beyond change: transforming culture, care and communities aphcas 28 th annual conference and trade...

Beyond Change: Transforming Culture, Care and Communities

APHCA’s 28th Annual Conference and Trade Show

Alabama Primary Health Care Association

2013 Annual Conference and Trade Show

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Governance Compliance Review:Board Authority

Presented byWilliam W. Rice

HRSA ConsultantAlexandria, Virginia

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Session Objectives• Determine Board Authority For a FQHC• Describe How to Demonstrate and

Document Board Authority• Best Practices in Board Oversight• Discuss Related Issues

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Determine Board Authority For a FQHC•Relationship to the 19 Program Requirements•How to Survive a HRSA Operational Site Visit

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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?

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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

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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

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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

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The 19 Program Requirements: Services•After Hours Coverage (PR #5)• After Hours Coverage: Board Role and

Responsibilities– Defined Arrangements– Delegation to Management

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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)

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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)

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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

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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

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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

Appropriate14




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

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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

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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

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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

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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

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The 19 Program Requirements: Mgt./Fin.•Scope of Project (PR #16)• Scope of Project: Board Role – Sites– Services– Target Population and the Service Area

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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

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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

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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

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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

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How Board Actions Are Demonstrated• Meeting Minutes• Board Approved Policies

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How Board Actions Are Demonstrated• Meeting Minutes– Level of Detail– Format–Approval Process– Importance

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How Board Actions Are Demonstrated• Policies–Board Approval Process– Frequency of Review/Approval–Policy Format Issues

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Best Practices• Board/Management Calendar• Committee Functions• Corporate Compliance Program

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Governance Compliance Review: Board Authority

Board Authority Issues•The Operational Site Visit–Process–Documentation

•By-laws–Compliance

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Discussion/Questions and Answers

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Conclusion

It has been an honor to have been a part of your conference.

William Rice

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beyond change: transforming culture, care and communities aphcas 28 th annual conference and trade...

Documents

annual conference

board role board approval

communities aphcas

board oversight

governance compliance

program requirements

board role formal arrangements

continuum of care