By JULIE MINDA
DETROIT — With his office window looking out into the entryway of Samaritan Center here, the facility's Executive Director Mark Owens sees a continual flurry of activity as clients of the dozens of health and social service organizations housed at the center arrive, depart or mill about.
Owens
Several times a year, a van from a women's shelter drops off a group en route to Jackets for Jobs. That nonprofit provides free business attire and job-hunting advice for low-income women. Owens said, "I'll see these young ladies come in like the world beat them down." Then a few hours later, he'll see them on their way out with shoulders back, heads held high and their bag of professional clothes in hand.
"It's amazing to me the change. This is a place that gives people hope," he said.
Health, social service center
The 500,000-square-foot Samaritan Center is housed in the former Mercy Hospital Detroit. The failing hospital was closed in 2000. The building reopened a year later as a hub for health and social service providers, community organizations, small businesses, government agencies and others serving Detroit's east side.
The building's 70-plus tenants include a primary care clinic run by Trinity Health. About 60 percent of its patients are insured by Medicaid, 5 percent are insured by Medicare and 35 percent are uninsured. Other center anchors are a 120-bed nursing home run by the for-profit provider Advantage Living Centers and a 55-bed nonprofit behavioral health unit that is part of a two-campus independent practice.
Tasha Adams gets a blood pressure check from Victoria Donald-Bougard, a registered medical assistant at the Mercy Primary Care Center. The facility is at the Samaritan Center in Detroit.
The center provides a platform for addressing social determinants — including homelessness, hunger, joblessness, illiteracy and poverty — that have a significant impact on people's health, said David Spivey, president and chief executive of Trinity's St. Mary Mercy Livonia of Livonia, Mich., in suburban Detroit. Spivey headed Mercy Hospital Detroit around the time of the closure, when it was owned by Mercy Health Services. He helped plan and develop the Samaritan Center, and still has a hand in facility oversight.
"While many may have thought that having a hospital was a higher purpose (for the campus), the Samaritan Center is a tremendous resource," he said.
Profit, loss and reset
During a breakout session at the 2017 Catholic Health Assembly in June in New Orleans, and during an August visit to Samaritan Center by Catholic Health World, Spivey and colleagues explained the financial circumstances that led to the closing of a 16-year-old, 268-bed hospital. The hospital opened as a replacement facility in 1984 in an area of Detroit that suffered severely during the crash of the city's auto industry. The worst of the decline happened in the 1970s and 1980s. According to statistics from Trinity, Detroit's population dropped by nearly 1 million between about 1966 and 2016.
While the hospital enjoyed modest profitability in the mid-1990s, by 1999 Mercy Hospital Detroit had lost more than $150 million cumulatively.
Detroit's Sonya Stallings says she appreciates the caring staff at Mercy Primary Care Center in the Samaritan Center.
As closure became imminent, hospital leaders, leaders of its parent Mercy Health Services, and hospital sponsors the Sisters of Mercy searched for a way to continue the hospital's mission of service to the community and landed on the idea of transforming the hospital into a center for community services.
Community engagement
Hospital repurposing experts Dynamis Advisors of Chagrin Falls, Ohio, interviewed hundreds of community members about unmet needs, identified community partners to help address those needs, found funding sources and finalized the plan to bring all of these pieces together.
A job assistance nonprofit called Service Employment Redevelopment Metro–Detroit, or SER Metro–Detroit, and a children's aid nonprofit called Holy Cross Services manage the property. A combination of philanthropy, government and other grants, and rent payments from tenants fund Samaritan Center's annual budget of upwards of $4.5 million.
Trinity is the successor of Mercy Health Services, the organization that once owned Mercy Hospital and that launched Samaritan Center. Trinity provides a $2 million annual grant. The money supports its clinic at the center and other health care and social services in the vicinity.
Wedding and funerals
Samaritan Center has become an anchor for Detroit's east side, which is primarily a low-income area with a high rate of unemployment and crime. In recent years, the community has seen some gentrification and some influx of people with moderate to high incomes.
Samaritan Center's initial roster of 15 tenant organizations has grown to more than 70. They include a literacy program, job training services, other social services, a dental care provider, a Head Start program, child welfare services and a trade school — with some of these services operated by nonprofits and some by federal, state and county government agencies.
Also on-site are the offices of several elected government officials and utility satellite offices, where customers can pay bills and talk with customer service representatives. A central corridor on the first floor leads to a cluster of small businesses, including retailers, beauticians and a caterer. Director Owens estimates all tenants' combined gross is about $50 million per year.
The campus also includes an activity space that community organizations and individuals can use for free and a gym where exercise classes and sporting activities are held.
Scott Keller, president and chief executive of the Dynamis consultancy, said community members have said they think of Samaritan Center as their own, and they feel a sense of safety and security there. Owens said the activity space served as a wedding venue when electricity went out at a local church just before the ceremony; it's been used multiple times for memorial services.
Brenda Bunnell adjusts a display at Jackets for Jobs. Housed at the Samaritan Center, the nonprofit provides professional attire and job hunting advice at no cost to low-income women.
Individual impact
Spivey and Keller said market forces are prompting health care providers to rethink how and in what venues they provide care. The move toward value-based care is continuing the shift away from a focus on inpatient care toward outpatient care with wraparound social services. They said the model employed at Samaritan Center could inform the strategies other providers are developing as they reset their operating models.
Tenants of the center say the model pays dividends for community organizations and the people they serve.
Tawana Nettles-Robinson is executive director of Trinity's Mercy Primary Care Center, a Samaritan Center tenant. She said the organizations renting space at Samaritan Center are closely linked to one another, meeting at least monthly, and are in ongoing communication outside those meetings. It is usual practice for the tenants to refer their clients to one another, and even to walk these clients to other on-campus providers.
Luther Keith, the director of ARISE Detroit!, a community organization with an office at the center, said there would be a "hole in the community," were it not for Samaritan Center.
Sonya Stallings has been coming to the primary care clinic at Samaritan Center for more than two years and says the clinic staff have helped her manage her diabetes, lose weight and bring down her blood pressure. A part-time worker at Red Lobster, she has no insurance. She said, "I don't know where I'd go if this clinic was not here.
"The people here are real friendly, and talk to you when you have problems," Stallings said. "It shows me someone cares."
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Trinity to help create 'healthy village' in far west Detroit
By JULIE MINDA
DETROIT — Trinity Health is guiding a collaborative of Detroit nonprofits in a joint effort to build a "healthy village" on Detroit's far west side. The development likely would cluster primary care, behavioral health services, dentistry, early childhood education, fitness and job training. The project aims to address social determinants of health that negatively impact adults and children in the community.
If all goes as planned, by late 2019, a coalition of community organizations will build a "healthy village" on this lot adjacent to an affordable housing development. Trinity Health is helping to facilitate progress on the endeavor.
The project will draw on learnings from the development of the Samaritan Center, a repurposed hospital on Detroit's east side that since 2001 has served as a hub for organizations providing health, social services and other community services.
William Evo is managing the planning phase of the initiative to create the healthy village campus. He directs physician alignment for Trinity's St. Joe's Medical Group and St. Mary Mercy Livonia in Livonia, Mich., about 14 miles away from the site where the project is to be built. Evo said Trinity is helping to facilitate and align the work of partners. Plans call for Holy Cross Services and Covenant Community Care to manage construction and the operation of the health campus.
Holy Cross Services is a children's aid nonprofit that is a lead organization at Samaritan Center; and Covenant Community Care is a federally qualified health center that will open its eighth Detroit clinic in the health village.
As planned, the healthy village would include a newly constructed 20,000-square-foot building with primary care, mental health and dental services. A 40,000-square-foot building on the 8-acre plot will house Head Start and other services. Construction could begin as early as June, with the Covenant Community Care clinic opening as the first tenant as early as September 2019.
Trinity said the campus is in a medically underserved area in the eighth poorest zip code in Michigan. About 64 percent of residents have incomes that fall below 200 percent of the federal poverty level. About 37 percent of households are headed by a single parent. And, nearly 20 percent of residents are uninsured.
More than one-quarter of the housing in the area is vacant. Along neighborhood blocks in the area, boarded up windows, overgrown grass and potholed streets are common. Evo said that there is no hospital and very few primary care providers in the immediate area.
The campus will be built on the former site of a housing project that was demolished in the early 2000s. The Detroit Housing Commission built Gardenview Estates on part of the tract. Opened in 2007, that contemporary and well-kept development has flower gardens, lawns and other landscaping. It includes 541 rental units and 66 homeowner-occupied units, most of them built under Section 8, a housing program for low-income populations administered by the U.S. Department of Housing and Urban Development.
Trinity is gathering neighborhood input on what services would be most helpful at the campus. In addition to Holy Cross and Covenant, potential partners include the Skillman Foundation, a Detroit youth assistance organization; the University of Detroit Mercy, a faith-based school; and the Cody Rouge Community Action Alliance, an activist group. Cody Rouge is the name of a neighborhood near the planned campus.
Evo said a combination of philanthropy and grants will fund the campus development. Trinity and St. Mary Mercy Livonia are providing $400,000 to Covenant to establish its primary care health center at the new campus. Trinity has awarded a separate $250,000 grant to the project as well. Covenant has secured a $1 million grant from the U.S. Health Resources & Services Administration. The partners are identifying other funding sources.
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