Good Neighbors: Hospital and College Expansions in Historic Districts posted by Joe Lawniczak When you think of vibrant and stable communities—ones that are active year-round, have seemingly recession-proof economies, and where construction cranes regularly dot the

skyline—many of these are college towns or regional medical centers. Universities, colleges and hospitals frequently expand or open new programs or centers, bringing in new employees or students who live, work, shop and entertain in the community. Think of Rochester, Minnesota, with world-renowned Mayo Clinic in the heart of downtown: the community’s growth and vitality is palpable because of Mayo’s presence. Or take Madison, Wisconsin, were, in addition to the large number of state government workers, the students give downtown a 24-hour, year-round vibrancy. Although these communities are thriving because of the presence of hospitals and universities, these entities can also cause tensions locally, as their constant growth and expansion threatens neighboring residential and commercial districts. There are some negative examples across the country where such expansion has destroyed entire neighborhoods, and others where a local historic landmark has been lost. But even in non-historic neighborhoods, these expansions can be devastating, because the scale is often out of context with existing structures, street flow or building uses that have defined the neighborhood for decades. Once demolished, these neighborhoods can rarely, if ever, regain their original character or serve the same purpose. In 1960, Legacy Emanuel Hospital in North Portland, Oregon, approached the City about the hospital’s expansion plans. The hospital needed land to realize its vision of a modern, sprawling medical campus, which was in style at the time. However, its existing campus was surrounded by a large African-American neighborhood called the Albina district. In order to qualify for federal urban renewal grants, the hospital commissioned a study that declared the neighborhood blighted—but instead of informing residents about the study, the hospital quietly started buying up and demolishing homes (101 in 7 years, to be exact). By purchasing these properties privately, the hospital avoided paying for residents’ relocation costs, which they would have had to do if federal dollars were used. The hospital was ultimately able to count what it spent on these purchases as a match toward the federal urban renewal grant, but by 1967, when the grant was approved and the hospital finally told the residents about the blighted neighborhood designation, it was too late to protest and too late to receive relocation funds. In the end, over 300 homes and buildings were demolished and over 3,000 people were forced to move to make way for Legacy Emanuel’s sprawling campus.

This is an extreme example, and many communities have learned from such mistakes and put tools in place to prevent such tragic loss of existing neighborhoods, but similar, smaller examples of this have happened all over America since the 1950’s and are still happening today. The new state hospital in downtown New Orleans is glaring proof of this. In just the past few years, the entire Lower Mid-City neighborhood has been demolished and decimated to build a new, sprawling hospital campus, in spite of the fact that the existing hospital could have been reused and expanded—and the existing hospital still sits vacant today. If something like this can happen today in one of the most historic cities in America, then it’s easy to imagine that smaller-scale situations like these can and do happen all over the country. Thankfully, there are many examples of hospitals and colleges doing the right thing and expanding with care for the concerns of their neighbors. Results range from mediocre to great, as shown by the following examples. Mediocre Results In the following three cases, expansions still threatened adjacent districts, but compromises were made to make it less detrimental:

The University of Tennessee and Fort Sanders Medical Center sit adjacent to the historic Fort Sanders neighborhood in Knoxville. Recent expansion plans by the university threatened two historic homes. In a show of goodwill, the university allowed local preservationists to buy both for a total of $1,615 and allowed them to be moved instead of being demolished.
When Children’s Hospital in New Orleans needed to expand, they bought the nearby, historic, vacant Marine Hospital complex. They unfortunately demolished six of the buildings, but are reusing and restoring nine of them.
Closer to home, the University of Wisconsin-Platteville has been expanding beyond campus boundaries, leaving many older and historic homes threatened. Local contractor Mark Ihm has been buying and moving many of them to vacant lots near downtown, and has renamed the area Eastmain Estates.

Great Results The following cases represent ideal results, where the campus made the right expansion decisions that allowed neighborhoods to remain intact:

When the historic University of Chicago needed a building for its new Economics Institute, they looked no further than a recently vacated theological seminary that was located right next door, and whose design already blended with the Collegiate Gothic campus architecture.
Boston University bought and reused two nearby commercial buildings: a former auto dealership to be used for its new Geothermal Building and a former Howard Johnson hotel to be used for dormitories.
The University of Oregon’s Portland campus reused the iconic White Stag Block for its main campus.
Georgia State University sits adjacent to the historic Five Points district in downtown Atlanta, and has reused several historic buildings in Five Points for its School of Music and School of Business, among others.
The College of Charleston is a beautiful campus, adjacent to fully restored residential neighborhoods and the thriving, historic King Street commercial district. Instead of building new buildings as it expanded, the college has converted dozens of historic homes for use as classrooms, offices, etc., creating a seamless transition from campus to neighborhood.
Similarly, Flagler College in St. Augustine, Florida, has converted historic homes into offices and classrooms, but its main campus is also in a converted building: the former Ponce de Leon Hotel, a stunning 1888 Spanish Revival resort hotel located in the heart of the community.
King’s Daughters Medical Center in Madison, Indiana, took the same approach as the Charleston and St. Augustine examples. Not only was the main hospital building built to a scale that didn’t detract from the surrounding historic district, but it also converted several historic homes into medical offices, clinic space, etc. Other related private entities, such as chiropractors, dentists, etc., followed suit and converted historic homes into offices as well. At first glance, it still looks like a completely residential neighborhood; only sensitively designed signage indicates otherwise.
The Rhode Island School of Design (RISD) and Brown University, both in Providence, Rhode Island, have come a long way in being good neighbors—but they weren’t always that way. In the 1960’s, both were known for their insensitive expansion and demolition practices, a fact made worse since they are located in one of the oldest neighborhoods in the U.S. But after the City and several local preservation groups spent decades coming up with tools and resources to prevent such practices, both schools eventually were forced to develop master plans, and both have succeeded wonderfully because of it. RISD is now world-renowned for its campus, which today is almost exclusively in reused historic buildings, and Brown has converted many nearby historic homes for office and classroom space—but old habits die hard. Recently, Brown submitted a proposal to demolish an entire block of homes in a hip, adjacent commercial district to build a surface parking lot. Local groups are working today to block this proposal.
Savannah, Georgia, is one of the best-preserved historic cities in the world, but it took the dedication of a group of local women to save it back in the 1950’s. Like most cities, Savannah was facing deterioration of its central city as suburbs and malls sprang up, and homes were regularly threatened with demolition. The group of women formed the Historic Savannah Foundation, and by 1970, had saved over 150 buildings. When the Savannah College of Art & Design (SCAD) was formed in 1979, it began in a vacant, historic armory. That first reuse sparked an unprecedented building reuse effort by the college. Today, nearly every SCAD building is a reused existing or historic structure, and they are dispersed throughout the central city. While this means that there is no central campus, it also means that the college has a positive impact on the entire community, not just within the borders of a defined campus.

Very few of these success stories would have occurred without planning, regulations and local advocacy, and many of the negative examples were allowed to occur because of a lack of planning and regulations. Planning boards can prevent hospitals from expanding into residential neighborhoods if the hospitals don’t prove that the scale of their plans is warranted, and campuses can help their own planning efforts by creating master plans ahead of time. Children’s Hospital in Seattle has a master plan that even addresses design guidelines for all buildings and landscapes that are adjacent to the neighborhood. The inner-city University of Illinois at Chicago campus created a new master plan that helps to undo its current “walled fortress” design and help it better blend with the neighborhood. These are just two among dozens of similar examples.


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