An April morning in Oakland, California, is reliably sunny. In a conference room
in the East Bay Asian Local Development Corporation’s (EBALDC) newly redeveloped
office building, representatives from eight organizations gather for a full-day
retreat of the nascent San Pablo Area Revitalization Collaborative. EBALDC’s
two-story office building anchors the southern end of that corridor. The San Pablo Hotel, a
144-unit single-room occupancy residence for seniors, sits on the next block. It is just one of
the twenty-one affordable multi-family residential buildings EBALDC has developed over its
40 year history. Many of the properties it owns and manages are historic structures in what
were disinvested neighborhoods at the time that the developments were built.
The Neighborhood
The San Pablo Hotel stands in stark contrast to most of the real estate along the 1.5 mile
West Oakland segment of San Pablo Avenue – a major north-south thoroughfare that extends
north through six San Francisco Bay Area communities. This West Oakland stretch of the
road is defined by an overpass carrying Interstate 580 to the north and another carrying
Interstate 980 to the south. To the North of the 580 lies the economically prosperous city of
Emeryville and, downtown Oakland, which is on the cusp of a wave of gentrification, sits on
the South side of the 980. EBALDC has focused on the stretch of road sandwiched between
those two freeway overpasses – the San Pablo Corridor – because it is the severely distressed
spine of West Oakland’s McClymonds and Hoover neighborhoods.
EBALDC has been active at both ends of that corridor. Its most recent project was another
former hotel, the California Hotel, at the northern most end of the corridor adjacent to the
I-580 overpass. EBALDC’s purchase and redevelopment of the California Hotel provides an
example of a project that includes an innovative cross-sector partnership that presaged its
PIP-funded activities.
The California Hotel is an architectural landmark. Its history traces the neighborhood’s
trajectory. It was once “a beacon for African-American travelers who experienced discrimination
elsewhere” according to the Contra Costa Times. In its heyday James Brown, Ray Charles,
Billie Holiday, Sly Stone, Aretha Franklin and Big Mama Thornton performed there. In the
1970s, however, after the blighting effects of the elevated 580 freeway construction just yards
from the hotel, the building fell into disrepair. It became subsidized housing in the 1980s
before finally being foreclosed and placed under court-ordered trusteeship. At that point
the building housed very-low income and formerly homeless residents, many with chronic
physical and mental illnesses. The prospect of homelessness and displacement led residents
to organize and institutions to mobilize to save the building and its tenants.
EBALDC raised $43 million in financing to completely rehabilitate the building, creating
137 units of mostly studio apartments, thirty-four of which are set-aside for people with
special needs. To operate successfully, EBALDC recognized the need for supportive services.
Before proceeding with the project, EBALDC partnered with Alameda County Behavioral
Health Services (ACBHS) and LifeLong Medical Care, a community-based Federally Qualified
Health Center with sites throughout the East Bay, to provide on-site support services
to residents. Through innovative financing, EBALDC and its partners fashioned a mechanism
to supplement the resources that ACBHS and LifeLong Medical Care had to provide
services on site. EBALDC also worked with a food justice organization, People’s Grocery, to
support a community garden that it had started on the site.
EBALDC also realized a change in strategy was necessary. Like many other community
developers, EBALDC reflected on decades successfully developing affordable homes for
4,000 low-income people and, despite their expanding portfolio of resident services and
other programs to improve the quality of life in distressed East Bay neighborhoods, these
communities remained centers of concentrated poverty. The persistence of neighborhood
poverty demanded more comprehensive strategies.
The Social Determinants of Health Framework
As EBALDC was considering the need for change, the media ran stories linking the
geographic concentration of chronic health problems to economic inequality, social
conditions and other larger social forces. This “social determinants of health” framework is
evident in “Shortened Lives”: a remarkable five-part series of in-depth reports published in
2010 in the Oakland Tribune based on Alameda County Public Health Department research.
The first installment compared two middle-aged Alameda county residents: one living on
a tree-lined street in ZIP code 94597, where life expectancy is 87.4 years – well above the
78.4 average for California men – and the other living in West Oakland’s 94603 ZIP code.
Life expectancy in West Oakland plunges to 71.2 years. The county’s data corroborates a
significant body of research showing that where you grow-up and live has an overwhelming
effect on your health and life expectancy. The poverty, crime, lack of services, and other
characteristics of chronically distressed low-income neighborhoods like West Oakland’s
94603, contribute to a range of chronic health problems and shortened lives.
Having developed deep roots and relationships in these neighborhoods over many
decades, EBALDC was primed for the social determinants of health framework. The organization
embraced this comprehensive neighborhood health perspective and, in the process,
transformed its approach to community development. The phrase “social determinants of
health” appears in EBALDC’s successful 2011 grant proposal to nurture an age-friendly
community along San Pablo Avenue. The evolution was completed with the organization’s
strategic plan for 2013-2016: Health Begins in the Neighborhoods Where We Live, Learn,
Work and Play. The document makes it explicit:
…We have woven years of experience, programs and projects into a comprehensive “Healthy
Neighborhoods” approach, organized around the interconnected social, environmental and
economic factors that determine the length and quality of an individual’s life. We are shifting
our focus from individual properties and programs to comprehensive solutions that improve
the health and wealth of neighborhoods…
Building the Collaborative
In November, 2013, EBALDC was awarded a grant from the Partners in Progress (PIP)
initiative, a national program funded by the Citi Foundation and managed by LIIF. These
grants were made to organizations that LIIF and the Federal Reserve Bank of San Francisco
described as community development “quarterbacks” in their book of essays, Investing in
What Works for America’s Communities. The PIP grant provided the wherewithal to pull
EBALDC’s new strategic vision from the printed page and to embark on the time-consuming
process of building the cross-sector, cross-silo collaborative in the San Pablo Avenue Corridor.
During the months preceding this April retreat, EBALDC’s executive director, Joshua
Simon, and chief operating officer, Charise Fong, worked to build interest in the San Pablo
Area Revitalization Collaborative. They met individually with various organizations and agencies
serving the neighborhood to explore their interest in developing a collaborative neighborhood
improvement strategy. A few of these meetings were with established partners, like
LifeLong Medical Care. But many were casual organizational acquaintances. Among the organizations
which made preliminary commitments to the effort and attended the retreat were:
- LifeLong Medical Care;
- Saint Mary’s Center, a faith-based organization that serves homeless seniors and runs
a preschool at its building on San Pablo; - People’s Grocery, a spirited organization working to improve equity and access in
the food system, including operating a community garden on the California Hotel
property and programming for its residents; - Alameda County Public Health Department, which conducted the health disparities
research reported by the Oakland Tribune; - East Bay Housing Organization, which conducts grassroots campaigns to expand the
supply of affordable housing; - City of Oakland’s planning department, which had recently prepared the West
Oakland Specific Plan outlining the city’s vision for redeveloping vacant land in the
neighborhood; and - The Federal Reserve Bank of San Francisco, which has been a national convener and
thought leader on how community development and health fields can work together.
In subsequent months two residents of the neighborhood and another community based organization, Healthy Communities, joined the collaborative. Each partner shared
the primary statistical data sources they use to inform their work. Through this process, Lifelong
Medical Care introduced EBALDC to Sutter Health, a nonprofit healthcare network
that operates the nearby Alta Bates Summit Medical Center, which serves many residents of
West Oakland. “We are really impressed with the work and the methods EBALDC is using,”
according to Mindy Landmark, Sutter’s regional lead for community benefits. “They are
thoughtful, open to learn and to feedback.” In December Sutter joined on as a partner and
sent a $25,000 check, its “initial community benefits contribution.” Additionally it offered
support to access Sutter’s data and evaluation resources.
The Partners in Progress (PIP) grant also enabled EBALDC to add a critical new role
for its healthy neighborhoods approach. EBALDC hired Romi Hall as its Healthy Neighborhoods
Manager to coordinate its San Pablo Area Revitalization Collaborative work. As
the participants filtered into the April retreat, they found the conference room lined with
“heat maps” displaying the education, crime, business investment, transportation, and other
indicators of community well-being in West Oakland compared with the city as a whole.
Handwritten signs under each map highlighted one or more of the disparities: 15 percent
unemployment in West Oakland compared to 7 percent; five times more likely to be locked
up as a youth for overwhelmingly nonviolent offenses, etc. EBALDC created the maps for
two reasons: It wanted to provide a compelling illustration of the social determinants of
health framework, and, from the outset, it wanted to nurture a culture that values data as a
programmatic driver. Seeing all of the data together in one room painted a more complete
view of the neighborhood stressors and assets.
The Quarterback Role
The process of assembling its team of partner organizations and planning the retreat
surfaced some of the organizational challenges inherent to serving as a community development
quarterback. Charise Fong, EBALDC’s COO, reflected on the delicate inter-organizational
dynamics:
One of the things we initially struggled with was to define what the quarterback role
actually consists of. There are lots of roles in exercising leadership. Some partners told us,
“We are glad you want to take this on.” But it is a tricky dynamic in leading and facilitating
a collaborative, which is one of the reasons we brought on a consultant as a neutral
facilitator. We are still the convening organization. So we have been very aware about
stepping carefully around those roles. We hold the backbone role now, but other groups
may play that role in the future. What matters to us is that the work gets done and the
outcomes are being achieved.
An influential series of articles published in the Stanford Social Innovation Review
on “collective impact” describes a “backbone” organization as one of the five conditions
for successful cross-sector partnerships. The backbone supplies much of the management,
facilitation, coordination and data collection and analysis required to adequately support
these partnerships. The articles depict the backbone as the back office or infrastructure
collaborators needed to operate smoothly, share data and coordinate activities. Fong
recognized how different EBALDC’s role was at this formative mobilization stage. The kind
of leadership competencies EBALDC was drawing upon to assemble partners and forge
a shared agenda at the beginning of the project may not be the ones the San Pablo Area
Revitalization Collaborative will need in the future.
In its capacity as the quarterback EBALDC sensed the delicate inter-organizational
dynamics at play among a group of such diverse organizations and institutions that have
never before tried to achieve the envisioned level of integration: The neutrality essential to
effective facilitation of retreat and other partnership meetings potentially conflicted with
EBALDC’s organizational self-interests as a participating partner. So, at the recommendation
of a colleague at the Federal Reserve Bank of San Francisco, EBALDC hired Marian
Urquilla as a consultant and facilitator. Urquilla directed a family support collaborative in
Washington, DC for 12 years and had most recently finished a four year stint as director
of program strategies for Living Cities, helping to oversee its Integration Initiative, which
supported an early cohort of cross-sector community development collaboratives. Thus, in
addition to her skilled group facilitation at the April retreat and subsequent meetings and
retreats, Urquilla had the experiential wisdom necessary to guide the retreat participants
through the process and address any content ambiguities that accompany early collaborative
meetings. She also served as a coach as EBALDC navigated the unfamiliar terrain of serving
as quarterback to a broad and aligned collaborative.
Use of Retreats To Build Alignment
The retreat involved both a focus on the human alchemy of building and strengthening
personal relationships among organizational staff unfamiliar with each other and also a focus
on a structured process of building agreements about how to work collectively and how to
construct a shared and holistic strategy out of the chaotic conditions depicted in the heat
maps arrayed around them. The participants agreed to constitute themselves as the steering
committee with the expectation that other organizations would be identified in the future
and gradually added to the collaboration. They agreed to meet monthly. And they grappled
with an issue that was not on the formal agenda: How to engage residents in the planning?
They observed that West Oakland residents had grown cynical about a succession of ambitious
initiatives that later achieved little if anything. This history, the legacy of racism and
disinvestment in the neighborhood and the increasing threat of gentrification and displacement
made it imperative that residents be partners in the development of the collaborative’s
action plan. It was less clear how to achieve this. Who could speak for the neighborhood?
How would they prevent resident participation from disintegrating into factional disagreements?
Was it fair for those seated around the table to be paid for their participation while
residents were unlikely to be?
They agreed to add four residents to the steering committee; two now and two more over
time. They formed an ad hoc committee to propose a process for identifying, recruiting,
orienting and supporting resident members of the steering committee. Acting on that
committee’s advice, at a subsequent meeting they agreed to pay residents $17 an hour, the
living wage rate for Alameda County, for their preparation and participation in meetings and
to cover any related child care and transportation expenses they might incur. By September,
when the San Pablo Area Revitalization Collaborative held its second all-day retreat, two
residents had been selected and were in attendance.
During the second half of the April retreat Tejal Shah, another member of EBALDC’s
staff, led an exercise exploring the social determinants of health framework. Participants
settled on four key determinants: affordable housing, public safety, economic development
and health and wellness. These struck the participants as the most salient issues for the
neighborhood based on a review of neighborhood data and initial input from longtime
residents during a senior summit meeting in 2013. During subsequent meetings and the
September retreat the collaborative fleshed out a theory of change. They called it the San
Pablo Area Revitalization Collaborative Health Resiliency Model. Their embrace of “resiliency”
reflects the partners’ growing sense of the larger economic and political forces continuously
buffeting the neighborhood and the health and wellbeing of its residents. Successful
community development builds a neighborhood’s internal capacity to cope with on-going
change and adversity.
A few weeks after the retreat, EBALDC began the process of engaging residents. At a
community event they set up a photo booth. Residents gathered around the booth and
completed surveys while EBALDC staff took pictures of them holding signs on which they
had written their hopes and dreams for the community. Reflecting back on the day, Romi
Hall said:
Let me just say, it was a hit! We met a lot of people that day. Sixty-six folks completed
surveys. More than 300 pictures were taken and the community members really
appreciated the simple questionnaire, asking them about their hopes and dreams, and
getting a free picture. I’d actually like to build out this strategy next year and host a photo
booth at other community events. It was such a win!Most gratifying, the surveys echoed the four priorities that emerged from the April retreat
– health and wellness, safety and community, housing affordability, and jobs and
income. During the next five months, working groups met to explore these four priorities.
The working groups reported back to the steering committee at SPC Collaborative’s
second all-day retreat. At the end of the day Urquilla, the facilitator, assigned one of the
priorities to each corner of the room. She asked the participants to physically move to
the corner he or she believed the collaborative would be most able to impact. With the
exception of three people, everyone found themselves in the health and wellness corner.
The exercise provided a surprisingly clear dramatization of how partners’ thinking had
coalesced around a shared neighborhood health framework. The partners left the retreat
resolved to treat health and wellness as the leading edge of their collective work.As noted in the summary of their plans, the Steering Committee has adopted core
strategies for 2015-2017 that integrate the collaborative’s efforts across silos. Like the
partnership between EBALDC and Lifelong at the California Hotel, these strategies bring
together collaborative members in innovative ways that leverage the strengths and
resources of each for better outcomes. For example, research has shown that combining
affordable housing plus on-site health services can help to improve the quality of life and
reduce public sector health costs, particularly for populations that are in poor health and
are homeless. The partners are now engaged in discovering and implementing similar
strategies across their silos.This outcome also demonstrates the role a quarterback organization can play when
it has the time and resources to support the partnership formation process. Monthly
meetings and check-ins have enabled partner organizations to build the trust,
organizational commitment and momentum to implement the core strategies described
in SPC’s resiliency model represent proof that the quarterback approach works. Equally
important EBALDC has been changed by the process. Its community development
approach reflects its own transition from a primary focus on real estate to serving as the
quarterback for a multidisciplinary people- and place-based agenda where progress is
measured by the collaborative’s ability to reduce the neighborhood stressors which result
in health disparities.
EBALDC’s experience highlights some of the initial insights about the community quarterback’s
role and the process of building a cross-sector, cross-silo collaborative:
Building commitment and trust
For collaboratives to be effective in integrating people- and place-base strategies, they
need to bring together organizations that often have little or no experience with each other.
The process of building trust and commitment takes time and face-to-face engagement. This
includes both initial one-on-one meetings and group retreats, in this case led by a neutral
and seasoned facilitator.
Quarterback vs. backbone
The literature on collective impact describes the backbone organization as essential infrastructure
for the collaborative. But the QB’s role in building the collaborative highlights a
qualitatively different role. A QB needs to be entrepreneurial and proactive in identifying
potential partners, establishing trust, building commitment, and forging a shared agreement
on the key focus for the collaborative’s work. This goes well beyond the backbone’s function
as the infrastructure and logistics to support the collaborative’s coordination, decision-making,
implementation and reporting.
Data used for understanding and decision-making
Presenting data in a clear, graphic form helps prospective partners reach a common
understanding of the challenges and the forces driving those challenges. EBALDC used heat
maps and other infographics to foster a culture of using data to inform action.
The grantee’s experience also provides promising indications that the community quarterback-driven
model for the San Pablo Area Revitalization Collaborative’s cross-sector and
cross-silo partnership is likely to achieve more together than each member could otherwise
accomplish working independently in their traditional siloed mode:
Strong evidence-based theoretical framework
The research supporting the social determinants of health framework manifests the
extent to which housing, employment and public safety issues, for example, are intertwined
and impact health outcomes. For instance, one study has shown that the best predictor of
whether children with asthma will need to be hospitalized is the percentage of homes that
have code violations in their immediate surroundings. Similarly, there is abundant evidence
that higher levels of chronic illness (particularly for children) can impact the ability of single
parents to get and hold jobs. Organizations face significant obstacles trying to address problems
in isolation from the complex interactions that cause them.
Collaboration as a framework for discovering opportunities for synergy and leverage
The interaction of factors across silos means that changes in activities in one silo affect
outcomes in other silos. The collaborative is the setting in which partners discover opportunities
for attaining improvements in outcomes through the synergistic effect of coordinated
action, and by being able to better leverage existing resources.
Unique resource development opportunities
The Robert Wood Johnson Foundation and Kresge Foundation, along with a group of
other funds, have formed the BUILD Health Challenge to support cross-sector community
partnerships, like the San Pablo Area Revitalization Collaborative, to improve the overall
health of local residents. EBALDC applied on the Collaborative’s behalf to implement the
plan it developed during the PIP planning year and was selected to be one of eighteen
community partnerships in the BUILD Health Challenge, providing external affirmation for
the quality of the partnership and the promise of its plans.
This case study was prepared by Carl Sussman of Sussman Associates and John Weiser of BWB Solutions.