A digital rendering of the center.

When Baltimore Medical System (BMS) decided to build the new Highlandtown Healthy Living Center in one of the unhealthiest neighborhoods in Baltimore city, one of its main goals was to demonstrate how a healthy environment contributes to healthy living. East Baltimore is known for its high health disparities and many of the patients served by the center suffer from illnesses related to their home environment -- skin diseases, asthma or lead poisoning.  BMS wanted the health center to educate people about healthy living outside of the health center.

As a Federally Qualified Health Center, BMS’s mission is to provide accessible, affordable health care to the thousands of people who may be uninsured or facing other barriers to care.  They deserved and needed a building that was good for their health.

Designing a center for this population presented some unusual opportunities for project architects RM Sovich Architecture, builder Highlandtown LLC and BMS staff. At the heart of BMS’ mission is patient-centered care, so the new Highlandtown Healthy Living Center needed to be more than a center that delivered quality healthcare -- it needed to be a place that helped people understand how to live healthier lives.

Since so many of its patients are newly arrived from developing countries, they have little familiarity with facilities such as a health center; the design needed to make them feel safe and comfortable. It was not enough to have a building that was “healthy,” with rapidly renewable and environmentally friendly materials -- the connection between a healthy environment and a healthy lifestyle also needed to be clear to patients.

The finished Highlandtown Healthy Living Center.

Thinking Practically While Going Green
Formerly a city-owned parking lot, construction for the 32,000-square-foot Highlandtown Healthy Living Center began in October 2009 and was completed in March 2010. The $10 million center was designed to meet LEED Platinum certification, which was officially awarded in July, making it the first Federally Qualified Health Center in the country to receive this designation.

During construction, 87.7 percent of unused construction debris was recycled, and 20 percent of building materials came from within 500 miles of the center, reducing the construction process’ impact on the environment.

When implementing green elements into the design of the building, it was important for BMS to consider how the overall center and the modular spaces within it would be used.

The center is designed in “neighborhoods” so that sections can be closed off when not in use in order to reduce wasted energy. The exam rooms are deliberately designed to be interchangeable so that if more obstetrics rooms are needed on a particular day, they can use the next grouping or “neighborhood” of rooms.

The waiting room includes reclaimed wood beams around the patient registration area and resin panels that allow for privacy but still permit light to access the space.

Nature's Role in Health
A white membrane roof reflects the sunlight, protecting the building from the heat of direct sunlight resulting in lower energy usage and expense.

The center employs an energy-wheel HVAC system that brings in fresh air and monitors and automatically adjusts the interior temperature based on the outside temperature. This is proven to alleviate “sick building syndrome.”

BMS also created green spaces in a neighborhood sorely lacking outdoor areas for residents. At the entrance of the center, patients walk past Baltimore’s largest rain garden. Volunteers both maintain the garden and serve as sidewalk “educators” about the importance of nature to one’s health and the role the garden plays in filtering rainwater before it goes into the city’s storm drains and eventually the Chesapeake Bay.

The value that natural places play in health is further illustrated on the second-floor landscaped terrace adjacent to the patient waiting room. Native plants combine with child-friendly vegetables in boxed gardens not only to provide patients a calm place to wait for their appointments but also to provide tips on urban gardening.

The kitchen, which is also used as community recreation space for public programming,  includes cork flooring, recycled and reclaimed furniture, energy-efficient lighting that shuts off automatically when the room isn't in use, and low-VOC paints.

Making the Connection
To help patients understand how the center was designed to be “healthy,” BMS staff members have been trained to explain the building’s green features and are encouraged to provide patients with informal tours as they move through the center. Due to the diverse languages spoken by patients at the Highlandtown Healthy Living Center, rather than use signage to explain the green features of the center, BMS has launched community programming to educate its patient population about healthy lifestyle choices such as using natural cleaning products and creating a home environment that minimizes triggers for health problems.

While BMS understands that all of the green elements of the center cannot be replicated by patients in their homes, it hopes that patients will begin to understand and adopt some of the elements that make up a greener, healthier lifestyle.