House of Delegates Adopts New Governance Structure
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Amanda Donohue
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March 20, 2017
Transforming ACA: House of Delegates Adopts New Governance Structure to Revitalize the Association
In a historic vote, ACA’s House of Delegates (HOD) approved a contemporary, revitalized leadership structure during its 53rd annual meeting March 17 in Washington, D.C.

The changes, which will go into effect in March 2018, are designed to transform the association into a more nimble, streamlined and relevant organization for generations to come. 

The new governance structure represents months of research and deliberation into best practices with the nation’s foremost expert on association governance, as well as in-depth surveys and interviews with current and former ACA leaders. The goal of the changes is to make ACA a stronger and more successful organization by enabling it to more quickly act on new opportunities in the healthcare marketplace, leverage new expertise within and outside the profession, engage a new generation of leaders to guide the association into the future and redirect critical resources into the strategic priorities of the association.

“The work this HOD has done as a team over the last year has created a new governance model that honors our traditions while empowering us to become more responsive to the needs of our members,” ACA President David Herd, DC, stated as he opened the meeting. “The new model makes us nimbler in dealing with the rapidly changing health care system…The new model will free the energies and creativity of all our members to contribute to moving this profession forward.”

Key components of the new governance model include:
  • Eliminating the Council of Delegates and district structure
  • Redefining the role of the HOD to:
    • Elect the Board of Governors (BOG) and Nominating Committee
    • Serve as a deliberative body to think about and discuss issues carefully
    • Provide two-way communication with states and constituencies
    • Approve the budget as proposed by the BOG
  • Shifting responsibility for ACA direction, strategy and policy to the BOG with input from the HOD
  • Reducing the number of BOG members to 6, elected by HOD
    • Includes president, vice president, 3 at-large DCs, 1 public member
    • Selection based on expertise and competencies, not geographic location
  • Reassigning essential committees to the BOG and increasing the use of task forces
  • Forming an Office of Clinical Councils and Certification Boards at ACA that will facilitate work and relationships with councils
  • Eliminating the position of chairman of the BOG, with ACA president presiding at both BOG and HOD meetings
  • Appointing a Nominating Committee that will maintain qualifications and criteria for members of the BOG, identify and vet board candidates, maintain a database of talent for consideration in committee and task force appointments, guide onboarding of new board members, and advise the BOG on committee and task force composition (The first Nominating Committee was appointed during the annual meeting so they can begin to vet candidates for the new Board that will be elected next year.)

  • During the annual meeting, Dr. Herd credited former ACA leaders for their work in “setting the table” and successfully positioning ACA for adoption of the new governance model.

    “Because we stand on the shoulders of the giants who came before us, we can see a new horizon full of the possibilities of a brighter tomorrow,” he said before the vote on the new governance structure. “Today we can begin to make that future our own.”
    More information on the new governance structure can be found at, including rationale for the changes, frequently asked questions and diagrams depicting the new structure. 
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