LOS ANGELES – Growing up in the Baldwin Village section of Los Angeles, Charles Slay roamed the streets as a member of the Bloods. "I used to rob people there," he said.
But three years ago, when workers began transforming a vacant lot into medical offices, there was Slay, employed as an apprentice electrician. "I never in my life used a power tool," said Slay, who spent 27 years in prison for a gang-related murder. "The only tool I used was a gun. Now, I'm driving forklifts."
His evolution from convict to tradesman had been spurred by an initiative within the medical industry to broaden the idea of how to keep a community healthy. A coalition of nonprofit health care providers is investing in the notion that ample paychecks, stable housing and nutritious food are no less critical than doctors, medical equipment and pharmacies.
Forty-one nonprofit medical systems across the United States, plus four government providers, have formed the coalition, the Healthcare Anchor Network. The goal is to shift their spending to local companies, keeping the wealth close by. They are also directing their reserve funds toward loans to nonprofits that buy homes to help low-income people; capital for minority-owned businesses; child care for the working poor.
This initiative was behind Kaiser Permanente's decision to reserve a third of the construction jobs at its campus for people who lived nearby. Among them were 70 former inmates employed as plumbers, carpenters and electricians. "You have individuals building homes rather than doing home invasions," said John Harriel, a former gang member turned tradesman.
The idea that turned into the Healthcare Anchor Network began with a man named Ted Howard. In the midst of the Great Recession, he used his hometown, Cleveland, as a laboratory for a new approach toward recovering from factory closings and joblessness. He started three cooperative companies in low-income neighborhoods. His laundry service won a contract at the Cleveland Clinic on competitive terms, with a guarantee: It paid workers better than rival national chains. It could deliver on that promise because it was a cooperative. It merely had to break even rather than enrich shareholders.
Rather than trying to pry money from Congress for social programs, Howard pressured companies to spend, and invest, locally.
In the U.S., health care has become especially fertile ground for his approach, in part because the Affordable Care Act requires that nonprofit hospitals assess the health needs of their communities in a broad context — including job markets and affordable housing — while finding ways to improve local life. Given that 56% of U.S. community hospitals are nonprofit, this amounted to a significant potential alteration of health care.
For health care companies, improved community fortunes help the bottom line. More jobs mean more people in stable homes, lowering the cost of care when they need hospitalization. It means more people can afford medical plans, which spreads health care costs across larger populations.
In 2015, Kaiser held meetings to ask residents what they wanted. Their testimony shaped the blueprint: The hospital would offer Wi-Fi and workspaces, enabling low-income residents to send out job applications.
The primary demand was the most basic — paychecks. "The No. 1 thing people wanted was jobs," recalled Jodie Lesh, who then oversaw Kaiser's construction projects.
Slay grew up in South Central Los Angeles. His mother died when he was 10. By 21, he was behind bars. In prison, he attended a class about the impact of gang violence.
"I started thinking about the magnitude of my actions," he recalled. "I said, 'If I ever get a chance to get home, I will relish it.' "
The chance came when he was 48. Back on the outside, he moved in with his aunt and attended Alcoholics Anonymous. Then, grim realities took over. He got a job unloading ships. It paid $9 an hour with no health care.
Then Slay met Harriel, who saw him as a potential electrician. Five years later, Slay is part of a crew handling the electrical work at a new Rams stadium. He earns $39 an hour — enough to buy a car, help his 86-year-old aunt and give presents to his eight grandchildren. He pays for a health care policy from Kaiser.
"I feel like I've been around the world twice," he said, "and it's amazing that I'm a productive member of society, the backbone of my family."