CHB Conference 2007 Planning for and Promoting Healthy Communities Roles and Responsibilities of Community Health Boards Presented by Carla Anglehart Director, Organizational Development October 2007

CHB Conference October 2007 Objectives Clarification on the roles, responsibilities and accountabilities of the Community Health Boards, the Board Chair, Individual Board Members Strategies for enhancing board process (e.g. increasing meeting effectiveness)

CHB Conference October 2007 Agenda The legislative framework for Community Health Boards Roles, responsibilities and accountabilities of your Community Health Board and individual board members; Strategies for enhancing board process

CHB Conference October 2007 Mandates and Accountabilities of Community Health Boards The Legislative Framework for Community Health Boards

CHB Conference October 2007 What the Health Authorities Act Does Establishes District Health Authorities Legislates Community Health Boards Defines roles, responsibilities and relationships Outlines annual planning and accountability process Addresses financial management

CHB Conference October 2007 Some Key Themes Strengthening connection of the system to communities through CHBs Accountability flows up from CHB to DHA to DoH

CHB Conference October 2007 CHB Roles and Responsibilities Fulfill mandate as key stakeholders in the health care system Prepare Community Health Plans for submission to District Health Authorities DHAs must consider Plans from Community Health Boards when developing Business Plans Select own members and nomination process

CHB Conference October 2007 DHA Roles and Responsibilities Delivery of health services (direct or primary responsibility) Submitting and implementing business plans, HR and IT plans Reporting to the public Reporting to DoH as prescribed or required by DoH, monthly, quarterly and annually Establishing and supporting CHBs Approving CHB By-laws

CHB Conference October 2007 District Health Authorities Roles and Responsibilities (HAA) –Govern, plan, manage, monitor, evaluate and deliver health services –Allocate resources –Avoid duplication of health services

CHB Conference October 2007 District Health Authorities Roles and Responsibilities (HAA) –Meet the needs of the district having regard for policies, directives, standards established pursuant to the Act –To endeavor to maintain and improve the health of the residents of the district

CHB Conference October 2007 DoH Roles and Responsibilities System leadership: strategic direction, standards, provincial policies Establishing DHAs and DHA boundaries (Governor-in-Council) Defining DHA services envelope Ensuring quality (ultimate responsibility) Monitoring, measuring and evaluating Allocating resources; and Managing DoH programs

CHB Conference October 2007 DoH Roles and Responsibilities (cont’d) Requiring and approving health business and other management plans Audits, reviews and examinations Giving directions, if needed Appointing members of DHAs Removal / suspension of DHA members and appointment of DHA administrator, if needed

CHB Conference October 2007 Integrated Sustainable Community- Based A Sustainable Health System A sustainable health system is one which is accountable for providing quality services where they can be supported in the long term and is affordable to the population it serves. A Community-Based Health System A community-based health system assures input by communities in planning and identifying strategies and services to improve the health and status of the population, and ensures that teams of providers participate in carrying out these strategies and services. An Integrated Health System An integrated health system ensures the coordination of services and allows providers to work together to improve the health status of the population. Critical to DoH Mission Health System

CHB Conference October 2007 The Board’s Leadership Role Steer the Mission and Strategic Direction Develop Appropriate Board Structures Ensure Board Understands It’s Role Implement Methods to Monitor Performance Communicate with Members, Stakeholders, Public Plan for the Succession and Diversity of Board

CHB Conference October 2007 Principles of Governance A Board governs on behalf of persons who are not seated at the table.

CHB Conference October 2007 Principles of Governance A Board speaks with one voice. –Or not at all!

CHB Conference October 2007 Principles of Governance A Board is responsible for, and designs its own, products and processes.

CHB Conference October 2007 Roles and Responsibilities of Individual Board Members

CHB Conference October 2007 Responsibilities of Each Board Member Attend and participate in board meetings Participate in at least 1 committee Actively help the board reach group decisions Approve, where appropriate, policy and other recommendations from the board, it’s committees and staff (if applicable) Monitor all board policies Review relevant legislation (Health Authorities Act) Approve the budget (if applicable) Assist in developing and maintaining positive relations among the board, committees, staff, and community to enhance the mission.

CHB Conference October 2007 Roles and Responsibilities of Each Board Member As a member of the board, to act in a position of trust for the community

CHB Conference October 2007 Responsibilities of the Board Chair Leadership – take lead in ensuring board fulfills its role, promote the CHB, serve as a link, promote ethical behaviour Chair Meetings – ensure discussions are fair, focused, objective, encourage participation, seek consensus, keep board aware of time constraints Preparation and Background Work – be available for meetings/discussions in addition to board meetings, follow-up on commitments, develop meeting agendas (in collaboration)

CHB Conference October 2007 Responsibilities of the Executive Committee _________________________

CHB Conference October 2007 Responsibilities of CHB Staff _________________________

CHB Conference October 2007 Board Process Working together as a board Strategies for Effective Meetings

CHB Conference October 2007 Board Performance Board Self-Evaluation Board Development Governance Action Plans

CHB Conference October 2007 What to Evaluate? Governance Check-up: Guidance for Health Care Organizations (CCAF and CCHSA) identify six characteristics of effective governance: being comprised of people with the knowledge, ability and commitment to fulfill their responsibilities. understanding their purposes and whose interest they represent. knowing and obtaining the information they require to exercise their responsibilities. once informed, being prepared to act. fulfilling their own accountability obligations to those whose interests they represent by reporting on their performance.

CHB Conference October 2007 Board Self Evaluation To reflect on and assess the boards performance; To check out progress toward the vision and strategic plan; To be accountable to those served by the organization; To meet the requirements of stakeholders/funding agents; To identify strengths and weaknesses; Identify the boards needs for information, education and development; To provide feedback to volunteers carrying out the work of the organization; To continually improve the work of the board and the organization.

CHB Conference October 2007 How to Evaluate? Annual Board Self-Evaluation – individual board members use self-assessment instruments to evaluate the board’s performance over the past year. Meeting Feedback - discussions, questionnaires or reviews at the end of each meeting to discuss strengths and weaknesses of the meeting. On-going Monitoring and Reporting – through business plans, financial reports, annual reports, etc. Constituent Feedback - interviews with key stakeholders, etc. Independent Governance Audit – an external consultant/evaluator conducts a review. Individual Governor Needs Assessment – individual board members identify their growth/development needs through reflection, discussion, and/or questionnaire.