The Corporation has the power under the Act to acquire, operate, and manage healthcare facilities and to issue bonds and notes to finance the costs of providing such facilities.

Under the Act, the Corporation is governed by a board of fifteen voting directors, of whom eight are appointed by the Governor (three on recommendation of the County Executive, three on recommendation of the County Legislature, one on the recommendation of the Speaker of the State Assembly and one on the recommendation of the Temporary President of the State Senate), and seven by the County Executive. In addition, there are four non-voting directors, which include the Chief Executive Officer of the Corporation as appointed by the board of directors, one director selected by the County Executive, one director selected by the majority leader of the County Legislature, and one director selected by the minority leader of the County Legislature. Directors serve for a term of five years. The directors, by a majority vote, select one of the fifteen voting directors as the Chairperson of the Board.