Sponsorship challenge: influence through governance.

References to sponsorship first appeared in the health care literature in the late 1970s and coincided with dramatic changes in the health care industry and a resurgence of lay commitment to Church ministries. During this period, religious institutes' traditionally managed health care organizations became corporate businesses. One of the first attempts to define "sponsorship" was led by Sr. Concilia Moran, RSM, who introduced the notion of influence and control over the direction of a corporate ministry as the principal concern of sponsorship. Sponsorship in its strictest sense refers to the exercise of reserved powers, which include establishing the ministry's philosophy, approving articles and bylaws, approving trustees, administering real property, and approving merger and dissolution actions. Religious-sponsored health care today is in a precarious situation: The majority of sponsors have fewer than four facilities and the survival of organizations sponsored by religious institutes with fewer and older members is at stake. As increasing numbers of laypersons have joined the ranks of leadership in Catholic health care, religious institutes' involvement has shifted from management to governance. Of key importance now is the development of skills in extending influence through governance.