Governance

Resource List

Community Health WorkerHealth centers are governed by volunteer boards of directors. Health center boards are unique among nonprofit organizations because federal law requires 51% of board members to be patients of the center, which helps the center be responsive to patient and community needs. Effective governance of community health centers provides the strategic direction and oversight needed to fulfill the mission of community health centers.

These resources have been developed by the National Training and Technical Assistance Partners (NTTAPs). Check back as new resources are continually added.

  • Artificial Intelligence & The Role of the Health Center Board. Brief by NACHC This brief resource introduces foundational concepts about Artificial Intelligence in health centers and discuss the role of the board.
  • Clinical Issues & Health Center Boards: Family Healthy Weight Programs for Boards. Guide by NACHC This resource discusses Family Healthy Weight Programs and how boards can support such programs through appropriate governance-level functions. This resource may also help orient new board or committee members to clinical issues.
  • Clinical Issues & Health Center Boards: Hypertension Management. Guide by NACHC This resource discusses hypertension management and how boards can support this through appropriate governance-level functions. This resource may also help orient new board or committee members to clinical issues.
  • Four Fundamentals of Value-Based Payment for Health Center Boards. Videorecording by NACHC This brief video outlines four fundamental things boards and board members should know about value-based payment. This resource might be helpful for new board member orientation or for a full board to view as part of their ongoing board education.
  • Health Center Board Composition, Recruitment, and Orientation. Policies/Guidelines by NACHC This resource will help your board understand board composition, recruitment, and orientation and engagement.
  • Health Center Board Roles & Responsibilities. Aid/Kit by NACHC This two-page resource discusses the three major categories of health center board roles: Strategy, Oversight & Policy, and Board Functioning. It also contains a sample statement of board responsibilities that can be customized by health centers; the sample captures both the general roles of a board and requirements of the Health Resources and Services Administration (HRSA) Health Center Program.
  • HRSA Health Center Facility Loan Guarantee Program: Overview for Health Centers. Fact Sheet by CapLink This fact sheet provides details about the HRSA Health Center Facility Loan Guarantee Program (LGP) for health centers.
  • Interoperability Readiness Scorecard (Printable Version). Template by HITEQ This scorecard encourages health centers to consider their processes, infrastructure, and action in a number of key areas. Each area key to interoperability are to be self-graded on a scale of 1 through 5, where 1 is poorly or not yet developed and 5 is well developed. Health centers can also use this to guide discussions and monitor progress over time.
  • Introduction to Health Center Governance. Microlearning by NACHC Like all nonprofit organizations, health centers must be governed by a board of directors. This microlearning provides a high-level introduction to health center board roles for health centers. 
  • Mergers & Acquisitions: The Role of the Health Center Board. Brief by NACHC This brief resource introduces foundational concepts in corporate consolidation, including merger and acquisition and address the board’s role.
  • Public Agency Health Center Monograph. Monograph/Book by NACHC This monograph is a practical guide for public agency health centers operating within the Health Center Program. It clarifies key HRSA requirements, governance expectations, co-applicant board responsibilities, fiscal and personnel considerations, and common compliance challenges. This publication offers actionable guidance to support effective collaboration, strong oversight, and alignment with current federal expectations. It is an essential resource for understanding and strengthening the public agency health center model. Designed for public agencies, public health center leaders, co-applicant boards, and Primary Care Associations.
  • Sliding Fee Discount Program - The Fundamentals for Health Center Boards. Microlearning by NACHC This short video outlines the fundamentals of the Sliding Fee Discount Program that is required under the Health Resources and Services Administration (HRSA) Health Center Program. This video is intended for health center boards and addresses the following topics: What is the Sliding Fee Discount Program and why is it important? What does a health center board need to know about the Sliding Fee Discount Program? Tips for boards related to the Sliding Fee Discount Program
  • Strategic Planning and the Board's Role. Microlearning by NACHC This microlearning provides an overview of the board’s role in strategic planning, including an overview of the board and management staff roles during different phases of the process, and practical ways for boards to partner with the Chief Executive Officer (CEO) and their management teams around strategic planning.
  • The Board’s Role in Financial Oversight. Microlearning by NACHC Health center board roles can be grouped into three categories: Strategy, Oversight & Policy, and Board Functioning. This microlearning explores the board’s role in providing financial oversight of the health center.  
  • The Boards Role in Reading the Income Statement. Microlearning by NACHC This microlearning is designed to help health center board members learn about the Income Statement so they can ask informed questions and contribute to the board’s financial oversight responsibilities. 
  • The Boards Role in Understanding Key Performance Indicators. Microlearning by NACHC Key Performance Indicators (or KPIs) are useful to assess a health center’s financial condition. This microlearning explores how health center boards can use KPIs to determine whether the financial picture is improving or declining.
  • Tips for Boards on Health Center Workforce Challenges and Opportunities. Guide by NACHC This article provides several tips for how health center boards can support worforce challenges and opportunities through appropriate governance-level functions. Boards can utilize their processes for strategic planning, budgeting, and policy approval to support workforce related goals and priorities.
  • Tips for Effective Health Center Board Meetings. Guide by NACHC This resource provides information on meeting practices used by health center boards and tips for better meetings. It includes tips for planning, designing, facilitating and keeping accurate board meeting minutes.
  • Tips for Health Center Boards for Evaluating the Sliding Fee Discount Program. Videorecording by NACHC Health center boards are required to adopt, review and evaluate at least once every three years, and, as needed, approve updates to the Sliding Fee Discount Program as noted in Chapter 19: Board Authority in the Health Resources and Services Administration (HRSA) Health Center Program Compliance Manual. This short video provides tips on how boards can work with the health center CEO to evaluate and approve updates to the Sliding Fee Discount Program. It contains sample data and questions a board may wish to ask as part of this process.

    • This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $6,625,000 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.