Governance

Shared infrastructure needs visible decision-making.

OHC Foundation exists so CARE is not controlled by one vendor, one donor, one state, or one implementation partner. Governance separates fiduciary stewardship from technical direction while keeping maintainers close to the work.

Stewardship model

Clear roles for institutional oversight and technical ownership.

Foundation Board

Mission, legal, fiduciary, financial, fundraising, risk, and long-term institutional stewardship.

Technical Steering Committee

Architecture, technical vision, maintainership, release discipline, and community process oversight.

Project maintainers

Day-to-day code review, roadmap execution, issue triage, documentation, and contributor mentorship.

Project groups

Focused ownership for CARE Core, Apps, standards, security, implementation guides, and clinical workflows.

How decisions are made

The board stewards the institution. Technical leaders steward the platform.

Mission, legal, finance, risk

Foundation Board

Architecture and technical roadmap

Technical Steering Committee

Code review and release readiness

Maintainers

Plugin compatibility and extensions

Project groups and maintainers

Clinical workflow safety

Clinicians, maintainers, and product leads

Security disclosure and response

Security maintainers and foundation

Public commitments

Governance should be published as operating practice, not branding.

Open contribution

Contributions should flow through public repositories, clear review rules, and a documented maintainer path.

License clarity

CARE code is MIT licensed. Documentation and implementation guides should use open content licenses where appropriate.

Release governance

Stable releases, compatibility expectations, and long-term support direction should be visible to implementers.

Security reporting

Vulnerability reporting, disclosure expectations, access-control practices, and auditability are foundation concerns.

Conflict handling

The foundation should make conflicts of interest and decision escalation paths explicit as the ecosystem grows.

Clinical accountability

Clinical workflow and AI-related changes need review paths that respect safety, auditability, and human accountability.

Trust and safety

Security, release quality, and clinical safety are governance work.

Open healthcare infrastructure must be auditable, maintainable, and safe to operate in real clinical settings. Governance connects technical review, responsible disclosure, release compatibility, and human-in-the-loop AI practices.

Audit trails

Access controls

Release readiness

Maintainer review