St. Joseph program helps residents achieve lasting change in their communities

April 1, 2014

Community Building Initiative


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ORANGE COUNTY, Calif. — Until just a few years ago, the Richman neighborhood in Fullerton, Calif., was plagued with problems. Many residents feared going outside at night because of gang activity. Drug dealers hung around schools. Community members called a pavilion at the park "the casino" because men used it around-the-clock for drinking and gambling. Many residents in the predominantly Hispanic, working class community feared involving the police because they didn't trust them.

Back then, "people who worked with me at the hospital said, ‘Don't drive through there at night, you might get shot,'" recalled Barry Ross, vice president of healthy communities at St. Joseph Health–St. Jude Medical Center in Fullerton.

The Community Building Initiative from the hospital's parent, Irvine, Calif.-based St. Joseph Health, equipped Richman residents with the knowledge, skills, resources and connections they needed totackle the community's issues. With St. Joseph's support, "they learned how the system works, and they built relationships with organizations" that could make fundamental improvements, said Ross.

A family enjoys the renovated playround at Richman Park in Fullerton, Calif. The park has become a safe community hub under St. Joseph Health's Community Building Initiative. At the far left is the medical clinic that St. Joseph Health – St. Jude Medical Center established in the park.

Broad-based change
Since 1986, the St. Joseph Health Community Partnership Fund, which is St. Joseph's grant-making arm, has been funding causes that benefit areas served by St. Joseph's 14 hospitals.

But St. Joseph leaders decided about 13 years ago that grants should go not only to "one-off" projects but also to bolstering the capacity of residents to improve their communities systemically, and to build on their progress, explained Gabriela Robles, St. Joseph vice president of community partnerships. So that fund created the Community Building Initiative, which has an annual budget of $750,000.

About two dozen nonprofit groups in the service areas of St. Joseph's California hospitals apply annually to lead a Community Building Initiative project. The hospitals submit a list of applicants and the applicants complete an extensive proposal. St. Joseph community partnership staff make site visits to potential grantees and interview them before selecting the recipients. Their selection is based on the grantees' ability to engage community residents, develop resident leaders, collaborate with other organizations and build relationships with decision makers.

Grant recipients get $80,000 for a planning year and $100,000 per year for three additional years to implement their plans. Staff of their local St. Joseph hospital serve as mentors and coaches. Currently there are two grantees in the planning phase and two in the implementation phase. Thirty-two have completed the program since its inception.

Motivated by family
Ross saw the potential for a successful Community Building Initiative project when, around 2000, he met a small group of women in Richman who had been trying — with little success — to address community issues.

Teresa Morales, a mother of three, was part of that resident group. She recalled, "It was horrible here. There was drug activity around the school — gangs would hang around the school in the morning around the children. We tried to get rid of the gangs, and nothing happened. And, we didn't have the confidence to go to the police."

Ross helped the women identify a lead organization — the not-for-profit Orange County Human Relations Council — to apply for the Community Building Initiative grant on their behalf. Under the grant, the Human Relations Council organized residents and taught them to identify — and lobby — the influencers that could help or hinder them. The women learned to attract more residents to their cause, present before the city council, meet with the police department and get results with the school district. "The motivation was my children" — and creating a better community for them, said Morales.

Before, during and since the grant period, Ross has used his connections — and his connections have used their connections — to pull together an ever-expanding collaboration of organizations to support Richman improvement efforts. Ross said, "We were able to use our influence to demonstrate why it was important to invest here, and we used our relationships."

Over time, that list of organizations that took part in improvement efforts came to include: St. Jude Medical Center, which built a medical clinic at one end of Richman's park, which is about one square city block large; the Children and Families Commission of Orange County and The California Wellness Foundation, which funded services in the clinic; the Fullerton City Council, which approved changes that made roads safer for pedestrians; the police department, which lent its support to a crime reduction program; and the U.S. Department of Housing and Urban Development, the State of California and the city of Fullerton, which provided revitalization funds for the park and neighborhood. The nonprofit Fullerton Collaborative helped convene these and other partners.

"The right partners were open to discussion, and there were lots of conversations and dreaming, and we got the right people to listen, and we helped the residents to go through the whole process," said Pam Keller, the Fullerton Collaborative's executive director.

Now, Richman has a community focal point that includes the medical clinic and a separate community center located on the perimeter of the refurbished park, which now is safe and "casino"-free. Gang and drug activity have been cut drastically with better police involvement and an active community watch program. And improved housing is attracting new residents.

The community "went from hopelessness and despair to having hope and a promising future," said Ross.

Unstoppable moms
About 20 miles southwest of Richman, the Oak View neighborhood in Huntington Beach, Calif., is just starting the planning phase of its Community Building Initiative, under a lead nonprofit organization, the Oak View Renewal Partnership.

In the one-square-mile Oak View, fewer than half of working-age people are employed; the per-capita income is $16,673 (nearly half that of Orange County as a whole); the average household size is nearly six people (nearly double that of Orange County); and 97 percent of homes are renter-occupied.

Fidel Cruz, who provides employment services for the Oak View Renewal Partnership, said those who do work often must settle for low-paying or day labor jobs because they lack the education or experience to get good jobs, or they lack legal immigration status. Edgar Macias, who manages community service programs in Oak View, said to make ends meet many parents must work multiple, low-wage jobs and those without family or friends to care for their children sometimes leave those children unsupervised and vulnerable to gang influence. Mollie Grierson, the Oak View Renewal Partnership's director of community engagement, said with multiple and unrelated families often living in one household — it is not uncommon for strangers to share a home — children are at higher risk of abuse by non-family members.

Robert Tapia, a community outreach specialist for the local Ocean View High School, said many residents in this predominantly Hispanic neighborhood in Huntington Beach are wary of involving the police or government in problems for fear that drawing attention could raise deportation risks for undocumented immigrants or because they learned to distrust government agents based on experiences in their home countries. Many residents worry about retaliation if they report on gang activity, said Oak View resident Martha Cervantes.

Since 2006, the Oak View partnership has used grant funds from numerous sources to improve public safety, set up mobile health clinics, start an employment help program, establish a youth soccer league, create community gardens and initiate a neighborhood cleanup program. It has successfully partnered with the school district, the library and some nonprofits on such efforts.

But, according to partnership Executive Director Iosefa Alofaituli, Oak View could make much more progress in narrowing the cultural, social, educational, health and economic gap between Oak View and the surrounding area by "cultivating local residents in taking responsibility for building change."

Very few grant-making organizations invest in this type of systemic change — most fund on a project-by-project basis, said Alofaituli. St. Joseph's approach will be more sustainable than one-time project funding, he said.

Grierson said the Oak View partners envision "building a bridge between residents and decision makers, and helping make residents more comfortable and showing them what channels to go through" to achieve change. For those who lack legal immigration status, this may mean a mechanism to inform authorities anonymously about violence and other issues impacting their community.

The partnership already is tapped into a small group of mothers, fathers and grandmothers involved in isolated efforts to better their community — and who can serve as a core group to build upon in organizing residents.

Resident Hortencia Maldonado is one of those moms. She said she is eager to get involved in the Community Building Initiative. "I am here because I want to see my community be different, and many parents want the same. No one is going to stop me (from making) a change."

Richman attracted millions of dollars in aid

Under changes achieved through the Community Building Initiative, Richman attracted the interest, resources — and often the funds — of many different organizations.

Organizations that provided grants included:

  • The city of Fullerton, which provided $37 million in neighborhood revitalization funds
  • St. Jude Medical Center, which allocated $2.5 million to build a medical clinic in Richman
  • The Orange County Children and Families Commission, which invested $750,000 for clinic pediatric services
  • The State of California, which granted $500,000 in improvement funds
  • The California Wellness Foundation, which provided $500,000 for clinic medical services
  • The U.S. Department of Housing and Urban Development, which invested $400,000 for revitalization of housing

St. Joseph's California hospitals contribute to, benefit from system grant program

The Community Building Initiative is part of a larger grant pool run by St. Joseph Health's grant-making arm, the St. Joseph Health Community Partnership Fund. The $4.7 billion Irvine, Calif.-based system allocates nearly $4 million annually in grants.

St. Joseph's grants arm gets 10 percent of the net income of its ministries each year. Of the amount the nine California hospitals contribute, 75 percent goes back to the hospitals for their care for the poor programs, which includes support for community clinics and mobile clinics, hospital donations to not-for-profit organizations that serve people in need and other programs that address the needs of the economically poor. (In Texas, 100 percent goes back to the hospital for its care for the poor programs.) This giving is in addition to the hospitals' charity care and their community benefit work locally.

Of the remaining 25 percent of the Community Partnership Fund, 7.5 percent goes toward an endowment that is reserved for safety net care. St. Joseph thinks of these funds as "rainy day" funds, for when other funding sources are insufficient to cover the expenses incurred in caring for the underserved. The remaining 17.5 percent of the Community Partnership Fund dollars annually goes toward system-level grant initiatives, including the Community Building Initiative.

Other projects funded in the system-level grant initiatives category include wellness and prevention projects; emergency food and shelter for community members in crisis; community clinics; and disaster relief.


Copyright © 2014 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2014 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.