In the social profit sector, trust is the biggest thing that mediates relationships between boards and leadership teams, but it’s not always easy to measure. At the Dr. Peter AIDS Foundation, Scott Elliott believes that the starting point for trust building is authenticity and integrity. Even in the midst of the COVID-19 pandemic, Scott and his team of silent warriors are waging a softer fight against an older pandemic and the larger social issues that have always gone along with it. Joining Douglas Nelson on the show, he shares some of the challenges of leadership and maintaining board relationships at a time when everyone in the sector is forced to do a lot of things differently.
Listen to the podcast here:
Dr. Peter AIDS Foundation With Scott Elliott
Our guest is Scott Elliott. He’s the Executive Director of the Dr. Peter AIDS Foundation in Vancouver. We’re thrilled to have him. Welcome, Scott.
Thank you so much. It’s great to be here, Doug.
Some of our readers may not be familiar with the Dr. Peter AIDS Foundation and the work that the Dr. Peter Centre does. Can you give us a quick overview of what the organization is and where you’ve come from?
We were started from a vision of Dr. Peter Jepson-Young. About many years ago, Dr. Peter contracted AIDS. If you think back to the ‘80s, people weren’t diagnosed with HIV. You weren’t diagnosed until you were sick. Peter was quite ill. He was diagnosed with AIDS. He went blind immediately. That was a neurological condition that affected him from the disease, but he didn’t die. He got together with some of his friends and they had some contacts at CBC Radio and Television, and they decided to do a ten-episode reality TV show on the day in the life of a guy with AIDS. Interestingly, this was the first reality TV show that CBC had ever been done. That ten-episode pilot turned into two years of a weekly show of documenting his life, struggle and eventual death living with AIDS.
It was nominated for an Oscar back in the day. In the same year, the movie, Philadelphia, won which was about HIV/AIDS as well. It won an Oscar for Best Movie. Before Peter passed, his friends got together and wanted his legacy to be in, and if there was something that could be taken out of that notoriety and the answer was to create a clinical organization that would provide comfort care for people living with AIDS. Comfort care now was more referring to palliative care. Back in the day, what he was thinking about was stigma-free care, that was compassionate, loving and that would provide a spot in space for someone to go in. If they were palliative and they were to die, someone is there to be with them and people to understand.
Fast forward, the Dr. Peter Centre is a facility in the West End of Vancouver. We’ve now been operating that facility for over many years. From day one, we’ve worked with people who have HIV, but also interestingly enough, when we opened the facility many years ago, in Vancouver the new HIV infections weren’t just with gay men anymore. That was the predominance originally, but that morphed into the intravenous drug-using community in the Downtown Eastside. At the same time, there were new antiretroviral drugs, which had come out. People were living longer and not dying right away, which is a fantastic thing.
In Vancouver, we had this super high rate of new HIV infections in the gay community, but also in the Downtown Eastside. The Dr. Peter Centre responded to that immediately. The participants in our day health program have that mix of having a background coming from a very diverse section of the Vancouver society. We have a day program, which we have about 450 people registered and they come to the center for medication management. They come to the center for food and also we have art therapy, music therapy, counseling and recreational therapy.
We’ll get into the pandemic impacts through our conversation but what you’re describing there is not a system that you can shut down because of the COVID-19 pandemic.
It was quite the opposite. Because we do medication management for a lot of these people, we have to be open. We are an essential service. During 2020, through the entire course of the pandemic, we haven’t closed. Quite the opposite of the day program, we normally close on stat holidays. In 2020, we remained open for stat holidays as well. We haven’t closed one day. Attached to us, we’ve also got a long-term care facility. It’s a 24-unit facility where we worked with highly medically complex and often, behaviorally complex individuals in that facility as well. Between the two, we haven’t missed a day during COVID.
One of the things we’ve observed in many guests on the show, they talked about how the pandemic has changed the way their organization operates. When we were speaking earlier, you said that your organization was born in a pandemic, the HIV/AIDS pandemic. You are, if not, ready for this, at least familiar with what was going to be required of your organization during this time.Trust is easy if everyone operates from a point of authenticity and integrity. Click To Tweet
People forget that AIDS globally is still a worldwide pandemic and it’s still a pandemic that’s quite deadly. If you don’t access to medications and you contract AIDS, it still is a death sentence. We have to keep that in mind. In Vancouver, I would argue that we have some of the best HIV care anywhere in the world. Our people are well cared for. However, when you bring in other complexities, like mental illness, substance use, chaotic life, homelessness, there’s a lot of other barriers that we need to think about and look at. For us, we deal with a pandemic every single day. When COVID was ramping up in March 2020, there were a lot of questions and fear in the community overall. We took it in stride. We did what we needed to do which is to remain open, that we had to remain open at all costs and we did. We wanted to keep our staff safe and our participants safe and we have. We had to find ways and means of dealing with the new pandemic just as we had dealing with the AIDS pandemic many years ago.
I was interested to see that a few months into the pandemic, the leadership that your organization demonstrates on a daily basis in the harm reduction space was recognized by Health Canada and you were asked to start the HUB. Could you tell us a little bit more about what that was and how it came to be that you were in the lead when Health Canada came knocking?
A bit of genesis on that. We’ve operated a supervised injection site at the center since it first opened many years ago. For us, the idea of harm reduction and helping people or working with people who have addictions is not new to us. We see it as one more piece of their whole medical history and we have no stigma around it. We’ve got no judgment around it. We approach it as we want to engage people in their healthcare. Harm reduction tools can help someone be healthier and engage them in a different way. About many years ago, we started working nationally through a Public Health Agency of Canada grant, working with organizations across the country, helping them doing policy procedures, training, and so forth of organizations who are looking to set up some supervised injection site.
A few years ago, we started an Intravenous Opiate Agonist Therapy Program and doing research and translation on that as well. Instead of giving someone methadone or methadone in the pill format, we are giving an injectable format, which is a lot stronger. We’re from the AIDS pandemic, we’ve now got the COVID pandemic. For the last many years, Canada has been struggling with an overdose epidemic as well. BC is being ground zero for that, but we’ve seen that spreading much more across the country, especially in urban settings, but we’re seeing it pop up all across the country. When COVID hit in March and April 2020 and shelter started having to retool how they do business, we started to see homeless.
We wanted to get the homeless off of the street into some shelter, even in a temporary manner. A lot of the organizations that were starting to do this were abstinence-based. All of a sudden, they’re running a shelter that used to be abstinence-based and now running a shelter that they’ve got people actively using substances in that facility and nobody knew what to do. That’s when the Federal Government came to us and asked us to set up a network where we can help people share best practices, find access to resources and learn from each other. We don’t profess to be the experts on one model. There are a lot of different models now across the country and different things work for different communities. What we try to do is try and broker some of that knowledge so it flows a little more effectively.
One of the things that come through in our conversation in learning about your organization is that adaptability and service to the mission are impressive. How do you keep your board aligned with the variety of services you’re offering, the national leadership role you’re playing, understanding what’s the mission of the organization and keeping that board informed and supportive as you move ahead?
We’ve got a fantastic board. We work well together. A few years ago, I started talking to our board about meeting a new strategic plan and we still haven’t finalized it. What we decided as an organization was, the key thing that we needed to be clear on, it wasn’t our mission and our vision per se, but it was our purpose. What is the reason that we exist? It’s not what we exist to do. It’s not who we want to be. It’s the actual reason why we exist. We spent about a year delving into that and exploring the why. We talked about DNA, but what was the DNA of the organization and why do we do what we do? What that’s done is that’s completely jelled the board members to be there for a common purpose? We’re all there for the same purpose. We may not agree on all the things. We may not agree on how to get there. We may not agree if we are there, but we agree that this is our purpose and it’s something that makes us quite strong. The board has been fantastic about that.
As an organization, you were an institution founded in service to a movement to meet the practical health needs of patients in the community. You’re at a point where as an institution, you are very well-respected. Through your harm-reduction work and your national leadership, that movement side of your organization is coming to the fore, and that calls for different types of governance. When you have an institution, boards have more control over the direction and they tend to be, even if they’re not in the operations, they’re paying close attention to the strategies. What we see are organizations that are more movement-focused. The board spends most of their time defining the common purpose or setting the North Star for the organization. It plays much more of a navigating role rather than that command and control model that some boards work on. How do you manage to keep your board more in that navigation navigator role rather than the “We’re the boss of you” role?
Our board’s quite clear. We don’t follow Robert’s Rules of Order or a lot of the governance things, but we do follow them. Some organizations and some boards that I’ve worked with, it’s all about that.
Most of the boards think they follow Robert’s Rules of Order.
They focus on the process of that rather than the purpose of the organization. When we look at who we attract to the Dr. Peter Centre, both at a staff level but also at a board level, that piece is important. The alignment of the individual to the organization is important for us. I’ll give you two examples. One is when I started at the organization many years ago, I did some work around our culture. I wanted to figure out what our culture was. I didn’t screw it up. We had a good culture. I was coming in after a long-term executive director. I wanted to make sure that we kept the things we wanted and were able to change things that we thought was time to change.
The archetype of our staff is they are quiet warriors and that’s also the archetype of our board. If I think about where we come to with that is that people are there for the right reason. When we need to fight, we’ll fight. We have no problem with that, but we don’t need to do that all the time. That’s not our mandate. Our mandate is to be effective. We don’t mind using the word loving and clinical service. Imagine going to your doctor’s office and somehow the word loving comes in. It wouldn’t happen. We’re dealing with the people that a lot of the doctor’s offices don’t want. A lot of the emergencies don’t want to see and they’re coming with us and we provide that loving approach.
Our board is the same. We’ve got board members who’ve been involved since day one. Day one, not always on the board. We have very clear terms of mandates. People have to rotate off the board, but we’ve got people that were involved with Dr. Peter himself, many years ago that are now on our board. We have this wonderful memory of legacy and we’ve got a lot of very smart people who are good at strategy, thinking, keeping the direction, and we’ve got fairly strong leadership in the organization too. That’s equally as important.
A board needs to work with and interact with particularly the executive director or CEO, but also have the trust that the organization is doing things in the way that we say we are. I make that part easy for our board when it comes to our financial management, when it comes to our reporting. We go above and beyond to do exceptional jobs so board members understand what we’re doing. When we have meetings, we don’t have to be nervous about something that could be quite tactical or small-budgeted item. They already know that they already have trust and we’re able to focus on the bigger picture.
You raised several interesting points there, but I want to go back to one in particular. You talked about the strength of having the legacy and the legacy relationship with Dr. Peter around your board table. Sometimes, those legacies can act as a weight on organizations. I’ve talked to several executive directors, CEOs who like you, the legacy is in the name of their organization. They’re trying to constantly push the organization to evolve to the current time, not the time that it was originally founded. It sounds like you’ve done a good job of leveraging the power of that legacy to do the work that needs to be done now. How do you strike that balance either in a board meeting or as you’re preparing for a board meeting and conversations with the chair and board members?
I’d like to say there’s a magic formula of where it’s organized or something, but it all comes down to relationships and trust as far as I can see, at least with us. We’ve got legacy going all the way back and the legacy is more than on the board. Dr. Peter’s mom, Shirley Young, the mother and father are both still alive and Shirley still volunteers with us. She’s 85 and she volunteers with us on a regular basis. I use her as my moral compass. I don’t hear that too often, my executive directors either, but I’d have conversations with her. If she was behind it, it makes easy for me to go to the board and say, “This is the way it is. It’s easy.”
There is some of that. Every board member we have is one individual. Board styles ebb and flow. For the past many years, the board of directors that we have is very respectful. They know how to listen to each other. We ensure during meetings that things are well-organized, but there’s also time for the board. There’s always an in-camera session. This is one little tactical thing that we do. Every committee meeting and every board meeting, there’s an opportunity for board members to speak without staff, without the executive director present and that’s important too. If they have conversations of things they’re not sure about, they can talk about that as well. We try not to have secrets. There are no secrets on our board. We’re not working against each other. We’re working for a common purpose and working with each other.
Your answer to how you manage the board and manage to balance legacy is that it comes down to trust. How do you measure trust?
That’s more of the nuance. I think I’ve been working in the not-for-profit sector for many years. If I think back at the very beginning, I don’t know if I do anything that differently. The actions that I do are more or less the same, but the way that I can read the nuances and understand the nuances have changed dramatically. A lot of that for me comes down to experience. There is that piece of it. It’s also taking time for people to know each other and understand each other. If we’re all operating from the point of authenticity and integrity, then trust is easy. As the executive director, I don’t try and be someone who I am not. I don’t try and make things sound fancier than they are. I don’t try and make things sound worse than they are. I present things to the best of my ability and then allow the discussion to happen.
It so much of the work in this sector, whether you’re working as a fundraiser or the CEO or the executive director. It comes down to trust, both with the board or with donors. For people who are successful in their roles, they say, as you did, it comes down to trust. That’s why I asked the question. I’m curious to how people earlier on in their career can get to that point of comfort to let things go and show up as their authentic self and say, “This is a problem. I’m struggling with an answer here,” and have a genuine conversation with their board, because the more often that happens, the better the organizations are going to be.As a leader, you need to get your ego out of the way and realize that it’s not about you. Click To Tweet
Something you said is that, I don’t have to have all the answers. I’m clear that often that I don’t. Even when I got hired at the Dr. Peter Centre, when I was going through the interview process, I was clear. I’m not a healthcare administrator. My predecessor was a brilliant healthcare administrator. That’s not me, I’m a leader. They need to decide tactically, do they want a content expert or a leader? They chose a leader. We become content experts, but that’s not how I started. I didn’t come to the job saying, “I know everything about everything.” I came to the job saying, “This is what I am proficient at and good at.” I’ll use the people around me. I surround myself with smart people. They’re the ones that are the content expert.
When we’re able to say that, “We don’t know or let me go find out. It could be a wicked problem that we can’t solve on our own that we have to bring others together.” In the sector that I’m in, a lot of the issues that we’re dealing with, homelessness, poverty, substance use and mental illness, none of these are going to be solved by the Dr. Peter Centre. We have to work with a wide array of organizations, people and systems to try and chink the small way at this massive problem.
You touched on something that’s been in the back of my mind in 2020 is that saying, “I don’t know,” when you’re in a leadership position, for most people in the sector is tantamount to an act of courage. It’s a courageous heroic act to say, “I don’t know.” I don’t know why it’s hard for us to do that. Can you think back in your career before the Dr. Peter Centre where you had that moment of courage, when you said, “I don’t know,” to a boss or to a board? “I don’t know the answer to that, but I’m going to figure that out.” Can you think of when you learned that lesson that it was okay and an advantage to be able to say that?
I’ve been fundraising for many years. When fundraising started back in the day, none of us knew what we were doing. There were conferences, but there were no courses. There were no degrees. We didn’t know what we were doing. We made it up and went forward. The key for me has always been if I can get my ego out of the way and if I realized, “This isn’t about me.” Asking for money is the easiest way to think about it. If you’re in alignment and you want to give to this cause, great. If you don’t, great.
I did speak for RBC. What I was saying to them is I don’t care who they give money to, just give. People need to be committed to the community now because the community is hurting and suffering. We should be helping the community the best. I don’t know where to give or how to give and what motivates you. I think that’s important. Personally, I’ve had lots of little mini-crises in my life. I think a lot of my own ability to have that humbleness is through my own life experience and understanding that I’m not a world scholar, never will be, never have been. Frankly, that doesn’t matter. I get stuff done. That’s my job. I do that quite proficiently, but there’s a lot of stuff I don’t know how to do. I’m okay saying that, I always have been.
Rather than ask your advice to future leaders and current leaders in the sector at the end, we’ll just underline that getting your ego out of the way and knowing what you’re good at and being comfortable saying, “I’m not good at this part, but I am good over here,” is a good recipe for leadership.
The two words that keep resounding for me and everybody has different definitions, but they’re important. One is authenticity and the other is integrity. Authenticity, even as an individual, I remember back in the day, a long time ago, another fundraising person said to me, “Scott, you’ve got to be more buttoned-down, slick and polished.” I tried for about six months and it wasn’t me. I shoot from the hip. I have a potty mouth, I say what I’m thinking and that’s what works for me because it’s authentic. The integrity piece is, “If people can trust me because I have high integrity, but if my integrity is in question, then I can’t be trusted.” That’s the same for systems and organizations, not just people. If people trust the Dr. Peter Centre as a brand, it makes our life a lot easier.
That goes back to how you measure trust is that being able to show up as your real self makes it a lot easier to build that trust to sustain it through difficult times in an organization. One of the transitions that I’m interested in asking you about is you have had quite a great career and you’ve been in lots of different organizations. One of my colleagues has said, “He’s been a renaissance man for the sector. He’s worked everywhere.” You were at the Vancouver Art Gallery as a Chief Development Officer. You worked at imagine1Day, which is an international development charity, and then you came to the Dr. Peter Centre. Your reputation, before you went to Dr. Peter Centre, was as an excellent fundraiser. You’re now viewed as an excellent leader in the sector. What was that transition like of being identified, not as the fundraiser for the organization, but as being the leader of the organization?
That transition happened more with imagine1Day than anything else. Even as a fundraiser, I’ve always worked in small shops. What that means is in many of the organizations that I’ve worked in, I’ve been the number two. I’m always the guy behind the scenes. I’m almost like a puppet master, but the number two of an organization, not the person who needed to be at the front. When I went to imagine1Day as the CEO, all of a sudden I’m the person leading from the front, not leading from behind. A lot of us in development do lead, it’s just we’re doing it quietly from behind and we’re manipulating not in a bad way, but in that sense of making things happen. Whereas the CEO or executive director, you’re in the frontend, you’re low. You’ve got a group of people that report to you and then you report to a board of directors.
It’s a different style and approach. imagine1Day is the charity founded by Chip and Shannon Wilson. Chip Wilson of Lululemon is all about leadership. I would say I had a leadership upgrade at the time that I was there. I had lots of opportunities to learn from very strong business leaders. We ran the organization. It is a not-for-profit, but we ran it with a very strong business sense. I brought all of that to this job as well and anywhere else at I’ll go. If we combine that whole piece back to, “I don’t know,” as the executive director, I have more power now to say, “I don’t know,” than I ever have because I’ve got a team around me who does know or if we don’t know, we find out. If we can’t find out, maybe there isn’t an answer yet.
It was a very interesting transition and I have to say, this is the type of role that I dig the most. I love being within the leadership of an organization. My team might say differently, but I’m not the dictator type, but I’m not the consensus guy either. It’s this thing in the middle and I can have different styles. To give an example, when COVID hit, it was beginning of April 2020, we sat down in the management team, had a conversation and I let them know. It was something like this, “Our leadership style is going to change. We’re now going to command and control, which means you’ll get instructions and you’ll follow them.” There wasn’t room at that moment for debate or, “Why do you think,” which we encourage most of the time. A few weeks later, we went back to normal. It’s being able to have that adaptability and having enough tools in your toolbox to pull other different leadership style as the moment requires.
In that counting, “I don’t know,” as being among your superpowers is also important. As we’ve gone through this conversation, you’ve mentioned adaptability 4 or 5 times, and one word you stayed away from is resilience. You haven’t said resilience. That seems to be the buzzword for how leaders are getting through this pandemic. From your perspective, is there a difference between resilience and adaptability? How does that play it out in the day-to-day life at Dr. Peter Centre?
There is a difference. Things can be resilient. It doesn’t mean they’re necessarily good. Donald Trump is resilient. Trumpism will be resilient. It’s not adaptable, it’s not good, but it is resilient. My staff is resilient and adaptable. Resilience is key. The participants at the Dr. Peter Centre are resilient. Many of the people that we serve should be dead. There is no reason why they’re still alive, they are and they do well because they are resilient. We do need that. It is both. Resilience is a word that we talk about and we use.
I don’t hear enough of or hear too much of it. It goes both ways is that we do need to take care of ourselves. How I am resilient is I’ve got routine. I’ve got systems in place like organizationally. I have trust from my board. If I’m fighting my board, if I’m fighting up as well as needing to put a lot of thought into how we’re managing the organization, it’s a lot of taxation power on our effort and emotion. Resiliency is yes, but it can’t be a cop-out for the work that we have to put in.
It is one of my concerns about the sector. If we fall in love too much with being resilient, which is about resistance and not losing ground that we run the risk of moving even being even slower in our adaptability to the world around us. My number one concern about our sector is that the world around us is changing faster than many of the organizations within the sector. We’ve got to find a way to be able to be more adaptable to accelerate that change. It sounds like you’re doing a great job of doing that at the Dr. Peter Centre. What are you looking forward to as we move into 2021?
It’s going to be a great year. I’m looking forward to a great year at the Dr. Peter Centre. We’ve got so much in place now between the day programs that we do that take care of the day-to-day living of many people. The compassion that our staff brings to the table, the adaptability and the trust that we have with our participants. It’s going to be an interesting year around vaccinations. I’m excited to see how we can get all populations of people vaccinated, and so forth as well when we’re hoping to play a role in that and think that we have some strategies that go back to relationships and trust that we can offer. There will be a lot of optimism. We have severe pain and it’s different from some of the other provinces, which are hurting, but I think optimism will be around the corner quickly.
That is a great place to leave our conversation. I know many of our readers are looking for optimism in their day-to-day life. I thank you for sharing yours with us. Thanks for being on the show.
It’s my pleasure. Thank you.