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The Health Center Program: Governance

An essential and distinguishing element of the Health Center Program is governance by and for the people served. Health centers funded by HRSA must have a governing body which assumes full authority and oversight responsibility for the health center. Governance requirements for health centers are addressed in law, regulations, and policies.

Board Size and Composition

Health center governing boards must maintain an acceptable size, composition, and meeting schedules. The governing body must have at least nine but no more than 25 members.

Health center boards are comprised of individuals who volunteer their time and energy to create a fiscally and managerially strong organization fro the purpose of improving the health status of their communities.

  • At least 51 percent of the board's members must be patients or “consumers” of the health center.
  • These consumer board members must reasonably represent the individuals served by the health center in terms of demographic factors:
    • ethnicity
    • race
    • sex
    • Where possible, it is encouraged that socioeconomic status be considered as well.
  • The remaining non-consumer members of the board (49 percent or less) must be representatives of the area served by the center and have expertise in community affairs; Federal, State, and local government; accounting; health administration; health professions; business; finance; banking; legal affairs; trade unions; insurance; and personnel management as well as social services such as religion, education, and welfare.
  • No more than half of these remaining, non-consumer members of the board (49 percent or less) can not earn more than 10 percent of their income from the health care industry.  (Example: if the board has 10 members, then no more than 4 members may be “non-consumers” of the center's services. Of those four, only two members may earn more than 10 percent of their income from the health care industry.)

Employees of the health center and their spouses, children, parents, or siblings (through blood or marriage) cannot be members of the health center governing board.

In general, the health center governing board should have at least enough members to:

  • Represent all segments of the community
  • Represent all areas of expertise required
  • Complete the work needed without overloading some or all of the board members.

Governance Regulations
 

Health Center Program Expections: Governance (Program Information Notice 98-23)

Implementation of the Section 330 Governance Requirements (Program Information Notice 98-12)