Oculus | Prescription for Paterson

Prescription for Paterson

James Crispino, Winter 2007/2008 Download PDF

St. Joseph’s Healthcare System teams with Paterson, New Jersey, with a master plan by Francis Cauffman Architects that is proving to be the best remedy for a former industrial city.

Hospitals help to cure people when they are sick. Less often do health-care institutions administer treatments to improve the economic health of communities – but that’s exactly what St. Joseph’s Healthcare System (SJHS) is doing for the residents of Paterson, New Jersey. Acting in the role of patron to the local community, the medical center/teaching hospital has partnered with municipal authorities in a hospital-sponsored initiative with two related goals: to improve residents’ access to health care and to help Paterson break its cycle of economic depression.

In 1992, Paterson was defined as an “Urban Center” by the state’s Office of Smart Growth in a program that supports concentrated growth in various sectors, from commercial to cultural, and investment in infrastructure, from education to health care. Paterson also established an “Urban Enterprise Zone” in 1994 to provide tax relief to businesses that invested in the city’s most economically disadvantaged neighborhoods. Concurrent with these programs, the city’s Department of Community Development focused on upgrading core areas and attracting viable industries. Local government has been eager to reach out to existing institutions, businesses, and private-sector partners who could share goals and even more importantly, attract capital, raise fund for infrastructure, and create a more sustainable community by providing public services, such as affordable housing.

In July 2005, William McDonald, then consulting CEO of SJHS, announced that he and his team were undertaking a major development of the medical center. Founded by The Sisters of Charity of Saint Elizabeth in 1867, SJHS has historically operated in the service of Paterson’s workforce and the underprivileged (thus its mission: “individual dignity, justice, charity, service, excellence, and care of the poor”). A facility that started with just 12 beds has grown into a health system that is the largest employer in Passaic County and the third largest provider of charity care in the state. Today, the 1,000 bed private hospital includes a regional medical center and a children’s hospital in Paterson, as well as a community hospital, a nursing home, visiting nurse services, and a number of off-site clinics.

The SJHS campus is located in downtown Paterson where Main Street, a major artery through Paterson, intersects with Barclay Avenue. There, SJHS is reconfiguring its campus by replacing three buildings and a parking garage with 152,000 square feet of new construction and 500,000 square feet of renovated spaces within the existing medical center. The 2005 master plan, designed by Francis Cauffman Architects and now being implemented, will upgrade the medical center’s facilities and, at the same time, create safer streets, opportunities for private development and affordable housing in one of the most distressed areas of Paterson.

To insure that the master plan would respond to the Paterson community, the design team launched independent research on the segments of the population that are directly served by the hospital. The demographic data found that Paterson has many single-parent families and a large number of immigrants. Such information is also helping SJHS (and, it is hoped, public health programs) to provide more comprehensive health care to the residents.

For example, since language continues to be a barrier for many residents (52% speak Spanish at home), SJHS will use bilingual signage and have multilingual greeters on staff to help non-English speaking patients. The new lobby will include a large waiting area for children, as single-mother households account for 13% of the total households, nearly double the state and national averages.

Paterson families are generally larger (3.8 people per family in Paterson, as compared to 3.3 in New Jersey and 3.2 in the U.S.), yet median family income is only about 50% of the state average and about 60% of the national average. Since many of the poorer residents are not insured, the new critical care building includes an expanded emergency department that will accommodate the large number of patients who may go to the hospital – rather than to a private doctor – for urgent care. Extensive renovations throughout the existing hospital will also increase its quality of services overall.

In addition, the master plan identified a range of new buildings adjacent to the campus that will support SJHS’s medical and teaching activities and the city’s development goals. These include:

  • A public parking garage
  • A hotel and an office building
  • A transit station
  • A series of low-affordable housing structures across from the SJHS campus
  • A high-rise apartment building for local residents as well as for medical students from affiliated institutions, Columbia University and the Mount Sinai Health System

The $240-million expansion and renovation of SJHS “manages the medical center’s development in a way that will help Paterson surmount some of the major financial and economic challenges as the city works to regain its economic prosperity,” says McDonald, CEO of SJHS since 2006.

So far, SJHS has contracted with a private developer to build a city-operated parking structure. Meanwhile, the city has started streetscape improvements along Main Street, which will include a new public park and community center. Private investors are still needed to develop the office building, hotel and housing.

“Although we initiated the master plan to upgrade our medical and teaching spaces, as a health system, it’s our mission to help people,” McDonald says. “While the plan will help use build state-of-the-art medical facilities, it is also redefining the delivery of health services to our patients and, we hope contributing to the well-being of the local population.”


James Crispino, AIA, is president of Francis Cauffman Architects, based in the firm’s New York City office.

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