Health Care Development in Central Florida

By Richard Reep

In this still cooling economy, Florida seems to be continually buffeted by a perfect storm of unemployment, record foreclosures, and stagnant population growth. As the state continues to suffer, the health care industry has unfolded two planning efforts aimed at building some economic momentum.

Florida Hospital?s Health Village, an urban revitalization of one of Orlando?s older core neighborhoods, is one planning effort to watch. The other, Lake Nona, is a classic suburban mixed-use campus planned around R&D facilities gilded with stellar names like Scripps and Nemours, occurring in the southeast periphery of Orlando. The vastly different values of their developers underscore the striking contrasts between the development strategies of Health Village and Lake Nona.

Lake Nona, a small lake just east of Orlando?s airport, is a new development centered around six major research facilities, four of which are under construction. Financing came from a 2006 program, the Florida Capital Formation Act, that has contributed millions to start up biomedical research in the state. Florida?s state venture capital fund lured Scripps, Nemours, Burnham, and M. D. Anderson. Two state universities are also participating, as well as the Veterans Administration with a new facility. This taxpayer investment was supplemented by Tavistock, the master developer of Isleworth fame, and smaller contributions by city, county, and other private investors all creating the impetus to develop this campus.

Lake Nona?s Robert Adams described his ?model? as San Diego?s biomedical cluster, which combines commercial, clinical, research, and educational facilities forming. Employment, in the form of the research facilities, was preceded by a country club and an indistinct mix of Florida residential building types ? estate homes, smaller single family homes, and multifamily clusters that are sprinkled amongst golf courses, pretty lakes, and remnant pockets of old Florida wilderness. It?s obvious upon visiting the campus that this is first and foremost a real estate development scheme. Like most developers, Tavistock programmed the uses and zones as if all the land, being flat, were relatively equal in nature except for the slightly more lucrative edges of lakes and the even more lucrative engineered waterways. Currently, the Town Center is an open, flat D-shaped parcel conveniently accessed from Orlando?s beltway, the 417. A comfortable, safe land development scheme with all the usual regulatory battles is underway, and eventually Orlando will find a new, attractive community themed around medical research competing with other new developments for market share.

In contrast, Florida Hospital selected, among its multiple sites in the state, about 96 acres squeezed between two close, parallel roads (Orange Avenue and Interstate 4) in a dense part of the city where the Adventist Health System quietly bought up dozens of individual parcels of 1930s era Orlando. Like most neighborhoods still suffering in the shadow of Eisenhower?s grand interstate system, this one has languished, and Florida Hospital intends to convert this neighborhood into a Health Village campus anchored by its adjacent hospital campus in a slow, organically grown and financed process.

Orange Avenue bisects this Health Village, with towering hospital facilities on one side and an aged, mostly 2-story commercial neighborhood on the other. Much of the older residential stock is past its useful life, and owners, grateful for a buyer to release them from the ragged edge of Interstate 4, quickly sold out and left. Inserting the Burnham Institute?s Clinical Research Institute for Diabetes will be the latest revitalization project, and the interior land is intended for residential development catering to hospital professionals and staff within walking distance.

With 17 hospital locations in Florida alone (the Adventist Health System operates medical facilities throughout the South and Midwest), the choice to locate a health village in a congested urban site is an interesting one. The city deal-making involved in such a move is reminiscent of the negotiations for New York?s Lincoln Center near Columbus Circle in the 1960s, and is rare in Florida where land is cheap. At first glance, it seems like Florida Hospital willingly hamstrung itself with this strategy, as compared to the huge blank slate being developed by Tavistock in Lake Nona.

Tavistock also has eyes firmly watching the global health care market, and hopes to compete with San Diego, Research Triangle, Dubai?s Medical City, Singapore?s Biopolis, and other stellar research clusters. Lake Nona?s growth potential is relatively large, assuming a smooth flow of funding and continuation of markets. The science-themed real estate development brochures for Lake Nona exude a breezy, hip confidence, putting biomedical research in the background and projecting an alluring lifestyle in the foreground.

Instead of amping up its marketing campaign to overcome its vastly smaller size, Florida Hospital?s Health Village eschews marketing altogether, as if it is too busy developing it to talk about it. The Adventist Health System is not visibly interested in the temporal nature of global markets, and its stated position as a Christian health care institution quietly suggests that reviving a struggling neighborhood ? an exercise most developers would shy away from ? is worth the effort. Florida Hospital?s ultimate end appears to be planned on a much longer timescale.

Both projects are refreshing pathways for Florida, as they represent an attempt to develop future jobs away from the dependence on tourism and second home development. Of the two, right now Lake

Nona seems much more poised for growth. With a vision for 16,000 jobs at maturity, Lake Nona hopes to capture a substantial portion of the real estate growth attached to those jobs, which is the tried-and-true Old Florida model. Shopping areas, recreational activities, and lifestyle creation will add one more new neighborhood cluster to a multipolar, decentralized region at the expense of 7,000 acres of Florida?s natural environment.

In contrast, Florida Hospital?s urban build out will benefit existing neighborhoods, certainly a new concept for Floridians. In this respect, Florida Hospital?s tiny contribution to growth (some 800 new residential units are proposed to replace the 150 existing homes) is more than offset by its larger contribution to Orlando?s development as a city. And it delivers this at no expense to Florida?s natural environment.

Each model offers something to a revived Florida. Florida Hospital?s campus in congested Orlando is instructive as a model for economic activity in the urban future. Religious institutions may become a more important force in the community, given the lack of wealth creation by the standard players in Wall Street and real estate speculation.

Tavistock could contribute as well, particularly as a move towards a new modality of wealth creation that transcends the traditional Florida focus on consumption activities: shopping malls, hotels, and theme parks. Placing the region on the world stage as a contender in health research can move Florida away from its failed model and towards a future shaped by important diversifications of its employment base.

Richard Reep is an Architect and artist living in Winter Park, Florida. His practice has centered around hospitality-driven mixed use, and has contributed in various capacities to urban mixed-use projects, both nationally and internationally, for the last 25 years.

Photo pf Lake Nona development by saikofish