The NACHC Mission To promote the provision of high quality, comprehensive and affordable health care that is coordinated, culturally and linguistically.

The NACHC Mission

To promote the provision of high quality, comprehensive and affordable health care that is coordinated, culturally and linguistically competent, and community directed for all medically underserved populations.

Training and Technical Assistance Department

Going Beyond WHAT Health Center Boards Need to Know: A Focus on the "How-To" of Effective Board Governance Jaime Hirschfeld and Tommy Royston

2012 NC Primary Care Conference & Annual Meeting Asheville, North Carolina June 21, 2012

Never doubt that a small group of committed citizens can change the world. Indeed, it is the only thing that ever has.

- Margaret Mead

Never doubt that a small group of committed citizens without appropriate planning and structure, can truly screw things up!

- Julie Boden Schmidt

Agenda

I. Introductions

II. Overview of a Board & Roles & Responsibilities of a Health Center Board

III. 19 Program Requirements & How They Relate to the Board

IV. Recruitment & Retention Board Members

V. Board Evaluation and Work Plan

VI. Resources

OVERVIEW OF A BOARD

ROLES & RESPONSIBILITIES OF A HEALTH CENTER

Why do we have a board?

1. “Govern” the center

2. Serve as a link with the community

3. Comply with State and Federal laws.

Board Size and Composition

• As defined by the program requirements - http://bphc.hrsa.gov/about/requirements/index.html

• Between 9 –25 members• Minimum of 51% of board members must be

active consumers of the health center’s services

–Must be representative of the demographics of the

Health Center’s service area in terms of such

factors as income, ethnicity and sex

–Must live in the Health Center’s service area

Board Size and Composition (continued)

• Definition of Consumer Board

–Individuals who are (or, for planning grantees, will

be) served by the Health Center and who utilize the

Health Center as their principal source of primary

care and who have used the Health Center’s

services within the last two years?

–Legal guardian of a consumer who is a dependent

child or adult, or a legal sponsor of an immigrant

consumer, may be considered a consumer for

purposes of Board representation

Scenario

You are a board member and are friends with one of the staff members. That individual confides in you that she is pregnant and, after review, believes that the maternity leave policy is too stringent. What do you do?

Board Size and Composition (continued)

–Non-consumer Board members • Should live or work in the service area• Should be representative of the community served and

be selected for expertise in areas such as finance and banking, legal community affairs, etc.• No more than one half of non-consumer members can

derive more than 10 percent of their income from the health care industry

– If funded under more than one section 330 program, must demonstrate appropriate representation from each of the populations served by the health center

Waiver of Certain Composition & Procedural Requirements

• Governing Board Composition and Meetings Waivers:

–Waivers allowed for programs funded ONLY under

330(g), 330(h) and/or 330(i), provided that an

appropriate plan is presented to assure consumer

input into the governance process

–Waivers are not allowed for programs receiving

330(e) funding

Board Size and Composition (continued)

• Board must be self-selecting• Must hold monthly meetings and provide

documentation of those meetings• Must exercise the duties of:

–Care - act in good faith in performing their duties

–Loyalty - acknowledge that personal interests

cannot be furthered at the expense of the health

center.

–Obedience - faithful to the health center’s mission

Program Requirements: Governing Board Authorities

Governing Board must autonomously exercise the following key authorities:

– Selecting, evaluating and dismissing the Executive Director/Chief Executive Officer

– Establishing and approving health care policies and procedures• Locations and hours of services• Scope and availability of services• Quality of care audit procedures

– Establishing and approving personnel policies and procedures • Selection and dismissal procedures• Salary and benefit scales• Employee grievance procedures• Equal opportunity practices

Program Requirements: Governing Board Authorities

• Establishing and approving financial management practices

–System to assure accountability for center resources

–Annual project budget and plan

–Center priorities

–Eligibility for services including criteria for partial payments schedules

–Long-term financial planning

• Hiring the auditor and accepting the annual audit report

Program Requirements: Governing Board Authorities

• Evaluating the FQHC’s activities

–Service utilization patterns

–Productivity

–Patient satisfaction

–Achievement of project objectives (and revising mission, goals, objectives, plans and budgets as necessary)

–Process for hearing and resolving patient grievances

–Assuring compliance with applicable federal, state and local law, regulation and policy

• Engaging in strategic and operational planning

Program Requirements: Management

• CEO must be directly employed by the health center– Preferred that management team members are directly

employed, but good cause exceptions are available

• Must have a direct line of authority from the Board to the CEO who delegates as appropriate

• Must have effective administrative and clinical leadership, systems and procedures, including a strong management team that

– Works with the Board

– Implements mission and strategic objectives

Role of the Board

• Board sets goals and priorities for, and provides overall direction, to the health center by –

–Establishing operational and strategic plans–Adopting general policies and procedures to

establish the “framework” for operations–Reviewing and as necessary updating policies–Hiring, evaluating, and, if necessary, firing the

CEO –Providing direction to and overseeing the CEO

Role of Management

• CEO manages the day-to-day operations of center by –

–Implementing and operationalizing the policies, procedures, operating plans, and long-term goals established by the Board

–Establishing and managing the operating systems–Hiring the workforce and maintaining full authority

over the health center’s management team and staff, including management, evaluation and dismissal

–Allocating and operating within available resources

Role of Management

• CEO manages the day-to-day operations of center by –

–Taking other steps necessary to operate the health center (i.e. vendor contracts)

–Overseeing and monitoring the effectiveness of daily operations on a regular basis

–Identifying and resolving problems–Interacting with the community, providers and

payors in the marketplace–Responding to opportunities and planning for

future events

Scenario

You are the Executive Director and during your annual evaluation, the Executive Committee informs you that they will also be doing an evaluation of the leadership team: Chief Financial Officer, Chief Operating Officer, and Chief Medical Officer. What is your response?

Health Center Board Members Do’s

• Do know the center’s mission, purpose, and goals as well as its programs and services• Do get to know the center’s strengths and weaknesses• Do pitch in enthusiastically and willingly• Do make sure you have all the information before

expressing an opinion or a judgment• Do get acquainted with the other board members and

the Center’s CEO and staff• Do come to meetings—and come prepared to

participate

Health Center Board Members Do’s (continued)

• Do ask questions• Do support the majority even if you disagree• Do support the CEO and staff, and understand that

they are operating with limited resources• Do avoid any possible conflict of interest• Do maintain a sense of fairness, ethics, and

personal integrity• Do understand the Center’s financial statement and

help the board plan for future revenue and expenses

Health Center Board Members Don’ts

• Don’t lose your sense of humor• Don’t speak for the board, unless authorized to do

so• Don’t ask the CEO or staff for special favors

Board Member Do’s and Don'ts

The Board should not – • Usurp or unnecessarily intervene in the executive

director’s authority for the day-to-day management of operations

• Communicate with center staff directly (except in “special” circumstances, e.g., serious issues concerning the CEO) and only in accordance with established policy and procedure

HEALTH CENTER BOARD MEMBERLEGAL AND PROGRAM RESPONSIBILITIESDo you know the answers to these questions?

Corporate Compliance Patient satisfaction

Sarbanes-Oxley Performance Measures

Fair Labor Standards Act Program Expectations

FMLA

Current ratio

So much to do – so little time!

Demands on the board

• Effectiveness: making a difference

• Efficiency: making good use of all resources (money, effort and time)

• Accountability: operating by high standards; keeping the community informed

Establishing & Maintaining an Effective Board

• Design appropriate structure and organization

–Board meetings• Ensure all materials are distributed with sufficient time

to review before the meeting• Adopt rules of conduct• Set (and stick to) an agenda• Encourage discussion and be respectful of each other• Keep minutes and approve at subsequent meeting –

Effective board meetings!

• Good attendance – bring • Prepared members • Clear and focused agenda• Written reports with proposed action of the committees

and requested action of the board noted• Consider use of a “consent agenda” to avoid spending

time on routine reports:– Does not require discussion before a vote– Standard, non-controversial, self-explanatory items

• Do in-depth review of issues at different meetings – don’t discuss everything at every meeting!

So what does it really take to make it work???

• Effective committee work• Established agreement about the authority

between the committees and the board – who does what??

Establishing Effective Committees

• Integrate committees and committee work into the Board

–Delegation is good

• Only the Executive Committee can act for the full Board, if necessary

–Board should subsequently ratify decisions made by

the Executive Committee

• An effective reporting system from committee to board• A mechanism to check with the board – Getting

enough information? Too much? In useful formats?

Problems with many meetings…

• Lack of preparation• Not focused – not able to fully discuss the critical

issues/decisions• Only a few people participating• Not realizing you have reached an agreement or

not realizing where the disagreement lies• Pressed for time but still feeling the meetings are

too long• Boring!!

If you are “stuck” in the discussion, what do you do?

• Only three people stuck – and they are at the bottom of

• Get a pulse! Find out who is stuck and why?

• Engage people: “give and take”, not “show-and-tell!” - do straw votes – ask them to speak from their area of expertise – then, ask them to wear different

19 HEALTH CENTER PROGRAM REQUIREMENTS

19 Program Requirements

• Divided into four categories:

–Need

–Services

–management and finance

–Governance

Assess & Monitor Needs of Target Population

• The mission, goals, and plans for a health center should be based on the needs of the target population served by the health center

– Document the needs of the target population

– Update their service area when appropriate.

– Board is required to oversee the organization’s

progress in meeting its mission and goals and

periodic updates

Goals of the Needs Assessment

• Presents a thorough description of

–Service area

–Characteristics

–Needs

–Perceptions of the target and patient populations

– Identifies the barriers to care

–The resources available

–The gaps in service

–The external factors affecting these conditions

Needs Assessment – Board Responsibility

• Assure there is a: – Written needs assessment that is periodically updated

– Ongoing process in place to regularly monitor the needs

of the target population and the external factors that

may affect the organization’s ability to meet those needs

– Needs of the target and patient populations are used in

strategic planning to define and adapt the health

center’s mission, goals, and plans

Questions for the Governing Board to Ask About the Needs Assessment

• Is the needs assessment in writing and is it up to date? • What are the barriers to care? • Is the approved service area accurate or should it be revised? • Is there service area overlap with other health centers or

safety-net providers? • Are all of the center’s services available to all residents of the

service area? • Is the health center’s mission, its goals, plans and its sites,

services and service area aligned with the needs of the target population?

Services

• Health Centers are required to provide:

–Primary

–Preventative

–Enabling health services

–Additional health services as appropriate and

necessary, either directly or through established

written arrangements and referrals

Services (cont)

• Examples of required services are:

– Pediatric, Well Child Care and Immunizations

– Internal Medicine and Geriatric Services

– Obstetrics, Prenatal, & Perinatal Services

– Gynecology and Family Planning

– Emergency and Preventive Dental Services

– Diagnostic Laboratory and Radiology Services

– Patient Education and Outreach

– Patient Transportation

– Interpretive Services

– Medicaid Eligibility Services

– Substance Abuse and Mental Health Services

Services - Board’s Responsibility

• Establish and approve the scope of the federal grant project including:

–Clinical staffing

–Number of sites

–Services

–Target population

–Service area

• Review and approve written referral agreements and other formal arrangements• Review and approve the hours of operation and the

after-hours coverage.

Services - Questions to Ask

• Are the service arrangements and hours of operation fulfilling the needs of the target and patient populations? • Does the board formally approve the scope of

services and hours of operation? • Are arrangements in place for all required services

and any additional services needed? • Are there appropriate written agreements for all

referred care arrangements?

Services - Questions to Ask

• Are there appropriate arrangements for hospital care? • Are appropriate arrangements made for after-hours

coverage? • Does the health center collaborate effectively with other

service providers and organizations in the community? • Are all of the center’s services available to all residents of

the service area?

Sliding Fee Discount

• Health center has a system in place to determine eligibility for patient discounts adjusted on the basis of the patient’s ability to pay.

–Must provide a full discount to individuals and

families with annual incomes at or below 100% of

the Federal poverty guidelines (only nominal fees

may be charged)

–For those with incomes between 100% and 200%

of poverty, fees must be charged in accordance

with a sliding discount policy based on family size

and income.

Sliding Fee Scale – Board Responsibilities

• Assure that the health center has a system in place to identify and enroll those patients who are eligible for the sliding fee discount program

• Assure that the schedule of sliding fee discounts and the sliding fee discount program policies comply with the HRSA/BPHC program requirements

• Approve the fee schedule and schedule of discounts and review and update the fee and discount schedule on a regular basis.

Sliding Fee Scale – Questions to Ask

• Does the health center’s sliding fee discount policy reflect the most recent poverty guidelines? • Does the sliding fee discount policy comply with

the program requirements contained in the Health Center Program law? • Are eligible patients aware of the availability of

discounts? • How does the policy define “income” and “family”?

Sliding Fee Scale – Questions for the Board to Ask

• Does the health center provide discounts by type of service? • What criteria are defined in the policy for referring

patients to other reimbursement programs? • Are there provisions in the policy to encourage and

enforce patient compliance with the policy requirements such as income documentation and fee collection?

Scenario

A member of your board has been a challenge – taking over the discussions, questioning all the committee reports, and finally, asking “why the focus on poor people”? His term is up at the next board meeting when there will be elections. What should you do?

Quality Improvement/Assurance Plan

• Health center has an ongoing Quality Improvement/Quality Assurance (QI/QA) program that includes clinical services and management, and that maintains the confidentiality of patient records. The QI/QA program must include:

–a clinical director whose focus of responsibility is to support

the quality improvement/assurance program and the

provision of high quality patient care;

–periodic assessment of the appropriateness of the

utilization of services and the quality of services provided or

proposed to be provided to individuals served by the health

center

Quality Improvement/Assurance Plan – Board Responsibility

• Review and approve the QA/QI plan annually• Provide for QA/QI orientation and training for board members • Ensure that there are board members with expertise in patient

safety and quality improvement• Board committee assigned to oversee the QA/QI function• Receive and act on periodic reports about quality assessments,

quality improvements, patient satisfaction, adverse incidents, accreditation findings, and other external reports concerning program quality and performance, such as the FTCA application that requires the date when the board approved the QA/QI plan

QI/QA Information for the Board to Review

• Annual QA/QI plan • Staff QA/QI program reports • Accreditation/ certification reports • External program and financial audit reports • Patient satisfaction surveys • Adverse incident reports • HRSA/BPHC required clinical and financial

measures and the health center’s performance

Quality Improvement/Assurance Plan – Questions to Ask

• What are the QA/QI activities and goals? • Who is leading the QA/QI program? • Is the Board QA/QI capability adequate? • Is performance being improved? Why or why not?

Management and Finance

• In order to receive federal financial grant support from HRSA/BPHC, health centers are required by law to:

– Maintain accounting and internal control systems appropriate to the

size and complexity of the organization;

– Use Generally Accepted Accounting Principles (GAAP);

– Separate financial functions appropriate to the organization’s size;

– Safeguard assets;

– Maintain financial stability;

– Perform an annual, independent, financial audit in accordance with

federal audit requirements, including the submission of a corrective

action plan addressing all findings, questioned costs, reportable

conditions, and material weaknesses cited in the audit report.

Health Center Grant Application – Board Responsibilities

• Assure that the health center has a realistic plan for achieving the organization’s annual and long-term goals• Assure that the grant budget accurately reflects

the expected revenues and cost of operations• Review and approve the application and

document approval in the board meeting minutes; • Regularly evaluate and revise the program and

financial projections as necessary.

Health Center Grant Application – Questions for the Board to Ask

• Does the application clearly address the review criteria identified in the application guidance?• Are there current compliance issues likely to be

found in the current application or any unresolved grant conditions from the previous Notice of Grant Award (NGA)?• Does the application propose reasonable health

service and financial goals?• Are there any changes being proposed in the

application that require prior HRSA/BPHC approval?

Assess and Monitor the Annual Budget

• Uses conservative assumptions based upon prior period actual data• Makes allowances for uncertainties yet reliably

achieves the projected result• Is routinely monitored, variances are explained,

and projected results achieved • Contributes to the improved financial well-being of

the health center

Health Center Annual Budget – Board Responsibilities

• Assure that the health center has a realistic plan for achieving the organization’s annual and long term programmatic and financial goals• Assure that the budget accurately reflects the

expected revenues and cost of operations • Review and approve the budget• Regularly evaluate budget projections and correct

as necessary

Health Center Annual Budget – Questions to Ask

• How did the health center’s actual performance compare to the budget last year?

• How did the fiscal-year-end interim financial statement compare to the audited statement?

• Is there prior period actual data supporting the budget and its key assumptions?

• Does the Health Center Program grant budget or its assumptions deviate significantly from the prior period actual data?

• Does the budget maintain or increase the health center’s service capacity?

• Does the budget achieve the organization’s program goals?

Scenario

During the preparation of the annual budget, the board should take on which of the following responsibilities:

–Define the policies related to salary increases

–Approve a total % of salary increases allowed

–Approve individual staff salary increases

–Approve the salary of the CEO

Independent Financial Audit – Board Responsibilities

• Select the auditor• Assure that the audit is conducted and submitted

in compliance with federal requirements• Assure that management resolves audit findings

as promptly as is feasible

Independent Financial Audit – Questions to Ask

• What is the OMB circular number A-133 and what are its implications for the health center?• When and where must the audit be submitted?• What is a management letter?• What should be done about the auditor findings

presented in the audit report or management letter?

Monitoring Financial Performance Using Financial Statement Data

• Assume legal fiduciary responsibility of the health center –

–assuring financial accountability

–effective oversight of the center

–sound financial viability

• Review and approve the annual audit and monthly financial statements

Monitoring Financial Performance Using Financial Statement Data

• Ensure that there are board members who are willing and able to perform the financial oversight function• Regularly review progress and ensure corrective

action is taken when necessary.

Monitoring Financial Performance Using Financial Statement Data – Information to Review

• Independent financial audit• Monthly financial statements

–Trend or other report that includes the required and

any supplemental financial statement measures

–Financial statement and trend report comments

• Grant application

Common Sources of Liability and Financial Loss

• Employment practices – the most common reason• Inattention to duties as board members• Conflicts of interest• Violation of federal and state laws• Violation of regulations affecting the

services that the organization providers• Claims by service recipients

With thanks to Jacqueline C. Leifer

Governance

• Board Authority• Board Composition• Conflict of Interest

Conflict of Interest

• Written, board approved policy that discusses conflict of interest

–Part of bylaws

–Separate policy

• No one on the board can be an employee of the health center or an immediate family member of an employee. • CEO is not able to being a voting member of the

board.

Conflict of Interest Policy

• Disclosure of personal and business relationships that could create an actual or potential conflict of interest.

• The extent to which a board member can participate in board decisions where the member has a personal or financial interest.

• Whether or not the health center will use board members to provide services to the center.

• Board member expense reimbursement policies. • Acceptance of gifts or gratuities• Personal political activities of board members • The consequence for violating the conflict of interest policy

RECRUITMENT & RETENTION OF BOARD MEMBERS

Recruitment, Retention and Development of Board Members

• Integral part of your efforts to create a more functional board.• Effective orientation will allow you to train your new

board members to effectively serve your board and the community, from the moment they arrive. • The recruitment and orientation process should set the

stage for your board members. – Board members are chosen to monitor and guide the organization to

ensure that the benefits and services the organization provides is

ongoing within the community.

• Good recruitment and orientation is vital to the success of your organization.

Recruiting Board Members

• Engage in recruitment / selection process

–Consider recruitment and selection an ongoing part

of overall strategic planning• Establish a standing committee (i.e., nominating or

Board development committee) OR• Add to responsibilities of an existing committee

–Develop a Board director job description • Focus on priorities and requirements• Provide Board members (current and potential) with

clear objectives and responsibilities

Recruiting Board Members (continued)

–Develop and use a Board profile• Federal Board composition requirements• Other skills, qualifications and knowledge necessary

to fulfill the health center’s mission and address priorities

–Remember to reach out to consumers• Community events• Outreach• Local establishments• Patient satisfaction surveys

Recruiting Board Members (continued)

• How can you make sure that you are recruiting the right people for your board and that they are well prepared for the job ahead of them?

–Define the job clearly

–Recruit good people from your community

–Provide your board members with orientation

Orientation for New Board Members

– Introduction to the health center

–Training and education regarding critical topics

such as legal requirements, roles and

responsibilities, confidentiality, governance /

management

–Review of the standards of conduct and conflict of

interest policies

–Distribution of Board orientation manual

BOARD EVALUATION & WORK PLAN

Board Evaluation

• Engage in Board self-evaluation

–Determines whether the Board is operating

effectively and meeting its (not the health center’s)

defined goals and objectives• Serves as a check to ensure that the Board is fulfilling

its responsibilities and promoting the mission• Identifies areas that need improvement

–Assists in determining resources and steps

necessary to accomplish identified improvements

Board Evaluation

• Board self-evaluation (cont.)

–Provides an opportunity to remind Board members

of their roles, rights and responsibilities

–Should be tailored to the Board’s strengths,

weaknesses, preferences, needs, resources, time

constraints

–Include an opportunity for each Board member to

evaluate him/herself and the Board as a whole

What is a Board Work Plan?

• A short-range tool focusing on the Board’s responsibilities 1 year at a time

– Sets guideposts & deadlines• Periodic review and update of policies & procedures• Approval of budgets • Submission of assurances, applications, and reports to

Federal Government• Approval of reports required by grants, contracts, and

various government agencies

– Accounts for actions needed to accomplish longer-range goals set by strategic plan

So, what should you do?

• Set ground rules for the board. Include “Take what you do seriously, but not yourself too seriously.”

• Remain grounded on the mission and vision and use that as a reference point to remind board members of the need for focus.

• Have a clear contract and understanding between the board and the CEO clarifying the ground rules.

• Develop a mechanism where board members can get 360 degree feedback as well as the CEO.

• Use the program guidance to help clarify expectations.

So, what should you do? (Continued)

• Hold board retreats to provide feedback and self-assessments of the board.

• The Chair should take on the coaching role for certain behaviors of board members.

• The board should view senior staff as their subject matter experts accessible through the CEO.

• The Medical Director should meet with board members periodically as a two-way education to understand the needs of the community.

• Senior staff should attend board meetings and strategic planning sessions.

So, what should you do? (Continued)

One best practice suggested was to have at each board meeting a quick review of the “day in the life” of a practicing provider in the organization to see the issues and challenges raised in daily work.

Scenario

One board member frequently calls one of the medical clinics for same day appointments and, if not provided one, immediately complains to the CEO. What should be the response of the clinical staff? CEO? Board?

FINAL THOUGHTS

If you don’t do anything else…

Ask these questions:1. What is your strategic plan and what

progress has been made?2. What is the one-year operational plan and

what progress has been made?3. What is the current financial position?

Total margin

Days cash on hand Days in A/R

Current ratio Days in A/P

If you don’t do anything else – ask…

4. What mechanisms are in place to ensure compliance with: 330 requirements; state and federal laws and regulations; Medicaid and Medicare requirements?

5. Is your staff satisfied? How do you know?

6. Are your patients satisfied? How do you know?

7. What goals have been set in the QA Plan and have they been met?

Learn from what worked and what didn’t!

• On a scale of 1 – 5, how satisfied were you with this training?

• What influenced your score?

• What would you have liked to be different to move you to a 4 or 5 if you rated the meeting lower?

RESOURCES

Board Education Video Series

http://www.boardeducationvideos.com/

• Module 1: What’s different about a Community Health Center?• Module 2: What Defines our Success?• Module 3: What can a board do to insure financial

health?• Module 4: What does it mean to be Community

Based?• Module 5: How does the Board add value?

Plus discussion and resource guides!!!

Resources

• National Association of Community Health Centers www.nachc.com

• Across the Board http://www.vacommunityhealth.org/across_the_board.cfm

• BoardSource

www.boardsource.org • Community Health Association of Mountains/Plains States

(CHAMPS)http://www.champsonline.org/ToolsProducts/CHCBoardResources.html

• National Health Care for the Homeless Council: How to Develop a Consumer Advisory Boardhttp://www.nhchc.org/NCAB/NCAB_Manual-rev-Jan10.pdf

Resources - HRSA

• BPHC/ HRSA T/TA Website http://bphc.hrsa.gov/technicalassistance/TA%20Resources/index.html#G• HRSA Board Governing Handbook

http://ask.hrsa.gov/detail_materials.cfm?ProdID=720 • Program Requirements

http://bphc.hrsa.gov/about/requirements/index.html

Resources – Training &Technical Assistance

• Governance Information Bulletins – This 19-document series provides information about health center board responsibilities and effective governance operations• COMING SOON Board Members’ Roles and How

to Do Them – This series focuses on governance requirements of the federal Health Center Program.

*** Both can be found at:

http://www.nachc.com/hc-info-governance.cfm

Resources – Training &Technical Assistance

• Conference Trainings and Education Sessions

–Board Member Boot Camp – This training is offered at

both NACHC national conferences and provides new and

veteran board members with an overview of four key

governance responsibilities

–Education Sessions – NACHC conferences include

education sessions where board members gain knowledge

and skills of high-performing board operations and legal

compliance requirements, as well as experience

networking opportunities to learn from other board

members via roundtable discussions.

Contact Information

Jaime HirschfeldHealth Center Growth & Development Specialist

(301) 347-0460

[email protected]

Tommy RoystonDirector of Education and Training

(301) 347-0445

[email protected]