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What Policies Need to be Approved by the Board?

In the HRSA Compliance Manual, Chapter 19 (Board Authority), HRSA provides guidance that the board has to adopt, evaluate at least once every three years, the following: Sliding Fee Discount Program, Quality Improvement (Assurance), Billing and Collections, Personnel and Financial Management and Accounting Systems. As an example, if your Billing and Collections Manual has 10 policies, then all those 10 policies need to be approved.

If your organization is a Public Entity, Co-Applicant Agreement, the Personnel and Financial Management and Accounting System Policies approval by the health center board may be not applicable. If you have any questions as to whether your organization is designated as this type of health center model, please check your Notice of Funding Award (NOFA) or ask your HRSA Project Officer.


Check your Notice of Funding Award (NOFA) or ask your HRSA Project Officer if you have questions about your health center model.

While this isn’t an inclusive list, remember to check with non-profit laws within your own state for any additional policies that are required. We would also recommend checking your NOFA in the “Program Notes” as there may be some additional policies. Finally, please remember, the governing board of a health center is generally responsible for approving policies that govern health center operations, so if there are policies that have been created to govern the operations of the health center, a best practice would be to have those approved.

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