Hospital Board Member
The Basics
Pretty much every hospital has a board of directors or trustees – for non-profit hospitals, it’s legally required. Similarly to the board of a company or other organization, the board is a group of people (usually volunteers) who make decisions together about the organization’s long-term goals and priorities, and set rules accordingly. They’re usually less involved with day-to-day operations and more focused on the big picture, but the organization’s executives often advise board members and give them regular reports. For non-profit hospitals, Board members need to balance a few different things: the hospital’s mission to provide care for the community, the long-term financial health of the hospital, and all the state and federal laws and regulations that health care facilities need to comply with.
Public hospitals are owned and funded by governments, and they play a special role in the U.S. health care system. They act as a safety net for patients who can’t get care anywhere else for various reasons, such as lack of insurance, inability to pay out of pocket, or location (lots of rural areas, for example, have very limited health care options). Public hospitals are generally required to accept all patients, regardless of inability to pay.
Most hospitals have appointed boards, and in the case of public hospitals, board members are often appointed by the local or state government that runs the hospital or healthcare system. But about 200 public hospitals have boards with members elected by the communities they serve. For these areas, electing board members directly adds an extra layer of accountability, to make sure the hospital is meeting its obligations to the community.
How can I make my voice heard?
Democracy works when you do! Learn how to advocate for what you believe in, no matter the office or government agency, with our handy Genius Guides to advocacy.
Sources: the National Institutes of Health’s National Library of Medicine; Healthcare Trustees of New York State; Texas Healthcare Trustees; NPR
What have Hospital Board Members done?
As the leaders of public hospital systems, Hospital Board Members play an important role in health care access and services in your community. Here are a few actions that have made a big impact:
- Sarasota Memorial Health Care System Board
Florida
Voted not to endorse the Florida Surgeon General’s guidance urging patients not to get mRNA-based COVID-19 vaccines, saying the board had committed “not to invade” the doctor-patient relationship
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For the 200 or so communities that have publicly-elected hospital boards, elections for these roles are typically pretty low-key, and the main concern is usually hospital finances. In the last few years, though, the coronavirus pandemic has brought national issues like healthcare policy and public health guidelines to the forefront – and with that increased attention has come a new crop of prospective candidates, contested elections, and increased scrutiny for boards. The 2022 elections for the Sarasota Memorial Hospital Board in Florida brought all these dynamics together, when a slate of three candidates ran on what they described as a “health freedom” platform and won seats on the nine-member board. The new board members were motivated to run because of their opposition to stay-at-home orders, masks, and the new COVID vaccines, and had critiques of how the hospital had handled the pandemic – some had lost loved ones and were looking for answers, and some wanted the hospital to prioritize non-mainstream treatments like ivermectin (studies have established ivermectin is not effective for COVID).
Journalists covering the ‘health freedom’ movement reported that these elections represented the first time its activists had won seats on a hospital board. Though the three new members didn’t have a majority on Sarasota Memorial’s board, they had enough sway to push the hospital for an internal review of its management during the worst years of the pandemic. The results of that review, which was completed in 2023 with the help of an independent quality control organization, showed that Sarasota Memorial had actually performed better than many other hospitals during that time: COVID death rates were 24% lower than national benchmarks, and COVID patients also had shorter hospital stays and fewer complications than the state and national averages. The review also made clear that the hospital had not required vaccines for all its staff as some activists had alleged – most chose to get the shot when it became available, but around 1,100 staff got exemptions. One area where the board voted to accept the report’s recommendations was visitation policies. In the early years of the pandemic, many hospitals adopted no-visitors policies to slow the spread of COVID, and the report acknowledged that this policy was painful for many families. Florida eventually passed a law guaranteeing visitor access during emergencies, and the report recommended the hospital adopt new tech to make communication easier between patients and their loved ones.
Sources: NPR, KUOW, WUSF Health News Florida
How does it work in my state?
Scroll down and click on your state to learn more about the specifics of a Hospital Board Member’s powers and responsibilities where you live. (If your state isn’t here yet, check back often – we’re adding more info all the time. If your state doesn’t elect Hospital Board Members, it won’t appear here.)
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Term limits: none; terms are six years
Eligibility: to run for any office in North Carolina, you must be at least 21 years old and eligible to vote in the state. There are no legally-mandated experience requirements to be a Hospital Trustee, but people who run for the job tend to have a medical, finance, or insurance background.
At least one public hospital in North Carolina – Dosher Memorial Hospital in Brunswick county – has an elected Board of Trustees. The Board has seven Trustees who are elected by the voters of the communities the hospital serves, which include Smithville Township, and parts of St. James and the surrounding areas. The elected members are supported by the hospital’s CEO and senior medical leaders. A Trustee, together with their colleagues, is responsible for making decisions about the hospital’s operations and financial management, helping hospital leadership implement new programs and improvements, and making sure the hospital is complying with state and federal laws. Trustees are unpaid.
Sources: the North Carolina Constitution, Article VI; Dosher Memorial Hospital; Brunswick County Board of Elections; the Wilmington Star News