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Florida Hospital Partners with the Bithlo Transformation Effort
In 2009, the newly formed nonprofit United Global Outreach (UGO) joined with the people of Bithlo, Florida, to launch the Bithlo Transformation Effort. A rural community of 8,200 located 13 miles east of Orlando, Bithlo had little infrastructure or basic services and struggled with high levels of unemployment and homelessness and low levels of academic achievement. The Transformation Effort ambitiously addresses nine issues of community focus through a broad partnership, which UGO hopes will serve as a model for transforming impoverished, forgotten places. Participants in the Transformation Effort have grown from UGO and Bithlo residents to a network of 100 organizations, including Orlando’s Florida Hospital, which agreed to become an anchor partner in the effort in 2011. In 2015, Bithlo won a Roadmaps to Health Action Award from the Robert Wood Johnson Foundation and a NOVA Award from the American Hospital Association for the substantial strides the effort is making to transform Bithlo into a healthy, vibrant community.
Attending to a Neglected Community
Bithlo’s municipal government went bankrupt and ceased to function in 1941, but the community was not technically unincorporated and placed under the jurisdiction of Orange County until 1977. As a result of spending decades in governmental limbo, the community lacked public water and sewer systems, had no public transportation or sidewalks, and could not secure environmental remediation of polluted sites. Residents had to leave the community to buy groceries, see a doctor, or obtain adult education and other social services. This situation caught the attention of Tim McKinney, the vice president and founder of UGO, who was interested in community revitalization through the formation of local partnerships. “Relationships have more value than money,” McKinney says. UGO began conversations with Florida Hospital in 2010, in part because the hospital, which is a member of the national Adventist Health System and the third-largest employer in Orlando, is an influential anchor institution.
For its part, Florida Hospital was interested in addressing the social determinants of health — the broad social and environmental conditions that affect people’s health. The hospital regularly undertakes international mission work as part of its commitment to service, but it was also interested in making a difference closer to home. The Bithlo Transformation Effort appealed to the hospital specifically because it offered the opportunity to provide local assistance beyond health care, in whatever form was necessary to facilitate a broad community transformation.
A Place-Based Transformation
The Bithlo Transformation Effort has influenced almost every aspect of community life: education, transportation, housing, health care, environment, basic needs, sense of community, economic opportunity, and arts and athletics. Many of the changes are concentrated in three locations: Transformation Village, Medical Village, and Dignity Village.
Transformation Village will serve as the nucleus for a community without a true center, designed around a property donated by the First Baptist Church of Bithlo in 2009. The church has been converted to Orange County Academy, a private, 40-student school for Bithlo children who are unlikely to succeed in a traditional education environment. As of February 2017, Transformation Village also features a model home funded by Florida Hospital as a demonstration of the houses planned for Dignity Village. The power of relationships is apparent in the way Transformation Village arose. In addition to the church’s donation of the land and buildings for Orange County Academy, one of Florida Hospital’s vendors contributed the necessary renovations. Physicians and other staff from Florida Hospital regularly volunteer at the school and, during one school year, donated uniforms and bicycles to all students. The University of Central Florida, at Florida Hospital’s request, dispatches nurses from their training programs to provide the children with health assessments. These and other partners will continue to participate in projects at Transformation Village, including a community library, aquaponics center, community center, commercial kitchen, community laundry, coffee shop, and hair salon. Before these features can be added, a new well and septic system must be installed and the power grid must be updated, improvements expected to be finished in early 2017.
Medical Village, located two-tenths of a mile from Transformation Village, has a federally qualified health center run by Community Health Centers, a nonprofit UGO approached in 2010. Florida Hospital donated a modular building to house the clinic, which includes its own laboratory. Volunteers from Florida Hospital staff a mobile dental unit supplied by the Orange County health department several times a month. This program is dedicated to “restoring whole smiles,” improving not only the health of patients but also their confidence and job prospects. Medical Village will expand to eventually include a larger Community Health Centers clinic, a pharmacy, and facilities for behavioral health and dental services.
Dignity Village will provide safe, healthy, green housing as an alternative to the dilapidated trailers occupied by many residents. Hoping to inspire private developers to provide innovative affordable housing in Bithlo, UGO is coordinating the 5-acre project, which will consist of 43 small, detached houses constructed by New Dignity Homes. Rent will be set at 30 percent of the resident’s income. The center of the new neighborhood will be a community house with amenities for residents and space for visiting service providers.
In addition to developing the villages, the Bithlo Transformation Effort is addressing pressing communitywide concerns such as transportation, economic opportunity, and the environment. Bus service has been restored after years of absence. The Florida Department of Transportation is expected to complete the expansion of a dangerously narrow bridge near Bithlo in 2017. These transportation improvements were championed by former U.S. Representative John Mica, who became interested in the Transformation Effort after discussions with UGO.
UGO, Florida Hospital, and other partners also collaborated to persuade Orange County to install public water and sewer facilities along State Road 50, the main commercial corridor through Bithlo, which will encourage new business and employment opportunities. In part because of the community’s lack of infrastructure, Bithlo’s major industry has historically been junkyards, which limited job opportunities and contributed to the water and soil contamination that the Transformation Effort is working with Orange County to remediate. To address economic opportunity more immediately, Florida Hospital worked with one of its construction vendors, Brasfield and Gorrie, to launch Hire Local Bithlo. In this program, Brasfield and Gorrie trains residents in the construction trades; after residents complete their training, they can pursue employment at Brasfield and Gorrie or with other firms.
Moving Forward: Bithlo and Beyond
According to McKinney, UGO, Florida Hospital, and their many partners will stay as long as it takes to transform Bithlo into a healthy community. This effort has already resulted in substantial improvements, reducing emergency room visits for nonemergency health care and bringing in nonprofits like Harbor House of Central Florida to serve victims of domestic violence and Aspire Health Services to provide behavioral health services. Moving forward, UGO plans to apply its relationship- and place-based model to other municipalities and neighborhoods in Central Florida and has begun a similar initiative in a Detroit neighborhood as part of the organization’s mission to go into any community that invites it. UGO also plans to pursue relationships with other hospitals in the Adventist Health System, and the health system is pursuing local partnerships around the country at its 43 other member hospitals following Florida Hospital’s successful experience in Bithlo.
Interview with Tim McKinney, vice president and chief executive officer of United Global Outreach, 7 December 2016; Robert Wood Johnson Foundation. 2013. “How Do You Transform a Community After a Century of Neglect?” Culture of Health (blog), 20 November. Accessed 25 November 2016; Natalie Orenstein. 2016. “Building Health Organically in a Small Florida Community,” Build Healthy Places Network (blog), 20 May. Accessed 29 November 2016; Stakeholder Health. n.d. “Case Study: Bithlo Transformation Effort.” Accessed 25 November 2016.×
Florida Hospital. 2015. “Florida Hospital receives national honor for Bithlo transformation efforts,” press release, 14 July. Accessed 28 November 2016; American Hospital Association. 2015. “2015 AHA NOVA Award.” Accessed 28 November 2016; United Global Outreach. n.d. “About Us.” Accessed 28 November 2016.×
Interview with Maureen Kersmarki, director of community benefit and public policy at Adventist Health System, 15 December 2016; U.S. Department of Health and Human Services. n.d. “Social Determinants of Health.” Accessed 16 December 2016.×
Interview with Tim McKinney, 7 December 2016; United Global Outreach. n.d. “About Us.” Accessed 28 November 2016.×
Interview with Tim McKinney, 7 December 2016.×
Interview with Tim McKinney, 7 December 2016; Interview with Maureen Kersmarki, director of community benefit and public policy at Adventist Health System, 15 December 2016.×
Interview with Tim McKinney, 7 December 2016.×
Interview with Tim McKinney, 7 December 2016; Taylor Shaefer. 2015. “Bithlo Water Contamination: Coming Together to Make a Difference,” news, 6 April. Accessed 29 November 2016.×
Interview with Tim McKinney, 7 December 2016; Florida Hospital. 2015. “Florida Hospital receives national honor for Bithlo transformation efforts,” press release, 14 July. Accessed 28 November 2016; Interview with Maureen Kersmarki, director of community benefit and public policy at Adventist Health System, 15 December 2016.×
Interview with Maureen Kersmarki, director of community benefit and public policy at Adventist Health System, 15 December 2016; Interview with Tim McKinney, 7 December 2016.×