“The Community Is Your Patient”

Photo by Ethan Pines C’92

The head of California’s largest private healthcare foundation looks back on a career investing in communities.


As the head of the California Endowment, the largest private nonprofit foundation in the state dedicated to improving residents’ health, Robert K. Ross C’76 M’80 G’92 transformed healthcare for underserved communities for nearly a quarter of a century. Ross retired from the Los Angeles–based philanthropic organization in September at the age of 69, leaving a legacy of health policy–focused grants that center on the community rather than individuals.

“It’s been a joyful, rewarding, privileged position,” he said.

During his tenure, the California Endowment made a game-changing investment to help implement the Affordable Care Act, popularly known as Obamacare. Ross said the $350 million investment—“the biggest we’ve ever made as a foundation”—went toward optimizing the success of Obamacare in California “through education, outreach, enrollment, and expanding services to immigrant communities who were left out.” Before the passage of the Affordable Care Act, approximately 20 percent of Californians had no health insurance. The unprecedented grant support boosted enrollment and cut the uninsured rate to approximately six percent, Ross noted.

Ross joined the California Endowment in 2000 with a wealth of healthcare and public policy experience shaped by his studies at Penn, where he earned three degrees. “I can’t say enough about how much my experience at Penn helped lay the groundwork for this career,” he said. “It’s been simply amazing.”

Born to a Puerto Rican mother and African American father, Ross grew up in the Bronx, New York. As a high school junior, he decided to apply to Penn after running in the Penn Relays. “I was flabbergasted at how beautiful and engaging the campus was,” said Ross, who majored in biology as an undergraduate before earning a medical degree from the Perelman School of Medicine. He completed his residency in pediatric medicine at the Children’s Hospital of Philadelphia.

Ross received a scholarship from the National Health Service Corps—a federal program that pays recipients’ medical school tuition in exchange for providing medical care in an underserved community—that kept him in the area. He then went to work as a pediatrician in Camden, New Jersey, during the crack cocaine epidemic in the 1980s, which “transformed my thinking about being a healer.”

Ross stopped seeing himself as simply a doctor treating patients and began to view his work in terms of treating a whole community, leading him to seek out public health administration roles.

“In public health, the community is your patient. And I just loved that idea, particularly in the context of the impact that crack was having on the health of Camden,” Ross said. Ultimately, he served as the commissioner of the Philadelphia Department of Public Health and later left the East Coast to become the director of the San Diego County Health and Human Services Agency.

After approximately eight years heading the San Diego agency, Ross joined the California Endowment’s board of directors just as the foundation was looking for a new president and CEO. With his strong background in public health leadership, it wasn’t long before the board asked Ross to head the foundation.

Blue Cross of California created the California Endowment in 1996. The foundation currently has more than $3 billion in assets and has awarded more than $3 billion in grants to community-based organizations throughout the state during its existence. The California Endowment seeks to “change the way people view health—from the notion that health happens in the doctor’s office to a belief that health happens where you live, work, learn, and play.”

From the start, Ross put his stamp on the foundation. “I wanted to focus on super-marginalized, ignored, and underserved populations,” he said. “We did a lot of investing in farm workers’ health across the state because they’re so ignored. So many of them don’t have legal immigration status and don’t qualify for any health services.” He also emphasized improving access to health and mental health services for young people of color in the juvenile justice and foster care systems, and youth in the LGBTQ+ community.

Under Ross’s leadership, the California Endowment became more focused on changing laws, policies, and systems that impede healthy living for a range of underserved communities. He counts the $350 million investment to support enrollment in the Affordable Care Act as one of his proudest accomplishments. But the ongoing difficulty managing the rising cost of healthcare and health insurance proved to be his biggest frustration. “Until we get to a more unified financing system in this country like single-payer [healthcare system] or some variation of single-payer, I don’t think we’re going be able to get our arms around it,” he said. “So that’s been a frustrating battle for us in the business of health philanthropy.”

Even as practice issues persisted, Ross concentrated on encouraging philosophical shifts within the California Endowment, particularly the foundation’s embrace of place-based funding, which lets community leaders decide how to best utilize investments in their communities.

“We ended up dropping anchor as a partner in 14 really low-income communities,” he said. The California Endowment then talked in-depth with community leaders to determine their needs. In East Los Angeles, for example, the foundation learned that a group of Latina women regularly walked in the cemetery for exercise to avoid gang violence in the neighborhood parks. “The cemetery ended up being the safest place for them to take a walk,” Ross said. “So we worked with them to get their parks cleaned up and make exercise more available and accessible.”

Ross believes being a good listener has helped make him an effective philanthropic leader. “In philanthropy, we often think about getting the smartest people in the room and making the smartest grant possible to solve an issue,” he said. “But what I’ve learned is [you need to] open your ears, lean forward, listen, and engage. Let your philanthropic investments be guided by grassroots organizations and grassroots leaders, and good things will undoubtedly occur.”

—Samantha Drake CGS’06

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