1. Alabama Primary Health Care Association
2013 Annual Conference and Trade Show

2. Governance Compliance Review: Board Authority
Presented by William W. Rice HRSA Consultant Alexandria, Virginia

3. Governance Compliance Review: Board Authority
Session Objectives
Determine Board Authority For a FQHC
Describe How to Demonstrate and Document Board Authority
Best Practices in Board Oversight
Discuss Related Issues

4. Governance Compliance Review: Board Authority
Determine Board Authority For a FQHC
Relationship to the 19 Program Requirements
How to Survive a HRSA Operational Site Visit

5. Governance Compliance Review: Board Authority
The 19 Program Requirements: Need
Needs Assessment (PR #1)
The Needs Assessment: What is the Board’s Role?
How Is the Needs Assessment Used?
How Often Is a Needs Assessment Done?

6. Governance Compliance Review: Board Authority
The 19 Program Requirements: Services
Required and Additional Services (PR #2)
Services of the Health Center: Board Role and Responsibilities
Selection of Services
Written Agreements

7. Governance Compliance Review: Board Authority
The 19 Program Requirements: Services
Staffing Requirement (PR #3)
Staffing for the Health Center: Board Role and Responsibilities
Budgeting for Staff
Privileging and Credentialing
Personnel Policies

8. Governance Compliance Review: Board Authority
The 19 Program Requirements: Services
Hours of Operation (PR #4)
Accessible Hours of Operation/Locations: Board Role and Responsibilities
Approval of Operational Plan
Relationship to Patient Satisfaction
Changes in Scope of Project

9. Governance Compliance Review: Board Authority
The 19 Program Requirements: Services
After Hours Coverage (PR #5)
After Hours Coverage: Board Role and Responsibilities
Defined Arrangements
Delegation to Management

10. Governance Compliance Review: Board Authority
The 19 Program Requirements: Services
Hospital Admitting (PR #6)
Hospital Admitting Privileges and Continuum of Care: Board Role
Formal Arrangements for Referral
Staff Qualifications/Standards (Relationship to PR #3)

11. Governance Compliance Review: Board Authority
The 19 Program Requirements: Services
Sliding Fee Discounts (PR #7)
Sliding Fee Discounts: Board Role
Board Approval of the SFD Policy
Annual Revision Based on Federal Poverty Guidelines (FPL)

12. Governance Compliance Review: Board Authority
The 19 Program Requirements: Services
QI/QA Plan (PR #8)
Quality Improvement/Assurance Plan: Board Role and Responsibilities
Monitoring the Ongoing QI/QA Program
Providing Clinical Leadership

13. Governance Compliance Review: Board Authority
The 19 Program Requirements: Mgt./Fin.
Key Management (PR #9)
Key Management Staff: Board Role and Responsibilities
Selection/Dismissal of the CEO
Annual Evaluation of the CEO
CFO and Medical Director

14. Governance Compliance Review: Board Authority
The 19 Program Requirements: Mgt./Fin.
Contracts/Agreements (PR #10)
Contracts/Affiliation Agreements: Board Role and Responsibilities
Oversight of Contracted Services
Contracts/Agreements/MOU’s and MOA’s
Delegation to Management Where Appropriate

15. Governance Compliance Review: Board Authority
The 19 Program Requirements: Mgt./Fin.
Collaborative Relationships (PR #11)
Collaborative Relationships: Board Role and Responsibilities
Indirect Primarily
Related Aspects: Strategic and Operational Plans; i.e. Mission Statement

16. Governance Compliance Review: Board Authority
The 19 Program Requirements: Mgt./Fin.
Financial Management (PR #12)
Financial Management and Control Policies: Board Role and Responsibilities
Selection of Auditor
Acceptance of Annual Audit
Approval of Financial Policies
Oversight of Control

17. Governance Compliance Review: Board Authority
The 19 Program Requirements: Mgt./Fin.
Billing and Collections (PR #13)
Billing and Collection: Board Role
Written Billing, Credit and Collection Policies
Monitoring Financial Indicators; i.e. Days Outstanding in Accounts Receivable

18. Governance Compliance Review: Board Authority
The 19 Program Requirements: Mgt./Fin.
Budget (PR #14)
Budget: Board Role and Responsibilities
Approval of The Annual Operating Budget
330 Grant Budget
Board Review of Budget Variences

19. Governance Compliance Review: Board Authority
The 19 Program Requirements: Mgt./Fin.
Information Systems (PR #15)
Program Data Reporting System: Board Role and Responsibilities
Data for the Strategic Plan
Monitoring of HRSA Reporting Requirements

20. Governance Compliance Review: Board Authority
The 19 Program Requirements: Mgt./Fin.
Scope of Project (PR #16)
Scope of Project: Board Role
Sites
Services
Target Population and the Service Area

21. Governance Compliance Review: Board Authority
The Program Requirements: Governance
Board Authority (PR #17)
Board Authority: Board Role and Responsibilities
Monthly Meetings & Minutes
330 Grant Application and Budget
CEO Position Oversight

22. Governance Compliance Review: Board Authority
The Program Requirements: Governance
Board Authority (PR #17 Cont.)
Board Authority: Board Role and Responsibilities
Measuring and Evaluating Progress
Developing Plans
Ongoing Reviews
Monitoring Assets and Performance

23. Governance Compliance Review: Board Authority
The Program Requirements: Governance
Board Composition (PR #18)
Board Composition: Board Role and Responsibilities
Board Size
The User Majority
Other Board Composition Requirements
Special Populations

24. Governance Compliance Review: Board Authority
The Program Requirements: Governance
Conflict of Interest (PR #19)
Conflict of Interest Policy: Board Role and Responsibilities
Board By-laws
Conflict of Interest Policy
Conflicts: Nepotism, Business Relationships, Dual Loyalties

25. Governance Compliance Review: Board Authority
How Board Actions Are Demonstrated
Meeting Minutes
Board Approved Policies

26. Governance Compliance Review: Board Authority
How Board Actions Are Demonstrated
Meeting Minutes
Level of Detail
Format
Approval Process
Importance

27. Governance Compliance Review: Board Authority
How Board Actions Are Demonstrated
Policies
Board Approval Process
Frequency of Review/Approval
Policy Format Issues

28. Governance Compliance Review: Board Authority
Best Practices
Board/Management Calendar
Committee Functions
Corporate Compliance Program

29. Governance Compliance Review: Board Authority
Board Authority Issues
The Operational Site Visit
Process
Documentation
By-laws
Compliance

30. Governance Compliance Review: Board Authority
Discussion/Questions and Answers

31. Governance Compliance Review: Board Authority
Conclusion
It has been an honor to have been a part of your conference.
William Rice