Gilbert Ramírez took the helm at the city’s Health, Housing & Homelessness (HHH) department Jan. 1, replacing outgoing director Carol Pierce. The position is a high profile one, as the city contends with a dual crisis of increased homelessness and lack of affordable housing. Roll-in additional complexities like mental health and addiction issues and Albuquerque, along with many cities across the country, are staring down big problems with big costs.

Ramírez has 23 years of experience as a licensed clinical and school social worker in Albuquerque. During a previous tenure as deputy director of the city’s behavioral health and wellness programs, he was involved in the launch of the Albuquerque Community Safety department and its violence intervention program, and the Gateway Center at Gibson Health Hub project.

Ramírez, 48, was born in Los Angeles to immigrant parents, but moved to Albuquerque at age 3. His wife, Cynthia, is also a social worker and executive director of technology at the Technology Leadership High School. The couple has two daughters aged 7 and 17.

City Desk ABQ asked Ramírez about his personal and professional background and some of the projects HHH is working on. Answers have been edited for length and clarity.

City Desk ABQ: Your family background has informed your work?

Ramírez: My father came to Albuquerque and bought a nightclub and was chasing that dream. He was a wonderful musician, recorded several albums, but didn’t have the business and finance background. He mortgaged the house for the club and then lost the house. I recall being very young and we had to be out by midnight. Eviction. Where are we gonna live? We ended up in HUD (U.S. Department of Housing & Urban Development) housing. I lived in HUD housing all the way through high school and my first year in college. 

That was kind of my upbringing — a little lived experience. It’s important. I’m always telling my team that while we do policy, we have to understand the impact. It’s for folks who are navigating hard systems.

Is it clear that the pandemic made housing and homelessness issues worse in Albuquerque?

Coming out of COVID, there’s just this compassion fatigue, and man has that been hard to deal with. Both with folks who think we’re not doing enough quickly, or they’re just done, their compassion is gone, and they just don’t want to see it. 

There was also a huge workforce withdrawal (in health-related industries) because other opportunities presented themselves, like telework, and jobs people sought with a more work-life balance. So there’s been workforce attrition and we’ve also seen a little less compassion for the folks who still need it. [The pandemic] was hard for most of us, but you can imagine how hard it was for them. Folks are struggling. 

The Gateway Center is a key focus. What is its potential?

We’re seeing a large amount of [homeless] folks exiting hospitals that have no place to go, and we’re getting them at the [Westside] shelter — folks with high, acute medical care needs, and we’re not a medical facility. We have light medical services, but nowhere near the services you would need. Gateway is important for the (50) medical respite and (50) sobering beds that we want to bring online in winter 2024. Where do folks go to heal? And actually heal well so that they’re not entering a very costly system over and over and over again? If they go back to the street, they don’t heal, they get infected or go back to the [emergency room] which is very costly. They discharge, and we just keep repeating that cycle.

It’s an expensive proposition?

In the end, it takes dollars to save dollars. It takes strain off the health care system, the medical workers; it saves [emergency room] beds needed for other health issues that need to be prioritized. It’s a trickle effect, right? But it’s not always thought of that way. We went out and looked at solid data. How many people were overdosing and how many people were going to hospitals? People are dying or clogging up hospitals. They’re basically sobering in the waiting room. We know what our rates are for death from alcohol, fentanyl, heroin, methamphetamines. We can do better. 

Can Gateway Center programs better track progress?

Gateway is a central location, because otherwise, where are they? Are they at a hotel? Evicted? In the shelter? It’s a centralized system in which you can discharge safely from a hospital to a resting place and have a guaranteed 45 or more days to heal (in a respite bed). It’s better humane care. It can make sure people don’t die. We have multiple projects happening, but this will be a huge addition that is significantly important. It’s making sure that you sober with medical oversight and don’t die — and then we work to connect you to recovery housing. We’re seeing a large population —  40% or higher — that are going to have some kind of behavioral health connected issue, whether that’s an addiction issue or mental health issue. It’s preparation for transitional living into being independent. 

What do you say to criticism that the Gateway Center has been too costly and hasn’t moved fast enough?

The criticism is going to be there. I’ve been in social services my entire career and you can pull any cost analysis report: for every dollar invested, you’re gonna get a little over $1 back — and decreased health care costs, longevity of life, workforce contribution. Of course the price tag you’re gonna see is going to be of concern because it’s these huge infusions of dollars. Where are they going? Where’s the payback? It’s a healthier community, holistically. Can we stand this up fast enough? I have to say, my little bit of argument is that we moved pretty fast to stand up what we have as quickly as we could, given construction issues and the pandemic. 

It does take bold leadership to say we’re gonna stick to a change and a path. We need to do housing navigation. We need to include those pieces that weren’t there before. We need to invest in vouchers and build more affordable housing, recovery housing, behavioral health services. That’s been our priority. Because if not, you have a clogged bathtub. You’re just warehousing. Yes, there’s a capacity limitation but it takes time to build and fund. Do we hide them, or help them?

Should people be fearful of the homeless?

There’ve been plenty of times where I’ve walked by a person’s car and heard the doors lock. I’ve walked in elevators and people have clutched their purse because of my presence. It’s very clear when I’m followed around in a store. So that personal experience of just being who I am — a first generation Mexican American oftentimes speaking Spanish — I know what that feels like; it’s no different with this population. 

A lot of people have good, kind intentions and wish to help. Not everyone has to solve the issue. Is it your intention to help? Is it your intention to understand? We get a lot of calls to 311 because people don’t want to stop or involve themselves. Great. It’s never a good feeling to feel afraid in your community. I get that; I’ve got my own children. Get involved. Volunteer. Sign up through our city portal. We’ll plug you in to identify your area of interest.
For more on HHH, click here.