There still seems to be confusion over why boards of health exist and if they do exist, why. Over the years, I have presented an orientation to about a dozen of these boards. The consensus seems to be that board members see themselves as volunteer without much authority. The boards recognize their role in the hiring and firing of the chief executive of the public health agency. They believe their key role is to micromanage the agency budget. Although the key roles of hiring the CEO and the budget are important, they are not the only roles that the board has.
The National Association of Local Boards of health has struggled with the issue of board function and they now have come up with six broad functions for these boards. The six functions relate to the issue of governance (See my posting on Board Leadership). The first function involves the important set of actions related to POLICY DEVELOPMENT. Policy development involves such activities as developing internal and external policies that support the mission of the public health agency to protect the community’s health. The board needs to work with the agency on the health vision for the jurisdiction. Priorities need to be set which build on evidence-based practice. Policies need to be evaluated and revised as necessary. The second governance function is RESOURCE STEWARDSHIP. This function involves the assurance of adequate resources for the agency to carry out the essential services of public health. Budget considerations are tied to this function. The third governance function involves the exercise of the LEGAL AUTHORITY as defined by law and statute. The provision of quality core services to the population needs to be provided by the local health agency or a community partner.
The fourth function relates to PARTNER ENGAGEMENT. This is an ongoing activity since the engagement of community partners will change over time. Working together with community partners to improve the health of the public is the ultimate goal to this partnership engagement. The fifth function is tied to the important issue of quality and the CONTINUOUS IMPROVEMENT of programs and services over time. This means that the assessment of the health of community people needs to be ongoing. High performance standards need to occur. Training of staff needs to occur as well in emerging tools, strategies, and practice. The final governance function is OVERSIGHT. This function involves the evaluation of the health department administrator. The board needs to make sure that mandates are being carried out. Governance needs to relate to the successful performance of the public health core functions and essential services.
It is clear that board members need to see themselves as not merely volunteers but rather as John Carver(BOARDS THAT MAKE A DIFFERENCE) has argued “trustees” of the community.
Rowitz On Leadership 