Community Health Centers –Governing Boards That Do Their Job – Part 1.

Community Health Centers –Governing Boards That Do Their Job – Part 1.

This next series of posts will address Community Health Centers –Governing Boards –

The entirely preventable failure of Community Health Center Governing Boards to guide their centers and executive directors to fulfill the dictate to serve the underserved that has unfolded has many culprits:

§ Reckless executive directors who gambled with their center’s futures,
§ Unmotivated federal regulators, and
§ Financially clueless governing boards.

But while senior managers and government regulators have justifiably taken heat for this multifaceted debacle, governing board members have largely been let off the hook. Why?

It is a community health center’s governing board's responsibility to oversee management and to ensure the center’s long-term survival. Its job, in short, is to represent the stakeholders, i.e., the patients, and the unserved low-income members of the community.

With the tumbling and collapse of dozens of medical groups and the underfunding of Medicaid, can we draw any conclusion other than that those governing directors utterly failed in this regard?

Increasingly, we hear apologists rise to the defense of governing boards, evidence that the process of obfuscation of the boards' guilt has begun. This is dangerous.

Nonexecutive governing board directors could not have been expected to understand the risks of complex, highly leveraged accounts receivable accounting during this crisis, the apologists have stated. That is nonsense.

A governing board member should be able to understand when a community health center is stating its accounts receivables that are over 180 days old as revenue, as some do. In my view, many community health center governing boards are not doing their jobs.

Apologists believe that some governing board members should have pressed senior management more on their accounting strategies. Chances are that some directors did take this approach. But did they demand any senior management behavioral change of course? Or did they just accept the management line that certain accounting strategies are necessary?

We have a right to expect more from governing boards of community health centers. The system of checks and balances between governing boards and executive teams has, in too many cases, disintegrated. We are seeing that many governing board members are demonstrably unqualified, abjectly remiss, or simply too cozy with their executive directors.

Next post: Community Health Centers –Governing Boards That Do Their Job – Part 2 - Strengthening Community Health Center Governing Boards.