Compliatric Quarterly Newsletter: Getting the Most out of Board Education

Being on a Health Center Board of Directors carries a weighty responsibility not only with the oversight and responsibilities of the HRSA Program Requirements, but also understanding the rules and requirements of each state’s non-profit requirements. It is important that regardless of whether board members are new or have been part of the board for several years, there is a responsibility to ensure that the Board of Directors receive education and training on their roles and responsibilities. Having regular governance education will ensure that the board members understand their role and have the knowledge base to fulfill what is required of them.

The following tips may be useful when considering board education:

1. Efficient and Effective Meetings. Having a board that fully understands their responsibilities and understands the line between managing and “getting in the weeds” can set the tone for how well meetings function. Regular education can allow members to learn new skills, understand the difference between policies and procedures and get feedback on their performance. If a board works together, recommendations by the CEO/Executive Director and their team will allow the board to approve organizational decisions. For example, it is an industry best practice to have committees of the board. Committees may include, but are not limited to, an Executive Committee, Finance Committee and a Quality Improvement Committee. It is during the committee meetings that much of the work is completed. Operational documents (financial, clinical, or other documents for decision making) are reviewed and analyzed and, with assistance from the health center team, recommendations are made to the committee. A smaller group can be more efficient and focused with the goal of providing recommendations and advice to the full governing board. Committees of the board do not have the authority to make policy, but do provide recommendations to the full board for approval of items. When the Board of Directors meet, the work is already completed, and the designated board member and/or health center employee can present on the work completed by the committee, the rationale for the recommendation and any discussion that the full governing board may have with the goal of approving the proposed recommendation. 




2. Supporting Decision Making through Documentation. The essence of the health center movement is to have a board of directors that represents the patients served. Health centers, at times, serve patients whose primary/preferred language is not English; hence, some board members’ primary language may not be English. Regardless of the language spoken (written or verbal), it is the responsibility of the health center to ensure board members receive reports to support decision making and oversight by the governing board. To help foster a supportive decision making environment, health centers should consider providing board reports in the preferred language of the board member and ensure any reports, graphs, or other documents are clear, concise, and easy to understand. For example, quality metrics are provided in graph form and utilize the “stop light” dashboard, where green meets or exceeds the measure, yellow is in process/close to meeting the measure, and red does not meet or exceed the measure. A second example would be to provide meeting minutes in the board members’ preferred language and ensure that translators are provided during the board meetings. Finally, asking the board if the documentation they receive is in a format that supports their decision making responsibilities is vital to determining if any changes should be made to how the board receives information. 




3. Learning Environment can Build Trust Within the Board. Providing education to the board of directors ensures that a culture of accountability is created, so everyone takes responsibility for their designated role. Understanding Duty of Care, Loyalty and Obedience will move the board to function in unison. Board members come from various backgrounds, have a mix of education, skills, and expertise, which elevates their ability to come together and make decisions. At times, coming together can have challenges. Board education will allow each member to take their individual skills and talents and align them to the health center’s mission and vision. A learning environment means having a safe, non judgmental space where board members feel comfortable asking questions or expressing themselves. The goal is to build trust among board members, so they feel comfortable to have frank discussions, discuss differing opinions and then back the consensus of the board. Board education can take many forms, whether it’s through a virtual learning environment, on-site training with a consultant or providing a membership to board organizations such as Board Source or Board Effect. Whatever training is decided upon, it must be culturally and linguistically appropriate to ensure all have access. 

Health Centers that train and educate their Board of Directors are investing in their leadership, which can have a direct impact on the well-being of their health centers. As health centers continue to play a vital role in the health care system, forward thinking Board of Directors also have a seat at the table as they are responsible for the health center. Providing them with the tools and resources for success will position the health center for even greater success. 

^1. Having committees of the board is not a HRSA requirement. Each health center should review their state non-profit laws to determine whether an Executive Committee is needed to maintain 501 c3 status.