Stephanie Beck remembers the moment clearly. Peace Arch Hospital and Community Health Foundation, where she serves as CEO, had been doing community grants for a few years. The mission felt right: community health fundraising allowed the foundation to fund upstream health and keep people well before they ever needed an ER bed. But something wasn't working.  

"We realized that we were suffering from scope creep," she says. "All of a sudden, we were looking at these huge problems in our community, like homelessness and transportation barriers and deep mental health issues." 

The foundation hit pause. And what they figured out in that moment of reckoning about governance, scope, board alignment, and what a community hospital foundation is actually built to do, turned into a 20-year playbook that three other British Columbia foundations have since adapted and built on.  

If you have started asking whether your foundation should be doing more in the community, their story is where you need to start. 

The Problem With "Building Stuff and Buying Stuff" 

Drew Mitchell, CEO of Sport for Life and a long-time partner of Peace Arch, opened a recent session at the AHP Convene Canada conference on community health philanthropy by naming the inherent limitations of hospital fundraising: it remains within the hospital’s walls, even though health extends far beyond them. 

"Hospital foundations, your work, which is so important to the community, is generally about building stuff and buying stuff,” he said. "How can we evolve that a little further, to take a little pressure off the stuff you built and bought?" 

That pressure on our hospitals is real. Emergency rooms running over capacity. Aging populations. A youth mental health crisis. Delta Hospital and Community Health Foundation CEO Lisa Hoglund didn't mince words about what's happening in her community south of Vancouver: "Last week, our ER was at 150% capacity."  

Hospital foundations have the structures and know-how to fund programs in the community that could relieve this pressure before it hits. But many find their charitable mandates tied to the hospital itself, with no ability to fund the programs in the community that could relieve that pressure before it hits. These foundations took steps to change that. 

Step One: Change Your Name. Mean It.  

Peace Arch changed its name and constitution in 2005 to become Peace Arch Hospital and Community Health Foundation. That formal step was, as Stephanie describes it, when they "embarked on this work."  

In the years since, others have followed suit. Delta changed its name in 2014. Langley Memorial Hospital Foundation spent five years in consultation before becoming Langley Community Health and Hospital Foundation last year. Burnaby Hospital and Community Foundation added "Community" to its name in 2024. 

A name change is a symbolic shift, signaling the expanding mandate to donors and the community. 

For Langley, Tim Staunton, Director of Philanthropy, describes the name change as "a very intentional way to announce our intention to go out into the community and fund health services. It was a strategic choice that was necessary for the next phase of our foundation."  

Beyond the symbolism, there are also practical reasons foundations take this step.  

Kristy James, President and CEO of Burnaby Hospital and Community Foundation, put it plainly: "You go to some grant sites and they say, 'Oh, I see the word Hospital in your name. We don't grant hospitals.' So this opened us up to more revenue." 

For Delta, the original trigger was more concrete: they wanted to build a long-term care facility to ease overcrowding in the acute care hospital, but their charitable mandate, as written, didn't allow them to fundraise for it.  

"Our charitable mandate at the time did not allow us to fundraise for anything that existed beyond the four walls of the hospital," Lisa explained. Changing the name was a legal prerequisite—the governance groundwork for everything that followed. 

Step Two: Build the Right Structures for the Work 

Once you've changed your mandate, you need committees and processes that give your board confidence in how community grants are being evaluated.  

Peace Arch runs a two-tier model. A grants committee handles all applications under $100,000. Community-wide projects over $100,000 go to a Healthy Community Steering Committee that includes community members alongside foundation staff. The division keeps routine granting moving while giving the board a dedicated, higher-scrutiny process for its biggest bets. 

Burnaby, in its first year of granting, took a different approach. They created a multi-stakeholder committee that includes firefighters, a city councillor, a doctor, and a nurse alongside foundation staff. Delta built its process around a letter of intent (LOI) system and a grant lifecycle platform that handles application intake, with a review committee that includes a hospital social worker. 

What they all share is a clear answer to the question: who sits at the table, and what do they see?  

Step Three: Define Your Scope Before Scope Defines You 

Scope definition is where Peace Arch's growing pains become the most instructive part of the story. When the foundation first started funding community health, it went broad. And then it went broader. 

"We had to take a step back," Stephanie said. "We created a working group to re-evaluate what we actually had control over as a community hospital foundation, and what services were the responsibility of our municipal and provincial governments. We knew we couldn’t fund all the issues in our community." 

The pivot was from systems to individuals. From solving homelessness to supporting mental wellness. From the entire mental health system to the specific human in front of them. 

That refocus produced some of Peace Arch's most compelling projects. The foundation partnered with the City of White Rock to fund an all-abilities playground. It launched a food security lens that led them to look hard at their own hospital kitchen, an operation where precooked food was trucked in, heated and cooled, and sent to (and often rejected by) patients. The result was a $15 million campaign to convert to a scratch production kitchen, because, as Stephanie put it, "food is healing." 

Delta took a deliberate approach from the start, choosing to spend its first two years focused on mental health and addiction, an area where both community need and donor interest were clear. Burnaby kept its criteria broad but bounded: grants for youth, seniors, and new Canadians; focused on physical or mental wellness, preventative health, and keeping people out of the hospital. 

The common thread: naming what you will not fund is as important as naming what you will. 

Step Four: Bring Your Board, Clinicians, and Donors Along 

Governance doesn't live in a policy document. It lives in the room where your board approves a $2 million community project, or where a major donor questions whether you've "turned into the United Way." 

Beck describes Peace Arch's board as "100% behind the whole healthy community purpose." But donor alignment has required nuance. For example, one conservative, longtime donor believes foundations should fund buildings and equipment, full stop.  

Peace Arch's response is to hold the line without making it a fight. Stephanie reassured the donor, "If you give to the hospital, that's where your money's going. It's not going to Healthy Communities. It’s that simple."  

"We don't let one person stop us from helping our community," she added. 

At Langley, the resistance came from clinical partners, not donors, who worried that community fundraising for a youth mental health program called Foundry would pull dollars away from the hospital. Like Stephanie, Tim's team assured the concerned clinicians that the foundation would only support Foundry with donations designated explicitly for it. 

They've stayed true to that and now bring in their community partner to present outcomes to the board every six months. Those detailed reports get distilled into one-page donor stewardship updates. Tim noted that the Foundry's success led the provincial government to increase its own funding from $700,000 a year to $1.2 million, the kind of meaningful and concrete result that keeps boards and donors engaged. 

A Well-Worn Path for You to Follow 

Twenty years in, Peace Arch has proven the concept. Delta, Langley, and Burnaby prove that it’s replicable.  

What makes this particularly useful for foundations in Canada and the US is that the model scales. Peace Arch is approving multi-million-dollar community projects with board confidence built over two decades. But the entry point doesn't have to be dramatic. Burnaby started with grants from $500 to $5,000. You can start there, too. 

It’s been 20 years since Peace Arch asked how they could positively influence the health of their community beyond the hospital’s walls. They're still answering it. The playground in White Rock is open. The scratch kitchen at the hospital is coming.  

What will the answer be for your community?