ADHA Governance Structure Changes Combine Urgency, Diplomacy and Emotion

For more than a decade, governance change at the American Dental Hygienists’ Association (ADHA) has been a regular topic of discussion. With a House of Delegates (HOD) and a district representation model for its board of directors, ADHA’s structure was complex, expensive, and slow to enact change, not to mention often lacking alignment with the strategic goals of the organization.  

From subtle conversations to the creation of a formal steering committee comprised of HOD members themselves, ADHA made several attempts to change its structure through its HOD as required by their bylaws. However, resistance to change and tradition created roadblocks. Meanwhile, those same traditions were the root causes of some of ADHA’s fundamental challenges, leading to a repetitive cycle of governance dysfunction.

But in the spirit of persistence, ADHA leaders kept pushing for change. Employing a revised strategy over the last two years, that combined urgency, diplomacy and emotion, they were able to accomplish their goals, including – believe it or not – the elimination of the association’s House of Delegates.

“We had the right people in leadership with the right perspectives at the right time,” said Jennifer Hill, ADHA’s CEO. “They were the drivers of change.”

They also were the individuals who could share firsthand experience with some of the challenges ADHA leaders faced. For example, a regionally elected Board meant an abundance of candidates in some districts, but a lack of interested volunteers in others. Additionally, while the Board had the fiduciary responsibility to lead the organization, the House of Delegates had authority over bylaws amendments and policies, among other key decisions, meaning responsibility and authority were not properly aligned. To top it off, politics undermined progress at these different levels within the governance structure.

“It was a combination of several things,” Hill said. “We had a couple of challenging (Houses of Delegates), and the tide was turning. We also saw a shift within our House of Delegates itself, hearing from many members that this model wasn’t working as it once did. People were getting frustrated with some of our governance practices.”

In addition to using the logic-based arguments shared during past restructuring efforts, this time their leaders made a more personal, emotion-based appeal. ADHA officers held town hall meetings and shared specific examples of challenges and deficiencies that were caused by the governance structure. They visited district meetings as well, where they stressed the urgency of the situation: for ADHA to survive as an association, governance changes were imperative.

The initial request was simple to understand and communicate: Shift the authority to amend the bylaws from the House of Delegates to the Board. Once that was approved, the Board had the flexibility to make other changes related to Board size, composition and governance processes.

‘We had prepared staff, leadership and communications for pushback that never came,’ Hill said. ‘The lesson for us was that you need to know your members well and what they will react to.’

Today’s ADHA governance structure is more aligned with leading practice in terms of size, selection process and general governance procedure. Board members are nominated and selected based on skills and expertise without a district requirement, and without a House of Delegates, the Board has final decision-making authority, in line with its fiduciary duties. This streamlined the overall decision-making process and increased ADHA’s ability to be nimble, but it also created the opportunity for members to have a direct line of communication with the Board. Through a new process, members can submit policy ideas or bylaws amendments to the Board throughout the year, with each submission reviewed and acknowledged through a formal process.

The Board vote last year to update the ADHA governance structure was the culmination of years of discussions and planning. However, the work is not over, as the association now turns its attention to implementation. A newly created Governance Committee now oversees the nomination and vetting process, and it’s in the middle of its first cycle under the new process. It’s been a busy term for committee members learning a new process, but leaders are excited about the benefits that lie ahead.

“Overall, it’s gone smoothly,” Hill said. “We were able to move quickly. Leadership and staff working hand-in-hand was key. We were at a major crossroads, and our Board had the courage to set us up for success in the future.”