 NACCHO is governed by a 27-member Board of Directors composed of health officials from around the country elected by their peers, a representative for Tribal health departments, and "ex officio" members representing the National Association of Counties, of which NACCHO is an affiliate, and the U.S. Conference of Mayors.The Board of Directors meets four times a year.The NACCHO Executive Committee includes four NACCHO officers and three Board members representing different geographic regions and population size.