The MFPA Association is run as a "democratic co-operative". All the member artists have a voice in how it is run as it is owned by all of them.
The President of the Managing Board is also the President of the Association and must be a mouth or foot painting artist who has won recognition as an artist and achieved success in international exhibitions.
Worldwide, the delegate's convention is ultimately responsible for control of all the Association's activities. The delegates also pass necessary resolutions, amend statutes and approve annual accounts and budgets. With the exception of their legal consultant, all members of the delegate's convention are disabled artists.
The delegates appoint a managing board, comprised of member artists with a maximum of seven people. The managing board appoints able-bodied professionals to run the publishing houses, which manage the marketing activities of the organization.
The management procedures are governed by the statutes, which require that a delegates' convention be held at least once every three years. Delegates are chosen to represent Association Members, who vote through postal ballot based on their region.
The Association divides the world into four regions; each region appoints at least one delegate for every five members.