Verona Greenland – transforming the Bronx with health services

Business Leader Nominee #6

Wednesday, November 16, 2011

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Verona Greenland landed in New York in the early 1970s with an unshakeable sense of mission.

Her passion for public health and community service had led her on a transatlantic journey to America’s most magnetic city, and she had very little time to waste.

Born in St Mary, Jamaica, Greenland left for England with her father at age seven, completed high school in that country, and was now in the Big Apple in pursuit of a career in which she visualised herself as an inspirational agent of social change.

A bachelor’s degree from New York’s most celebrated institution of learning — Columbia University’s Mailman School of Public Health — was Greenland’s first step towards a life dedicated to helping America’s most disenfranchised reach out towards a brighter future. She further burnished her academic credentials by enrolling in the health care executive programme at the prestigious UCLA John E Anderson Graduate School of Management.

Few could have imagined the pivot towards entrepreneurism that followed — how this ambitious woman, a minority thrice over, was able to parlay her scholarship into an efficient and self-sustaining business model for community development.

The prosaic name by which Greenland’s institution is known — Morris Heights Health Centre (MHHC) — reflects its geographic location and scope of service at formation just over 30 years ago.

Today, the name masks the true breadth, reach and transformational impact that MHHC’s 18 branches and outreach centres have had within the Bronx communities that they serve.

Morris Heights Health Centre is a non-profit enterprise that offers the full gamut of health care services to the underprivileged and social intervention programmes custom-designed to meet the unique challenges faced by Bronx’s inner city youth.

In short, each year the institution directly touches the lives of 60,000 Americans — from pregnant women, lactating mothers and their infants, to teenagers, schoolchildren and adults. For many, MHHC is their only contact with speciality medical personnel, or first access point to primary care and dental treatment, mental healthcare intervention, as well as the critical but often overlooked educational and social services.

Though this federally supported operation is headquartered at 57-69 West Burnside Avenue, in central Bronx, most of the services offered at the primary location are replicated throughout its multi-branch full service network. There are three broad and distinct institutional arrangements through which the services are funnelled.

• Since 1988, MHHC has operated (at its headquarters) the Women’s Health and Birthing Pavilion — a multi-care facility that provides the full spectrum of health and education services to customers. Broadly speaking, this covers prenatal care, labour and delivery — and just about everything in-between. The out-of-hospital, midwifery-run childbearing service is a pioneering model for low income American communities. It has served as the template for others similar operations across the United States, and is accredited by the National Association of Childbearing Centres and the Joint Commission and is affiliated with area hospitals.

• Beginning in 1982, the institution has offered onsite access to healthcare, including mental health and health education services, under a school-based health centre network that lists 10 schools in the Bronx with 10,000 children, as participants. Under the programme, the MHHC health team advises parents on securing health insurance for their children and family.

• Last year January, the organisation broke ground for a US$50 million 48,700 square foot wing at MHHC’s Harrison Circle location, bringing the total square footage to 112,000. This marked the entry into a new, self-sustaining business line with 70 housing units for low-income seniors, rental space for a large commercial enterprise, in addition of course, to the space dedicated to medical services.

While the priority of this medical/social intervention enterprise is unlike the narrow focus on economic returns at most private companies, it nevertheless remains at its core, a legitimate entrepreneurial venture.

"We are a (US)$68 million net worth organisation," says Greenland, the visionary founder who has served as president since inception. "Any profit that we earn has to go back into the organisation."

This highly labour intensive operation provides jobs for 450 individuals, the bulk of them medical personnel. The US$3.5 million monthly payroll not surprisingly accounts for the bulk of Morris Height Health Centre’s annual operating budget of $45 million.

Most of the money to cover current expenditure is raised from fees that clients or, more often than not, their insurers, pay. There is also rental income, but the budget, especially capital expenditure, is subsidised largely by public grants and, in some instances, donation from private foundations.

Greenland says that the service provided by the doctors, nurses and other medical personnel at her organisation is delivered more cost-effectively than at the alternative healthcare models, and that the fees that patients and their insurance providers are asked to pay are therefore lower — without compromising service quality.

"We provide high quality care at a fraction of the emergency room cost, or the cost of hospitals," she notes.

The recently completed US$50-million Harrison Circle Building is a classic example of how Greenland has successfully angled her organisation to tap into public resources and create value for the underprivileged communities it serves.

The 48,700 square foot building qualified for 96 per cent funding or US$22.3 million of the projected construction cost from a special tax credit initiative that encourages investment in underserved communities. With escalation, the building cost about US$29 million of which US$9 million was raised from New York State Assembly, US$13 million from New York City Council, and US$4 million from the borough — all through the New Markets Tax Credit (NMTC) programme.

This facility is designed to provide an additional 18,000 individuals access to medical services, and has enabled MHHC to add new services like physical therapy, mammography, orthopaedics and cardiology to those already on offer.

"We had a delay and construction escalation and so we had to cobble together different resources to make the project happen," Greenland tells the Business Observer. "The building is completely funded. We owe no money on it."
The separate 70-unit residential housing complex for low-income elderly that is part of the entire development qualified MHHC for US$19.4 million in funding from the US Department of Housing and Urban Development. The entire area — the medical complex and housing development — is about 112,000 square feet.

Another example of the capacity of this organisation to marshal resources for community development is the US$4 million that was secured in May this year to support its teenage pregnancy prevention initiative aimed at 2,000 at-risk youth in the Bronx. The money was provided by the Office of Adolescent Health in the Department of Health and Human Services.

These achievements reflect just how far Morris Heights Health Centre has come. In the late 1970s when Greenland began looking around for employment opportunities in community development, she discovered in the Bronx, "that the Third World was right in my back yard".

Apart from the obvious urban blight — "Bronx was a scary place" she says — there was one galvanising static that signalled to Greenland that she was indeed in the right place: the shocking infant mortality rate of 25 per 1,000.

"Health care is a basic human right," she declares. "If you are not healthy you cannot learn, and if you cannot learn, well…"

At six per 1,000, the current infant mortality rate is more closely aligned with the reality in most First World countries.

There is no doubt that Greenland and her organisation can take some of the credit for the improvement in the lives of those living within the underserved communities of the Bronx.

But she along with concerned citizens who had formed the Morris Heights Neighbourhood Improvement Association had to fight for funding to advance their cause.

After community agitation and lobbying, the federal government eventually yielded, providing a US$25,000 grant to seed the project.

"Frankly, they gave us the money but did not expect anything to materialise from it," she says. "They did not expect it to survive."

What they did not count on was the fact that they were dealing with a woman for whom transforming the community had become more of a calling than a job.

"It was more than a job, I felt an obligation to do something," she lets on. "Bronx was a scary area; although we are in central Bronx, it had all the characteristics of south Bronx; individuals were in need of social services."

Greenland’s drive to make the Bronx a better place has not only been channelled through the organisation that she founded, and which has been the most visible vehicle for her remarkable life as an agent of social transformation.

A review of her personal biography reveals a life of tireless and unconditional giving.

For example, she answered the call when New York’s governor Mario Cuomo sought to draft her on his taskforce to deal with issues related to nutrition.

She was also extremely well equipped to say yes to serving on the taskforce on infant mortality established by the US health and human secretary, Donna Shalala.

This corporate executive has chaired and continues to actively serve on the boards of several state, national and local organisations including:

• Affinity Health Plan;

• Community Health Association of New York State (CHANYS);

• Bronx Regional Health Information Organisation (Bronx RHIO);

• Schuyler Centre for Analysis and Advocacy; and

• The Perkins Advisory Council at Bronx Community College.

Public recognition has come with such stalwart service. In 2010, she was recognised with MHHC’s first Legacy Award for her 30-plus years of distinctive leadership and community service, as well as the 2010 National Association of Community Health Centre’s (NACHC) Outstanding Achievement Award for Excellence in Leadership and Dedication to America’s Community Health Centres. Recently, she was acclaimed as one of 25 Most Influential Bronx Women by the renowned Bronx Times publication.

"My grandmother," Greenland says, "always told me that to whom much is given, much is expected. This has been my mantra."

Moses Jackson is the founder of the Jamaica Observer Business Leader Award programme. He may be reached at

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