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Los Angeles Times Interview

Robert Ross

Adapting Health Care to the Country's Most Diverse State

November 12, 2000|Susan Anderson | Susan Anderson has written for The Nation and LA Weekly

Major shifts in the U.S. health-care system have transformed many nonprofit institutions into business enterprises. In May 1996, for example, the nonprofit insurer Blue Cross of California became a for-profit company, WellPoint Health Networks. In agreement with the state of California, the new corporation gave $900 million in cash to the California Endowment and a substantial portion of WellPoint stock to its sister organization, the California HealthCare Foundation.

The California Endowment, currently with assets of $3.7 billion, is the largest private health funder in the state and is dedicated to helping the underserved gain access to affordable quality health care. To date, it has awarded 1,580 grants, totaling about $559 million, to community foundations, universities, neighborhood care providers, affordable-housing developers and foster-care and family-services groups. In the L.A./Orange County area alone, the Endowment has awarded $86 million through 436 grants. Together with the Bill & Melinda Gates Foundation (assets $21 billion) and the David and Lucile Packard Foundation (assets $13 billion), the California Endowment makes the West Coast home to some of the nation's largest--and newest--philanthropic funders.

But since its inception four and a half years ago, the Endowment has been in turmoil. Two CEOs have come and gone, and critics charge that the Endowment still acts like a start-up organization and that its grant-making criteria are vague. Enter Robert K. Ross, who became the third president and CEO in July.

Described by some as a "visionary," Ross, a pediatrician, has a solid reputation as an advocate for expanded health care access to children, the disabled and underserved minorities. Previously, he was director of the $1.2-billion Health and Human Services agency for San Diego County and is credited with having overhauled and integrated various departments under a single public health umbrella. Ross believes that as "Los Angeles proceeds with dealing with [health] challenges, California will follow, and as California proceeds, the rest of the country will follow."

Ross received his bachelor's, master's in public administration and medical degrees from the University of Pennsylvania. He, his wife, Robin, and two of his three children reside in Woodland Hills.

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Question: How do you answer your critics?

Answer: A lot of the criticisms are appropriate but also expected. This is an organization that may not be in its infancy, but may be in its toddler stages in terms of development. By large-foundation standards, we are still a young organization. So it is not surprising that we have been somewhat broad in our grant-making and focus.

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Q: What is your focus now?

A: The issue of disparities in health care and health status [is] a major area of emphasis. It includes strengthening and expanding some partnerships that we have undertaken with the Centers for Disease Control and Prevention in Atlanta under a "REACH [Racial and Ethnic Approaches to Community Health] 2010" initiative, which has to do with ethnic approaches to improving health status. We've allocated some funding to allow community-based partnerships to identify health issues [associated with] significant health-status gaps in communities of color. There'll be a minimum of five such communities throughout the state of California, [and] Los Angeles will be part of that contingent.

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Q: The California Endowment talks about multicultural health care. What does that mean?

A: This is perhaps the most diverse state in the world. California, as it attempts to address some of the disparities in health, in particular, in communities of color, in the poor and rural populations, does not have the luxury of sitting back and waiting for innovative models and approaches to be developed elsewhere [in the United States]. . . . For example, we have a three-year, $1 million grant at White Memorial Medical Center in Boyle Heights. [The money funds] a program [to develop] a curriculum of cultural competence for faculty and residents. When you ask me what does cultural competency mean, my answer is: We are still developing the definition and standards for how that translates into practice guidelines, into what kinds of education medical residents and interns ought to receive, what kinds of linguistic and translation capabilities health institutions ought to have at their disposal. So that's part of our investment: developing a standard and a definition for cultural competency so it doesn't sound like liberal babble-speak.

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Q: Where has cultural competency been achieved?

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