The Tragic, Yet Avoidable, Mistake Made By Community Health Center Boards - An Introduction

The Tragic, Yet Avoidable, Mistake Made By Community Health Center Boards - An Introduction

An Introduction

As vital as Community Health Centers (CHCs) are, and as elemental as it may seem that hiring a competent Executive Director is crucial:
Why are so many CHCs managed by below-par Executive Directors?
What is the primary cause of the CHCs inability to achieve its mission?
Is it lack of funding?
Is it lack of providers?
How many excuses with CHC Boards tolerate until they face-up to the fact that they, the Board, have a fiduciary duty to hire an operationally strong Executive Director?
How many excuses with CHC Boards tolerate until they face-up to the fact that people have a right to competent management?

A typical medium-sized city has a population of 200,000, with 26,800 people at 200% of poverty level or below. That typical city’s community health center will serve 10,000 to 12,000 people during a calendar year. Thus leaves more than 14,000 people without basic medical care. These are the very people who are unable to afford health insurance.

The National Association of Community Health Centers (NACHCs) http://www.nachc.org/default.cfm , in its Governance materials, outlines the accountability, responsibility, and skills necessary for a community health center Executive Director:
1. Communicate with the board and management team;
2. Operationalize board policies;
3. Manage personnel and systems;
4. Allocate resources and operate within available resources;
5. Identify and resolve problems;
6. Interact with the community and providers and payers in the marketplace;
7. Respond to opportunities;
8. Plan for future events; and
9. Implement board-established long-term goals and operating plans.

The NACHC also states four areas of competency for an Executive Director:
1. Management and operations
2. Clinical program and oversight
3. Finance oversight
4. Marketing and development

These nine skills and four basic competency areas are foundational. Without these skills a community health center Executive Director is not competent to plan, organize, staff, direct, and monitor the CHC toward consistently living up to its stated mission of serving the underserved.

Why?
Why do so many community health center boards fail in this endeavor?
Why do boards seem unable to select a person with the basic competency of serving more of the underserved in its area?

Our sense is that boards may not fully appreciate the skill required by them in finding someone who can fulfill the above requirements. These volunteer Boards may not have a complete grasp of how intricate, yet basic, it really is. However, there are a few areas that, if the Executive Director is skilled, and if the CHC Board chooses an Executive Director effectively, will pave the way to success.

Just what those areas are will be the subject of our next series of posts.

Next Post: The Tragic, Yet Avoidable, Mistake Made By Community Health Center Boards - 1. Failing To Hire an Operationally Strong Executive Director.