcoDistrict platform perspective to work with partners such as MetroWest Community Development Organization and its Director Ricardo Leon, Ward 14 Councilwoman Jasmin Santana, Freddie Collier of City of Cleveland Planning Commission and the Keisha Gonzalez at the Cleveland Foundation to align its programs and initiatives to better serve the neighborhood through a comprehensive neighborhood plan. MetroHealth is also seeking certification as the nation’s first Eco District with a health care institution as an anchor. This involves commitment to equity, community resiliency, climate protection, and sustainability

   Together the partners have funded a master plan for the Clark Fulton neighborhood. Towards this end Zucca said the firm WRT out of Philadelphia has be hired to evaluate the master plan for the neighborhood. He said they reported back on eight elements of the plan: 1) Population & Migration; 2) Health & Safety; 3) Jobs and Workforce; 4) Entrepreneurs and Small Businesses; 5) Housing; 6) Arts and Culture; 7) Greenspace and Recreation Programs; and 8) Connectivity – including transportation and digital connectivity.

   Zucca said to help inform residents about the neighborhood master plan and seek their input, fourteen individuals from the neighborhood have been recruited as neighborhood ambassadors.

   Zucca hopes addressing social determinants of health in the neighborhood will help to improve health and wellness and life expectancy of residents. He said residents of the Clark Fulton neighborhood have a lower life expectancy than the city as a whole, one of the worst lead exposure rates in the city, and a very high unemployment rate with only 84% of working age adults employed. The highest areas of employment are in health care and social service agencies. The number of businesses in the neighborhood have been declining over the past decade, he said. The plan calls for improving the infrastructure and helping to support small businesses on the major commercial corridors in the neighborhood – W. 25^th Street, Fulton Road and Clark Avenue.

   The plan will address the housing cost burden of both renters and homeowners in the neighborhood. If a family spends 30% or more of their income on housing “that is considered to be a housing cost burden”, said Zucca.

   The plan also hopes to work with faith-based community institutions and organizations that play a critical role in the neighborhood such as Scranton Road Ministries, City Life and the Family Ministry Center, said Zucca.

   While the City of Cleveland plans an upgrade for Meyer Pool at W. 30^th and Meyer, other than the pool, there is not a lot of accessible green space in the neighborhood, said Zucca.

   MetroHealth plans to help remedy that by building 25 acres of greenspace on its redesigned campus, he said. He asked, “How can we look at leveraging the proposed MetroHealth Community Park? How do we create a vision for that park that will be an asset for the neighborhood and a place the community can come and interact together, and also a place where the hospital and the community can come together?”  

   Adequate Transportation of many modes and digital connectivity are part of the plan for the neighborhood, said Zucca.

   Zucca urged residents to get involved and offer input into the planning process through the neighborhood ambassadors, community events and meetings and visiting the website at www.clarkfultontoghether.com to offer input and stay informed.

   MetroHealth Medical Center and MetroWest Community Development Organization are also partnering with the Regional Transportation Authority (RTA) to form a plan for the W. 25^th Street Corridor. They are looking to create a bus-rapid transit line from downtown to Broadview Road. Zucca noted that the #51 MetroHealth Line has the second highest ridership in the RTA system. Zucca said planners are working with RTA to leverage the transportation planning to compliment the neighborhood master plan. He hopes that using policy and design tool kits can create market conditions and increased population density to support the transit system and help create more “economic investment opportunities in our neighborhood.”

    Zucca said Stantec and Seventh Hill are the firms working on the RTA plan. He said their planning process includes surveying different profiles of transit users to understand their usage experiences. Zucca urged residents to offer their input on the transit corridor planning by going to www.25connects.com. Zucca noted that the website includes updates, a survey, information about the project and maps. He said the website also has dates and times for upcoming virtual meetings in which residents can participate.

Development Projects

   Three development projects adjacent to the main campus are planned to both serve the hospital and the broader neighborhood community. Zucca shared a video featuring MetroHealth President and Chief Executive Officer (CEO) Doctor Akram Boutros talking about the first of the three projects. Boutros said MetroHealth and the NRP Group broke ground for a project called “Via Sana” or “Healthy Way.” Via Sana will have 72 units of affordable housing as well an Economic Opportunity Center run by Cuyahoga Community College.

   Via Sana will be built at W. 25^th and MetroHealth Drive, and is expected to have a grand opening next fall. Part of the financing comes from Ohio Housing Finance Agency Fact 50 tax credits and Housing Trust Fund dollars pledged by the City of Cleveland. The 5,000 square foot Workforce Development Economic Opportunity Center will front on W. 25^th Street and partner with Cuyahoga Community College and Lincoln West School of Science and Health. The townhomes will feature separate entrances and their north face will be on Sackett Avenue. Zucca said the definition of “affordable housing” used for the project is housing affordable to people whose incomes are 30% to 80% of the median income for Greater Cleveland. He said for a family of four this means an annual income between $25,000 and $53,000. Income qualification would be based on family size, he noted.

   The second project involves building a 100-unit mixed use building which will provide housing for MetroHealth medical residents. Zucca said the plan for this building involves hopes of partnering with a local grocery to build a 12,000 to 15,000 square foot store. Zucca said the goal is for the grocery to partner with MetroHealth’s “Food as Medicine Program” and “Healthy Cooking Class Program.’ This project will be built on the west side of W. 25^th Street across from the main campus.

   The third project involves creating 80 units of workforce housing and a headquarters for MetroHealth Police. Housing in this project will be aimed at people making 80 to 100 of the area median income. This project will be built on the west side of W. 25^th Street across from the main campus.