By Candace Baldwin, Director of Strategy, Aging in Community
Wouldn’t we all like to age in our homes and communities, surrounded by what is familiar, supported by a health care team that really understands who we are and how to serve us as individuals with unique needs? This kind of age-friendly health system has generally been an anomaly in the United States, particularly for low-income, older patients. Coupled with the fact that 90 percent of older adults want to age in their own homes, integrated care models are best supported at the community level.
The lack of capital for real estate projects, community facilities, and small businesses in low-income communities is a problem that spawns a host of other problems. When there is limited access to capital, there are fewer businesses and jobs, fewer sources of affordable housing, and fewer chances for these communities and their residents to enter the economic mainstream of American life. In short, the lack of capital perpetuates the lack of opportunity.
By Katherine Groves & Daniel Ramirez, Loan Originations Team
When Tri-City Health Center (TCHC) opened in Fremont, CA in 1970, it was one of just a handful of clinics serving low-income, minority women from Fremont and the neighboring Alameda county cities of Union City and Hayward.
Since its founding more than 40 years ago, the Tri-City has expanded to include four health clinics, a dedicated dental site, and a mobile health clinic. Together, these sites serve more than 23,500 patients from Fremont, Hayward, Union City, Newark, and San Leandro. As a Federally Qualified Health Center (FQHC), the clinic’s mission is to provide medical and behavioral health care for patients covered by MediCal and other programs under the Affordable Care Act (ACA) umbrella.
Implementation of the ACA has required FQHCs in California to meet a growing demand for services. Tri-City saw an opportunity to meet that demand, but that effort required a significant expansion of its clinic.
That two-step process began with purchasing an existing two-story, 20,000 square foot property in downtown Fremont. To secure the necessary financing, we worked with the Nonprofit Finance Fund (NFF), a partner Community Development Financial Institution. Each organization put in half of the needed $6 million loan in December of 2015.
Now that TCHC owns the building, it needs to complete a major renovation to turn the building into a state-of-the-art medical clinic. Once again we joined with NFF to provide another $2 million in financing to support that effort, with each of us contributing $1 million.
Our Healthier California Fund loan was a perfect source for the capital we needed. We debuted this fund in early 2016 to support health centers and clinics serving low-income patients in California, and to bolster the state’s efforts to meet ACA requirements in new and innovative ways. This project represents our first transaction through the fund!
As a bonus, using the Fund to deliver the Tri-City Health Center financing allowed us to provide a lower interest rate, and helped them put more of their money into services instead of paying off the loan. This deal is win-win-win for them, their patients, and Capital Impact’s mission-driven lending efforts.
There is a lot to like about this project: the new clinic will have ten exam rooms and ten dental exam rooms, and the expansion will allow TCHC to see 8,000 new patients annually. Almost all of these patients are low-income and approximately 70% are Medi-Cal beneficiaries.
The clinic is strategically located near Five Corners, where many people in the area already shop and work. With free parking and access to multiple public transit routes, the clinic will be easily accessible.
Improving Healthcare for Local Families
This increase in clinic capacity can only improve the care for patients like Maria Guizar, who sought treatment at TCHC for her son Armando’s asthma after several trips to the emergency room failed to provide him relief.
“They referred him to a specialist and thanks to all the treatment, now Armando can play and be a healthy kid. I am very happy with services of TCHC. All the staff has treated me and my family well. Dr. Mogri even tries to speak Spanish and I like that she makes an effort to communicate with me.”
Staff at the clinic speak 20 languages, a necessity in the ethnically-diverse Bay Area. More than a third of the clinic’s patients speak a language other than English, including Maria, who is a native Spanish speaker. Her appointments are attended by a translator so that Maria and Armando get the best health care possible.
“Armando’s condition was making me lose sleep. His condition would have worsened if I had not found Dr. Mogri and TCHC. Dr. Mogri has helped me to improve the life of my family.”
Tri-City has already had a tremendous impact on the area’s low-income residents who otherwise would not have access to quality health care. This expansion makes them that much stronger. That is why all of us at Capital Impact are proud to be part of this project.
At Capital Impact, we’re committed to building stronger communities. While we do this primarily through financing, we also recognize the importance of giving back to the communities in which we live and work.
Capital Impact staff celebrate our commitment to our communities throughout the year with individual contributions and volunteer activities. An annual volunteer event has also been part of Capital Impact’s summer all-staff retreat. This year we took our retreat to Detroit, MI, where we visited several of our project sites and learned more about our place-based strategy in the city.
Driven by another year of strong lending, Capital Impact ended 2015 with a solid financial position. The organization’s overall portfolio increased by $22 million or 11 percent. This growth was matched with continued strong credit performance, as our delinquency rate was just 0.4 percent. Once again, our focus on financial strength and social impact was rewarded with AERIS’ highest possible rating of AAA+1. This honor pleases us greatly.
Top-line revenue continued to grow as well. Net income rose by $11 million—a year-over-year increase of 213 percent. Net assets saw an expected decline as a result of launching our Green House and Cornerstone Partnership programs and the accompanied grant revenue that was used to fund those activities.
At Capital Impact Partners we put money to work, focusing our efforts on the best ways to use dollars to achieve powerful outcomes. Our lending work at Capital Impact Partners in 2015 increased more than 17 percent above our 2014 level—a success that we celebrate in the present as we look ahead to new levels of accomplishment. This level of lending volume is a source of strength as it supports our organization financially while simultaneously reinforcing communities with increased access to critical housing, services and employment opportunities.
As Capital Impact’s new CEO, I am incredibly excited to take this opportunity to both look back at 2015 and to expound on our new five-year vision to 2020.
Over the past year, we continued to build upon the organization’s strong financial position, deep partnerships, and innovative product development. We provided ongoing leadership in the health care space, helped a number of charter schools expand their educational offerings, and saw several of our projects come online across Detroit. We also launched two new lending initiatives that will expand access to healthy foods and support age-friendly communities.
As I think about my 32 years with Capital Impact Partners, I am overwhelmed when I consider the thousands of stakeholders that have made contributions to our work of helping people and communities across the country reach their highest potential.
This army of people and organizations, all part of the ongoing and thriving community development finance sector, includes partners who have worked shoulder-to-shoulder with us; investors whose capital participation helped us stand up a strategy that continues to generate high impact outcomes; foundations whose contributions increase our capacity and enable transactions that otherwise would not be possible; and our many board members whose selfless contribution of their time and talent helped to guide us in our endeavor. In my mind, they are our real heroes.
Since Benjamin Franklin launched the first mutual fire insurance company in 1752, the cooperative sector has seen waves of success in the United States. Dairy and cheese coops were first organized in the early 1800s, and other agricultural cooperatives followed. By the Great Depression, cooperative businesses were developing in urban and rural areas, bolstered by President Roosevelt’s New Deal legislation. In the late 1960s and 1970s, a new wave of consumer food co-ops grew out of the counterculture movement. In 1981 Capital Impact was born out of federal legislation to keep up that momentum. And for the last four decades, Capital Impact has sought to do this through a mix of financing, capacity building and technical support.
More than 10,000 low-and-moderate income homeowners are sleeping better at night thanks to our partner ROC USA. Instead of worrying about rent increases or land sales that might force them to move, residents of manufactured-home communities (what many commonly refer to as mobile home parks) across the country have purchased their land and put down roots through ROC USA’s cooperative ownership program.
Since 2008, the nonprofit social venture’s innovative model has spun off 182 resident-owned communities in 14 states, ranging in size from eight to 300 dwellings. The 10,000th home was recently secured at Turnpike Park Cooperative in Westborough, Mass.
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Driven by another year of strong lending, Capital Impact ended 2015 with a solid financial position. The organization’s overall portfolio increased by $22 million or 11 percent. This growth was matched with continued strong credit performance, as our delinquency rate was just 0.4 percent. Once again, our focus on 
