MTC Transit-Accessible Locations for Health Care and Social Services (2009-2011)

The ultimate goal of this project was to identify ways to improve coordination between public transit operations and decisions about where health care and social service facilities are located, improving access to these essential services, particularly for transit dependent populations. Site planning is a difficult and arcane art, complicated by considerations of cost, land and building availability, proximity to existing facilities, and very often the personal preferences of the decision-makers. Community concerns about the users of health care and social services sometimes lead to NIMBY (“Not in My Back Yard”) responses, further complicating locational decisions.

Health care and social service facilities in Alameda and Contra Costa Counties were mapped in relation to proximity and frequency of transit service utilizing two different databases. Using the larger database which includes social service facilities, only 12% or 81 of the 648 sites had inadequate transit service, defined as no service or less than one bus every 30 minutes stopping within a ¼ mile between 7AM and 7PM. The project also included a thorough literature review of existing policy at the federal, state and local levels, focusing on policies relevant to Alameda and Contra Costa Counties. Outreach participants included elected officials; real estate and development professionals; land use and transportation planners; transportation service providers; social service providers; public health professionals; and community-based organizations.

In order to further the understanding of the decision processes involved in selecting a location for a health and/or social service facility, four case studies in Alameda and Contra Costa were selected for detailed description and analysis. These include the relocation of a county social service office, two community-based medical and social service providers, and the planned relocation of a hospital required for seismic and capacity reasons.

On September 15, 2010, the Metropolitan Transportation Commission sponsored a regional summit as part of its Transit-Accessible Locations for Health and Social Services project. The purpose of the summit was to share key findings from project research into the issues surrounding transit access to these services; and to solicit input on a set of strategies or recommendations for improving location decisions with respect to transit access. Approximately 70 people attended the event.

A series of 23 findings were made based on the input received above. Among the most commented on findings were: “…rent may be as low at 3% of a clinic’s operating cost when including labor costs, benefits, supplies, utilities, etc., so a higher rent level may not represent a significant cost factor in location decisions.” Another key finding was the lack of utilization of existing tools in some cases to facilitate good locations decisions: “The State of California Government Code requires that state, city, and county buildings in metropolitan areas be located in transit corridors unless a finding is made that doing so is not feasible. There is no evidence that this section of the Government Code has been explicitly applied.”

Twelve solutions were offered to decision-makers to improve location decisions of health care and social service agency facilities. Among the solutions were:
1. Agencies and service providers need to survey their clientele and determine if access is a significant problem.
2. Agencies should spend more on rent or property acquisition to locate in a transit rich environment.
3. Longer-term site planning is required to find or develop appropriate spaces that also have transit accessibility.

The complete reports for each task are available for review at http://www.mtc.ca.gov/planning/smart_growth/services/. The project was completed while Cliff Chambers was a Principal of Transit Resource Center

Key Staff: Michael Fajans (Project Manager), Cliff Chambers (Principal-In-Charge), Sean Hedgpeth, Lou Hexter (MIG) Nicole Lewis (MIG)

Project Budget: $196,000

The final report is included below:

FinalReport_F

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