Brownfields
    Success Story
                              .
    A New Home for  Affordable

    Health Care  on  the Hilltop

    Tacoma, Washington

    For decades, fears of contamination from nearby gas stations deterred
    potential investors from the vacant properties along Martin Luther King Jr. Way
    in Tacoma's Hilltop neighborhood.

    But a local health care clinic overcame reluctance to redevelop one of these
    brownfield properties. The clinic snatched up a small corner lot that was the
    site of an old grocery store, built in 1931 and repurposed over the years as
    equipment storage and office space. New life was coming to the Hilltop.

    Investors wanted to  build a larger, multidisciplinary clinic, the Hilltop Regional
    Health Center. Before redevelopment could happen, the question of possible
    contamination and what to do about it had to be answered. Enter the
    U.S. Environmental Protection Agency's (EPA) Targeted Brownfields
    Assessment Program.

    The Opportunity

    Community Health Care (CHC), a  nonprofit organization providing health
    services for low-income and uninsured residents in Tacoma and in Pierce
    County, has had a clinic in the Hilltop neighborhood since 1969. The clinic got
    its start in the basement of the nurses' convent at nearby St. Joseph Medical
    Center, where it was staffed by volunteers. In the late 1980s, the Downtown
    Clinic, as it was known, purchased its own site, where it would remain until 2013.

    By the early 2000s, CHC leadership could see that the Downtown Clinic was
    outgrowing its space. To better meet the needs of this diverse, economically
    depressed neighborhood, CHC began looking for a new location where it could
    expand. Eventually, the organization purchased the 1-acre parcel at 1202 Martin
    Luther King Jr. Way,  which was just two blocks away from the existing clinic and
    had a parking lot.

    The site offered another major benefit: The property lies right in the middle of
    Tacoma's "Medical Mile" between two major regional health centers-MultiCare
    Health Systems  and  CHI Franciscan Health.
xvEPA
EPA Assistance Recipient:
Tacoma-Pierce County
Health Department

Assistance Type:
EPA Targeted  Brownfields
Assessment

Former Uses:
Grocery store, equipment storage,
mental health  agency and
college campus

Current Use:
Hilltop Regional Health Center
    United States
    Environmental Protection
    Agency
                                                                    building
                       eery store
                     her King Jr. Way.

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Site preparation began in September
2012 with removal of the old building.
     From the
     public health
     standpoint, CMC
     will  provide
     increased access
     to health care in
     a neighborhood
     with higher rates
     of poverty and  a
     high percentage
     of ethnic
     minorities. Plus,
     the area holds
     great promise for
     future  economic
     development. JJ
                Gregory Tanbara
               Health Promotion
                     Coordinator
          Tacoma-Pierce County
             Health Department
The  Environmental Assessment

Because the site was surrounded by old gas stations, environmental concerns
about the soil and groundwater needed to be investigated. Tacoma-Pierce
County Health Department had worked with EPA for more than 10 years to
assess contamination at former gas stations in the area. In January 2011, the
department applied for assistance through EPA's Targeted Brownfields
Assessment Program to evaluate CMC's new site. Under this program, designed
to help minimize the uncertainties of contamination associated with brownfields,
EPA directs a contractor to conduct environmental assessments to address the
requestor's needs.

"We made the argument that the EPA assessment would be a worthwhile
expenditure of public funds because the project would help increase CMC's
capacity to provide health care, especially preventive care, to a lower income
neighborhood at a time when the Affordable Care Act was taking shape," says
Gregory Tanbara, health promotion coordinator at Tacoma-Pierce County
Health Department.

In April 2011, EPA and its contractor conducted a site visit to assess the old
building and surrounding land. Soil borings and temporary groundwater
monitoring wells followed in June 2011. By September of that same year, the
assessment was completed. The final report brought good news. "The Targeted
Brownfields Assessment concluded that no contamination was present," says
Joanne LaBaw, brownfields project manager with EPA Region 10 in Seattle.
"Therefore, cleanup was not necessary, and CMC got the green light  to proceed."
The  Fundraising
Even with the contamination question settled, CMC still faced a fundraising
challenge to bring the new Hilltop Regional Health Center to life. A $12 million
grant from the U.S. Department of Health and Human Services' Health Resources
and Services Administration jumpstarted the nearly $26 million project. Russ
Sondker, who oversees marketing and resource development for CHC and
spearheaded the capital campaign, says the grant advanced the project in two
ways. "First," he says, "it was one of the first donations we received, and it gave
the fundraising effort a big boost at the beginning. Second, the grant enabled us
to build a larger project, since it significantly increased the amount of funds we
could raise."

Another critical piece of the financing puzzle was new markets tax credits, which
enable individual and corporate taxpayers to receive a credit against federal
income taxes for investing in qualified community development entities in low-
income communities. CHC raised $7 million in such funds.

Justin Morrill, CHC's capital campaign director, and his team also landed a
$1.5 million grant from the state and an $800,000 loan from the City of Tacoma
through the National Development Council's Grow America Fund. Rounding out
the capital campaign were funds from private donors, corporations and private
foundations, including 405 individual donations totaling $1,050,843.

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                                                                                                                               "'iii
The  Redevelopment
Financing in hand, CMC broke ground in September 2012 with demolition of the old
building. And, in just over a year's time, in November 2013, construction was completed.

The new three-story Hilltop Regional Health Center is a mixed-use development that
includes medical and dental clinics, a primary care medical residency program, a pharmacy,
specialty medical services, internal medicine and obstetrics, pediatrics and urgent care
services. Retail space is available at street level. A multistory parking structure was also
built on the west portion of the site.  There's even a community room that people can use
at no charge.

Architecturally, the new facility's brick facade is reminiscent of the old building. The new
structure is adjacent to the sidewalk, helping create a more pedestrian-friendly street
environment. "The clinic occupies a key intersection in this business district," Tanbara says.
"Historic traffic flows hit that corner. Buses stop there. We're looking forward to more than
100 employees and  200 patients and visitors coming  and going every day. The clinic will
bring more activity to the area. It'll be good for the  neighborhood."

In fact, in recognition of the environmental and community-friendly features, the new
facility earned silver certification under the U.S. Green Building Council's Leadership in
Energy & Environmental Design (LEED) program.
The  Benefits
The new health center is one of the first in the nation to co-locate medical residency
and nursing, dental and pharmacy internship programs in one facility, making a cross-
disciplinary training environment possible. "Medicine, dentistry and mental health
are usually looked at separately," Tanbara says. "In Pierce County, we're focusing on
collaboration. This is a key strategy for improving coordinated health care."

In addition to providing health care services, the facility is staffed with medical social
workers who can help patients, including non-English speakers, navigate the challenges of
dealing with insurance, Medicare and Medicaid.

The new Hilltop Regional Health Center is also taking pressure off of the emergency rooms
at the two nearby hospitals and reducing the burden on the health care system. "A lot of
people who didn't have insurance went to the emergency rooms," Tanbara says. "You'd
see people with diabetes issues and chronic situations turn up in the emergency room.
CHC provides a medical  home where people can engage in preventive care instead. A visit
to CHC might cost $150 versus a $1,500 visit to the emergency room.  CHC provides an
opportunity for a good number of people to approach their health care differently. And
that's  a good thing."

During construction, the project created more than 250 local jobs, and nearly 140
permanent employees now staff the health care center. Plus, the clinic will serve a total of
17,200 patients annually, 600 percent more than at the old Downtown Clinic.

"The Hilltop neighborhood is an area of rental homes, vacant buildings and poverty," CHC's
Sondker says. "This project is the first major investment in the area in many years. Getting  the
environmental work done on this site will encourage others to do the same. We hope that this
clinic and  those who it brings to the neighborhood will start a revitalization of the area."
Energy-efficient lighting and natural
building materials helped  CHC qualify
for LEED silver certification.
  For more information:
  Visit the EPA Brownfields website
  at www.epa.gov/brownfields
  or contact Joanne LaBaw at
  (206)553-2594 or
  Labaw.Joanne@epa.gov.

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