As a little girl, Charlene Flash saw how those diagnosed with HIV were treated. It was the early days of the HIV pandemic, and she couldn't help but notice the stigma. Neighbors whispered and gossiped; people paused before helping others in need.
Flash's goal became clear: Become a doctor, then work to end the HIV pandemic.
As Flash grew up and became a doctor, the heart of her goal stayed the same, even as the goal itself shifted. Originally she wanted to establish health care programs in sub-Saharan Africa. But after getting married, Flash evolved her mission to helping those in the U.S. At Baylor College of Medicine, for example, she developed the first HIV prevention program in the country outside of clinical trials to prescribe prophylaxis medication.
In January 2020, Flash was recruited to serve as CEO of Avenue 360 Health & Wellness, a Houston-based nonprofit with a mission to provide primary health, behavioral health, and dental care to medically underserved communities.
Avenue 360's history, like Flash's, is one of serving communities impacted by HIV. Three nonprofits came together to form Avenue 360 — including Texas's first HIV hospice, a health care provider for patients, and an NPO that provided resources for those living with and dying from the disease.
With the combined capabilities of three nonprofits, and HIV being more treatable, Avenue 360's mission expanded. Now, as Flash says, its mission is to provide high-quality and caring services to promote healthy people and communities. Providing medical, dental, and behavioral health services, Avenue 360 also helps people access the resources needed to live well.
“What I'm doing is so aligned with my childhood goal that even on the hardest days, the meaning in the work makes it more manageable,” says Flash, a 2024 Vistage Member Excellence Award winner.
New to that dream is her role as CEO. Soon after she started, the COVID-19 pandemic left her with an immense list of challenges as the organization's leader. Flash felt well equipped to help people as a doctor, but she wanted to grow as an executive to ensure she was pointing Avenue 360 in the right direction.
In September 2022, she received a call from Vistage Chair Mickey Peters. He had seen her featured in a magazine and saw her potential as a powerful leader with medical and master's degrees. When they initially met, Peters told her that he believed that she could grow faster as a CEO by joining his group. This being her first time in the role, Flash agreed to join. Perhaps, she thought, this group could serve as an on-the-job MBA.
At her first Vistage meeting, Flash saw the power of having a group of peers as a sounding board. As she described problems, her group prescribed a novel solution: Dig deeper.
"They told me they heard the questions I was asking, but it sounded like the question was, 'Do you have the right CFO?'" Flash says. "It made me pause. I didn't think of it in that way, but it was true."
Even in this first meeting, Flash says that she was able to get down to the root of her problem. She needed a C-suite partner to provide financial analysis to help the organization thrive, but she also needed to get comfortable with the financial side of the business. This led Flash to dig into the numbers herself and tell the board she wanted to replace the executive.
With a new C-suiter — and Flash working more on the business than in the business — Avenue 360 thrived. In 2023, Avenue 360 served more than 13,000 patients and 500 families, bringing in $1.5 million. The organization now serves a larger client base, maintains stable finances, and has a more diverse revenue mix under Flash's leadership.
Even in 2025, when many nonprofits suffered cuts to federal funding, Avenue 360 didn't lose a single program or employee, Flash says. She has developed as a leader, now relying on strategy and tools like the Entrepreneurial Operating System (EOS) rather than trying to outwork every problem.
"We have been able to ride the storm by being strategic," Flash says. "We saw clouds on the horizon and prepared. Some of that comes from the Vistage way of asking 'What's happening?' and 'What's the root cause?'"
Through it all, she's loved that her Vistage group keeps her honest. Being a CEO can feel isolating, Flash says, but her peer group has her back and challenges her thinking at every meeting.
"I know how valuable it is for someone to call you out and say, 'You're talking about this when you should be talking about that,'" Flash says. "When you realize the root cause of an issue, it helps you solve problems within your organization."
