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Built Environment Cohort
Call #3
Monday, September 19, 2016
ATTENDEES
*Albuquerque(LeighCaswell,Michelle
Melendez,TatiyanaRodríguez)
*Baltimore - Grace, Roscoe Johnson
*Cleveland –MandyMetcalf
*Chicago- Rod ChicagoDepartmentof Health
*Des Moines – Claire Richmond
*Springfield –Sarah Page
Kelsey - AcademyHealth
Janna– PL
Kenisha–PL
Courtney – TA Coordinator
BUILD HEALTHY PLACES NETWORK
Colby Dailey, Managing Director, Build Healthy Places Network (BHPN)
About the BuildHealthy PlacesNetwork:
BasedinSan Francisco, BHPN launchedin2014 withfundingfromRWJF. BHPN connectsleadersacross
sectors,andbuildsthe knowledgebase forcollaboration byprovidingresourcesandexamplesof what
works.
 CommunityDevelopmentandPublicHealthsectorshave beenworkinginsame placeswiththe
same people,butoftennottogether.
 CommunityDevelopmentSector- $2 billionsectoristhe actionarmfor addressing social
determinantsof health andpromotinghealthequity.IthasCommunity Development
Corporations (CDCs) and Community DevelopmentFinance Institutions (CDFI’s).
 Examples of Community Developmentinvestments - healthclinics,grocerystores,affordable
housing,communitycenters.
Joining forces program with Kresge Foundation to connect BUILD grantees through
the CDC sector.
JoiningForces PlanningGrant- BHPN recognizedanopportunitytospecificallylinkthose workingonthe
builtenvironmentwith the CDCsectorinan intentional way. Theyhostedabreakfastwith the
OpportunityFinance NetworkAnnualMeetinginDetroit.
 ConnectedCDFI'sand4 Buildgrantees identified byKresge:Cleveland,Springfield,Albuquerque,
and Harris County.Small Planninggrantopportunityforthose whoattended,workwithCDFIto
developafinancingplan.Springfield,Albuquerque,andHarrisCounty were awardedPlanning
Grants.
 Opportunitytoreallytapintonewmarkettax creditdollars,new marketfundingstreams,and
packetsthat investorswouldneedaboutinvestingonprojectsBUILDare workingon.
Sustainable/Non-traditional Funding Sources for Housing Repair
 HealthyHomesprogram – programby the U.S. Departmentof HousingandUrban Development
(HUD) that providesgrantstolocal governmentsandotherorganizationsto assesshousing-
relatedhazardssuchas asthma andleadpoisoning.Thisnotjustlimitedtopublichousing. Check
withyourcity and countygovernmentstosee if there are anylocal agenciesthatallocate these
funds.
o Example:AlamedaCountyallocatesthese fundsthroughtheirCommunityDevelopment
Agency.Inothercities,itmightbe a city governmentorevennon-profitprogram.
 CommunityDevelopmentCorporations (CDCs)andhousingdevelopers oftenspecialize inhome
renovationlike the BedfordStuyvesant RestorationCorporationinNY.
o If you are interestedinlearningmore aboutwhatisinyour city,check outthe National
Alliance of CommunityEconomicDevelopmentAssociations orNeighborWorks togeta
bettersense of the communitydevelopmentplayersin yourarearelevantto your
project.
o Local InitiativesSupportCorporation (LISC)–CDFIworking to integratefinancing with
local CDC’sand local orgs doing thiswork.They would begood to connectto.
o BPHN Partnerfinder - find a list of LISCsand otherpartners.
o CapitalImpactPartners - nationalCDFI thatdedicatesa specific partof its mission to
assisting in financing housing forseniors.
o Enterprise CommunityPartners - nationalCDFI'sjuststarted a health and housing effort
- they haveofficesaround thecountry.
o OpportunityFinanceNetwork willhavea list of all CDFI's registered with OFN.
o The CDFI'saren't doing it directly, but they are finding waysto partnermoreand more
o CommunityLand Trusts - way forfamilies to own homes - there’sa reserve component
thatall homeownerspay into (similar to an HOA) forownersto pay forenhancements
on their propertywitha specific codeof the land trust. Many of thosealso address
health. Thatprovidesa reserve mechanismforhomeowners.
 HealthImpactAssessments - The BHPN has a blogposton how HealthImpact Assessments
(HIAs) guidedthe renovationof manufacturedhousinginCurryCounty,OR.Itmentionsapublic-
private partnershipthatwascreatedtofundhome repairs.
o QualifiedAllocationPlan - housingauthoritiesuse thesetoallocate tax creditsto
developersaround the state.
o In GA,healthimpactassessmentshave beenusedasa wayto drive policysothat
qualifiedallocation plansfromdevelopers.
o HealthyNeighborhoodsEquityFund - InMassachusetts,aHIA actuallyinformedmetrics
that an Equityfundusedforinvestinginlow income communities.Metricsare derived
directlyfromHIA.Excellentpolicylever.Tothe extentthatBUILD can influence policyin
that direction,that'sa biggermacro.
 In affordable homeownershipprograms – those runby citiesorCommunityLandTrusts –
frequentlyhomeownersare requiredtocontribute toareserve inorderto addressrepairs
includinghealthhazards. Looktothe Community LandTrustNetwork formore information.
 Bonds on the balletor city initiativesfor retrofitting - multifamilyandnotnecessarily
affordable housing - allowsformitigation fordifferenthealthhazards,e.g.energyefficiencyand
pestcontrol.The city isoftenthe initiator- thatcan be a voteable bondon a ballet.
 Utilitycompaniesoftenofferincentivesforenergyefficiencyprograms that can address
healthmultiple ways, e.g.installingenergyefficientairconditioning,insulation.Sometimes
utilitycompanieswillprovidegrants,orcompensation.
o Clevelandwasable topartnerwitha utility company - to workon a weatherization
program.Interestedinopportunitiesto partnerwithcities’ moderate incomeenergy
saversprogram.
 UtilizingCommunityHealthNeedsAssessments (CHNA’s) - every 3 yearsnon-profithospitals
are required to go through a CHNA processthat requiresbroad stakeholderinput. Organizations
should try to be a partof thatprocess, if notalready, to encouragea focuson prevention and
communityneeds. (Clickhere fora guideto understanding CHNAs).
o Example:Trinity Health - Transforming Community’sInitiative - $80 mil investment
through CDFI'sand their hospitalsin addressing SDHin their communities.$40 through
CDFIsand $40 through tracking obesity and smoking. View slides fromPPBNational
Meeting presentation by Bechara Choucair,MD,SeniorVice President,Safety Net
Transformation and Community Benefit,Trinity Health.
o Children'shospitals arecoming around to thisidea (especially in Ohio).They just
convened an Ohio based meeting talking abouttherole thathospitalsplay asan anchor
institution.
 Example: A children's hospitalin Philadelphia partnerswith a city to develop a
health, literacy and recreation hub – Read More.
o Example:In Samford CT, the housing authority partnered with thelocalhospitalto work
on housing contiguousto thehospital. Read More.
o How do you steer CHNA to focuson housing and notchronicdiseases?Finding entry
pointsinto CHNA processis the bestway to get started. Moreand more, hospitalsand
healthdepartments arealigning their CHNA processes.Thathasbeen a good entry place
forexpanding focuson chronicdisease.Example:in Ohio,a hospitalasked their local
CDFIto be partof the process,conversation wasfocused on affordablehousing and
accessto healthy foods.
How are BUILD Sites thinking about funding these programs?
Clevelandhada healthyhomesprogramthatcombineditwiththe cityof Clevelandweatherization
program.Targetedasthma caseswithpatientsbeingadmittedonaregularbasis.Those are not available
everyyear,sonot a source theycan reallyrelyonfor sustainability.Tryingtofindothersources - Care
Source (local healthcare insurer)tofundasthmainterventionswithlocal hospital - show Care Source
that it'sworth investingin.
In Springfield,MA,PartnersforHealthierCommunityappliedforregularhealthyhomesfunding,and
didn'tgetit lastyear,but now the citygot fundingthroughdisasterresilience aftertheywere hitbya
tornadoand qualifiedandcompetedwell inthatcompetition.Asthmacoalition,aspartof partnersfor
healthiercommunity,hasfundingthroughthat.Alsoputtingtogethera pay forsuccessprogram (like
the one beingdone in Baltimore) whole financingpackage thatisfundedbyinvestorsandrepaidby
hospital andinsurance if they're able toprove thatthe asthma triggerswere addressedandhealthcare
costs wentdownafterthey didremediation.Payforsuccessmodel hasalot of potential,butnotmany
people aroundthe countryhave gottenthemoff the ground.
Baltimore’sfallsreductioninitiative isengagingneighborhooddatawith greenandhealthyhome
initiatives.Gointohome andlookforhealthrelatedhome repairsspecificallyrelatedtoaging
populations.Theseorgshave moneyfromHUD,but theirgoal with the Baltimore HealthDepartment,is
to pushthose resourcestowardsindividualswithhighestriskforfalls.Theyare gettinglessandless
fundingforthese repairprograms.
Des Moinesisattemptingtominimizeasthmatriggersinhomesusingreferralsfromhospitals.Looking
at waysto sustainthe program. Currentlyuse PolkCountyHousingTrustFunddollars.Came tothe
board to presenthealthyhomeswhentheywonthe BUILDgrant. Goal is to preserve affordablehousing
that residentsare currentlyin. The Boardhas beensupportive andtheywill continue tosustainit.They
are lookingforfundingtomaintainotheraspectsof programs.TalkingwithMCOsandstate Medicaid
office.
Conclusion and next steps
 Folksare encouraged toshare successesand opportunities withBHPN sotheycan learn
aboutthese kindsof partnershipsandliftupexamplesof whatworks.
 BuildHealthyPlacesNetworkwillbe hostinga#NetworkCommonson October5 at 10 a.m.
PT featuringthe BUILD Granteeswhohave usedtheir JoiningForcesPlanningGrants (via
Kresge) topartnerdirectlywith CommunityDevelopmentFinancial
Institutions (CDFIs). Springfield,HarrisCounty,andAlbuquerqueare participating.Register
here.

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Notes built environment cohort call 9 19 16

  • 1. Built Environment Cohort Call #3 Monday, September 19, 2016 ATTENDEES *Albuquerque(LeighCaswell,Michelle Melendez,TatiyanaRodríguez) *Baltimore - Grace, Roscoe Johnson *Cleveland –MandyMetcalf *Chicago- Rod ChicagoDepartmentof Health *Des Moines – Claire Richmond *Springfield –Sarah Page Kelsey - AcademyHealth Janna– PL Kenisha–PL Courtney – TA Coordinator BUILD HEALTHY PLACES NETWORK Colby Dailey, Managing Director, Build Healthy Places Network (BHPN) About the BuildHealthy PlacesNetwork: BasedinSan Francisco, BHPN launchedin2014 withfundingfromRWJF. BHPN connectsleadersacross sectors,andbuildsthe knowledgebase forcollaboration byprovidingresourcesandexamplesof what works.  CommunityDevelopmentandPublicHealthsectorshave beenworkinginsame placeswiththe same people,butoftennottogether.  CommunityDevelopmentSector- $2 billionsectoristhe actionarmfor addressing social determinantsof health andpromotinghealthequity.IthasCommunity Development Corporations (CDCs) and Community DevelopmentFinance Institutions (CDFI’s).  Examples of Community Developmentinvestments - healthclinics,grocerystores,affordable housing,communitycenters. Joining forces program with Kresge Foundation to connect BUILD grantees through the CDC sector. JoiningForces PlanningGrant- BHPN recognizedanopportunitytospecificallylinkthose workingonthe builtenvironmentwith the CDCsectorinan intentional way. Theyhostedabreakfastwith the OpportunityFinance NetworkAnnualMeetinginDetroit.  ConnectedCDFI'sand4 Buildgrantees identified byKresge:Cleveland,Springfield,Albuquerque, and Harris County.Small Planninggrantopportunityforthose whoattended,workwithCDFIto developafinancingplan.Springfield,Albuquerque,andHarrisCounty were awardedPlanning Grants.  Opportunitytoreallytapintonewmarkettax creditdollars,new marketfundingstreams,and packetsthat investorswouldneedaboutinvestingonprojectsBUILDare workingon.
  • 2. Sustainable/Non-traditional Funding Sources for Housing Repair  HealthyHomesprogram – programby the U.S. Departmentof HousingandUrban Development (HUD) that providesgrantstolocal governmentsandotherorganizationsto assesshousing- relatedhazardssuchas asthma andleadpoisoning.Thisnotjustlimitedtopublichousing. Check withyourcity and countygovernmentstosee if there are anylocal agenciesthatallocate these funds. o Example:AlamedaCountyallocatesthese fundsthroughtheirCommunityDevelopment Agency.Inothercities,itmightbe a city governmentorevennon-profitprogram.  CommunityDevelopmentCorporations (CDCs)andhousingdevelopers oftenspecialize inhome renovationlike the BedfordStuyvesant RestorationCorporationinNY. o If you are interestedinlearningmore aboutwhatisinyour city,check outthe National Alliance of CommunityEconomicDevelopmentAssociations orNeighborWorks togeta bettersense of the communitydevelopmentplayersin yourarearelevantto your project. o Local InitiativesSupportCorporation (LISC)–CDFIworking to integratefinancing with local CDC’sand local orgs doing thiswork.They would begood to connectto. o BPHN Partnerfinder - find a list of LISCsand otherpartners. o CapitalImpactPartners - nationalCDFI thatdedicatesa specific partof its mission to assisting in financing housing forseniors. o Enterprise CommunityPartners - nationalCDFI'sjuststarted a health and housing effort - they haveofficesaround thecountry. o OpportunityFinanceNetwork willhavea list of all CDFI's registered with OFN. o The CDFI'saren't doing it directly, but they are finding waysto partnermoreand more o CommunityLand Trusts - way forfamilies to own homes - there’sa reserve component thatall homeownerspay into (similar to an HOA) forownersto pay forenhancements on their propertywitha specific codeof the land trust. Many of thosealso address health. Thatprovidesa reserve mechanismforhomeowners.  HealthImpactAssessments - The BHPN has a blogposton how HealthImpact Assessments (HIAs) guidedthe renovationof manufacturedhousinginCurryCounty,OR.Itmentionsapublic- private partnershipthatwascreatedtofundhome repairs. o QualifiedAllocationPlan - housingauthoritiesuse thesetoallocate tax creditsto developersaround the state. o In GA,healthimpactassessmentshave beenusedasa wayto drive policysothat qualifiedallocation plansfromdevelopers. o HealthyNeighborhoodsEquityFund - InMassachusetts,aHIA actuallyinformedmetrics that an Equityfundusedforinvestinginlow income communities.Metricsare derived directlyfromHIA.Excellentpolicylever.Tothe extentthatBUILD can influence policyin that direction,that'sa biggermacro.  In affordable homeownershipprograms – those runby citiesorCommunityLandTrusts – frequentlyhomeownersare requiredtocontribute toareserve inorderto addressrepairs includinghealthhazards. Looktothe Community LandTrustNetwork formore information.
  • 3.  Bonds on the balletor city initiativesfor retrofitting - multifamilyandnotnecessarily affordable housing - allowsformitigation fordifferenthealthhazards,e.g.energyefficiencyand pestcontrol.The city isoftenthe initiator- thatcan be a voteable bondon a ballet.  Utilitycompaniesoftenofferincentivesforenergyefficiencyprograms that can address healthmultiple ways, e.g.installingenergyefficientairconditioning,insulation.Sometimes utilitycompanieswillprovidegrants,orcompensation. o Clevelandwasable topartnerwitha utility company - to workon a weatherization program.Interestedinopportunitiesto partnerwithcities’ moderate incomeenergy saversprogram.  UtilizingCommunityHealthNeedsAssessments (CHNA’s) - every 3 yearsnon-profithospitals are required to go through a CHNA processthat requiresbroad stakeholderinput. Organizations should try to be a partof thatprocess, if notalready, to encouragea focuson prevention and communityneeds. (Clickhere fora guideto understanding CHNAs). o Example:Trinity Health - Transforming Community’sInitiative - $80 mil investment through CDFI'sand their hospitalsin addressing SDHin their communities.$40 through CDFIsand $40 through tracking obesity and smoking. View slides fromPPBNational Meeting presentation by Bechara Choucair,MD,SeniorVice President,Safety Net Transformation and Community Benefit,Trinity Health. o Children'shospitals arecoming around to thisidea (especially in Ohio).They just convened an Ohio based meeting talking abouttherole thathospitalsplay asan anchor institution.  Example: A children's hospitalin Philadelphia partnerswith a city to develop a health, literacy and recreation hub – Read More. o Example:In Samford CT, the housing authority partnered with thelocalhospitalto work on housing contiguousto thehospital. Read More. o How do you steer CHNA to focuson housing and notchronicdiseases?Finding entry pointsinto CHNA processis the bestway to get started. Moreand more, hospitalsand healthdepartments arealigning their CHNA processes.Thathasbeen a good entry place forexpanding focuson chronicdisease.Example:in Ohio,a hospitalasked their local CDFIto be partof the process,conversation wasfocused on affordablehousing and accessto healthy foods. How are BUILD Sites thinking about funding these programs? Clevelandhada healthyhomesprogramthatcombineditwiththe cityof Clevelandweatherization program.Targetedasthma caseswithpatientsbeingadmittedonaregularbasis.Those are not available everyyear,sonot a source theycan reallyrelyonfor sustainability.Tryingtofindothersources - Care Source (local healthcare insurer)tofundasthmainterventionswithlocal hospital - show Care Source that it'sworth investingin. In Springfield,MA,PartnersforHealthierCommunityappliedforregularhealthyhomesfunding,and didn'tgetit lastyear,but now the citygot fundingthroughdisasterresilience aftertheywere hitbya tornadoand qualifiedandcompetedwell inthatcompetition.Asthmacoalition,aspartof partnersfor healthiercommunity,hasfundingthroughthat.Alsoputtingtogethera pay forsuccessprogram (like the one beingdone in Baltimore) whole financingpackage thatisfundedbyinvestorsandrepaidby
  • 4. hospital andinsurance if they're able toprove thatthe asthma triggerswere addressedandhealthcare costs wentdownafterthey didremediation.Payforsuccessmodel hasalot of potential,butnotmany people aroundthe countryhave gottenthemoff the ground. Baltimore’sfallsreductioninitiative isengagingneighborhooddatawith greenandhealthyhome initiatives.Gointohome andlookforhealthrelatedhome repairsspecificallyrelatedtoaging populations.Theseorgshave moneyfromHUD,but theirgoal with the Baltimore HealthDepartment,is to pushthose resourcestowardsindividualswithhighestriskforfalls.Theyare gettinglessandless fundingforthese repairprograms. Des Moinesisattemptingtominimizeasthmatriggersinhomesusingreferralsfromhospitals.Looking at waysto sustainthe program. Currentlyuse PolkCountyHousingTrustFunddollars.Came tothe board to presenthealthyhomeswhentheywonthe BUILDgrant. Goal is to preserve affordablehousing that residentsare currentlyin. The Boardhas beensupportive andtheywill continue tosustainit.They are lookingforfundingtomaintainotheraspectsof programs.TalkingwithMCOsandstate Medicaid office. Conclusion and next steps  Folksare encouraged toshare successesand opportunities withBHPN sotheycan learn aboutthese kindsof partnershipsandliftupexamplesof whatworks.  BuildHealthyPlacesNetworkwillbe hostinga#NetworkCommonson October5 at 10 a.m. PT featuringthe BUILD Granteeswhohave usedtheir JoiningForcesPlanningGrants (via Kresge) topartnerdirectlywith CommunityDevelopmentFinancial Institutions (CDFIs). Springfield,HarrisCounty,andAlbuquerqueare participating.Register here.