In six months on the job as director of Santa Cruz County’s new Housing for Health division, Dr. Robert Ratner has seen plenty of interest and passion in the community around housing but perhaps not enough ways to channel engagement and elevate positive solutions.
Wrestling with a persistent housing and homelessness crisis, Santa Cruz County last fall brought in a fresh face to lead a newly created division to tackle the far-reaching issue.
After 14 years working for the Alameda County Health Care Services Agency and six years with a nonprofit community health center in Berkeley, Dr. Robert Ratner was hired as director of Santa Cruz County’s Housing for Health division, heading the county’s response on homelessness.
A little more than six months into his new job and after the county this spring launched an ambitious rehousing effort to help transition residents from emergency shelters into more stable housing, Lookout caught up with Ratner to get his thoughts on the state of homelessness in the county, his hopes for the future and his worries about the challenges that remain.
Here are the highlights of the conversation, edited for clarity and conciseness.
Q: You came to Santa Cruz County in November to lead the new Housing for Health division. What is your assessment of the housing and homelessness situation in the county six months later? What are your big takeaways so far?
I’d say, No. 1 — and this is a California-wide issue, but it’s particularly acute in Santa Cruz — the availability and the cost of rental housing, and even ownership opportunities, is really tight and challenging in Santa Cruz. And I think before I started working here I didn’t appreciate it as deeply as I do now. I think the level of resources available to help create more housing affordability, there’s some really significant gaps there.
There’s been a lot of tendency to focus on the negative, and folks blaming each other.
I think that some really positive things that have struck me about the community is that there are a lot of people that really want to lean in and contribute and do something to help address this issue, but there haven’t been clear ways of engaging and keeping people involved and honoring the positive things that are happening. There’s been a lot of tendency to focus on the negative, and folks blaming each other.
Santa Cruz has one of the highest rates of homelessness per capita of any of the counties in the state. But moving away from the blaming and shaming to kind of honoring and appreciating, because there are some really committed and passionate people here. And I think bringing them together will help us make a significant difference.
Do we want an inclusive community that allows for people at different incomes and different backgrounds, different levels of ability to be able to live in Santa Cruz? Or do we want a community that’s just for wealthy earners?
I think Santa Cruz County is in a moment of identity transition. All communities go through these identity transitions at different phases. … There’s been a movement of people from Silicon Valley, because now you can work remotely, into the Santa Cruz County community, changing the landscape, changing the real estate markets. And so I think fundamentally when it comes to addressing homelessness: What community do we want? Do we want an inclusive community that allows for people at different incomes and different backgrounds, different levels of ability to be able to live in Santa Cruz? Or do we want a community that’s just for wealthy earners? And I think that decision plays itself out in electoral politics and policy decisions that get made in different jurisdictions.
If we want to have a community that doesn’t accept homelessness, we have to have a community that’s allowing seniors and people with disabilities and students and others who don’t have these high incomes. We need to find a way that they can afford to live here. I think it really gets to the heart of: What kind of county do we want to have?
Q: What drew you to working in the field of housing and homelessness initially?
For me, my interest in this issue goes back to when I was 18 and just starting college down in Los Angeles … this was in the late ‘80s — 1989 to be specific — when homelessness was a relatively newer thing in the nation. The level of the problem really struck me. And I started doing volunteer work at a clinic called the Venice Family Clinic, and they were part of the Homeless Health Care network there.
And I volunteered at a shelter and worked at a soup kitchen, and just heard people’s stories and just felt this deep-seated frustration, sadness, an element of anger that in our country with so much wealth that we would have people who don’t have a place to sleep at night. So it just really created a passion for me to move my personal life and work life in the direction of trying to do something about the problem.
And back then, I mean, I distinctly remember having a moment where I thought: I’ll work on this for a little while and then we’ll fix it. The kind of youthful idealism. And it’s been, you know, over 30 years, and the problem has actually grown.
I think in the end it really boils down to collective commitment to the idea of housing as a fundamental need. And we’re just not there yet as a society.
Q: What do you think you learned in your time in Alameda County?
I learned over and over again that we spend a lot of energy on a lot of different topics when we talk about homelessness, but when people get a key to a room and have some support to move in, it’s really actually quite simple. I came to appreciate the amount of time and energy and money we spend on things that aren’t related to that. And how when we keep that focus on closing the gap between the cost of housing and people’s incomes, and getting people the supports they need to keep the housing — but that’s really how we have to solve the problem. And because we have a lack of resources to close those gaps and to make housing affordable, we end up spending a lot of time arguing and blaming and disagreeing about how to spend limited pots of money. So a lot of time gets spent managing scarcity and we forget the larger, collective goal we’re trying to achieve.
So I think we are living in a world where we don’t have those kinds of resources and that kind of commitment to fully close the gap to make housing options available for everyone. But we should spend less time blaming, criticizing — and acknowledge that partially where we’re stuck is we’re dealing with difficult scarcity challenges, and having to make tough decisions about … if you have 12,000 people on a waiting list, like we do in Santa Cruz County, for a housing voucher, and you only get 300 openings: All right, how are you gonna decide who gets it? And we can spend a lot of time on that, or we can spend more time on figuring out how do we get closer to being able to help 12,000 people instead of just the 300 that we’re able to get. So it’s finding that right kind of balance.
The other thing that I learned in Alameda is the importance of the partnerships between the private sector, private nonprofit, for-profit entities and governments, and really building collaborations and working across — the term that’s often used is silos. People get very used to being in their world, whether it’s education, mental health or substance use or housing. But when you can really bring people together who all have an interest and stake and commitment in dealing with the housing challenges of people in the community, you get a multiplier effect, and our efforts create much greater impact. And it takes a lot of time to build those relationships and ways of working together.
Later on in my time in Alameda, I started to ask myself, in part because I went to some trainings with some folks who do international work: Well, why is it that in the United States people don’t think housing is something that everyone should have? And that question got me to think about: What is it if you look at the data around who’s much more likely to experience homelessness in our society, not just Santa Cruz, but across the country — it’s a laundry list of stigmatized, historically disenfranchised, excluded groups. So I think there’s a lesson in looking at who experiences homelessness that in some ways is a reflection back to society.
Why is it that we have such stigma and fear around mental health issues? And how does that feed into this reality that we underfund many of our health care services, and more folks are homeless with those health conditions than other health conditions?
People who end up without a home, they’re telling us, ‘This is the space where you need to lean in and make some changes.’ Like the fact that African Americans are so overrepresented, I think is a mirror on us collectively. Why is that? What has happened in our country since its founding that’s contributing to this and how we’re going to get to those root causes? If we look at the fact that people with serious mental illnesses are so overrepresented: Why is it that we have such stigma and fear around mental health issues? And how does that feed into this reality that we underfund many of our health care services, and more folks are homeless with those health conditions than other health conditions?
That’s where I’m at this moment in my life, in my work life, it’s like: What are the underlying values and mindsets that make it hard for us to really get to sustain progress on this issue?
Q: What would you say gives you hope that a long-term fix to the problem could be in reach? What has you excited?
During the presidential campaign, Vice President (Kamala) Harris and (President Joe) Biden made a statement that they wanted to make the Section 8 program available to all eligible households. … So I think the biggest thing that can happen to address homelessness is at the federal level, if we could shift our housing financing policy to make sure lower-income people had the resources to be able to afford housing, homelessness would be a much less significant issue across the country.
The fact that we had a president and a candidate actually raise that issue, gives me some hope that people are realizing that housing matters in our country, and that it should be elevated as a policy issue.
Other things that give me hope is that I think the Santa Cruz community … is generally very caring and compassionate, wanting to solve challenging issues and bring people together to have an impact. And, you know, this particular moment where we have a lot of resources post-pandemic to try to reenergize our health and human services and housing safety nets is a real opportunity for us to start doing things differently — that I’m excited about. And it’s unprecedented. I’ve been involved with this stuff for 30 years and I haven’t seen this level of federal and state resources on this issue.
Q: What still worries you or keeps you up at night when you think about all this?
I think that the things that are most concerning are the kind of affordable housing gap and that we’re getting a lot of one-time commitments. Kind of the flip side of what I just said is that we need to sustain those federal and state investments over time.
It’s not as simple as just snap your fingers and stop using or snap your fingers and stop your voices that are going on in your head. And so I think it keeps me up (at night) in the sense that I’d like to figure out how people can get that same kind of understanding of the humanity.
And the other one that keeps me up at night is just hearing how people refer to folks experiencing homelessness who may be struggling with a whole variety of issues. Just the dehumanizing language. I think that’s the thing that keeps me up the most, is the just kind of forgetting the humanity.
I’ve had that moment in my life where I actually got to sit down with people and really hear their stories. And that changed me. That changed how I thought about this issue. Until you really sit down and hear someone’s history, you don’t fully understand how and why they got there.
I wish I could wave a wand and have everyone kind of have that opportunity that I had to really hear people’s stories — I mean deeply hear them. And understand that people struggling with mental health or substance use issues or things that are really stigmatized; there’s a story there. That it’s not as simple as just snap your fingers and stop using or snap your fingers and stop your voices that are going on in your head. And so I think it keeps me up in the sense that I’d like to figure out how people can get that same kind of understanding of the humanity.