Notes from the first call of the BUILD Built Environment Cohort.

1. Built Environment Cohort
Call #1
Monday, May 9, 2016
ATTENDEES:
Albuquerque (MichelleMelendez, FirstChoice
Community Healthcare)
Bronx (Sandra Lobo, Northwest Bronx Community &
Clergy Coalition)
Cleveland (Mandy Metcalf, Environmental Health
Watch)
Denver (Jodi Hardin,Civic Canopy)
Des Moines (ClaireRichmond,Polk County Housing
Trust Fund)
Houston (Katie Chennisi,HarrisCounty Public Health
& Environmental Services)
Los Angeles (Alba Pena, National Health Foundation)
Seattle (ValerieTran, Interim CDA)
Springfield (Jessica Collins, Partners for a Healthier
Community)
Staff:
Courtney Bartlett – BUILD TA Coordinator
(Duke/PPB)
Kenisha Bethea – PL (Duke/PPB)
Laura Trent (Spark Policy)
Katie Miller –PL (Prevention Institute)
Rachel Keller Eisman (BUILD Executive Director)
Catherine Patterson (de Beaumont)
Purpose:To convene the siteswhomayaddressissuesaroundbuiltenvironmentintheir(proposed)
implementationplans,inorderto:
 Learn fromeach otheraboutwhat strategiestheyare considering/implementing
 Forumfor sitesworkingonbuiltenvironmentissues toshare resources,brainstormideas,and
troubleshootissues.
 Share Toolsusedby sitesspecifictoBuiltEnvironmentissues;provide adatabase of additional
toolsthat sitesmaybe aware of or are needing - askparticipatingsitesforcurrenttools/data
metricstheyare usingand if there isa cost related.
 Bringon subjectmatterexpertsasneededtoshare bestpracticesfroman upstream,
community-level perspective.
Site Introductions
Albuquerque,NM
Albuquerqueisdoinglanduse policyworkwith communitymemberstolookattheirownlanduse
patterns. Theyare lookingatlowcost communityorganizerinterventions (e.g.installinglights)asa way
to raise awarenessandjumpstartthe political process. InSouthvalley,theyare building awellness
ecosystemcampus,calledSouthValleyCommunityCommons(SVCC).SVCChasa large federally-
qualified healthcenter,social service providers,andschoolsall co-locatedinone place. The campusis
beingdesignedwith the communitytobe healthpromoting,e.g. walkable,farmersmarkets, easyto
connectto otherdestinations(transit,national wildlife parks,etc.),sothe healthychoice isthe easy
choice.BUILD fundingissupportingthe developmentof acentralizedwellnessreferral system.Providers
can make referralsforthingslike healthyeating, andacentralizedcall centerwill call the patientand
coach themon ways to remove barriers tohealthyeatingand helpthemfollow-through. Theyare also
usingthe capital funds available throughBUILDtoconstruct SVCC.Throughthiscohort, theyare hoping
to learnaboutresourcestoleverage everylittle bittomake the campusa reality.

2. Bronx,NY
The Bronx site overlaiddatafrom a local hospital todohotspottingaroundasthmatriggers andER visits,
to identify buildingswithhighrates of these thingsamongresidents.The Healthy BuildingsProgram
addressesthe rootcausesof asthma triggersbyhelpingtoretrofitthe buildingstoaddressthose issues.
A finance partnerismakingitpossible toprovide incentivestolandlords tomake theirbuildingsgreener.
Theyallowthe landlordsto payback loansthroughenergysavings,sothere are noupfrontcosts. They
are couplingthose programs withresourcesfrom the local healthdepartmentandthe hospital partner
to provide individual asthmamanagementforpatientswithhighlevelsof asthmainthose buildings.
Theyare takinga holisticapproachby buildingapartnershipwiththe landlord,butalsoempoweringthe
tenantsto address triggersintheirapartmentandintheirpersonal lives. Theyhope toshare learnings
and challengesonthe ground. The builtenvironmenttopicarealooksatsocial determinantsof health,
so itwill be importantengage hospitals inthis toeffectively addressrootcauses.
Cleveland,OH
The Clevelandsite isworkingwithMetroHealth(hospital partner),the local communitydevelopment
corporation (non-profit), the cityhealthdepartment, andtwoHispanicorganizations.One goal isto
involve the Hispanic-Latinocommunityin the work they're doing. Twostrategies:1) implement ahome-
visitmodel inthe neighborhood totargetspecificareaswiththe mostdeterioratedhousing.Theyare
buildingthe case forinsurerstopayfor these home visitssotheyhave asustainable source of fundingin
the future. Referrals come fromthe communityandfromMetroHealth. 2) Work onproactive policiesfor
preventivemaintenance of housinginthe neighborhood. Todate,the healthdepartment hasnotbeen
on the database forlead.Theyare workingwiththe healthdepartmentandIT to get themonthat
database so theycan communicate withhousingandcommunity developmentdepartmentstodirectly
linkandtrack leadabatementstrategies andinvestigationsof leadpoisoningin children. Theyhope to
provide aportal that listslead-basedhousing. Theyare alsoworkingwith landlordstopilotstrategiesto
helpbuildpolitical supportlocally andtoencourage landlordstovoluntarilygoafterhealthyhomes
certificates.Clevelandisinterestedinwhatothersitesare doingaroundhousingpolicy(interestedin
DesMoinesrental registry).
Denver,CO
Eastside Unifiedis addressingasthmainfive neighborhoodsineastDenverwhohistoricallyhave
disparities. Theydid notundergothe planningprocessthroughabuiltenvironmentlens,but the
communityhasidentifiedthattheywouldlike toincrease safetyin placesthatimpactchildren. Theyare
interestedinhow the builtenvironmentcanpromote communitycohesion,safety, andplacesand
spaceswhere people come together.
Des Moines,IA
HealthyHomesDesMoinesfocusesonminimizingasthmaby lookingatthe sourcesof household
triggersandlifestylebehaviorsof all familymembers. ThroughBUILDtheyare providing home repair
and/orbehaviorchange suggestions. Theyare alsoupdatingthe rental code inDesMoines,sothere are
manyopportunitiestoincorporate healthyhomeselementsintothatcode.DesMoineswouldlove to
learnaboutneighborhoodorhousing-basedworkandbounce ideasoff people.
Houston,TX
In Houston,theyare developingacomprehensivefoodsystemfor the northernmostpartof Pasadena
(the mostunderserved). Theyare tacklingall aspectsof the foodsystemmodel:production,distribution,
and consumption. Production:Theyare developinganindoorurbanfarm to produce fruitsand
vegetables,andwhichwill includean educationcomponentinpartnershipwith the local community
college andtechnical highschool. Theyare alsopilotingahealthycornerstore andhealthyrestaurant

3. initiative,afood-co-op(calledbrighterbite) withanelementaryschool.Consumption:how are they
gettingthe community toeatthe healthyfoodthey're producing?FoodRx program- workingwithlocal
healthcare providerstoproscribe fruitsandvegetablesthatcanbe redeemedat a local foodbank.Food
scholarshipprogram – workingwithworkforce developmentproviders(ESLproviders) givingfood
scholarshipstooffsetsome of costsforstudentspurchasingfoodfortheirfamilies. Theyare potentially
facinghurdlesaround the urbanfarm site. The propertytheyhave beenplanningtoturnintoan urban
farm needstobe remediated,whichisanunexpectedexpense.Currently,theyare approachingthe city
of Pasadenaanda local economicdevelopmentcorporationtoraise funds.Theydidnotapplyforone of
the BUILD loans,astheydidnot anticipate the costwhentheyappliedlastyear.Theywanttoknowif
any of the other BUILD implementationsitesare doingactive construction,andif so,whattheycould
learnfromthemabout accessto capital and otherfinancingsolutionsthey've come upwith.
Los Angeles,CA
FocusedinsouthLos Angeles,theyare workingcloselywithyouthtodeveloptheiractionplan. Intheir
planningprocesstheyidentifiedthree topicstoaddress:accesstohealthyfood,openspace,andsafety.
Highrates of obesity - accessto healthyfoods - lotsof cornerstoreshave unhealthy foods.Theyare
lookingintoacooperative purchasingprogram, where people canpurchase foodsatlowercosts. They
are workingcloselywith the cityparksandrecreationdepartment toimprove the safetyatparks. They
hopestoshare ideasandlearnfromthe process.
Seattle,WA
The neighborhoodismostlyAsianPacificIslander/immigrant/refugee withconcentratedpoverty,
limitedgreenspace,highcrime,historicdisinvestmentof publicsafetyefforts,andnearthe highwayand
largesttransithub. Theirultimate goal is todevelop acomprehensive neighborhoodhealthactionplan
focusedon1) publicsafety,2) environmental qualityandcleanliness,3) addressingsocial isolation,and
4) limitedopportunitiestobe healthyinthe neighborhood.Theyare exploring waystolayerapproaches
and tackle issues:airqualitystudytomeasure airtoxicsaround the neighborhood,studywithSeattle
University onhealthimpactof communitygardeninneighborhood,grantfromparksand recreation
foundationtotake ona year-longparksandrec programmingtofostersafe andoutdoorspaces.
Workingwithbusinessimprovementtorampup cleanstreetsandpedestrianenvironment.Working
withpolice to addressa homelessencampmentandstorefrontgraffiti issues. Theyaimtoaddresshealth
issueslike asthma, cardiovasculardisease,andlimitedphysicalactivity. Theyare interestedinhearing
whatothersare doingand tipsforworkingcollaborativelywithpartnerstoapproach
Springfield,MA
Springfield(specificallythe OldHill Neighborhood) hasanalyzedtheirdataandconductedcommunity
forumsto identifythe followingissues: social isolation,lackof physical activity,needforhealthierfood,
and issuesaroundhousing.They're partof a safe neighborhoodinitiative involvinglocal/state police, the
sheriff’sdepartment,reentryprograms,25housing service providers,communitycenters,etc.The
challenge isthatthe initiative isnotwell-linkedwiththe residentslivinginthe neighborhood. Theyare
still decidingwhatthe implementationplanisgoingtobe,but are lookingat supportingcommunity
organizingandlinkingto the publicsafetyinitiative,andtophysical activity(e.g.creatingwalkingclubs,
givingstipendstoresidentstoengage them). Springfieldrecentlypassedasafe streetspolicy.Theyalso
have a home’sinitiative where theyare partneringwiththe hospital,serviceproviders,andCHWsto do
home remediation.They're workingwithfolkstodoweatherization,gettingridof mold,fixingleaky
sinks,etc.Cityjustgot moneytodo leadabatementthroughasthmaprogram. Theyare interestedin
howothercommunitiesare takingcontrol of the park sothey're trulyfor play.

4. Discussion
 Katie (Houston) - doesanyone know of particular fundingresourcesforasbestosorleadabatement
that's not specificallyforahome?
o BUILD national staff will lookintothisandidentifyresourcesif possible.
 Sandra (Bronx) –They are tryingto figure out if an air qualitystudy isfinanciallyfeasible andhow
that wouldlook?Canothersrecommendagoodmodel thatis cost-effective?
o Seattle'sChinatown - InternationalDistrictreceivedfundingfrompartnersatPugetSound
CleanAirAgencytoconduct an air toxicsmonitoringstudy. Valerie will share more details
on theirfunding,model,timelinefordatacollectionwithSandra.
o Houston receivedfundingtosupportanair qualitymonitoring study inPasadena. Katie will
ask themthe model they're using.
o Albuquerquewaslookingat Brownfieldsprograms underEPA forcontaminatedsites.
 Sandra (Bronx) - Theirstate islookingtoreduce cost withinhospitalizations. Doesanyoneelsehave
insightintohow tobringthe hospital tothe table as a real partner?
o ClevelandisworkingwithMetroHealthhospital(publichospital).TheylookedatwhatMetro
healthwasalreadyfocusedon – MetroHealth hada transformationplanaddressingthe
neighborhoodsrightaroundtheirhospital.MetroHealthprimarily pledgedin-kind
contributions tosupportthe asthmahome-visitprogram. A portionisactual dollars. The key
isto alignwithsomethingtheyare alreadyworkingon tofacilitate partnering/collaborating.
Workingwiththe hospital hasbeenchallengingbecause they are sobig,butthey're luckyto
have goodhospital partners(fundraisingperson,greatatnegotiatingthe in-kindmatch) and
she connectedthemwithacommunityoutreachpersonaddressingthe Latino communityat
MetroHealth.
 Alba(LosAngeles) –Albaisinterestedinlearningmore aboutthe centralizedwellnessreferral
centerand the call-centercomponent.LosAngeleshas acomponenttoinclude the clinicsina
referral program. They receivedsome pushbackfor feasibility.
o Albuquerque’sprogramis nottechnically usingprescriptions. Theydon’twantto slowdown
the clinicprocess. Theirprocessdon'trequire alotof paperwork – justtwolinesof a form
that a patientisbeingreferredfor awellnessactivity(e.g. healthyfood/activelivingand
CDSMclasses),andIt’sup to the call centerto take on the legwork.Otherpieces: mobile
farmersmarket(at healthcenterspecificdaysof the week).Presbyterianhealthcare services
are subsidizingthe costof local food. That isachievable whenyouprovide coupons,snap
benefits,anddouble upbucks.Afterpatients attendthe farmersmarketone time, theyget
intothe marketingsystem toreceive textreminders.Havingadoctorchampionwaskey.
Otherdoctors are now interestedinhow theygettheirpatientsthatservice.
o Who managesthe call center?Communityorganizationrecipientof the BUILD award. This
non-profitalreadyhadagrant fromthe AgingandLong TermServicesDivisiontoprovide
phone-basedenrollmenttoMedicaidandSSI.Theyadded the wellness referral center
resource to theirexistingcall-centeroperationandtrainedexistingpeople.
Themes across Sites
Sitesare interestedinhearingmore onthe followingtopics:
 Strategies forengagingthe cityonpublicpolicyrelatedtohousingandbuiltenvironment
 Hospital engagement

5.  Fundingforremediation (includinghousingandfarming)
 Park andrecreationsafetyissues
 Asthma,airqualityresources/tools thatare feasibleandcosteffective
 Cleanstreets,store fronts
 Weatherization,mold,lead
 Accessto healthyfoods(mobile markets,communitygardens)
 Workingwithlandlordsinthe remediationprocess(buy-in)
 Healthyhomes
Conclusion and next steps
 Sitesfoundthiscall useful.
 Decidedtomeetbi-monthly movingforward –nextmeetingwillbe scheduledforJuly.Pleasefill
out thisdoodle poll withyouravailability.
 Communitieswillsend anyresources/tools they have beenusingorfound helpful relatedto
builtenvironment andwe will compilealist.
 Courtneycreateda listservforthiscohorttoshare resources,ideas,andtroubleshootissues.
You shouldhave receivedaninvite,butif not,email Courtney andshe canadd you.
o To use the listserv,justsendanemail to built-environment-cohort@googlegroups.com