Johnese Spisso, CEO, UCLA Health
c/c Rick Cole, City Manager, Santa Monica
Dear Johnese,
UCLA Health is going from strength to strength under your leadership. Congratulations! I am a resident of Santa Monica and I understand that the hospital is now the largest employer in our fine city. Welcome to "populus felix in urbe felici." For the healthy transportation advocate the car dealerships on Santa Monica Blvd always were a sorry sight. I am sure your new premises there will be a great improvement.
Over many years our city has developed a sophisticated planning process which ensures new developments conform with the long term vision of our community. While you are exempt from most of this process as a state entity, I am sure you will use this privilege with caution and keep in mind your local impacts on our community.
But the relationship between the hospital and its community is also about money. The IRS has certified the hospital as a charity, hence exempting you from local (and other) taxes. As a resident of Santa Monica I personally do not mind that I may now pay a little more for our roads, schools, policing and garbage collection because the tax-paying car dealership will be replaced by a 501c3 entity. But I am extremely interested that the tax privilege is part of a local engagement that makes a real difference in your service area.
Let me outline some pointers how the hospital can become a positive presence in Santa Monica, rather than a tax exempt trip generator, unrestrained by planning guidelines. (Traffic engineers tell us that medical offices do generate a great deal of car traffic)
A recent piece by Danielle Ofri, MD, in the New York Times ("Why are Nonprofit Hospitals so Highly Profitable") has argued that the arithmetical exercise that declares Medicaid losses as a community benefit may be insufficient to justify these tax benefits. Those health fairs she considers marketing pure and simple. That is why improvements in the structure and delivery of community benefits are needed. The community is footing your tax break and it must have a say in the design of such benefits. But delivering benefits from inside the marketing department gives them a self-interested appearance that is most disconcerting. The Bicycle Academy engaged with the Community Health Needs Assessment (CHNA) process recently but were disappointed: The Metro Best program, which would have delivered bicycle safety education for staff, patients or community members at no cost, was not pursued, in spite of our best efforts. Ofri's piece suggests there may be legal remedies.
At the UC Regents Health Services Committee, UC Health CEO Carrie Byington has recently spoken of the need to better present the community benefits the system must provide as part of its tax exempt status. Ambiguity at the highest level is often paired with a real reluctance about proper, hands-on community engagement. Sure, medical research is a benefit for humankind, but what is needed across the road from the hospital in Santa Monica may be funding for a Safe Routes to School program to keep kids healthy and to reduce driving in our community. Because community (and planetary) health suffers greatly from a transport system that discourages the use of active modes, we hope the hospital will establish a Healthy Transportation Committee in conjunction with public health researchers on the other side of Westwood Blvd. Your marketing department will then be keen to place your brand on a local bike share system and underwrite the message that active transportation is healthy. The committee would remind capital programs never to enter into leases that include bundled car-parking. And R Gluckson's message that "unfortunately", "u-n-f-o-r-t-u-n-a-t-e-l-y, there are no bike racks or any place for visitors to park and lock their bikes at your new premises in Glendale" will seem as outrageous as a doctor who recommends smoking. Your director for government relations will then eagerly seek the dialogue with local transport agencies, because he has your back when joining the conversation about community health (obesity, diabetes and cancer) which need to be addressed in the transport domain. Because less drive we must! And if we drive less, we and our planet will be healthier.
Welcome to Santa Monica, Johnese! The UCLA Bicycle Academy and many stakeholders in Santa Monica and on the Westside are eager to assist you to become a shining beacon of healthy transportation. Perhaps a meeting in Santa Monica City Hall with Professor Richard Jackson or another public health expert of your choosing would be a good beginning.
Dr Michael Cahn
Secretary, UCLA Bicycle Academy
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