Robert K. Ross, M.D., President and CEO, California Endowment: September 11 as Symptom

July 15, 2002
Robert K. Ross, California Endowment

For residents of New York City and Washington, D.C., the terrorist attacks of September 11 were a profoundly traumatic experience likely to reverberate on both a personal and communal level for years to come.

But, as becomes more apparent every day, the impact of the attacks extended far beyond Lower Manhattan or the Pentagon. From the war on terrorism to heightened tensions in the Middle East and Kashmir, from faltering stock indices to fading confidence on the part of U.S. consumers, from mounting calls for tighter immigration policies and increased scrutiny of legal aliens (especially those from Arab and Muslim countries) to the proposed creation of a federalized Homeland Security Department with cabinet status, 9/11 continues to ripple through almost every aspect of American life.

In May, Philanthropy News Digest spoke with Dr. Robert K. Ross, M.D., president and chief executive officer of the Woodland Hills-based California Endowment, a health foundation established in 1996 to address the health needs of Californians, about the activities of the Endowment in response to the attacks, the significance of 9/11 in the context of global health, and the lessons learned by organized philanthropy in the months since the attacks.

Prior to his appointment in September 2000, Dr. Ross served as director of the Health and Human Services Agency for the County of San Diego and was on the Endowment's board of directors for three years. In addition, he has served as the commissioner of the Philadelphia Department of Public Health; as medical director for the LINK School-Based Clinic Program in Camden, New Jersey; as an instructor of clinical medicine at Children's Hospital of Philadelphia; and as a faculty member at San Diego State University's School of Public Health. He is also actively involved in community and professional activities at both the local and national level, having served as chairman of the national Boost for Kids initiative and on the President's Summit for America's Future, as a member of the National Vaccine Advisory Committee, and on the boards of the National Marrow Donor Program, the San Diego United Way, and the Jackie Robinson YMCA.

Ross, who received his undergraduate, masters in Public Administration, and medical degrees from the University of Pennsylvania in Philadelphia, has received numerous awards and honors, including the Youth Advocacy Humanitarian of the Year award (1999), the Outstanding Community Service Award from the Volunteers of America (1999), and the Leadership Award from the Hospital Council of San Diego and Imperial Counties (1999). He was also a recipient of the Public Officials of the Year Award presented by Governing magazine in 1999 and is a recipient of a Robert Wood Johnson Clinical Scholar Fellowship and the National Association of Health Service Executives' Health Administrator of the Year Citation.

Philanthropy News Digest: September 11 was one of those watershed moments in American history that we're likely to remember for a long time to come. Can you tell us where you were you on the morning of the eleventh?

Robert Ross: On the morning of September 11, my wife and I were actually spending our first afternoon in Venice.

PND: Venice?

RR: Not Venice Beach. Venice, Italy. I had been invited to participate in the Rockefeller Foundation's annual board meeting in Bellagio, on Lake Como, where the foundation has a study and conference center. As soon as that meeting was over, my wife and I left for Venice. When we got to the hotel —— I guess it was around three o'clock in the afternoon —— I turned on CNN and immediately learned that a plane had hit one of the Twin Towers. At first, I thought I was watching one of those made-for-TV disaster movies or something, but of course it turned out to be all-too real. My wife and I are both native New Yorkers, so it affected us on a very personal level. But at the same time, we were out of the country and away from family and friends, and that complicated our pain.

PND: Were you able to get in touch with your staff at the endowment on the eleventh?

RR: With some difficulty. I finally did get a phone call through to my chief operating officer, and she assured me that things were under control at the office back in Los Angeles. But it was really quite a numbing and disorienting experience for me personally.

PND: At what point did you start to think the endowment was going to have to do something in response to the attacks?

RR: Only after the initial shock had worn off —— maybe seventy-two hours or so. At that point I began to think about the role philanthropy should and could play, although at the time I didn't have a clear idea about what that might be and knew that I would have to engage my board of directors in a discussion about what we could do.

PND: When did you start to have those conversations —— not only with your board, but also with other foundation leaders?

RR: I would say within a week of my return to the States. I can't recall exactly when the concept of an emergency fund, what came to be known as the September 11th Fund, was first suggested. But my suspicion all along was that there was going to be a tremendous outpouring of support for the family members who were directly impacted by the events of that day, and that that support would translate into significant dollars and resources for the affected families. And although that might be an appropriate way to respond, I also had a sense that there ought to be other ways in which philanthropy could play a role.

"...My view was then, and continues to be, that September 11 may be a symptom of our failure to tolerate and accept differences, and that we ought to respond to the events of eleventh in a way that gets at the root of the problem...."

So we began to have that discussion internally. You should know that, although we're a health foundation, we believe very strongly in diversity as a value. Being in California, we believe in an approach to health care that is multicultural and that taps the state's diversity as strength. My view was then, and continues to be, that September 11 may be a symptom of our failure to tolerate and accept differences, and that we ought to respond to the events of eleventh in a way that gets at the root of the problem. And again, although we're a health foundation, in my view, in our view, healthy communities don't spawn hate crimes, they don't spawn hateful events. So I viewed the events of September 11 as a direct assault on the health of the global community, and in that context we began to think about what role we could play at a local level in California.

Shortly thereafter, we started getting data and information about the impact of 9/11 on tourism, which is a major economic driver for California. And as data began to pour in, it became clear that 9/11 was also having an impact on access to health services, particularly for tourism and hospitality industry workers.

PND: Which led the endowment to team up in November with Kaiser Permanente and a number of local unions in Los Angeles County to extend health insurance coverage to tourism and hospitality industry workers in the state....

RR: Yes. That was one part of our three-pronged strategy, to be responsive to and supportive of workers adversely impacted by the damage to the tourism industry, especially in regard to their health status and health needs. The second piece came later, as we began to field concerns from community-based nonprofits that provide health services to poor communities. In many cases, fundraising by those organizations had been negatively impacted by 9/11, both because, in terms of corporate and private support, so many resources had been diverted to the September 11th Fund and, secondly, because of the adverse economic impact of 9/11 on tourism, which resulted in increased demand for their services due to corporate downsizing and layoffs. So the second piece involved supporting and responding to the needs of those community-based organizations, and to that end we created a $13 million fund to provide emergency grants to boost their funds, so that they could continue to serve communities without interruption.

The third piece was to raise the level of public awareness — at a time when the front pages were still filled with stories about 9/11 and terrorism and bioterrorism —— about the very negative impact on safety-net institutions and community-based nonprofit providers, both in terms of the demands on their services and their difficulty in raising funds. So we actually commissioned a statewide media campaign that ultimately cost us something like $2.3 million, with some in-kind contributions from the networks, to raise the level of awareness of the economic impact of 9/11 on the working poor and other Californians.

PND: Will any of the initiatives you've just described impact your future funding priorities?

RR: In one respect, yes. And that has to do with the issue of hate crimes. One of the things we did in response to 9/11 was to initiate a new $3 million program to support community-based agencies and nonprofits that engage in hate-crime prevention and intervention work. Now, some may think that's unusual for a health foundation, which more typically focuses on things like diabetes, asthma, and cancer prevention. But, as I mentioned, we view the events of September 11 as the ultimate hate crime against this nation. And very much in the spirit of thinking globally and acting locally, we wanted to support the work of those who respond to and try to eliminate hate crimes in their own communities. So September 11 did put the issue of hate crimes on our radar screen as a community health-promotion investment and shaped our thinking in that regard.

PND: If I'm not mistaken, you also recently announced a series of grants to promote racial tolerance.

RR: Yes, we did. Our staff, our board of directors, myself, we all received a quick education around the issue of intolerance and hate crimes as a public health issue in our communities.

PND: Generally speaking, do you think the philanthropic sector responded effectively and in proportion to both the immediate and longer-term needs of the people and communities affected by the events of September 11?

RR: Well, I'm not sure. I think if you define the families of the victims of the World Trade Center tragedy as the sole victims of 9/11, then I would say yes. Private and corporate philanthropy was exceedingly generous in responding to the needs of those three thousand families. But I think philanthropy may have been short-sighted in looking at the possible root causes of these types of events and in responding to those root causes, as well as about the needs of the so-called indirect victims of the events of 9/11. In my view, I think it was important to first provide monetary help to the families and loved ones to help comfort them in a terrible time of grief and mourning. However, we should not limit our response.

PND: Some people —— the folks at the September 11th Fund, for example —— would argue that they've always had their eye on the needs of those who were indirectly affected by 9/11 —— displaced residents of Lower Manhattan, people who lost their jobs or businesses, and so on. Are you suggesting they could have or should have done more to help those people?

RR: No, I think their immediate response was very appropriate. However, we must also look at what happened in communities of color after September 11, particularly in Muslim communities, where there was a sharp increase in hate crimes involving many innocent individuals, mostly American-born Muslims and others who happened to look like the terrorists.

PND: Do you feel the efforts of agencies and foundations like yours to grapple with some of these longer-term issues and to address some of the problems of the indirect victims were and are being effectively communicated to the public?

"...From the standpoint of everyone remembering where they were when it happened, there's no question about 9/11 having a lasting impact. But as an event that transformed and touched the soul of the nation, well, quite frankly, I haven't seen much evidence of that...."

RR: I don't think so. The media has mainly focused on 9/11 as a seminal event in our nation's history. Any other story or message would have a hard time competing with that approach. From the standpoint of everyone remembering where they were when it happened, there's no question about it having a lasting impact. But as an event that transformed and touched the soul of the nation, well, quite frankly, I haven't seen much evidence of that. For example, I haven't seen an increase in philanthropic or charitable giving, or policy makers responding differently or more effectively to disenfranchised populations and communities. So I'd have to say that while I was looking and hoping for evidence that the soul of our nation had been touched and transformed in a fundamental way by 9/11, I'm still waiting for it to happen.

PND: Do you think the media criticism of various relief agencies in the first few months after the attacks was warranted?

RR: I think it was partially warranted, but for a different reason. Even though I'm a relative newcomer to philanthropy —— I've been in it for about twenty months now —— I can say with certainty that giving money away is much more difficult than it appears. And, of course, hindsight is always twenty-twenty. But my guess is that had the Red Cross and other charities gotten the money out much faster —— and I'm sure the issues that prevented them from doing so had to do with process, accountability, and making certain that the right resources got to the right people in the right way —— the media would have reported a different kind of story, perhaps one that was more about fraud, waste, and sloppiness in the allocation of resources. I think what the Red Cross and other charities failed to do was to adequately address the expectations having to do with timeliness —— that is, if the Red Cross had come out and said, "Look, we want to make certain that we are one hundred percent accurate in getting resources to the families in need, and we want to make sure we can account for every dime of the hundreds of millions of dollars we have received, and it will take us X number of months to ensure a hundred percent accuracy and accountability," the public, policy makers, and the media would have been much more understanding of the other things the Red Cross was doing. But clearly, that wasn't done adequately, and it's a reminder for all of us in philanthropy that we need to be better communicators with the public about our actions.

PND: Was the endowment criticized by the media in California for its response to 9/11?

RR: Actually, the work we did was fairly well received, in that what media coverage we did get was generally very positive. The hate-crimes money, the safety-net money, the media campaign all got put together, approved by the board, and mobilized between, I would say, mid-October and Christmas. And I think the media was appreciative of that. Certainly, the feedback I got from community leaders, United Ways, and community foundations in the state was quite positive in terms of the timeliness of our grants and the campaign's ability to energize donations.

PND: You've already touched on this, but I'll ask it in a different way: From your perspective as the head of a major West Coast philanthropy, are there areas or issues post 9/11 that have not received their fair share of funding or attention?

RR: Well, at the risk of sounding corny or even cosmic, I would say that America in general, and California in particular —— and New York City is much like California in this regard —— are living experiments of multiculturalism and diversity. As a California philanthropy, we can't directly address the situation in the Middle East, but we can certainly play a role and do our part to reduce and eliminate hatred and violence fueled by differences in East L.A. and Oakland and Fresno. So, it would be my hope that more foundations come to view investing in multiculturalism and diversity as an asset and a strength of our country, because, clearly, it's important and critical work.

PND: As the president of a major California health care philanthropy, what do you see as the greatest areas of need in your state going forward?

RR: Well, we have been focusing on the disparities in health care and health status and health access among at-risk communities and populations. The majority of those communities are primarily, though not exclusively, communities of color and immigrants. That was the focus of our work prior to 9/11, and since 9/11; and quite frankly, I think all of us —— the board, the staff —— have felt affirmed in the importance of that work. Having strategies in place to reach out to disenfranchised and marginalized communities, and to utilize diversity as a strength and asset in improving the health of all Californians, is very important work to us.

PND: A final question: What, in your view, are some of the lessons the sector has learned as a result of 9/11?

"...The most important experiment on this planet today has to do not only with whether individuals and nations of varying ethnicities and cultural backgrounds can learn to live with and tolerate each other, but whether they can resolve their problems in non-violent, mutually respectful ways...."

RR: Well, there's a clear lesson around the importance of clearly communicating to the public information about the philanthropic process. But it would be shortsighted to leave it at that. As I mentioned, I think the most important experiment on this planet today has to do not only with whether individuals and nations of varying ethnicities and cultural backgrounds can learn to live with and tolerate each other, but whether they can resolve their problems in non-violent, mutually respectful ways.

PND: Would you care to comment about what might happen if we can't learn to resolve our problems in non-violent, mutually respectful ways?

RR: I'd rather not speculate, but I would say that we must all work to continue to find nonviolent and meaningful ways to address the issues of diversity and multiculturalism throughout our nation.

PND: Well, thank you, Dr. Ross, for sharing your time and thoughts with us this afternoon.

RR: Thank you for asking.

Mitch Nauffts, PND's editorial director, spoke with Ross in May. For more information about the Newsmaker series, contact Mitch at