A Community Education Partnership UIW School of Osteopathic Medicine at Fox Tech August 28, 2013 Dr. Sylvester Perez Dr. Lou Agnese Superintendent President and CEO San Antonio ISD University of the Incarnate Word
August 28, 2013
Syl and Lou,
Centro Partnership welcomes this opportunity to present our recommendation for the University of the Incarnate Word and San Antonio ISD to lead a Community Education Partnership (CEP); anchored by UIW’s School of Osteopathic Medicine at Fox Tech. Our vision is for the CEP and the school to be a magnet that brings together students, educators, the health care industry and the public sector to find solutions to today’s education and health care challenges in our community.
Collaboration between SAISD and UIW will drive the success of this vision, and:
• Help UIW and SAISD advance their respective educational missions • Deliver fair value to SAISD for its land holdings and provide sustainable education and career development support for SAISD students and faculty • Provide UIW with a platform at a location in the heart of UIW’s student base and at the core of the downtown medical district to build upon its successful health degree programs • Anchor complementary development in downtown San Antonio’s Northwest Quadrant
Through a formal Education Partnership Agreement, SAISD and UIW can formulate an action plan to unite SAISD’s health magnet program with UIW’s health-related degree programs.
The collaborative effort is the educational foundation, but we also need a physical foundation. To achieve that end, Centro has identified needed infrastructure improvements that will require public sector support. We have also identified state programs that could support education initiatives.
Before we collectively pursue public sector support, we need to confirm your commitment to our proposed site. We respectfully request that you do so by signing the enclosed non-binding Letter of Intent, which spells out the deal points outlined in our recommendation.
In closing, let us say that it’s been a pleasure to work with you and your leadership teams. We congratulate you both on your willingness to explore a partnership that can have a real impact -- from increasing the number of health care providers to expanding opportunities for students and faculty.
As you begin to put your partnership plans in place, please let us know how we can be helpful.
Sincerely,
Pat DiGiovanni Don Frost President and CEO Volunteer Chairman table of contents
I. Executive Summary...... 5
II. The Need...... 7
III. Community Education Partnership...... 15
The Concept...... 15
The Location & Site Plan...... 20
The Value Equation...... 37
IV. The History...... 41
University of the Incarnate Word...... 41
San Antonio Independent School District...... 42
V. Downtown San Antonio...... 45
VI. Next Steps...... 49
executive summary
I UIW School of Osteopathic Medicine at Fox Tech
Throughout South Texas, there is a growing demand for health care services, but a shortage of providers across the professional spectrum. With a growing population and insurance mandates linked to the Affordable Care Act, the demand for services will grow exponentially. For the Hispanic community, which historically has been underserved and underrepresented in health care, the situation is particularly bleak.
San Antonio needs to recruit, educate and retain talented students who share a passion to serve in health care professions. The city benefits from two educational institutions, the University of the Incarnate Word and the San Antonio Independent School District, that are committed to health-related education programs that can help close the talent gap. San Antonio also offers something that students may not find in other professions -- an excellent job market in San Antonio’s fast-growing health and bioscience industry.
These positive factors, coupled with UIW’s plans to launch a School of Osteopathic Medicine and SAISD’s desire to expand its health magnet program, create a great opportunity to fill the pipeline of health career candidates. Centro Partnership’s vision is to leverage these assets to launch a Community Education Partnership (CEP) -- an initiative to bring together students, educators, health care professionals and businesses and the public sector to: • Enhance, integrate and sustain the health-related educational opportunities necessary to prepare and grow the health care work force in San Antonio. • Bridge K-12 with higher education to create a K-16 system that forms the building blocks to opportunity and success. • Retain home grown talent and brainpower to serve the needs of San Antonio and surrounding areas.
Built at the right location, the UIW School of Osteopathic Medicine can form the CEP’s foundation. Centro Partnership believes that the best location is in downtown San Antonio. Our recommended site, adjacent to the Fox Tech Campus, is: • In the heart of the city. • At the core of a population base that statistics show is underserved and underrepresented in health care.
5 • Centrally located between multiple health care service providers and prospective partners. • Adjacent to a health careers magnet school that has great potential for growth.
At the Fox Tech site, UIW’s School of Osteopathic Medicine becomes an anchor that will symbolize progress towards Mayor Castro's "Decade of Downtown" vision. The focus of our recommendation, however, is not downtown development. It’s not about a real estate transaction, even though one between SAISD and UIW is required. IT IS ABOUT the ability of the Community Education Partnership to meet a significant community need through investment of money, time and talent.
UIW plans to invest nearly $50 million to launch the medical school, $5 million to support a parking garage, $1.5 million to enhance SAISD’s health magnet program, and an estimated $17 million (over 25 years) in grants to SAISD students and faculty. UIW will also invest its people to support an Education Partnership with SAISD. UIW’s return on investment is access to 3 acres of valuable SAISD land, to key clinical partners in the downtown medical district, to a pipeline of SAISD students and faculty, and to donors that will see value in the CEP platform.
SAISD will invest roughly 3 acres of land appraised at more than $3 million. It also has invested $7.5 million to upgrade the Fox Tech Campus. It is committing its people to support the Education Partnership. SAISD’s return on investment (cash payment, net land value appreciation and student and faculty grant awards) totals nearly $24 million over 25 years ($18M in today’s dollars.)
The public sector has the opportunity to invest $11.9 million in infrastructure improvements and another $800,000 in incentives to support the UIW Medical School and the CEP. The return on investment for San Antonio and nearby or surrounding communities is higher-performing students, a talent pool of prospective health care professionals, two vibrant educational institutions in UIW and SAISD and a healthier community.
6 the need
II Health Care and Education
You must never so much think as whether you like it or not, whether it is bearable or not; you must never think of anything except the need, and how to meet it. - Clara Barton Founder American Red Cross
This quote from the founder of the American Red Cross, speaks to the heart of what it takes to meet need. Complain and your complaint will still echo tomorrow. Wish for change and your wish will remain just that, a wish. But focus on the need, act on your ideas, and that need may very well be fulfilled.
Of course, the health care and educational needs of San Antonio and South Texas will not magically be met by our proposed Community Education Partnership. There will still be a shortage of health care professionals. There will still be population segments underserved and underrepresented in the health care arena. There will still be schools that struggle to raise a banner of success in student and teacher performance.
But we can set the example that shared focus, collaborative action and time can make a positive impact. The reality is that the needs are significant.
The Need for Health Care Professionals Today, there is a shortage in the United States of 9,000 Primary Care Doctors. Health care leaders predict that the shortage could grow to more than 65,000 doctors in as little as 15 years. (source: The New York Times) • Texas ranks 47th in the U.S. in the ratio of primary care doctors to population base (source: Houston Chronicle) • Bexar County, the 4th largest county in Texas, ranks 34th in the same ratio among all counties in Texas • None of the ten most populated counties in Texas ranks in the Top 10 in any primary care health profession
7 • As shown on the map below, the vast majority of counties in Texas are underserved by primary care health professionals; including Bexar County and five of the seven collar counties surrounding Bexar County. These areas have been designated as Health Profession Shortage Areas (HPSA’s) by the U.S. Department of Health and Human Services.
The need is likely to get much greater. • The population of the United States is growing and aging; with the fastest growing segment being the Hispanic community. Hispanics are historically underserved in health care due in part to language barriers, limited access to preventative care, and lack of insurance. 30% of Hispanics are not covered by health insurance. • Texas is one of the fastest growing states, and the percentage of Hispanic residents is now above 38%. Bexar County’s percentage is nearly 60%, and four of the seven collar counties are at or above the state level. • Finally, with mandates related to the Affordable Care Act set to kick in at the start of 2014, bringing with it a host of newly insured individuals and families, the pressure to provide primary medical care increases.
The Need for Educational Opportunities in the Health Care Fields The high demand for health care services and the short supply of primary care providers creates the perfect storm. In economic terms, when demand is high and supply is low, the price goes up. In health care, the price to be paid is a high one – a less than healthy population.
Since we know demand is high, the priority is to increase supply by: • Recruiting and retaining talented, inspired students who want to pursue career opportunities in health care. • Provide them a great educational experience and pathways to a variety of alternative education programs. • Increase the number of institutions that provide the specialized health care education and training.
8 The Need The Needs of the San Antonio Independent School District San Antonio ISD is the third largest school district serving San Antonio and the City’s urban core. Like many urban school districts, SAISD serves an area with a low tax base, families with limited financial means, a high minority population and a large student population identified as at-risk.
Despite these challenges, San Antonio ISD has momentum. 2011 State Accountability Ratings showed SAISD with 3 schools rated as “Exemplary” and 26 as “Recognized”; representing 35% of the district’s 82 rated schools. Only six district schools (7%) were rated academically unacceptable.
The district is also seeing improving results from its magnet programs. Specific to the health care field, SAISD offers magnet programs at Fox Tech and Edison High Schools, and Whittier Middle School. Fox Tech is a stand-alone magnet school that offers curriculums in health and law/public policy. Edison High School is a traditional high school with an embedded health magnet program. Whittier feeds into Edison High school.
Looking at the health magnet program, SAISD is showing some very positive results compared to overall district wide performance. A specific comparison of its health magnet program to two model programs, Health Careers High School in San Antonio’s North Side ISD and DeBakey High School for Health Professions in Houston’s ISD shows that SAISD has opportunity to elevate its performance to become competitive with these model programs.
Given the tremendous needs in the health care field, SAISD’s health magnet programs offer great career potential for students. For those that successfully complete the challenging curriculum, there are a variety of career pathways where demand is high and the supply of applicants is low. District-wide, SAISD needs to build on its momentum by: • Improving attendance rates at schools that are underperforming; a key measure to secure funding. • Increasing enrollment levels and attract students from outside the district; another key to funding support. • Delivering improved results as measured by the State’s new Accountability Standards. • Driving higher graduation rates. • Preparing students at a much higher level to pursue post-secondary education opportunities. Between 2009 and 2012, an average of only 45% of SAISD graduates went on to college. • Expanding opportunities for faculty members to pursue advanced degrees.
The following pages look at both the demographic and performance profiles of these magnet programs.
The Need 9 demographics
SAISD’s health magnet high schools, Fox Tech and Edison, serve a significantly higher Hispanic student population than the “model” health magnet schools. This factor needs to be considered when comparing performance.
Source: Texas Education Agency. (2012). 2011-2012 Academic Excellence Indicator System District Reports.
SAISD serves a much higher percentage of students that are deemed at-risk, and those that face economic and language barriers. These factors also need to be weighed when drawing comparisons.
Source: Texas Education Agency. (2012). 2011-2012 Academic Excellence Indicator System Campus Reports.
SAISD and the Houston ISD both rank higher than the state average for at-risk students, and those that face economic and language barriers. This is symbolic of some of the challenges that an urban school district faces. It should be noted that the HISD encompasses a much larger geographic footprint compared to SAISD.
Source: Texas Education Agency. (2012). 2011-2012 Academic Excellence Indicator System District Reports.
10 The Need performance
Fox Tech and Edison are on par with an overall district trend that shows sizable improvement in performance in college readiness. The results for DeBakey and Health Careers, while significantly higher, reflect in part the longevity of their programs. They offer examples and targets for SAISD schools to aspire to reach.
Source: Texas Education Agency. (2012). 2011-2012 Academic Excellence Indicator System District Reports.
Fox Tech’s advanced course/dual enrollment is trending upward and has outperformed Edison and the district average in this measure for the past two years. Its results were on par with Health Careers in 2010-2011, which saw HC experience a noticeable decline. Fox Tech is within shouting distance of DeBakey. Source: Texas Education Agency. (2012). 2011-2012 Academic Excellence Indicator System District Reports.
Although Fox Tech, Edison and SAISD showed improvement in the second year of this comparison, all are lagging significantly beyond Health Careers and DeBakey in these two subjects, which are critical in the field of health science. The good news is that there is opportunity for growth.
Source: Texas Education Agency. (2012). 2011-2012 Academic Excellence Indicator System District Reports.
The Need 11 performance Under the new accountability standards, Fox Tech is leading the way and is on a track that is bringing them closer to the high achievement levels of DeBakey and Health Careers. SAISD’s health magnet programs are outperforming the district in this area.
Source: Texas Education Agency. (2013). 2013 Accountability Rating System.
Results are similar to the student achievement measure. Fox Tech and Edison are significantly outperforming the district; with Fox Tech again on a path to challenge DeBakey and Health Careers.
Source: Texas Education Agency. (2013). 2013 Accountability Rating System.
Ironically, this measure shows Fox Tech and Edison lagging both the district and their tier health magnet group. This requires further study, but there are definite opportunities here.
Source: Texas Education Agency. (2013). 2013 Accountability Rating System.
This measure shows strong results, but there is a disconnect. For example, Fox Tech had only 48% of its graduating seniors last year go on to college.
Source: Texas Education Agency. (2013). 2013 Accountability Rating System.
12 The Need The Needs of the University of the Incarnate Word The University of the Incarnate Word is riding a tremendous wave of momentum. UIW set an enrollment record in 2012 when it exceeded 9,200 students on its combined campuses. It is expected to surpass 10,000 students in the near future. It has substantially expanded its health-related degree programs over the past decade with the launch of its schools of optometry, pharmacy and physical therapy. It also continues to expand its nursing program.
UIW will expand its health programs with the planned opening of the UIW School of Osteopathic Medicine in Fall of 2016. Its needs related to the opening of the medical school are substantial. For accreditation, UIW needs to show: • A strong level of UIW and community support • Adequate staffing and a sound organizational structure and hiring plan • Verification of sufficient clinical clerkships • Adequate financing • Clinical partners that will offer clerkships and residency programs for medical school students • A location that is in close proximity to targeted clinical partners • Access to housing and amenities that will appeal to students and faculty • A long-term feeder system to drive and maintain enrollment • Donor support
community education partnership
III Meeting the Needs
Tell me and I’ll forget. Show me and I may remember. Involve me and I’ll understand. - Confucius Chinese philosopher
We can’t know the context in which this ancient Chinese philosopher uttered these words 2,500 years ago. It wouldn’t be a stretch, however, to say that San Antonio’s leaders are putting these words into practice today. Transformational programs like SA2020, the Mayor’s "Decade of Downtown" and his Education Initiative are involving the community in ways perhaps never before seen in the nation’s 7th largest city.
Centro Partnership, a not-for-profit corporation, has embraced these programs and views downtown revitalization as a key element to their success. The UIW School of Osteopathic Medicine could be a transformational development project in downtown’s Northwest Quadrant and its burgeoning Downtown Medical District. (Diagram 1) The medical school could also prove to be so much more.
We have a vision for the UIW School of Osteopathic Medicine to become a catalyst for an organically grown Community Education Partnership. A place where students, educators, health care professionals, health-related businesses and the public sector will come together to form an ecosystem that will:
• Enhance, integrate and sustain the health-related educational opportunities necessary to prepare and grow the health care workforce in San Antonio. • Change the culture of learning that is prevalent in today’s urban schools. • Bridge K-12 with higher education to create a K-16 system that forms the building blocks to opportunity and success. • Promote an education environment of creativity and innovation. • Retain home grown talent and brainpower to serve the needs of San Antonio and surrounding areas.
15 The Community Education Partnership (CEP) is a mechanism to build on successes taking place in SAISD: strong attendance rates, rising test scores, positive trends in college readiness. It’s also a means to tap into the strength of the UIW brand and its nationally and internationally recognized health care programs. It’s a vehicle to implement best practices from successful models like the DeBakey High School of Health Professions in Houston. It’s a chance to adopt the philosophy embedded in the words of Confucius’, “…involve me and I’ll understand…”
SAISD’s current health magnet program is a great place to start. A laboratory where the CEP can generate ideas, test theories, and produce positive, lasting results. By involving key stakeholders in a collaborative effort, each will understand the needs that exist. From this base of understanding, the Education Partnership becomes the platform for idea generation and action.
STAIRWAY TO OPPORTUNITY
Career Possibilities in San Antonio Primary Care Physicians Optometrists UIW Pharmacists School of Physical Therapists Osteopathic Medicine Nurses School of Graduate Studies Licensed Vocational Feik School of Pharmacy Registered UIW FUTURE SAISD EXPANSION Physician Assistants Undergraduate Program Ila Faye Miller Fox Tech High School School of Nursing Technicians Alamo Colleges FUTURE K-8 EXPANSION Health Professions Magnet Undergraduate/Certificate School of Physical Therapy Administrators Edison High School Rosenberg School Additional opportunties Whittier Middle School Health Professions Magnet of Optometry
K-16 CONTINUUM
Core Elements Experienced educators from SAISD and UIW would come together to design and implement an expansion and programatic sustainability plan for SAISD’s health magnet program. The plan would also identify the steps needed to integrate the program with UIW’s undergraduate and graduate degree health programs. SAISD, UIW and Centro Partnership have studied two nationally recognized health magnet programs to identify key strategies and best practices that could be incorporated into the Community Education Partnership: • DeBakey High School for Health Professionals: a collaboration between the Baylor College of Medicine and the Houston Independent School District • Health Careers High School: a magnet school in San Antonio’s North Side Independent School District
16 Community Education Partnership The core elements noted below reflect many of those strategies and best practices: • A full time equivalent (FTE) to act as a liaison to oversee management of UIW-provided operating funds, curriculum development, integration into UIW’s curriculum and sustainability measures. • Development support for SAISD health magnet faculty to strengthen their depth of knowledge and ensure successful curriculum delivery. • Access to and participation in faculty summer work sessions focused on core and elective curriculum development, hands-on labs and in-classroom resource support. • Access to and participation in summer work sessions for middle school students and incoming 9th graders to introduce them to the health magnet program. • Mentoring of SAISD students who choose to enter the annual Alamo Regional Science Fair. • Mentoring and tutoring programs led by UIW undergraduate and graduate students that take place on both UIW and SAISD campuses. • A structured clinical rotation and internship program for SAISD and UIW students. • Access to UIW and UIW Medical School facilities to conduct classroom and lab training. • Consideration for dual credit opportunities similar in scope to programs SAISD has in place with Alamo Colleges and UTSA. • Development and implementation of a “guest lecture” series.
Collaborations Health Care Providers • Key to the success of the UIW School of Osteopathic Medicine and SAISD’s health magnet program is the ability to team up with health care service providers. The medical school needs these partnerships to offer important educational opportunities -- clerkships, internships, and residencies. • SAISD already has a relationship with University Health System, and can use the partnership to broaden opportunities with other partners for shadowing, rotations and internships. • The proposed site is centrally located between several major health care providers and a number of primary care physicians and specialists: • Christus Children’s Hospital of San Antonio • University Health System's Robert B. Green Campus • Baptist Health System • Metropolitan Methodist Hospital
The Health Care Industry • A strong CEP offers the potential to attract support from key stakeholders in the health care industry who benefit from a well-educated work force. They include: • Insurance Providers • Pharmaceutical Companies • Equipment Suppliers • Managed Care Facilities • And many more • They are a source of potential financial support for the CEP through Foundation grants.
Community Education Partnership 17
The Public Sector • Engaging the public sector is an important part of the CEP. The City of San Antonio, Bexar County and the State of Texas share concern with today’s growing education and health care challenges. They want to slow the exportation of locally educated, talented young adults who leave Texas to pursue careers elsewhere. Keeping the public sector informed and identifying specific needs that they can support are crucial to success • Centro’s recommendation contemplates and requires a significant financial commitment from the public sector for: • Infrastructure improvements to the proposed site adjacent to the Fox Tech Campus. • Continued support for curriculum development and enhancement under current and future state and federal programs. • Job growth incentives for medical school faculty and support staff.
Public Engagement • As the partnership begins to deliver results, SAISD and UIW will have a great story to share with the community. Success breeds success. Programs like DeBakey and Health Careers have sustained themselves because parents and students hear about the great results and want to be a part of it. • 100% graduation rates and 100% college attendance rates are compelling magnets for SAISD to put in place to grow overall health magnet enrollment and to attract out of district enrollment. • For UIW, the partnership offers a compelling story of how the educational community came together for the benefit of students, faculty and the community. That message can translate into increased enrollment in UIW’s undergraduate and graduate degree programs.
Through the CEP, UIW and SAISD can put these core elements in place, bring partners to the table and engage the public in a meaningful way that will help them to: • Advance their respective educational missions. • Transform the lives of current and future students who aspire to pursue health careers in the growing field of health care. • Plant the seeds that will produce the next generation of care-givers.
The Location Built at the right location, the UIW School of Osteopathic Medicine forms the foundation on which to build the Community Education Partnership. The best location of the four under consideration is in downtown San Antonio on unimproved surplus SAISD land next to the campus of Fox Tech Health & Law Careers Magnet High School. The site is: • In the heart of the city • At the core of a population base that statistics show is underserved and underrepresented in health care • Centrally located between multiple health care service providers and prospective partners • Adjacent to a health careers magnet school that has great potential for growth • Bordering San Pedro Creek, an historic area that will be converted into a linear park • Close to other parcels, including SAISD-owned land, with strong, synergistic development potential
At the Fox Tech site, UIW becomes an anchor that will, over time, transform an important downtown corridor.
Community Education Partnership 19 The Site Plan The Fox Tech campus is comprised of more than 24 acres bordered by Main Street to the east, Quincy to the north and Camaron to the west. Privately owned parcels form the southern border. North Flores runs through the middle of campus between the main buildings and the football/track field. (Diagram 2) UIW’s plans for its School of Osteopathic Medicine call for: • A 120,000 square foot main building with floor plates ranging from 14,000 – 20,000 SF • Sufficient parking to accommodate 500-600 vehicles for students, administrators and faculty • A footprint to accommodate future expansion for UIW’s educational purposes
• Site Plan Goals: Centro Partnership’s site plan recommendation, designed with support from Duende Design Architects and Pape-Dawson, seeks to: • Create a safe, convenient environment for students to move between campuses • Provide visibility from two high-traffic highways bordering the site • Improve access to the campus from the east and west bordering streets • Minimize the acreage needed for UIW’s School of Osteopathic Medicine • Maximize the amount of acreage that SAISD has available to repurpose or develop • Enhance the value of SAISD’s surplus land adjacent to the campus • Offer a parking solution that meets SAISD, UIW and public needs • Link the campus to historic San Pedro Creek
• The Evolution in Site Plan Design • Design Option 1 (Diagram 3): The initial design, on nearly 9 acres, included space for the medical school, surface parking and a pad for future expansion of UIW’s education mission. It incorporated a new road, “Medical Arts Boulevard” to provide east/west access to the campus and movement between Fox Tech and the medical school. This design met UIW’s needs but not all design goals. • Armed with input from UIW, SAISD and experienced developers, Centro Partnership focused on the core challenge: parking. Surface parking swallowed up almost 6 of the 8-9 acre footprint. • Design Option 2 (Diagram 4): The best solution was to introduce a parking garage to free up acreage for SAISD future development. The first revision placed the parking garage between the medical school building on the northwest corner and the expansion pad at the northeast corner. This met the need, but left unused space and affected the aesthetics, an important consideration when looking towards future development.
The updated design in Diagram 4 addresses these limitations, moves the parking garage to the northwest and closer to San Pedro Creek. It also integrates the medical school into a portion of the parking garage on the east side. The parking garage yields three tremendous benefits: • It reduces the total footprint for the medical school from 8-9 acres to 3 acres • It maximizes the acreage that SAISD has available for its purposes • It provides a gateway and access point to San Pedro Creek and its planned linear park
It also provides options for SAISD for its parking needs. Depending on their long-range development plan, they can continue to use existing parking, or develop the baseball field parcel as additional parking.
Ultimately, the parking garage is the element that allows us to achieve all of the site plan’s goals.
While it adds a more costly alternative to surface parking, it opens the door for future development that will leverage infrastructure improvements that are needed to support the UIW medical school, the Fox Tech Campus and the surrounding area.
20 Community Education Partnership diagram 1
Downtown Medical District
The UIW School of Osteopathic Medicine at Fox Tech will be in the heart of the Downtown Medical District.
21
diagram 2
Fox Tech Health and Law Magnet High School - Aeriel View
A. Main Campus = 12.4 acres B. Football / Track Field = 5.6 acres C. Softball Field = 1.4 acres D. Parking Lot = 2.1 acres E. Baseball Diamond = 2.5 acres
23 D C
B A
E diagram 3
Design Option 1
Elements • 120,000 SF Medical School Building • Surface Parking for 602 vehicles • Future Development Pad for UIW • New road to provide access • Total Medical School Footprint = 8-9 acres encompassing: • The football and track field • The softball field • The existing school parking lot
ADVANTAGES • The lowest cost alternative to UIW for this site • Good visibility to the highway • Improved access to the site • Link to San Pedro Creek
CHALLENGES • Is not the “best use” of all available acreage • Limits the acreage available to SAISD to roughly 3 acres • Does not provide the safest and most convenient access • Fails to meet SAISD needs for student and faculty parking • Provides little opportunity for proximate future development
25
diagram 4
Design Option 2
Elements • 120,000 SF Medical School Building • Parking Garage for 550 vehicles • Future Development Pad for UIW • New road to provide access • Total Medical School Footprint = 2.5-3 acres, encompassing, • Only the northern half of the football and track field
ADVANTAGES • Reduces the needed footprint by more than 60% • Doubles the acreage available to SAISD for future development • Enhances the value of SAISD’s land holdings • Maintains great visibility to the highway • Provides safer movement between the campuses • Offers a better gateway and link to San Pedro Creek • Improved access to the site
CHALLENGES • The main challenges are addressed
27
a vision for the future
UIW School of Osteopathic Medicine at Fox Tech
29
Like many, I hope to see the medical school on the Fox Tech campus become a reality. The medical school would be a tremendous boost for the students of SAISD and downtown revitalization. I feel that Fox Tech’s enrollment will grow once students and parents recognize the unique opportunities that will come from this partnership. - Carlos R. Orozco, MD Chairman of the Advisory Committee Fox Tech Health Professions Magnet School
Infrastructure Improvements The proposed 3-acre site for the medical school, which represents the northern half of the school’s football and track field, is “unimproved land”. The other “available” SAISD-owned parcels, not in use today nor a part of the main campus, are also considered unimproved. All this available land requires infrastructure improvements to make it viable for development.
Several areas around the Fox Tech Campus and proposed UIW Medical School site would also benefit from infrastructure improvements. Fortunately for SAISD and UIW, the City of San Antonio and Bexar County have already Example of a "complete street" being contemplated for the area identified key projects and earmarked financial resources to move them forward. They include: • The Romano Circle Project (at the intersection of Main and San Pedro) • Soledad and Main Street improvements • The San Pedro Creek Project
These projects, while providing tremendous enhancements to this portion of the northwest quadrant, don’t incorporate the needs of the medical school project and SAISD: road access, a parking garage and utilities (water, sewer, electrical, communications) at the development sites. Public sector support is a must if we are to bring the vision of the Community Education Partnership and the UIW School of Osteopathic Medicine to life.
The most viable solution to meet the significant infrastructure needs is for UIW and SAISD to collaborate with the public sector. Centro Partnership recommends a phased approach that spreads the effort amongst the partners and provides for a two-to-five year window for financial investment and construction of the key components. Those components are summarized in Exhibit 1. Please note that the estimates are preliminary and for discussion purposes only. No detailed and comprehensive final engineering work has been done. No projects have been put out to bid and do not reflect any engineering.
We have enclosed diagrams showing existing main utility routes, a proposed water line and also a floodplain comparison map from the San Pedro Creek Study.
Community Education Partnership 31 Exhibit 1
32 Community Education Partnership Fox Tech Utilities Fox Tech 12" Water Main Westside Creek Restoration value proposition The University of the Incarnate Word plans to invest nearly $50 million to fund construction and start-up operations for a School of Osteopathic Medicine. This investment represents an incredible “WIN-WIN-WIN” opportunity for SAISD, UIW, San Antonio and the region. It also builds a foundation for the Community Education Partnership.
Investment and Returns Successful partnerships require that each partner invest money, time and talent. When managed wisely and with vision, these combined investments generate value for the partnership, and a substantial return on investment.
SAISD • Investment: a commitment to enter into a long-term ground lease with UIW for up to 3 acres of SAISD unimproved land adjacent to the Fox Tech Campus for the UIW School of Osteopathic Medicine (SAISD secured an appraisal that valued the land at $3.25 Million; or roughly $25 per square foot).
SAISD will also invest resources to form a formal Education Partnership Agreement with UIW to develop and implement an enhancement, sustainability and integration plan for its health magnet program.
• Return on investment: SAISD, its students and faculty will benefit UIW and public sector investments. • SAISD will receive from UIW a direct cash payment of $1.5 million to support the expansion and programatic sustainability of SAISD’s health careers program. The Community Education Partnership will work to leverage this investment to generate incremental support from the private and public sector. • The value of SAISD’s remaining land (5+ acres) could double from $5.45 million (using appraisal $/ SF) to $10.9 million as a result of UIW ($5 million) and Public Sector ($11.5 million) parking garage and infrastructure investment. Without UIW as a catalyst, SAISD would have to make infrastructure investments using its own resources in order to create additional to value for its land. • SAISD students will benefit from a new SAISD-UIW Undergraduate Grant Award Program valued at a minimum of $13 million for the first 25 years and $26 million for 50 years. Any graduating senior from any SAISD school is eligible. They must meet UIW’s admissions requirements and enroll full time in any UIW undergraduate degree program. (Exhibit 2 shows the value based on the four-year average of student enrollment at UIW and aid that SAISD students received.) • SAISD faculty will directly benefit from a new SAISD-UIW Graduate Grant Award Program that will provide $50,000 in annual grant funding. The program is valued at $1.25 million over 25 years and $2.5 million over 50 years. It’s available for SAISD faculty wishing to pursue a Master’s Degree or Certificate or License from UIW in the specific discipline they teach. • A graduate school student endowment program which UIW will fund with a $100,000 annual constribution for the initial 25 year term and 25 year extension. Earning from the endowment will be earmarked for SAISD students wishing to pursue a graduate degree from one of UIW's health related professional schools. The value, as shown in Exhibit 2, is $1.625M for 25 year and $6.375M for 50 years. • The most telling return on investment for SAISD is the chance to advance its educational mission. The community education partnership will improve and expand participation in the health magnet program. It will drive increased enrollment from outside SAISD. It will contribute to improved student performance and district accountability measures. It will increase district revenues tied to funding formulas. Over time, SAISD will also be able to monetize its land holdings to fund its mission.
SAISD Students and Faculty • Investment: To be successful, the Community Education Partnership requires only that students and faculty invest their passion, time and brainpower to take full advantage of the opportunities offered to them. • Return on investment: The return on investment is tangible.
Community Education Partnership 37
• The opportunity to learn and develop in their fields of interest and passion. • Sustained financial support to help them achieve their goals. • Incredible career opportunities and the chance to make a difference in the community.
UIW • Investment: UIW is making a transformational investment in its School of Osteopathic Medicine and the Community Education Partnership: nearly $50 million for the school; $1.5 million to support the health magnet program; $5 million for the parking garage; and nearly $24 million in grants in the first 25 years.
UIW will also dedicate substantial resources to form a formal Education Partnership Agreement with SAISD to develop and implement an enhancement, sustainability and integration plan for the health magnet program. • Return on investment: SAISD will see significant immediate returns. UIW’s will materialize over a much longer time period. • The most immediate ROI comes from access to and use of up to 3 acres of SAISD unimproved land (appraised at $3.25 million) to construct and operate the School of Osteopathic Medicine. The medical school adds to UIW’s already strong portfolio of health-related degree programs, and will enhance its growing reputation as a talent source in the health care field. • The Fox Tech site offers easy access to a community of medical service providers in the downtown medical district. UIW needs to forge partnerships with providers to put in place clinical internships and residency programs. These are required for accreditation and to attract the best students. • UIW gains an important feeder system for its undergraduate and graduate school degree programs. Through the community education partnership, UIW can help impact graduation rates. As an active and visible participant, UIW will be top of mind with students as they make their college choice. • UIW gains a valuable education platform that will resonate with the donor community. A partnership between a private institution like UIW and an urban school district with a history of challenges offers an incredible platform on which to build support from donors. • The most telling return on investment for UIW is the chance to advance its educational mission. Through the community education partnership, UIW can expand its educational mission to K-8. It also allows UIW the opportunity to leverage its experience at the high schools level into the health magnet program. The long-term return comes from increased enrollment, sustainable revenue streams and continued funding for UIW’s mission.
The Public Sector • Investment: The Community Education Partnership can only become a reality with public sector support. $11.9 million in infrastructure improvements have been identified for the medical school, and the needs communicated to the City of San Antonio and Bexar County. The project is also expected to create nearly 80, high-paying full time positions. Since the City has programs in place to support job creation, they have been made aware of the job potential of the project and are considering a potential incentive of $800,000.
Although public sector support would appear to be investments in roads, utilities and a parking garage, at their core they would be investments in education and the future of our communities.
• Return on investment: The return on investment is immeasurable. • Improved performance results and increased graduation rates for the City’s urban school district. • An education program and career path designed to meet the needs of a population that is underserved and underrepresented in health care. • A platform to address the critical shortage of health care workers in San Antonio and South Texas. • The chance to stem the export of talent to other communities outside of South Texas and the State.
Community Education Partnership 39
the history
IV Growing Together
University of the Incarnate Word University of the Incarnate Word, located near the heart of downtown San Antonio, has deep roots in providing medical care to the community. In 1869, the Sisters of Charity of the Incarnate Word came to San Antonio to care for victims of a cholera epidemic and established the first hospital in the city, now known as Christus Santa Rosa. From the time the school moved to its current location in 1900, to being recognized as a university in 1996, UIW has continued to grow in its role as one of the top universities in the region, boasting a record-breaking 9,188 global enrollment in the fall of 2012.
University of the Incarnate Word is a proven partner in the community, having recently teamed the Rosenberg School of Optometry, founded in 2009, with Northside Independent School District to provide free eye exams to students. These types of programs have earned the University well deserved recogition, including:
• Recipient of the 2013 President’s Higher Education Community Service Honor Roll. The Honor Roll distinguishes institutions as leaders in community service and service learning that achieve measurable impacts in the community. UIW is one of 23 institutions recognized in Texas.
• Named as one of the “Great Colleges to Work For” by The Chronicle of Higher Education in 2013, an honor that the University has received for five consecutive years. Among the criteria for recognition was the University’s standard of excellence in Collaborative Governance, Job Satisfaction, Professional/Career Development Programs, Respect & Appreciation, Teaching Environment Tenure Clarity and Process.
In 2013, UIW’s Board approved plans to expand its mission in the health care field through the launch of the UIW School of Osteopathic Medicine, which would be the second medical school in Texas and one of only six private schools in the country.
Osteopathic medicine, founded in the late 1800s, provides all of the benefits of modern medicine, including prescription drugs, surgery, and the use of technology to diagnose disease and evaluate injury, while also offering the added benefit of hands-on diagnosis and treatment. Osteopathic medicine emphasizes helping each person achieve a high level of wellness by focusing on health promotion and disease prevention. Osteopathic physicians, also known as DOs, are trained to communicate
41 with people from diverse backgrounds and work in partnership with their patients, considering the impact that lifestyle and community have on the health of each individual.
There are currently 29 colleges of osteopathic medicine offering instruction at 37 locations in 28 states. As of 2012, there are more than 82,500 osteopathic physicians in the United States, with more than 4,200 new osteopathic physicians entering the workforce each year. Today, more than 20 percent of medical students in the country are training to be osteopathic physicians and, by 2020, experts predict that the number of osteopathic physicians will be over 100,000. san antonio independent school district For more than 100 years, SAISD has been steadfast in it’s mission to improve lives through a quality of education that is driven by an unrelenting determination to graduate all of its students and prepare them for success in higher education. SAISD is a family-oriented, urban community of thriving FOX TECH : A LOOK BACK neighborhoods and businesses, many of which are within the downtown Public Improvement District. Serving more than 54,000 students, the District ranks third in student population >1879 among the 15 school districts in Bexar County. Founded as Central Grammar and High School, San Antonio’s first public high school An important core belief of SAISD is “every student can learn and achieve at high levels.” Three schools within the District -- >1908 Fox Tech High School, Edison High School and Whittier Middle Renamed San Antonio High School School -- are key to accomplishing this goal. These Health Professions Magnet Schools, Whittier being a Charter School, provide a more specialized environment for children at-risk >1929 and high-ability (gifted/talented) children who are interested Renamed San Antonio Vocational & in a career in health care. Technical High School (SA Tech)
Louis W. Fox Academic and Technical High School >1949 A public, tuition-free, college preparatory magnet high school, Renamed Louis W. Fox Vocational & specializing in medical science, law and public policy, Fox Tech Technical School High School, the oldest public school in San Antonio, offers a curriculum that includes real-world experiences and >1996 internship opportunities. During the 2011-2012 school year, Law Magnet Program launched close to 600 students were enrolled at Fox Tech, with the majority of those students being Hispanic and categorized as economically disadvantaged and at-risk. Located in the >2010 heart of downtown and embodying the magnet program’s SAISD/UHS partnership is created for the slogan, “Downtown and College Bound,” Fox Tech sits at the Medical Profession Magnet Program center of the downtown medical district. Surrounded by world-class healthcare institutions -- Baptist Medical Center, Nix Health, Children’s Hospital of San Antonio, Methodist Hospital and University Health System -- SAISD’s decision to
42 The History create a magnet high school for health careers has been applauded and TOP OSTEOPATHS IN SAN ANTONIO Fox Tech has received the coveted designation as a Blue Ribbon school in recognition of the students’ outstanding achievements. Dr. Billy Burge, MD 16 years experience Thomas A. Edison High School Through a partnership with University of Texas Health Science Center at San Antonio, students at Edison High School can experience the Dr. Daniel Franks, DO responsibilities of many health career jobs first-hand. In addition to learning 13 years experience anatomy, medical terminology, and health science technology, students at Edison, a traditional high school with an embedded Health Professions Dr. Sudhir Gogu, DO Magnet program, have the opportunity to visit local hospitals three times 12 years experience per week to shadow healthcare workers and observe procedures and clinical practice. During the 2011-2012 school year, close to 1,700 students were Dr. Harry Hernandez, DO enrolled at Edison High School, with the majority of those students being 28 years experience Hispanic and categorized as economically disadvantaged and at-risk. Over the past few years, Edison has been recognized as one of the “Best High Schools” in 2008 by US News & World Report, one of the “Best Public Schools” Dr. Steven Cyr, MD by Texas Monthly in 2007, and a “Top American High School” by Newsweek 13 years experience in 2006. Edison is also the first SAISD High School to achieve “Distinguished Million Dollar Campus” with San Antonio Education Partnership for Dr. Bernard T. Swift, Jr., DO, MPH student scholarships. 37 years experience John Greenleaf Whittier Academy Dr. Paul Saenz, DO As a companion to Edison High School’s Health Professions Magnet School, 23 years experience students at Whittier have the privilege of advanced and specialized study in the field of medicine at the middle school level. Professors, physicians and scientists from UT Health Science Center visit students and provide field trip opportunities to their facilities, allowing them to explore the many occupations in the healthcare field. During the 2011-2012 school year, close to 950 students were enrolled at Whittier Middle School, with the majority of those students being Hispanic and categorized as economically disadvantaged and at-risk.
A great educational partnership will provide ongoing relevant and cutting edge professional development for our teachers, engaging learning experiences for our students, role modeling for higher education in health and medical professions, and a joint commitment to grow Fox Tech, Edison and Whittier’s health related programs into model programs to meet future workforce needs. In addressing these areas, this proposal appears to be just that: a great long-term educational partnership. - Carrie Baker Wells, Board Chair SAISD Foundation
The History 43
downtown san antonio
V The Decade of Downtown
great cities have great downtowns Through the SA2020 planning process, a vision for downtown was created – “In 2020, downtown is the heart of San Antonio and is everyone’s neighborhood.” In April 2011, Mayor Julián Castro called on Centro Partnership, the official Lead Partner for the Downtown Development cause area for SA2020, to create a strategic plan for downtown and the center city. The Partnership worked with other stakeholders to develop the Strategic Framework Plan for the Center City, which serves as the road map for the growth and development of the center city over the next decade. As stewards of the Plan, Centro is setting a core strategic vision and planning concepts to fulfill that vision, as well as serving as the liaison to the City on future master plans for targeted growth areas, and strengthening their role of policy advocate to develop and support key positions. Implementation of the Strategic Plan is in progress, with Centro at the helm of several key projects, including a study of the Northwest Quadrant of the center city.
northwest quadrant of downtown In April 2013, Bexar County commissioned Centro Partnership to study the Northwest Quadrant of downtown for future uses for the publically owned property and its ability to stimulate growth in that area. The study includes the involvement of key stakeholders and the public through the process of public workshops. The study shows that the expanse of underutilized land within the Quadrant represents an incredible opportunity to create a new downtown district that is within walking distance of the River Walk and existing civic office buildings.
With some of the most underutilized properties in the center city, the Northwest Quadrant is roughly bounded on its west side by the VIA West Side Multimodal Center & Medina Street, the San Antonio River to the east, Nueva Street on the south, and Elmira Street & IH 35 on the north. There is already a growing focus on this area, with major public investments planned to take place over the next few years for the Westside Multimodal, Romano Plaza, Commerce Street, Main Avenue and Soledad Street. A Streetcar initiative and San Pedro Creek improvements are also being considered and planning efforts for both of these projects are currently underway.
the downtown medical district Tourism, civic center offices, the historic business core and key elements of San Antonio’s bio-medical economy are all around the edges of the district.
45 Graham Weston has shared his vision of a tech hub within the district that would focus on start-up companies and cloud computing, creating an urban environment that would appeal to round-the-clock hospital workers and medical students. With the addition of the Westside Multimodal Transit Center and improved public transit connecting downtown to the medical school and reseach campuses, the district is poised to become a lynchpin of San Antonio’s future.
Establishing the UIW School of Osteopathic Medicine at the Fox Tech campus would be a major milestone in solidifying a true Downtown medical district, with four major health care providers surrounding and geographically centered around the collaborative campuses -- the UIW School of Osteopathic Medicine and Louis W. Fox Acacemic and Technical High School. This partnership has the potential of being a national model on how at-risk students from a low-income district can access premier health care opportunities in higher education.
The current strategic public investment projects, including creating great public spaces, pedestrian friendly streets, improved transportation and more effective flood control, are catalytic for the Quadrant and will provide new opportunities to live, work, do business and play in the center city. The Medical School would be a major anchor in the district and serve as a catalyst for more residential, commercial and mixed-use development around the Fox Tech campus. With the enrollment of 500 students and the addition of 70-plus faculty, administrative and support staff, the School would generate an estimated $11 million in annual salaries, which would have a sizable financial impact on the SAISD tax base. Because many School employees would likely live near the campus and enroll their children in local schools, this School will serve as a significant economic generator, fostering growth in areas such as housing, shopping and restaurants, as well as employment opportunities. This will benefit the 500 medical students who will need housing and related services close to the campus. In addition, education, medical offices, restaurants, neighborhood services and residential development will cater to the particular demands of health care professionals in the area.
As an owner and taxpayer in the center city, I think that bringing the medical school to downtown would be a major catalyst in promoting the Central Business District as a place for students, faculty and staff to live, work and play. Great ideas and great people working together can make great things happen! - Terry Casey Property Owner Milam Office Building
46 The Location REVITALIZATION : SAN PEDRO CREEK
Rendering courtesy of Muñoz & Company
VI next steps
Centro Partnership submits Letter of Intent to UIW and SAISD
UIW and SAISD approve and sign Letter of Intent
Signed Letter of Intent triggers the process to secure commitments for public sector funding
SAISD and UIW assign implementation teams to negotiate binding agreements and to establish a collaboration team to draft the Education Partnership Agreement
SAISD, UIW and Centro Partnership meet to discuss potential ongoing facilitation role
Binding documents submitted to respective Boards for approval
49
Centro Partnership was created in 2011 to champion the SA2020 vision for Downtown Development -- “In 2020, downtown is the heart of San Antonio and is everyone’s neighborhood."
Through its mission to foster a vibrant and prosperous downtown that benefits the entire San Antonio community, Centro Partnership plays a key role as the steward for the overall vision for the center city, including:
• identifying opportunities for the implementation of the Strategic Framework Plan for the Center City, a plan created by Centro Partnership that serves as the blueprint for downtown's revitalization process • protecting and enhancing the values and usage of downtown properties and businesses by making downtown San Antonio an exciting place to live, work, shop, play and be entertained • participating in a strong business and retail recruitment program that is designed to attract office tenants and retail business offerings to the center city • promoting the revitalization and beautification of downtown • preserving and protecting the historical and cultural resources of downtown • promoting improvements, marketing, maintenance and security of the downtown area • encouraging and assisting private and public development in downtown
Centro Partnership wishes to thank the following for their hard work and contributions towards this proposal: Duende Design Architects, Inc. Pape-Dawson Engineers, Inc. The Superintendent and Staff of San Antonio Independent School District The President and Staff of University of the Incarnate Word