Joel Kalmin – Legacy Community Health Services

Joel Kalmin of Legacy Community Health Services does not wear a stethoscope or take care of patients, but for the last 10 years as director of facilities design, he has worked with Legacy staff to build clinics that reflect and invigorate the communities they serve.

As the largest nonprofit Federally Qualified Health Care Center, or FQHC, in Texas, Legacy provides comprehensive health care to thousands of patients in southeast Texas, regardless of their ability to pay. It offers adult and pediatric primary care, OB/GYN, geriatrics, dental and vision services and it has become a community centerpiece.

“At Legacy, we open our doors and hearts to everyone without judgment,” Kalmin says. “It’s been amazing for me to be an integral part of creating state-of-the-art and welcoming environments for underserved communities to access high quality, affordable health care close to their homes.”

Building the caring environment

As of August, Legacy was working on a new 33,000-square-foot clinic in southwest Houston, built to replace one in use next to the new site.

“The new clinic is being built right next to Legacy’s existing clinic, which provides us with numerous challenges,” Kalmin says. “The existing location must stay open during construction and the move, because we can never have a day without care.

At the new clinic, there will be pediatric and OBGYN services and a pharmacy to serve a neighborhood comprised largely of Latin American residents. Features to enhance the patient and staff experience include innovative floor plans to accommodate high patient volume and protect patient privacy, and color-coded care areas that are easy for patients to navigate.

There will also be a large kitchen adjacent to the community room; Kalmin envisions it will be used for nutrition classes that could help community members learn how to better prevent and manage diabetes—and encourage families and kids to eat more nutritious foods.

The final Legacy touch for its clinics is always locally produced or procured art that centers the clinic in the environment of its patients. Plans for the new southwest Houston clinic feature an interior mural whose design is under consideration, and an exterior wall showcasing the textile arts found in patients’ native countries. The building materials are wood and concrete as can be found in construction in those regions.

“It is an amazing multicolored facility that will stand out for miles around,” Kalmin says.

Care in the desert

The new clinic follows one opened in Houston’s Fifth Ward in 2017 that drew attention from architectural journals for interior and exterior appeal.

The Fifth Ward has been dubbed a “health care desert” locally. Legacy’s new clinic there replaced one several blocks away and offers 17,000 square feet of exam rooms and a pharmacy, among other services. The clinic has the Legacy touches, such as two doors on exam rooms to improve work flow and reduce patient stress, Kalmin says.

The exterior of the clinic is adorned with Healing Hands—tiled handprints set against hues of blue, violet, green and red. The palms of each hand feature intricate designs, pieced together by a local artist using tiles created by staff and community members.

Community appeal

Legacy’s history can be traced to the late ‘70s and early ‘80s when the Montrose Clinic opened to provide screening, treatment and prevention of sexually transmitted diseases, primarily for gay men. As HIV and AIDS took a deadly toll in the early 1980s, Montrose became a nonprofit and added testing, counseling and education services for individuals and families.

In 2002, Montrose opened a second clinic, and in 2005, became Legacy Community Health as it merged with the Assistance Fund, a nonprofit that paid insurance premiums and medication expenses for AIDS patients. Today Legacy has clinics throughout greater Houston, and in Baytown, Beaumont and Deer Park.

Legacy has built or acquired two dozen clinics since Kalmin was hired, and he is part of the site selection once a need for community care has been determined. He says his building designs are much less his idea than the results of outreach.

“I look to see what the community is about,” Kalmin explains. “I reach out to community resources and find out the demographics.”

He and his team of 10 may not have to go far to get information, he adds. “My first resource is actually staff on hand; I can find out who may live in those neighborhoods and poll them,” Kalmin says.

Kalmin estimates Legacy’s new southwest Houston clinic will cost $15 million, and will meet LEED energy efficiency standards. The basic design factors—exam rooms that are typically 8 feet by 12 feet, inviting lobby space, consultation areas outside an exam room and areas for employee breaks are incorporated. How many exam rooms are built depends on a number of variables such as building space.

On the drawing board

Kalmin says he began sketching his first floor plans in elementary school, thinking he would become an architect. He graduated from the University of Texas with a degree in organizational communication, and followed by another from the Harvard Graduate School of Design in 2004.

At Legacy, Kalmin does not manage the construction of new clinics, but his design work began when was hired as an independent consultant to help the nonprofit combine three of its facilities into one main campus.

Kalmin has design experience in residential, hospitality and health care fields, and had only done one high-end senior living design before joining Legacy. He wanted the building to be imbued with the experience of what the nonprofit offers its patients and communities.

“In previous roles, I was trying to make a small group of people or the owners happy,” Kalmin says. “At Legacy, I get to help improve patient and staff experiences with what can often be stress provoking times. I get to provide a place of joy for community members and my fellow employees.”