Endowment CEO Discusses Challenges for Minority Health

In a Los Angeles Times interview, California Endowment President and CEO Robert Ross shared his views on the challenges of and possible plans to adapt health care to suit the needs of minority communities. The California Endowment was founded in May 1996 when the
not-for-profit insurer Blue Cross of California became the
for-profit WellPoint Health Networks. The new corporation gave $900 million to the California Endowment and "a substantial portion of WellPoint stock to its sister organization, the California HealthCare Foundation," the Times reports. With assets of $3.7 billion, the California Endowment is currently the state's largest private health funder and is "dedicated to helping the underserved gain access to affordable quality health care." The Endowment has awarded 1,580 grants, totaling $559 million, to universities, family service groups and community foundations. However, the Endowment has been in "turmoil" since its creation four and a half years ago as critics contend that the philanthropy "still acts like a start-up organization" and has "vague" grant-making criteria. Ross, the Endowment's third president and CEO, came on board in July. Calling some of the criticism about the Endowment was "appropriate" and "expected," Ross said, "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." He added that the Endowment is currently focusing on "strengthening and expanding" its partnerships with the CDC under a REACH "Racial and Ethnic Approaches to Community Health 2010" initiative, which adopts "ethnic approaches to improving health status." Ross added that a "major point of emphasis" for the California Endowment will include encouraging and continuing grant-making to community clinics, which "have far more experience" implementing "cultural competency," or adopting health care to meet the needs of certain groups, than traditional health institutions like hospitals. "We hope to take some of what the (clinics) have learned in terms of culturally appropriate responses in health care delivery and apply those lessons to hospitals, larger clinics and HMOs. ... There is no question that the incubator for innovation is generally at the community and neighborhood levels, and with not-for-profit community-based institutions," Ross said.

When asked about the role philanthropy should play in addressing minorities' health care needs, Ross said that "philanthropy ought to play a more significant role, not just at the level of grant-making, but at demonstrating leadership at the policymaking level to turn the successful pilots into large-scale meaningful change." Foundations also need to examine health issues facing farm workers and their families, "both from a moral standpoint and a policy standpoint," Ross said, adding that many of these individuals are "invisible to public programs in terms of public health services," despite their "large numbers." Ross concluded by calling for more interaction between families and health providers to increase cultural understanding between the two groups. He said, "[I]nteractions between family and provider, in part, are responsible for and explain some of the health status gaps and disparities that still exist. Whether you're an African American with diabetes or an Asian woman with cervical cancer, those issues are best addressed with an enhanced cultural understanding of what the issues are" (Anderson, Los Angeles Times, 11/12).