Alabama Primary Health Care Association 2013 Annual Conference and Trade Show

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

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

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

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?

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

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

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

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

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)

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)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Governance Compliance Review: Board Authority Discussion/Questions and Answers

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