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A Green and Healthy Urban Health Clinic

The LEED CI Gold-certified Tom Waddell Urban Health Clinic is a green renovation developed as a part of the overall sustainable development of the Kelly Cullen Community (KCC) located in the Tenderloin District of San Francisco, California. KCC is the result of an environmentally conscious transformation and historic preservation of a 100-year old YMCA building. It was developed by Tenderloin Neighborhood Development Corporation (TNDC), designed by Gelfand Partners Architects, and built by Cahill Contractors, Inc.  The Clinic is operated by the City of San Francisco Department of Public Health.

The reception lobby at the LEED CI Gold-certified Tom Waddell Urban Health Clinic in San Francisco is a modern and space-conscious room accented with cheerful colors. (Photo by Mark Luthringer)

The reception lobby at the LEED CI Gold-certified Tom Waddell Urban Health Clinic in San Francisco is a modern and space-conscious room accented with cheerful colors. (Photo by Mark Luthringer)

As a part of the Tom Waddell Urban Health network, this multidisciplinary primary care clinic provides care to homeless adults and families, residents of permanent supportive housing, and other medically under-served individuals. It is expected to serve 25,000 visitors annually. The clients are often faced with challenges arising from chronic disease, substance use, mental illness, poverty, social isolation, and a history of multiple traumatic life events. The Tom Waddell Urban Health network’s services are aligned with health care for the homeless and harm reduction models, and also include specialty services such as comprehensive HIV prevention and care, office-based opiate treatment, transgender care, podiatry, dental services, and urgent care.

Entry to the LEED CI Gold-certified Tom Waddell Urban Health Clinic is located in the Kelly Cullen Community building in San Francisco. (Photo courtesy Gelfand Partners Architects)

Entry to the LEED CI Gold-certified Tom Waddell Urban Health Clinic is located in the Kelly Cullen Community building in San Francisco. (Photo courtesy Gelfand Partners Architects)

The Tom Waddell Urban Health Clinic is located at street level in a high-density neighborhood with easy access to multiple public transportation alternatives. Being part of the Kelly Cullen Community (KCC) gives the Clinic additional benefits. It is allotted 8 of the 50 designated bicycle parking spaces housed in KCC’s basement and has its own changing rooms available to staff and clients who arrive there via bicycling. Additionally, KCC’s gymnasium is open to the Clinic’s clients for health and fitness classes.

The Tom Waddell Urban Health Clinic’s exam rooms and hallways are finished with low-emitting interior finishes including flooring, paint, and low-mercury lamps. (Photo by Mark Luthringer)

The Tom Waddell Urban Health Clinic’s exam rooms and hallways are finished with low-emitting interior finishes including flooring, paint, and low-mercury lamps. (Photo by Mark Luthringer)

Occupying approximately 11,700 square feet of former YMCA locker rooms and support spaces on the ground floor, the Clinic is a state-of-the-art facility that includes exam rooms, individual and group counseling rooms, a pharmacy, a laboratory, offices, meeting rooms, and restrooms. It has gone through strict commissioning, measurement, and verification processes to ensure optimization of the energy performance of HVAC systems, general equipment, and appliances. The hot water supply for the entire KCC building is pre-heated by a rooftop solar thermal system. Light fixtures are outfitted with low-mercury lamps while all non-medical equipment such as computers, monitors, printers, and appliances are Energy Star-qualified.

The solar thermal system on the rooftop of the Kelly Cullen Community in San Francisco pre-heats the building’s hot water system and helps minimize the use and operation cost of gas. (Photo courtesy Gelfand Partners Architects)

The solar thermal system on the rooftop of the Kelly Cullen Community in San Francisco pre-heats the building’s hot water system and helps minimize its gas consumption and operational cost. (Photo courtesy Gelfand Partners Architects)

In creating a health clinic, the project team believed that achieving good indoor environmental quality was an essential design strategy. An indoor air quality management plan was executed during construction to minimize pollutant contamination within the building. Thermal comfort was carefully designed and verified onsite to ensure that installation matched up with design goals. To minimize off-gassing and “new building” smells, materials with low-VOC emissions were selected and installed throughout the Clinic: flooring materials; composite wood products; paints, adhesives, and sealants; and GreenGuard or SCS-certified seating and systems furniture.

The LEED CI Gold-certified Tom Waddell Urban Health Clinic is outfitted with ergonomic furniture designed with adjustable moving parts. (Photo by Mark Luthringer)

The LEED CI Gold-certified Tom Waddell Urban Health Clinic is outfitted with ergonomic furniture designed with adjustable moving parts. (Photo by Mark Luthringer)

To promote a healthy ergonomic environment for and practices amongst staff, a comprehensive ergonomic program was designed with employee feedback and implemented at the Clinic. Furniture was selected for its adjustability (seat height, arm height, lumbar support, keyboard trays, and monitor arms), giving users a range of options to achieve workplace comfort. Post-occupancy evaluation was conducted with at least 30% of the full-time employees and adjustments were made accordingly in response to the evaluation results. A two-hour Office Ergonomic Awareness Training is offered monthly to all Department of Public Health employees at their headquarters.

San Francisco Mayor Ed Lee, Director of Primary Care Homeless Services for the San Francisco Department of Public Health and the Clinic’s Medical Director Dr. Joseph Pace, and other community members marked the grand opening of the Tom Waddell Urban Health Clinic at a ribbon cutting ceremony in the fall of 2013. (Photo courtesy Mayor Ed Lee)

San Francisco Mayor Ed Lee, Director of Primary Care Homeless Services for the San Francisco Department of Public Health and the Clinic’s Medical Director Dr. Joseph Pace, and other community members marked the grand opening of the Tom Waddell Urban Health Clinic at a ribbon cutting ceremony in the fall of 2013. (Photo courtesy Mayor Ed Lee)

The thoughtful design of the Tom Waddell Urban Health Clinic enables an environment that is welcoming and calming to it clients. As a project that is dedicated to the evaluation and treatment of people’s health, the Clinic underscores the importance of creating a space that is inherently environmentally friendly. Everything from the design of the heating and ventilation systems to the selection of interior finishes helps create an indoor environment that is safe and non-toxic for both full-time (staff members) and part-time (clients and guests) building occupants. Regardless of whether or not a building is dedicated to the health field or green building-certified, shouldn’t we continue pushing hard for creating healthy, indoor environments for all building occupants and all building types?

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