This project will construct an integrated health center with a holistic approach at one site. The Departments of Health Services (DHS), Public Health – Community Medical and Social Services and Wellness Center (DPH), and Mental Health (DMH) would all provide services at this site, resulting in integrated patient care to better serve our constituents in prevention, diagnosis, treatment, care, rehabilitation, and health promotion and wellness. Starting in 2019, Community Wellness Complexes began replacing “Public Health Centers” in Los Angeles County. The vision is regional hubs for planning and implementing health programs and initiatives. The importance of this vision has only been reinforced by lessons of the COVID-19 pandemic regarding benefits of managing the totality of an individual’s health history, as well as the recognition of the interplay between physical and mental health. Five sites have been converted to date; North Hollywood Health Center (NHHC) will be the sixth and final clinic to be transformed into a physical space for promoting treatment, healing and wellness.
The project would demolish the existing single-story building at the site and replace it with a new three-story, approximately 50,000 square-foot building and adjacent parking structure to house the integrated health center. The new center’s vision focuses on an integrated care model, where patients can access services across the healthcare spectrum at a single location, including medical, mental health, and general wellbeing services. This service concept centers around the patients, from primary to urgent care. And just as the pandemic has reinforced the importance of the social fabric, the center will also be a place where communities can come together for peer support or to learn the skills needed to maintain healthy lifestyles. Additionally, this new building will be equipped with the infection control measures necessary to see infectious clients.
The facility will provide primary care, mental health, and other health services to the surrounding community. The building will include examination rooms, phlebotomy stations, patient registration stations, staff break rooms, and other facilities will be shared among different departments to maximize building efficiency, allowing more expansive public areas and streamlining interdepartmental communication. Aside from staff areas, the program will also include a large community conference room with a demonstration kitchen, outdoor community gardens, wellness center, pharmacy, medical legal department, group rooms, exam/interview rooms, and two laboratories. DHS will provide primary care services, while DMH will provide culturally competent outpatient mental health services for adults. DPH will be responsible for Community Medical and Social Services, Wellness Community, Public Health Nursing, Sexual Health/Family Planning, and, potentially, Substance Abuse counseling.
Planned programs and services in the new NHIHC will include:
• Comprehensive primary care
• Sexually Transmitted Infections testing and treatment services
• Family Planning Access Care Treatment (PACT)
• Immunizations
• Laboratory services
• Pharmacy
• Community Engagement
• Health and wellness education and workshops on topics such as:
o Substance use
o Sexual and reproductive health
o Nutrition and exercise
o Chronic diseases
o Oral health
o Emergency preparedness
• Fresh Produce Distributions
• Healing and Trauma Prevention Center with resources including:
o Mental health assessment, triage, and referrals
o Individual and group therapy services
o Crisis intervention services
o Case management and linkage
o Psychiatry services
o Peer-led rehabilitation groups
NHHC will also serve as headquarters for a team of District Public Health Nurses (DPHNs) assigned to the clinic and surrounding communities. Some of their duties include the following:
• Perform communicable disease investigations on individuals, families, and communities (schools, health care facilities, worksites)
• Perform home/site visits to complete disease investigations, provide interventions and recommendations to stop the spread of disease
• Participate in educational outreach and outreach clinics to promote community health and wellbeing
NHIHC services multiple overlapping jurisdictions. NHHC is in East Valley Health District (HD) and adjacent to West Valley, Glendale and San Fernando HDs. NHIHIC is in the larger region known as the Service Planning Area (SPA) 2, which encompasses the San Fernando Valley, Santa Clarita Valley, Burbank/Glendale and the Verdugo regions of Southern California. SPA 2 is a dynamic and diverse area, with a population of neighborhoods that span from resource-rich and affluent to under-resourced and historically disadvantaged. The geographic area of SPA 2 is comprised of 34 cities and communities that include North Hollywood, Burbank, Glendale, Northridge, Pacoima, Panorama City, Reseda, San Fernando, Sunland, Van Nuys, and Santa Clarita.
North Hollywood itself is a community in a Qualified Census Tract (QCT) which has been highly impacted by the pandemic, experiencing over 50,000 cases and nearly 500 deaths by August 2022 (out of a population of nearly 73,000) . While the site itself is rated as “moderate need” by the COVID-19 Vulnerability and Recovery Index, most data averages all of SPA 2 and hides greater need in the North Hollywood area, which is “highest need” according to the 2021 Community Needs Index. As referenced above, the center will serve a diverse set of communities; the location is adjacent to and accessible by multiple neighborhoods that qualify as “high” and “highest need” Under the COVID-19 Index. Several needs – a scarcity of primary care facilities, prevalence of HIV and other STI transmission, homelessness, substance use and overdose, and food insecurity – have been affecting this community for years. All of these issues are areas where the COVID-19 pandemic has wreaked demonstrable havoc, especially upon low-income communities of color. Approximately 70% of North Hollywood’s population is BIPOC , and as a QCT, 50% of its households earn less than 60% of the area median income. The pandemic’s mental health impacts have also been incurred disproportionately, and this community was already distressed in that regard. In SPA 2 self-reported adult psychological distress impaired work/family/social life has increased by 67.9%/68.5%/69.9% respectively from 2017 to 2020, higher than the County average. Yet practitioners such as Open Paths Counseling Center have observed that low-income Angelenos of color face financial, geographical and cultural barriers to accessing mental health services. Thus, establishing a centrally located public health center that provides not only primary care but also mental and behavioral health services will be a critical tool to help North Hollywood and environs overcome the pandemic’s impact.
The facility embraces the innovative “On Stage/Off Stage” medical planning concept, incorporating a highly efficient layout whereby all medical staff circulation paths are separated from the public. Based on this approach, medical staff focus on patients at scheduled time slots and return to a central huddle space to prepare for the next appointment without reentering the public corridors. This concept, and the building layout that supports it, promotes increased workflow efficiency and improves attention to patient interaction. Additionally, this new building will be equipped with the infection control measures, including improved Heating Ventilation and Air Conditioning (HVAC) systems, necessary to see infectious clients.
