A New Board Unfolds

Maple City Health Care Center relies on grants to meet part of our budget.

But because we are committed to having vision rather than funding drive our work, we don’t ask the question, “What grants can we apply for, for which we can meet the funding entity’s objectives?” Rather we ask, “What are we already doing or planning to do, that we can describe in such a way that a funding agency will recognize it as something they want to support?” It is rare that we find grant applications inspiring, let alone that they transform what we do.

But one day, it happened.

I was writing a grant application and came to the question, “How does your board reflect the diversity of your patient population?” I gulped. “It doesn’t” didn’t seem like a promising answer.

It wasn’t that we didn’t want lower-income and non-Anglo members on our board. We did. We had asked a variety of people to serve on our board. When the health care center was forming a decade and a half earlier, we had gathered community leaders of various classes and subcultures to form a board.

That first board included the principal of the elementary school across the street, some parents of children attending the school, a family physician, a lawyer, a nurse living in the neighborhood, a school social worker, tenants working with a community organization to create rental housing standards, and people working in local factories.

As we generated ideas, made plans, raised funds, and rehabbed a building, there were plenty of ways for all kinds of people to get involved and contribute.

As the years went by, though, the work of the board became a matter of gathering for monthly meetings to oversee operations, approve budgets, and establish policies.

We drifted into a classic approach to board function that relied on middle-class white assumptions about how you do business. You develop an agenda, you proceed through it in an orderly fashion, discussing each item and making decisions where necessary.

The non-middle-class and non-white members had been committed enough to the health care center that they stayed for a while with a board organization and process that was foreign, but they eventually drifted away.

What else could we do? Did we want to invite people back into a structure they found alienating and dis-empowering, or could we rethink how we do our work at the board level?

We began to ask ourselves, “Where in our organization is cross-cultural and socioeconomically diverse group process happening most effectively?” The clear answer was, “In Centering Pregnancy groups.” Then we asked, “How can we build on that success and carry it over into our board organization and process?”

At that point, we had a board composed of six middle-class Anglos, ranging in age from forty-something to ninety-something. The board included two staff members, Beth (a nurse midwife) and me. All of the board members were deeply committed to the organization and most had served on the board for at least ten years.

Organizationally we were not in crisis and could function with openness and some excitement at the possibility of re-imagining the board’s shape.

Beth and I proposed that we experiment with borrowing from the Centering Pregnancy circle model of group interaction and facilitative leadership, especially as we had adapted the model to cross-cultural groups. For months the board had been hearing the staff’s excitement about the Centering Pregnancy groups, and they responded without hesitation to our proposal: “We have so much to gain and nothing to lose. Let’s go for it.”

We decided to invite four people to join a reconstituted board. All four were patients, and we selected them after inviting our whole staff to consider the question, “Who of our patients is deeply involved in the life of our neighborhood and brings passion and energy to their interactions at the health care center?”

The four people that the staff recommended were an Anglo single mother of seven, a factory worker who had been involved in student organizing as a youth in Mexico City, an employed but undocumented Latina mother of two who had participated in a Centering Pregnancy group, and another young Latina mother.