• Board Authority
  • Board Composition
  • Conflict of Interest Policy


Board Authority

Health center governing board maintains appropriate authority to oversee the operations of the center, including:

  • holding monthly meetings;
  • approval of the health center grant application and budget;
  • selection/dismissal and performance evaluation of the health center CEO;
  • selection of services to be provided and the health center hours of operations;
  • measuring and evaluating the organization’s progress in meeting its annual and long-term programmatic and financial goals and developing plans for the long-range viability of the organization by engaging in strategic planning, ongoing review of the organization’s mission and bylaws, evaluating patient satisfaction, and monitoring organizational assets and performance;* and
  • establishment of general policies for the health center.

Note: In the case of public centers (also referred to as public entities) with co-applicant governing boards, the public center is permitted to retain authority for establishing general policies (fiscal and personnel policies) for the health center.


Board Composition

The health center governing board is composed of individuals, a majority of whom are being served by the center and, this majority as a group, represent the individuals being served by the center in terms of demographic factors such as race, ethnicity, and sex. Specifically:

  • Governing board has at least 9 but no more than 25 members, as appropriate for the complexity of the organization.*
  • The remaining non-consumer members of the board shall be representative of the community in which the center’s service area is located and shall be selected for their expertise in community affairs, local government, finance and banking, legal affairs, trade unions, and other commercial and industrial concerns, or social service agencies within the community.*
  • No more than one half (50%) of the non-consumer board members may derive more than 10% of their annual income from the health care industry.*

Notes: Upon a showing of good cause the Secretary may waive, for the length of the project period, the patient majority requirement in the case of a health center that receives a grant pursuant to subsection (g), (h), (i), or (p). Portions of program requirements notated by an asterisk “*” indicate regulatory requirements that are recommended but not required for grantees that receive funds solely for Health Care for the Homeless (section 330(h)) and/or the Public Housing Primary Care (section 330(i)) Programs.


Conflict of Interest Policy

Health center bylaws or written corporate board approved policy include provisions that prohibit conflict of interest by board members, employees, consultants and those who furnish goods or services to the health center.

No board member shall be an employee of the health center or an immediate family member of an employee. The Chief Executive may serve only as a non-voting ex-officio member of the board.

Please review the HRSA Policy Information Notice on Health Center Program Governance released January 2014.



Patient Satisfaction Quick Guide: Addressing Patient Satisfaction in Health Care for the Homeless Projects

(2016). This resource examines how HCH grantees can gather and utilize patient satisfaction data to improve patient experiences. Patient satisfaction is a key measure of quality health care, and regular assessment is required for all Health Center Program Grantees. This quick guide provides a succinct review of the strategies necessary to plan for, collect, and respond to such information. These practice recommendations emerged from a 2015 focus group of expert HCH administrators and client advocates, HRSA guidance, and scientific literature.

Board Composition Quick Guide

(2014) The Health Care for the Homeless movement is committed to meaningful involvement of people with the experience of homelessness at all levels of our work.  To assist with consumer involvement, the Council has now published A Quick Guide on Board Composition for Health Care for the Homeless Projects. A related workshop will be presented at the 2015 National HCH Conference & Policy Symposium.

Webinar: Consumer Involvement in Governance

(2014) This webinar will explain the significance of consumer involvement and describe how HCH grantees can fulfill this particular requirement. A special focus on Consumer Advisory Boards will feature presentations from an HCH Executive and CAB leader. Among other specifics, we will explore how CABs function, CAB recruitment, and the influence CABs can have on HCH operations. We will highlight relevant material from the new Public Information Notice (PIN 2014-01) on the HRSA governance requirement and finally, we will describe the role of the National Consumer Advisory Board (NCAB) in supporting consumer involvement in HCH governance.

Webinar: Consumer Involvement in Governance – Chicago

(2013) Would you like to engage consumers in leadership decision-making at your health care for the homeless project? Are you considering developing a consumer advisory board? In this webinar, consumer leaders will discuss how consumer advisory boards and consumer board members have helped to maximize the ease of use and comfort of their facilities for all of their patients. Learn how important consumer participation is to the board and leadership team and how it can benefit your project.

Public Entity HCH Grantees and Co-applicant Arrangements

(2013) This webinar was produced in response to a technical assistance request for public entity health care for the homeless grantees developing their co-applicant agreements. This webinar covers the nuts and bolts of the health center program requirements on governance, public entity/agency structure, and co-applicant arrangements. The webinar will also feature two health care for the homeless public entity grantees that have successfully developed their co-applicant agreements. They will share their experiences with the process including potential pitfalls and some tips for success.

Governance Requirement in Health Care for the Homeless

(2010) HCH administrators discuss the important aspect of community ownership of HCH projects. They briefly discuss the barriers in creating a successful Consumer Advisory Board (CAB), and they give some examples of CAB issues and their solutions.

Governance – Pages from Organizing Health Services

(2001) Pages from Organizing Health Services for Homeless People in Part III. Developing a Framework, which reviews special challenges in setting up a Health Care for the Homeless board.

Strategic Planning in Health Care for the Homeless

(2001) Pages from Organizing Health Services for Homeless People Part V. Organizational Skills.

Resource Webpage: National Consumer Advisory Board

Grantees interested in information and resources on the topic of consumer involvement in governance will be interested in this page. This is the homepage for National Consumer Advisory Board (NCAB), which is made up of homeless and formerly homeless persons who have been clients of Health Care for the Homeless projects across the country and who are involved in the governance of those HCH projects. NCAB is a standing committee of the National Health Care for the Homeless Council, and NCAB’s elected Chairperson sits on the National Council’s Board of Directors.

Sample by-laws and other governance policies are available. Please email TA staff with your requests,

You may request in-depth or personalized technical assistance on any of these topics. Visit our Get Assistance page.