Edward M. Kennedy Community Health Center – Erland Construction Inc.

In 2012, the Edward M. Kennedy Community Health Center (Kennedy CHC) celebrates 40 years of providing primary care to those most in need. A collective of eight women living in one of the largest public housing complexes in Worcester, Mass., founded the institution as the Great Brook Valley Health Center in 1972. They saw a better way to provide preventive, primary care to those who might only have access to medical services through the local emergency rooms. The founders’ intuition couldn’t have been more spot-on and the health center gradually grew with an on-site dental clinic, behavioral health services, a laboratory, its own pharmacy and additional locations.

Forty years later Kennedy CHC continues to deliver on its mission to help people live healthier lives, typically serving over 24,000 patients every year. In response to demand from patients who lived in the MetroWest area of Massachusetts (about halfway between Boston and Worcester), the Health Center eventually added both a medical and dental practice in Framingham, Mass., a community about 20 miles east of Worcester. The Kennedy CHC enters a new era of community healthcare in 2012 with the opening of its expanded facility in downtown Framingham.

“Over the past 15 years we have witnessed a large and growing demand for our services in the surrounding communities,” expands John Hess, vice president of planning at Kennedy CHC. “We already have two medical offices totaling nine exam rooms and one dental office here in Framingham, but we just needed more space to serve the growing needs in our community.”

Building a New Model for Community Healthcare

The new $12 million expansion is designed to provide 14 state-of-the-art exam rooms and roughly 8,000 square feet to accommodate medical providers, nurses and other patient care staff in one consolidated space, giving Kennedy CHC the capacity to serve even more patients. Financing the project relied on a series of partnerships, including $1 million from the MetroWest Community Health Foundation and $6.4 million from the federal Affordable Care Act. MassDevelopment – the state’s finance and development authority – issued a bond to help finance the remainder of the construction of the new center, and the Kennedy CHC supplemented federal and foundation funding by organizing additional fundraising initiatives.

“We couldn’t have taken on this project without federal funds from the Affordable Care Act, which many don’t realize allocated funding for infrastructure like the Kennedy CHC,” adds Hess.

With funding secured, Kennedy CHC tapped Boston-based Steffian Bradley Architects (SBA) to design the center. “The new center was designed using the most current configuration for medical facilities today, where the treatment rooms are located along the perimeter of the building to take advantage of the daylight, which connect to the centrally located nurse’s stations through a staff corridor,” expands Marek A. Garlicki, senior associate architect at SBA.

Following a rigorous bidding process, the Health Center selected Erland Construction Inc. (Erland) as general contractor and construction manager for the project, which involves the complete renovation of the first floor of an existing three-story medical office building on Waverly Street in downtown Framingham.

“We preselected a number of contractors to serve as construction manager on the project, looking at companies that not only had experience in the healthcare market, but those with experience in working with primary care providers as well as working in an occupied building, which naturally led us to Erland,” explains Hess.

Kennedy CHC occupies the first floor and half of the third floor of the building, which was expanded with a 2,000-square foot lobby and main entrance. One of the existing tenants opted to stay put after Kennedy CHC acquired the property. Advocates Inc. occupies the entire second floor. Advocates Inc. is one of the largest human services organizations in the state that specializes in working with elders, people with disabilities and those with other challenges who may need extra support to navigate life’s obstacles. Part of Advocates Inc.’s work is providing 24-hour emergency psychiatric services, requiring all construction activities be coordinated to respect the tenant’s patients’ needs.

Untangling Logistics

Erland is an open-shop construction company based out of Burlington, Mass., and has been in business since 1977. The company has thrived over the years by providing superior program management, design-build, general contracting and construction management services for clients. Erland puts tremendous value on developing long-term relationships with clients, and it does this by employing professionals that assure high-quality work and a safe environment that limits disruption.

Limited parking and the relocation of existing elevators posed some of the earliest challenges for the team. “We got involved very early on to ensure Advocates Inc.’s patients would be able to get in and out of the building,” says Stephen A. Craft, project manager at Erland.

Ultimately, crews installed an enclosed wheelchair lift to the building’s exterior, equipped with a security system of its own to ensure the lift entrance was equally as secure as the original entrance. Crews took care to complete any demolition and loud renovation activities to the building during off hours and over nights and weekend. The new fire sprinkler system was installed similarly, allowing the tenants and the emergency crisis hotline to remain operating with minimal disruption.

Likewise, parking lot improvements and repaving were completed one small quadrant at a time over weekends, leaving plenty of spaces open for patients and employees during the week, including the 24/7 Psychiatric Emergency Services. “Communication was key and our field superintendent, Carlos E. Melendez, had an ongoing conversation with the tenants, alerting them by phone and email of any issues to expect on a daily basis,” adds Andrew E. Burns, project executive at Erland. The owner and the contractor met with the tenant representative on a weekly basis to ensure tenant concerns were addressed properly.

“We had to prepare a lot of signage over the course of construction to ensure that all the different kinds of visitors to the building wouldn’t get lost, so to speak, and it’s because of the field superintendent and project managers that all these pieces fit together in the end,” adds Hess. Melendez’s bilingual skills helped ensure the concerns of all parties were effectively and accurately conveyed.

Connected to the Community

The clear and consistent communication paid off big time from the get-go and helped crews gain an extra access point to the site with the help of the neighboring property’s tenant, the South Middlesex Opportunity Council (SMOC). SMOC is a private not-for-profit organization dedicated to connecting low-income people with public and private resources that improve quality of life. The Kennedy CHC property had just one access point leading to the only parking lot and the neighboring property owned by SMOC allowed crews to stage construction activities from part of the adjacent property and access the Kennedy CHC site from the rear.

“The SMOC property really allowed us to be a 24-hour operation and ensure adequate parking at all times,” admits Burns. The extra access proved a godsend when crews discovered the facility wouldn’t be able to connect to the existing town’s water and sewer lines as originally planned, since the connections had partially caved in over the years. To make matters worse, the property lies just 30 feet from a freight railroad on one side, which required crews to build a longer sewer and water connection and obtain extra permits from the town, since the new connections required crews to build through the railroad’s right of way.

“We were very concerned about the sewer connections delaying our progress, but it ended up being a very positive experience and we just want to express our gratitude to all of the town and municipal agencies involved,” states Craft.

Establishing a proactive working environment on-site helped the crews stay flexible enough to overcome the major challenge of having very little overhead room. Crews had to install all overhead HVAC, mechanical, electrical and lighting systems into approximately 18 inches of overhead space. “It was unbuildable on paper, something I never encountered in my 25 years of experience,” laughs Garlicki. “It’s truly because of the top-notch contractors and subcontractors that we were successful.”

The project is on-track for the Kennedy CHC to begin providing services at the new center in September 2012. As personnel settle into the new Edward M. Kennedy Community Health Center, patients and end users across Massachusetts should give thanks to Erland Construction Inc., Steffian Bradley Architects and the entire project team for delivering a space that contributes to a healthy, thriving community.