Oculus - Spring 2016 Institutional Shifts - (Page 32)

feature ©Francis Cauffman U A More Perfect Union The Hotel Trades Council's new mixed-use medical center transforms the healthcare experience while taking cues from the neighboring BAM Cultural District ©Francis Cauffman BY BILL MILLARD (top) The undulating façade of the Brooklyn Health Center features fritted glass and vertical metal fins that cast ever-changing shadows while aiding thermal performance. (above) The ground floor will feature retail and a restaurant with a landscaped plaza facing BAM Park across the street. 32 Oculus Spring 2016 nderstanding the building rising at 620 Fulton Street requires jettisoning certain preconceptions. Forget the image of labor unions as narrowfocus organizations vulnerable to corruption and declining in influence. Abandon fatalism about the U.S. healthcare sector as a morass of perverse incentives that underperforms relative to other nations in actually promoting health. These impressions may be true elsewhere, of course, but not at 620 Fulton. The New York Hotel Trades Council (HTC) engaged Francis Cauffman for an ambulatory-care building that used the streamlined-care model of its successful Harlem Health Center. But first the design team suggested the HTC think bigger, according to James Crispino, AIA, Francis Cauffman's president and design principal. "We don't think you should build a 60,000- to 65,000-squarefoot building," he recalls telling the client. "We think you should be building a building as large as 200,000 square feet," which would optimize the allowable scale. Instead of an insular singleuse facility, Crispino and colleagues envisioned a multifunctional commercial and institutional magnet for jobs and energy. His team proposed sandwiching four stories for the clinics below commercial space and above ground-level retail and a restaurant, and a public courtyard - 12 stories and 187,000 square feet in all. "It took them about a second and a half " to say yes, he recalls, "one of the shortest board presentations I've ever made in my life." In design, operations, and community integration, the Brooklyn Health Center finds new ways to boost the health of both its members and its neighborhood. Straight to the point The HTC is a unique client. "We're responsible for providing benefits to about 30,000 unionized hotel workers, about 10,000 retirees, plus their dependents," notes medical director Robert Greenspan, MD, CEO for HTC's Employee Benefit Funds. "That's about 90,000 union lives." Rather than contract to health insurers, HTC provides care directly, employing "about 250 physicians, 60 dentists, 20 pharmacists - about a thousand people in all," Greenspan says. "And we've been doing it for about 65 years." He answers to a board equally representing major New York City hotel chains and nine hotel-industry unions. By eschewing marketing, profits, and top-heavy administration, and by minimizing negotiation-related friction through unusually long-range contracts, HTC achieves impressive efficiency in providing patient care. "It's Institutional Shifts

Table of Contents for the Digital Edition of Oculus - Spring 2016 Institutional Shifts

Letter from the President
Letter from the Editor
Center for Architecture
One Block Over
Opener: The Intersection of Technology and Walkability
The Challenges of Expansion
A Win-Win at Rockefeller University
Course Requirements
1,087 Windows (and a Unique Focus) on the City
Tech Time
Playing a New Tune
A More Perfect Union
Social Innovation by Design
In Print
117-Year Watch
Last Words
Index to Advertisers

Oculus - Spring 2016 Institutional Shifts

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