Podcast 16: Tyler Norris

May 30, 2019 | Stakeholder Health Podcast | 0 comments

Tyler Norris, MDiv, is chief executive, Well Being Trust, an impact philanthropy with a mission to advance the mental, social and spiritual health of the nation. Over the past three decades, Tyler has shaped health and development initiatives in hundreds of communities in the US and around the world. He has an extensive background as a social entrepreneur, animateur, and trusted advisor to philanthropies, health systems, government agencies and collaborative partnerships working to improve the health of people and places. Prior to becoming the first chief executive of Well Being Trust, Tyler served as vice president, Total Health at Kaiser Permanente, where he led “anchor institution” work, applying all organizational assets to impact the economic, social and environmental determinants of health. He previously served as the founding president and CEO of a leading health consultancy, Community Initiatives, and as founding board chair of IP3, the social enterprise that gave birth to the Community Commons, a GIS data mapping platform. In recent years, Tyler also served as a board member and/or advisor to the Convergence Partnership; Enterprise Community Partners; Active Living by Design; Samueli Institute; the Public Health Institute and the YMCA of the USA. Previously, he helped open the Abraham Path through the heart of the Middle East, and led the Kuhiston Foundation that helped establish the national park system in Tajikistan. He is a graduate of Harvard Business School’s Executive Program, earned a Master of Divinity degree from Naropa University, and has a bachelor’s degree in World Political Economy from Colorado College.

Gunderson: I’m in Chicago at the Catalyst Ranch with a meeting convened by one of our earlier interviewees, Bobby Milstein. With a group that is much like the groups I’ve met Tyler Norris in for many years. People who have given their lives to changing community for the better. We’re going to unpack a little bit about your day job, one of the coolest jobs probably in America today, and in networks that span the wide range of things that people think of in terms of health and community. But Tyler, how did Tyler become Tyler?

Norris: Good morning, Gary. So good to be able to spend this time maybe three decades of a friendship. Incredible. My journey really started with probably a wound as a teenager. I was raised by great parents in a family of relative privilege but I really struggled. My family was struggling frankly at that time. My parents getting divorced and sister and I felt a little lost on a move from California to Idaho. Within a couple of years of that I fell in with a crowd that was pushing the limits of healthy behavior and found myself drinking and in a bit of an addictive pattern.

Gunderson: This wasn’t when you were like 25?

Norris: I was 14.

Gunderson: Yeah, you were advanced.

Norris: I was at 14 in a resort community. We grew up pretty fast. One day—actually Mother’s Day, to put a fine point on it to what it would mean to my mother later—we went on a bit of a rampage that involves substance fueled vandalism in the community. A couple of days later, we were arrested. I found myself at 14 with what would have been a felony had I been of age and, of course, a small rural community. There was a lot of shame and we just, what are we going to do and my parents and the community, a new school that we’ve been part of. It was as bad as rough as it could get for me.

But it turned. I’ll never forget the day we had a community meeting that was held by the principal of the school about three weeks later after we’ve been called before the judge. Sam Hazard was his name. Deceased now. He started with his big, bold, heavy voice, “Any kids that would do this to this community…” Drum roll…. “Need this community.”

Rather than getting set off to reform school, or whatever else would have been our fate, we were folded back in. It took us two years of working at his dad’s landscaping business and met down at my uncle’s ranch dawn to dusk outside of school to pay back the damages we had done. But we had a chance for reconciliation. We had a chance for healing. We were folded back in. My takeaway is community saved my life. I have no idea what would have happened to me had I not been folded back in. Like so many kids that get in trouble early in their life, who don’t experience a diversion strategy like we did with our relative privilege in a small community, they’re sent off to some kind of a detention and get in a scrape or a fight. So many kids today, particularly kids of color never have that kind of opportunity.

I dedicated my life to healing. I don’t think I was quite that clear about it at 15 or 16, but it certainly became my path and shaped everything I did going to school and the things that I did right out of school.

Gunderson: I’d never heard that story of you as a 14 year old. I’ve probably seen you as a relative grown up.

Norris: I feel ashamed to talk about it, Gary.

Gunderson: Tell me about that. That’s amazing.

Norris: I’m going to be 60 this year, and only in the last couple of years have I found the courage to talk about this because of my own shame, which helps me understand the shame people feel for other things in their own lives. Sure, at one level I thought, oh, if I talked about it, it would limit my career or people wouldn’t want to befriend me or it didn’t match the goodness I feel in my heart or try and bring into the world. Now, I just realize I was hurting. I wasn’t sure how to fill the gap in myself in that point. I didn’t have much of a faith or community life and we turned a little… as my mentor, the late Thomas Keating, Father Thomas Keating would talk about, we turned to our favorite programs for happiness, which included substances. I found myself ashamed.

Gunderson: It’s fascinating that our scars are often the most significant marker of the most consistent patterns of our life. We could talk about a dear friend, John Kilzer who’s a great musician who wrote a song called Scars. You learn to love the scars. He actually killed himself about a month and a half ago. But it’s the way we live with shame and our scars that helps explain our lives actually. I’ve always seen you as a super successful kind of guy. This actually is illuminating to me about it, it helps me make sense of your life, actually.

Norris: Maybe we can start to redefine what success looks like that’s inclusive of all of our scars.

Gunderson: I hope we can do that. You have a day.

Norris: Exactly.

Gunderson: You have a day job, but you also, we were talking over here, we’re in Chicago. We walked by the guys sleeping. In Oakland you would probably know his name.

Norris: Yes, I do have a bit of a street chaplaincy practice. I get to lead a foundation. I’m sure we’ll talk a little bit about the work of Well Being Trust later. But as I button up for a job helping try and shape state federal policy and transform clinical care and all that stuff, and also a little bit tough, important at times. I’ve taken it upon myself to get to know the people that are not housed in my community of Oakland, which there’s a lot of them. I know when I arrived in Oakland eight years ago and moved in, many people on the street became my first friends. I still know and see many of them to this day. I probably have a couple hundred people whose names I know and who have become what Oakland is for me as my adopted home in this time. I walk a lot because I’m downtown, I live and work. I couldn’t tell you where my car’s parked, I don’t really know. Other people borrow it, so, I walk and use BART and my bike and all.

Having those relationships on the street is a part of my well-being. I hope I do some things that are and conversations that are of value to them. I know I feel healthier and better after those conversations. The street wisdom always seems to surface the thing that I need to hear in my own life and remind me how close we all are to that kind of fragility and vulnerability. It’s a big part of me staying sane.

Gunderson: You came to Oakland to work with Kaiser.

Norris: Yeah.

Gunderson: And did what I thought was a career’s worth of work in just a few short years to help this massive organization with values at its heart understand the full scope of what was possible to do with the health care thing. Now your Well Being Trust. Connect those two dots for me.

Norris: Well, I guess, first and tying back to my youthful indiscretions story. Right out of college, I was in the aviation business and had a really good job and all that then too. I was called one thanksgiving to spend three or four days on the streets, which I did in Denver. I was 22 or 23. I met a number of homeless women and men and dined with them and slept down shelters a couple nights. I met this guy, Ray Hayworth, he’s since passed, who had six guys and a little storefront down at 21st and Larimer, and started an organization now called Step Denver.

They were just trying to get sober and go to work every day and help each other through AA and other ways that they did. Later, we raised some money for them and helped them start a board. It was my first real deep service project. But we kept eyeing the old A&P supermarket across the street. It was a 30,000 square foot building gutted for 10 years, and it was part of Denver Skid Road. Now you go down that part of 21st and Larimer is LoDo and as fancy as it gets. But back in the day it was sketchy, scary.

We were eyeing that. We went down to the Disabled American Veterans, me and a woman named Kathy Ellis whose mother was on the street with her schizophrenia and periodically on there. Kathy and I went down there and convinced these elderly veterans that because of the number of veterans that were in the program at that time that we needed to have them starting … By that time, the fire marshal was ready to throw us out. There was too many men in the building. They said you can use that building for 10 years and it’s going to cost you 10 bucks a year but it’s yours.

Kathy and I walked out the door and went, “Oh my god, what have we done?” We don’t have any money, we don’t know where everything is. We went into these guys who were having an AA meeting-

Gunderson: Actually, you’re 10 bucks in the hole.

Norris: That’s 10 bucks in the hole. We told the guy who was running the program, a wonderful man, Bob Coté, who ran it until his passing a couple years ago, what happened and he was like, “That was great.” Bob in his charming way and forgive the expletive here said, “We didn’t even have a F-ing plumber.” He said it kind of loud. One of the guys that was in the AA meeting stood up and said, “Well, I’m an F-ing plumber.” The guy next to him, said, “And I’m a master electrician.” We went, “Whoa, whoa, tell us about it.” The guy launched in his story of how drinking and drugging had taken him out of running one of the most successful plumbing companies in Denver at that time. Lost his family and everything. You can imagine the dialogue that ensued.

We realized the core principle John McKnight and the others had, we have all the assets we need. In fact, the last guy that spoke said, “I don’t have any of these skills, but my uncle is the president of Sutherland Lumber.” A month and a half later, we went down to Mr. Sutherland. He was very proud of his nephew for getting sober again, he gave us $150,000 worth of equipment. That building is still operating today having served tens of thousands of men through it. Never a paint brush or a drywall hammer or a toilet or anything was lifted ever in that building outside of the women and men in that program. Which is just a reminder of, we have all we need and people who others have given up on can be a big part of their own solution if we support that.

That really shaped my life. I’ve had a chance through my early work at the National Civic League and then later through community initiatives, and all the friends and partners and allies working in over 500 communities across this country and help build the Healthy Communities Movement through that kind of an asset based, human potential approach. We’ve learned a lot through what communities raised me and taught me a lot.

The work I came to do at Kaiser Permanente to lead total health there about seven, eight years ago was rooted in a handful of learnings from 500 communities over that period. It was between just getting going a decade ago.

Gunderson: The thread I’m hearing is the Knight thread, undergirded by the gravity saving you. Pretty amazing story. We did this Winnebago thing last November. The premise, I wonder whether you think this is true that the premise of that was everything we hope for is already happening. But we frequently cover up what would give us the most hope by rushing to fix something.

Norris: Yes.

Gunderson: Do you think that’s actually true?

Norris: I actually do think it’s true. I think we not only know that through the new physics and emergent principles, but I think we know that in practice, and I can certainly validate that in my experience having been in so many communities in every state in this country over that period. That one, what’s wanting to happen is happening, that our communities respond like an immune response in our bodies, to rise to what’s called, and people rise because people find their purpose at the intersection of what is really theirs to do. Their soul compact, as I think about it, or what their life purpose is, and it gives them more meaning is perfectly matched with what’s needed in the community.

That’s such a beautiful part of being a human in my own experience is that intersection between what’s rising in us and what’s rising as needed in community. Therefore, our job as professionals—watch out for us—is how do we support what’s wanting to happen, and what’s naturally occurring, the assets that are rising?

I was talking about some of the learning out there and it certainly informed the work at Kaiser Permanente, in fact, was informed by the learning at Kaiser Permanente of how so many of us, particularly if I can say this in a kind way to all of our friends in community benefit and I’ll put myself on that list of culprits. That we’re often tinkering around. The kind of grants we make, and the projects we do are not … What we learned at Kaiser is they lack sufficient dose for population-level impact and not enough reach, not enough intensity and not enough duration.

That when you get to know that that’s true, we realized that as investors, whether it’s a hospital community benefit, or through anchor institution strategies like changing our purchasing, changing our hiring, using the investment portfolios of our health systems, meeting social needs, or bank Community Reinvestment Act responsibilities, or foundations like the one I’m now leading, that once you know that these short term grants and projects don’t have a population level impact, it’s unethical to continue behaving as if they will.

That’s a real learning for, I think, those of us in philanthropy and service that if we’re one, recognizing what you started with on the Winnebago tour, that it’s already happening in community and the good people are part of the solution. If we’re going to partner with them, we need to go in with the kind of commitments we make to our own families. My kids are 24 and 26 now. They’re hardly kids at all, they’re young adults … That’s the kind of time span we need to be thinking about is really building a generation, not these kind of in and out, well, it didn’t work after three years. We need to move from doing good things to being accountable for outcomes. That’s what I really appreciated about my time at Kaiser Permanente was the understanding of that, and then the deepening that has led to the social needs strategy we’ve seen recently. The implementation of an anchor institution strategy. And that we’re now starting to see, I think there’s 55 or 60 some health systems now in this healthcare anchor network that are recognizing that it’s about comprehensiveness and sufficient dose of investments rooted in local democracy and local people dialoguing, setting the priorities and implementing change themselves. The most important thing is to support that, and not think we’re going to drive it.

That’s a place of humility and learning that I think all of us in our field of trying to help have an opportunity to learn.

Gunderson: You use this word democracy. For 25 years, I thought you would be a senator by now. You’ve been around the formal structures of representative constitutional democracy in these United States. How’s that going?

Norris: I have more faith in our communities than I do in Washington. I respect those very much who’ve chosen public service in the form of putting themselves on the line and all that. I didn’t want to go on the make raising money for myself and making that about my life. After talking to Tim Wirth earlier, and his senatorial views describing what it was life like and going into cocktail parties to raise money on the make and looking around who’s going to write a check? I said, “Not for me.” Because I think there’s more power in community. I go for a higher aspiration of public office, which is being servant and trying to support community, which is where I think the action is.

Therefore, I see so many bright spots and pacesetters and promising initiatives in communities of business, government, nonprofit, with community residents coming together in a trans-partisan way. It’s not Republican, Democrat, it’s get it done in American pragmatism. I’m inspired by what’s happening in communities as the font of change, the font of democracies. People have heard me talk about Alexis de Tocqueville a lot, who wrote home this fellow Frenchman in the 1830s. It’s like, “Who are these Americans? They meet, they set priorities, and they go about doing things as if they’re in charge.” We are. That’s the blessing of this democracy, which in a few years will have its 250th birthday.

But as we know, we’re going the wrong way, which my kids hold me accountable to. We’ve had now three years of declining lifespan and the diseases and deaths of despair have doubled in the last decade. According to the CDC data, they’re slated to double again. On our watch, despite all the goodness, and all our tinkering, the nation’s going the wrong way. I think that’s really the opportunity that we’re seeing at Well Being Trust and what we and our partners are now focused on.

Gunderson: Talk a little bit about your day job.

Norris: Well, thanks to the generosity of the Providence St. Joseph Health System, which came together and combined three years ago, the sisters and the sponsors and Dr. Rod Hochman and the Board of Providence St. Joseph Health made a commitment at the combination to make mental health and wellbeing a priority for that health system. They made a major financial commitment, which included birthing Well Being Trust, which I’ll talk about in a moment. But also to have Providence St. Joseph’s Health be a pacesetter and a blueprint for mental health and wellbeing in its ministries from Anchorage, down to LA and out into West Texas and western Montana where that health system operates. And not do it alone, but to do it with the other health systems, including lead competitors, like Kaiser Permanente and Common Spirit, Adventist and others out in the footprint. But also to partner with other health systems across the country.

Our mission as Well Being Trust, which was a very powerful commitment, to literally move the money out of the health system, out of this major Catholic faith based health system with the sisters standing behind them, these incredible social justice leaders in our nation. With the healing mission of Jesus for the poor and vulnerable. If that’s not your language, just think equity and social justice, because that’s what they mean by this. What’s radical inclusion, what is all means all mean, which really aligns with the equity principles that we know are so important to our economy and our democracy, to advance the mental, social and spiritual health of the country.

Our goal is to increase healthy life years, which have grown for a century before turning around three years ago, and reverse the diseases and deaths of despair in a decade. That’s what we are tied to. We have five focus areas, the first of which because our resources and our mandate comes out of a health care system is to address mental health at its roots, substance abuse disorders of their roots, is to transform clinical care. To make sure that we don’t just do physical care over here and mental behavioral health over there, but that we integrate them. So, integrated whole person care with no wrong door, in primary care, in acute care, in the emergency department, and in clinical community integration strategies. That if we’re going to talk to somebody about their diabetes, we’re going to talk about their depression too, because you’re not going to get somebody to eat healthier and move more and cut their tobacco if you don’t talk about the depression, which is why they’re self-medicating through eating poorly, and screen time, and tobacco or whatever substance of whatever they’re, back, Thomas Keating, whatever their program for happiness is to deal with the pain that they’re feeling in their own wound.

We are helping drive that in a clinical performance group led by Dr. Arpan Waghray and others and Dr. Robin Henderson inside Providence St. Joseph Health with the leadership of that health system behind our transforming care. And with IHI’s who for healthcare improvement, we’ve got a consortium of eight health systems soon to grow too many more, that are driving integrated whole person care. That’s job one.

Our lead initiative right now led by Dr. Ben Miller is about federal policy change, to pay for affordable access to integrated whole person care with no wrong door. Because as we know, only one-in-10 people seeking substance use disorder care can get it in this country. Only four-in-10 seeking mental health services can get it. Even if you got a health plan, the Mental Health Parity laws in this country are not being forced.

I got to tell you, it’s an abomination. You want to help me get upset on this call, it’s the way in which health plans andstates are not living up to the Mental Health Parity law in this country that’s 10 years old thanks to the work of Patrick Kennedy and his late father, Teddy Kennedy and others. And a bipartisan commitment in this country to have mental health coverage be provided at that same way that we do provide coverage for everything else.

Norris:We are committed to states and health plans living up to that as the law of the land and making sure that that care is provided and paid for so that people can get that care just like we would for their cancer or any other care. That policy work at the state and federal level is a key piece of what we’re doing. We’re working very strongly in California with our new governor and Steinberg Institute and others, and nationally with the Bipartisan Policy Center and a few dozen of the mental health groups to help drive that.

Those two are important; transforming care and policy to pay for it. But you and I know, and my life focused on what used to be called the determinants of health. That’s, I think a little bit of a tired term, even though family health care’s think it’s discovered fire by talking about it with all respect. It’s a 30 year old language and 30 year old evidence base, we’re now framing this as creating the vital conditions for intergenerational wellbeing. Because the determinants aren’t just social, they’re economic and environmental and they’re not determinants, because all kinds of people find their way. But these seven vital conditions for intergenerational wellbeing are the same basic list. But we know that we need to create living legacies in our community that create these conditions for human flourishing, that create the conditions for human potentiation across the lifespan. That not only that first thousand days of life that we know so much about the neuro plasticity of the brain and brain development, but helping childcare and daycare that’s good in our schools with social emotional and ethical learning and diversion for kids that find themselves struggling like I did as a teenager. And the job training that helped people not only raise a healthy family and have a good life, but get a living wage job and earn that.

We know that that’s key. Our community strategy, yeah, we got to transform care, yeah, we got to drive the policy to pay for it. That’s not going to turn the tide on the diseases and deaths of despair. By community strategies like all of us have been learning for the past 30, 40 years from Main Street through healthy communities, sustainable communities, resilient communities, equitable communities, name all these movements, that’s what we’re really trying to drive through that.

Our fourth area is through essentially normalizing, talking about our wounds, our anxiety, our depression, our addiction, our suicidal ideation. I could no longer lead Well Being Trust without talking about my own struggles, which is probably why I’m more comfortable talking about these things now, and when I’m facing young people and not trying to be some guy that was perfect, but rather no different than them, in fact, struggle just as much.

Anyway, our… is focused on tweens and teens and normalizing having conversations about the real thing. And having that in our faith communities and in our healthcare systems and liberate the conversation that wants to happen about where the hurt is, as the font of healing. Like you were describing Gary, the wounded healers that we all are. I think that are turning to one another really is getting… Yeah, we go to care and we need more professionals to provide that substance use care… Of course, of course, of course. We’ve got to get that right as professionals. But I also think we need to reawaken the premise of who we are for and with each other. By turning to one another as human beings, and love one another as ourselves since we are-

Gunderson: So, there’s a fifth one?

Norris: There’s a fifth area, which is really about innovation and learning. It’s really about how we get smarter together, and innovate and measure and get smarter and drive quality improvement. Clinically, I think a lot of us talk about clinical quality improvement or ideation to prototyping and driving new innovation. We are, as the only national scope foundation in this country focused on mental health and substance use issues committed to creating wellbeing in the nation. We feel a particular responsibility to help this nation learn, build the evidence base and set the pace for what’s actually possible and have other not only providers and payers and purchasers of healthcare, but philanthropy to step up on these issues and help policymakers do their job.

But we’ve got to support our policymakers, those that have putting themselves on the line elected jobs, by building the evidence base, and bringing a trans-partisan constituency together from our communities. We know how to get it done in communities—red, blue or otherwise—we know how to get things done. But we need to support our elected leaders in being trans-partisan and not getting stuck in the toxic partisanship that has caused Washington to essentially shut down when it comes to doing the work.

We need to say most of the work can get done in communities. As Republicans, Democrats and Independents alike, we’ve got your back. If you’re a Republican, you’re a Democrat, you need to do something that’s not part of your committee structure or party line, we’ve got your back to support strategies that are rooted in American pragmatism that are creating impacts on the ground for the health of people in places.

We think we can help bring that constituency to bear. God knows, every community has got some kind of a healthy community like effort. We think it’s our job, all of our jobs to help lift that up to build the community and political will to get behind our policymakers, to shift the federal policies that are needed to make the change.

Gunderson: Probably while you’ve been talking with such courage and energy, about half of the people listening to the podcast have been grabbing for their Google to find your address to send their resumes. I want to work for Tyler. But what you actually want is people to work where they are with courage and vision. How do you be brave enough to do that?

Norris: Well, I love the… by [Howard] Thurman that says, don’t ask what your community needs, ask what makes you come alive. Because what the country needs, what the world needs is people who’ve come alive. I’m interested, yeah, with the partners of Well Being Trust and partners that will co-fund with us and line up with us, proof points in communities. If you’re a health system that wants to get into this, or a payer, or a purchaser that wants to transform what’s going on in your workplace. Let’s all in, let’s talk about our workforce as our fellow care caregivers.

But what I’m really interested in is the distributed leadership, that is this nation, the democracy that is this nation. That we can all do, what we can do, where we are, where we serve. Not only by turning to one another as human beings, as family members, as friends, but by stepping up in our workplaces, and in our schools and in our health systems and in our philanthropies to invest in a dose sufficient, comprehensive way to do the things that are really going to add up. I think that’s the special job for those of us who are finding ourselves as leaders in roles of privilege like I have now, like you have, like so many people who are listening. We’re in roles of privilege with trust placed in us to lead. I think it’s time for us to step up and come alive and do something that’s worthy of who we are as human beings, worthy of the health systems and organizations that have given birth to us and our abilities to lead. That’s what the country is asking of ourselves.

Gunderson: Tyler, thank you. Just thank you for your story and for what you’ve done with your life. I’m grateful the community took care of you when you need it. I know the community around you is still taking care of you.

Norris:Thank you.

Gunderson: Thank you.

Norris: It’s an unfinished agenda. So, let’s stay with it. How wonderful to have this friendship over the years. Thank you.

Gunderson: Thank you.



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