The Chattanooga-Hamilton County Hospital Authority, more commonly known as Erlanger Health System, is governed by a Board of Trustees consisting of 11 members who serve without compensation.
The City Mayor appoints four Trustees with the approval of a majority of the City Council members. The County Mayor appoints four Trustees with the approval of a majority of the County Commissioners. The City Mayor and the County Mayor jointly appoint one Trustee with the approval of the President of the Chattanooga-Hamilton County Medical Society. The Chancellors of the Chancery Court jointly appoint one Trustee. The Legislative Delegation appoints one Trustee by a majority vote. Trustees are appointed for an initial term of four years and may serve for no more than eight consecutive years.
| Trustee | Appointing Body |
| Charles F. Longer, MD, Chairperson | Medical Society |
| Aldous McCrory, Esq. Vice Chairperson | County |
| George L. Shuford, III, Secretary | County |
| Bruce E. Adams | City |
| Ray Albright | Legislative Delegation |
| Ronald A. Loving | City |
| Dan R. Quarles, Ed.D | County |
| Patrick E. Quinn | County |
| Kim H. White | City |
| Thomas A. Williams, Esq. | Chancery Court |
| James A. Worthington, Jr. | City |
In November 2007, the Chattanooga-Hamilton County Hospital Authority Board of Trustees received certification from the Tennessee Hospital Association at the THA meeting in Nashville. At the November 29 board meeting at Erlanger, Mary Layne Van Cleave from T HA presented certificates to the board, noting that only four health systems, ten hospitals and 113 individual trustees across the state have achieved this status. Certification is achieved by the individual board members completing specialized education regarding their roles and responsibilities.
The Board presently holds a monthly public meeting at the Baroness Campus to consider and approve resolutions effecting the business and affairs of the Authority. It also has a number of very active committees that work to review, study, organize and prepare the items to be considered by the Board.
Erlanger originally had a five-man Board of Trustees that was charged with operating the hospital, but had no authority to borrow money. Though Erlanger was expected to provide indigent care to area citizens, it could only ask for money from local government and other sources, and shift net revenue from paying patients to cover indigent care costs.
In 1970, Dr. David P. McCallie proposed a larger Board of Trustees. County Judge Chester Frost submitted a bill to the County Legislative Delegation to create an 11-member Board. No action was taken on the bill in 1971.
Dr. McCallie became Chairman of Erlanger's Board in 1975, advocating the formation of a governmental hospital authority. All Erlanger property would be transferred to the authority, and Erlanger would no longer be totally dependent upon the City and County for funding. The authority would be able to pledge authority assets and would be responsible for paying the debt.
In 1976, hospital officials began an aggressive campaign to inform the public and employees about the need to create a hospital authority. The bill became law in 1976 when the legislature of the State of Tennessee passed the Private Acts establishing the Authority. In June, a steering committee was named to gather support for the Hospital Authority Referendum.
In August 1976, the citizens of Hamilton County approved the creation of the Chattanooga-Hamilton County Hospital Authority by a 64 percent margin, transferring Erlanger from the City and County to the Authority.
The Act creating the Authority states it is formed to perform the governmental function of owning and operating the Baroness Erlanger Hospital, T.C. Thompson Children's Hospital and other similar or associated hospitals and existing health centers as deemed appropriate to be operated by the Authority as sole operator for the purpose of providing healthcare facilities and programs for the residents of Hamilton County, Tennessee.