Training & Technical Assistance

Governing Board Responsibilities and How to Do Them

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Governing Board Responsibilities and How to Do Them

This series of documents looks at nine governance requirements of the Health Center Program.  Each document addresses a particular requirement and describes what board members can do to achieve their oversight responsibilities, including information for the board to receive (usually from staff) and review, questions for the board to ask, and the significance of particular answers on health center operations and viability.  The guidance for each of the nine requirements can be downloaded for free by clicking on the title of the document below.  A 48-page hard copy publication of all nine governance requirements can be purchased for $20 each.  Click here to place an order.

1. Assess and Monitor Needs of Target Population – The governing board is required to oversee the organization’s progress in meeting its mission and goals and should expect to see a periodic update of a written needs assessment document prior to engaging in the strategic planning effort.

2. Approve Health Center Program Grant Application –The governing board has a legal obligation to formally approve the proposed activities compared to the budget requested in the application.

3.  Adopt a Sliding Fee Discount Program – The governing board is responsible to adopt policies for financial management practices including a system to assure eligibility for services and criteria for partial payment schedules.

4.  Approve and Monitor Annual Budget – The governing board is responsible to assure that the health center has a realistic plan for achieving the organization’s annual program and financial goals and to measure and evaluate the organization’s progress in achieving these goals. 

5.  Review Independent Financial Audit – The governing board is responsible to select the auditor, guarantee the audit is done in compliance with federal requirements, and assure that management resolves audit findings.

6.  Monitor Financial Performance Using Financial Statement Data – The legal fiduciary responsibilities of the board include assuring financial accountability, effective oversight, and financial viability of the health center. 

7.  Establish a Quality Assurance/Quality Improvement (QA/QI) Program – The governing board has the responsibility to review and approve the QA/QI plan each year and to make sure the plan is being implemented effectively.

8.  Select Services Provided and Hours of Operation – The governing board has the authority to approve and oversee the scope of services and whether to provide those services directly by staff or referral to another provider. 

9.  Engage in Long-Term Strategic Planning – The governing board is responsible to set the course of the health center by taking a leadership role  and participating in developing goals and objectives to guide the health center’s decisions and actions for the next 3-5 years.


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