This story starts with a veteran who liked to garden.

The East Orange Campus of the Department of Veterans Affairs New Jersey Health Care System (VA NJHCS) practices a patient-centered approach to health and healing. When a 71-year-old veteran was undergoing outpatient treatment for substance abuse, his recovery was enhanced by becoming a Rutgers Master Gardener. A seed was planted that led to healing, stress reduction, and innovation—and touched the lives of many other veterans and staff.

The recovery was fortified by a psychologist and work restoration coordinator who integrated gardening and vocational rehabilitation into recovery treatment. Additional partnerships were forged when the veteran, an urban gardener, the psychologist, and work restoration coordinator envisioned partnership with the VA’s Planetree staff as a way to enhance recovery and a healthier VA community. Funding was identified and a compensated work therapy (CWT) program was established to provide veterans with gardening and ground maintenance employment opportunities.

In addition to gardening and a Master Gardener program, Jan Zientek, senior program coordinator, Rutgers Cooperative Extension of Essex County, and Kurtis Hanscom, MPA, COTR, coordinator of the Work Restoration Program at VA NJHCS, also developed a landscaping technologist certification course for veterans.

Training includes soil science, propagation, disease management, and pest control. Veterans benefited from the landscaping technologist course and one started his own landscaping business. The group instituted gardening on campus, growing their own tomatoes and herbs. They used 20-by-50-foot plots and harvested more than 1,000 pounds of produce in the summer of 2010. The Foxhole Café restaurant at one campus uses vegetables and culinary herbs provided from the garden. The first group of eight veterans received their landscaping technologist certification in October 2010. The second group of eight veterans began the program in May 2011.

In addition to the landscape maintenance training, Amy Rowe, PhD, environmental and resource management agent–Essex and Passaic counties, Rutgers New Jersey Agricultural Experiment Station, has expanded the curriculum for one course, which also will provide veterans with education in storm water management. The veterans will learn about storm system disconnection, water conservation techniques, and how to build rain barrels for capturing roof runoff that will be used to water the gardens that have been planted around the property.

Participants also will learn how to design, install, and maintain rain gardens that will reduce erosion and storm water issues at the facility. Finally, the veterans will receive training in the concepts behind and designing of permeable pavement, which is a porous surface that allows water to infiltrate to native soil and, therefore, reduces flooding and ponding of storm water in trouble areas. The classes will have hands-on components to them, such as installing rain gardens and participating in the installation of the permeable pavement.

Greenhouse for year-round gardening

Using her expertise in evidence-based design as a Pebble Project partner with The Center for Health Design and Planetree, Mary Therese Hankinson, MBA, MS, RD, EDAC, Planetree coordinator, collaborated with Hanscom, on a VHA grant based on Planetree’s model of healthy communities. VA NJHCS received $100,000 from a VHA Innovation Funding for the Advancement of Patient-Centered Care grant to construct a greenhouse so the veterans could garden, and receive instruction on landscaping and storm water management year-round. The 26-by-36-foot greenhouse would make it possible to continue growing tomatoes and herbs, and earn potential income from developing their own farmer’s market.

Acquisition of a greenhouse was seen as a sustainable strategy for veterans to receive therapy, education, vocational rehabilitation, compensated work therapy, and continuous employment opportunities year-round. Veterans established a veteran-operated farmer's market as a greenhouse goal. Stakeholders, including the Foxhole Café (veteran-managed) and the VA retail store, and the VA food service department expressed interest in volume purchases.


Naomi Sachs, ASLA, and Jerry Smith, FASLA, both members of the Environmental Standards Council of The Center for Health Design, pointed to evidence-based research around gardens and their impact on healing environments. Sachs is director and founder of the Therapeutic Landscapes Network (TLN), a Web-based gathering place for all things therapeutic in landscape design, and Smith serves on the TLN Advisory Board and the Green Guide for Health Care (GGHC) Steering Committee, and he is principal at Smith\GreenHealth Consulting in Columbus.

Their work on the Environmental Standards Council is currently focusing on building a research database and trends analysis supporting access to nature sections in the Guidelines for Design and Construction of Hospitals and Healthcare Facilities.

It was through Smith’s work on the GGHC steering committee that the evidence-based research on the health benefits of nature was included in the sustainable sites s
ection of the guide and is now in the new LEED for Healthcare (LEED-HC). These are some of the defining credits that distinguish GGHC and LEED-HC from the other sustainable design toolkits and helped introduce the benefits of nature into the realm of sustainability, including access to nature, daylighting, views of nature, and its redeeming sustainable attributes for human health and wellbeing.

Additionally, growing produce and collecting rainwater reduce food transportation and support conservation of natural resources. The beauty is when an attribute, like a garden or meditative space, can act as a component of healing, yet exist in a sustainable manner through resource conservation and education.

Healing garden planning

While few would argue the value and benefit of green space, as with any design feature, the earlier it is included in the planning process, the better. Connection to nature, horticulture programming, greenhouses, green roofs, water features, and gardens need to be considered in the earliest visioning sessions of a project and championed from programming through design and construction administration.

If they aren’t, there is a greater chance of being value engineered when the budget is challenged. Interestingly, it has been found that healing gardens have the potential to harvest new sources of funding and identify new partnerships with academia, community groups, and local garden clubs and botanical gardens, providing first-time donor opportunities so the funding does not need to compete with other project goals.

As with any other initiative, diverse team participation is critical to success, including a focus on patients, needs of the community and staff, infection control, safety, clinical staff, facility maintenance, and more. Having the right players at the table at the right time—in this case, landscape architects with professional expertise in therapeutic garden design—is critical in healthcare design.

Because of the multidisciplinary design teams and integrated systems required for healthcare facilities, the Integrated Design Process is a prerequisite in both the GGHC and LEED-HC as well as in the Sustainable Sites Initiative. Having the right players at the table at the right time is critical in healthcare design, perhaps more so than with any other building type.

The GGHC can be downloaded for no charge for view of the sustainable sites section in the version 2.2 operations section, including a landscape management plan, protecting or restoring open space or habitat, stormwater management, places of respite, and more. The TLN also is blooming with information.

It started with a veteran who liked to garden. HCD

Janet Brown can be reached at