PRINTER'S NO. 1447
No. 1225 Session of 1977
INTRODUCED BY D. R. WRIGHT, DeWEESE, FINEMAN, IRVIS, KELLY,
COLE, COHEN, GOODMAN, C. GEORGE, MANDERINO, FEE, GALLAGHER,
CALTAGIRONE, LETTERMAN, LAUDADIO, KOLTER, RENWICK, GIAMMARCO,
GRIECO, SCANLON, B. F. O'BRIEN, GATSKI, MILANOVICH, TENAGLIO,
ARTHURS, BERLIN, CIMINI, YAHNER, VALICENTI, HARPER, CASSIDY,
SWEET, ZITTERMAN, RICHARDSON, LIVENGOOD, STEWART, RIEGER,
GILLETTE, SCHMITT, GARZIA, PRATT, DeMEDIO, GREENFIELD AND
GEISLER, JUNE 6, 1977
REFERRED TO COMMITTEE ON EDUCATION, JUNE 6, 1977
AN ACT
1 Providing for the creation of medical districts as bodies
2 corporate and politic in counties, cities, boroughs,
3 townships and towns within this Commonwealth; providing for
4 the election of boards of medical district directors;
5 prescribing the rights, powers and duties of such boards
6 including the power to borrow money and issue bonds
7 therefore; and imposing powers and duties upon the Secretary
8 of Health and the Secretary of the Commonwealth.
9 The General Assembly of the Commonwealth of Pennsylvania
10 hereby enacts as follows:
11 Section 1. Short title.
12 This act shall be known and may be cited as the "Medical
13 District Act."
14 Section 2. Legislative findings.
15 The Commonwealth of Pennsylvania has many qualified
16 physicians and others involved in the delivery of health care
17 services. In addition, the Commonwealth has many excellent
18 facilities for the delivery of such health care services.
1 Unfortunately, too many physicians and facilities are located in
2 areas close to metropolitan centers of population. Too few
3 physicians have located in less populated areas or in areas of
4 economic distress. The result is that the degree and quality of
5 the delivery of health care services is disproportionate among
6 the citizens of the Commonwealth. There are many areas where
7 few, if any, such services are available. This is an intolerable
8 situation which has existed too long. It is imperative that the
9 General Assembly takes immediate steps to help alleviate this
10 problem.
11 Section 3. Creation of medical districts.
12 (a) The legislative body of any county, city, borough,
13 township or town may by proper resolution or ordinance create a
14 medical district, subject to the approval of the Secretary of
15 Health, for such county, city, borough, township or town. In any
16 such case, the boundaries of the medical district shall be the
17 same as the county, city, borough, township or town creating
18 such district.
19 (b) The legislative body of any county, city of the first
20 class or city of the second class may by proper resolution or
21 ordinance create a medical district, subject to the approval of
22 the Secretary of Health, for such county, city of the first
23 class or city of the second class the boundaries of which may
24 comprise only a portion of the county, city of the first class
25 or city of the second class creating such district as set forth
26 in such resolution or ordinance.
27 (c) The legislative bodies of any two or more counties,
28 cities, boroughs, townships or towns, or any combination
29 thereof, may by proper resolutions or ordinances create a
30 medical district, subject to the approval of the Secretary of
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1 Health, for any such combination. In any such case, the
2 boundaries of the medical district shall be the same as the
3 combination creating such district. All legislative bodies in
4 such a combination must vote in the affirmative for such a
5 district to be created.
6 (d) Any proposed resolution or ordinance creating a medical
7 district in accordance with the provisions of subsections (a),
8 (b) or (c) may by the process of initiative be submitted to the
9 proper legislative body by a petition signed by the electors in
10 the following manner:
11 (1) The administrative clerk of any county, city,
12 borough, township or town, upon the written request of 100
13 qualified electors of any proposed medical district, directed
14 to him, asking for the preparation of a petition for the
15 submission of such a resolution or ordinance creating a
16 medical district to the legislative body, and accompanied by
17 a copy of the proposed resolution or ordinance, shall prepare
18 such petition within ten days, and in the meantime notice
19 shall be published, at least one time, in one newspaper of
20 general circulation as defined by the act of May 16, 1929
21 (P.L.1784, No.587), known as the "Newspaper Advertising Act,"
22 that such petition will be ready for signature at the
23 expiration of ten days from the presentation of such request.
24 The notice shall state the purpose for which the petition is
25 made and the time and place where it may be signed. Fifteen
26 days shall be allowed for signatures.
27 (2) The signing shall be done only in the office of such
28 administrative clerk, or other place designated by such
29 clerk, who shall keep such office or other place open during
30 such 15-day-period from 8 a.m.to 10 p.m. except Sundays and
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1 holidays.
2 (3) Each signer shall add to his signature his place of
3 residence by street and number, if any, and shall make oath
4 before the clerk that he is a qualified elector at such
5 residence.
6 (4) Upon the expiration of the 15 days and within ten
7 days thereafter, such clerk shall examine the petition, and
8 from the list of registered electors ascertain whether or not
9 such petition is signed by electors equal to 5% of the
10 registered electors of the proposed medical district. The
11 legislative body shall allow the clerk extra help, if
12 necessary.
13 (5) The clerk shall attach his certificate to the
14 petition indicating the result of his examination.
15 (6) If less than the required 5% is certified, the
16 petition shall fail and the petition shall be filed in the
17 office of the clerk.
18 (7) If sufficient signatures are certified, the clerk
19 shall submit the petition and resolution or ordinance to the
20 legislative body without delay.
21 (8) Upon receipt, the legislative body shall either:
22 (i) pass such resolution or ordinance without
23 alteration within 20 days; or
24 (ii) forthwith call a special election to be held at
25 the time of the next general, municipal or primary
26 election occurring at least 90 days thereafter; and at
27 such election, such proposed resolution or ordinance
28 shall be submitted without alteration to the vote of the
29 electors of the proposed medical district. Notice of such
30 election shall be given as provided by the act of June 3,
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1 1937 (P.L.1333, No.320), known as the "Pennsylvania
2 Election Code."
3 (9) The ballots or ballot labels used when voting upon
4 said resolution or ordinance shall be supplied by the county
5 board of elections and shall contain a question, stating the
6 nature of the proposed resolution or ordinance, followed by
7 the words "yes" and "no" and shall be as provided in the
8 "Pennsylvania Election Code." The votes shall be counted and
9 returns thereof made and computed as provided in the
10 "Pennsylvania Election Code."
11 (10) If the majority of the qualified electors voting on
12 the proposed resolution or ordinance shall vote in favor
13 thereof, such resolution or ordinance shall, subject to the
14 approval of the Secretary of Health, become a valid and
15 binding resolution or ordinance of such county, city,
16 borough, township or town.
17 (11) Any resolution or ordinance so proposed by
18 petition, whether passed by the legislative body or adopted
19 by a vote of the electors, cannot be repealed or amended
20 within two years of its effective date except by a vote of
21 the electors.
22 (12) The legislative body may submit a proposition for
23 repeal or amendment of any such resolution or ordinance to be
24 voted upon at any succeeding municipal, general, or primary
25 election occurring at least 90 days thereafter. Notice, the
26 statement of the question and computation of votes shall all
27 be as provided in the "Pennsylvania Election Code."
28 Section 4. Approval by Secretary of Health.
29 (a) No medical district shall be finally created without the
30 approval of the Secretary of Health. Whenever any such
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1 resolution or ordinance is passed, either by a legislative body
2 or by a vote of the electors, such resolution or ordinance shall
3 be forthwith submitted to the Secretary of Health for his
4 approval.
5 (b) Prior to such determination, the Secretary of Health
6 shall confer with the appropriate Regional Advisory Board to the
7 Pennsylvania Medical Education Council for its advice.
8 (c) In making his determination, the Secretary of Health
9 shall consider the following:
10 (1) is all or any part of the proposed medical district
11 a medically deprived area which has been so designated by the
12 Secretary of Health; and
13 (2) are there enough people and resources in the
14 proposed medical district for such district to be able to
15 meet financial and other obligations which the creation of
16 such a district would bring about.
17 (d) The Secretary of Health shall render a decision on any
18 such resolution or ordinance within a reasonable time after
19 consultation and evaluation. Such decision shall be transmitted
20 to the administrative clerk of the legislative body which
21 submitted the resolution or ordinance and such clerk shall keep
22 such decision on file. If the decision is one of approval, such
23 clerk shall send a copy thereof to the Secretary of the
24 Commonwealth who shall maintain a register of all such medical
25 districts.
26 (e) The Secretary of Health shall have the power to
27 promulgate such reasonable rules and regulations as may be
28 necessary to perform these duties.
29 Section 5. Nature of medical district.
30 Any medical district in this Commonwealth, created under the
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1 provisions of this act, shall be and hereby is vested as a body
2 corporate and politic, with all necessary powers to enable it to
3 carry out the provisions of this act.
4 Section 6. Board of medical district directors.
5 (a) Any medical district in this Commonwealth, created under
6 the provisions of this act, shall be administered by a board of
7 medical district directors, to be elected or appointed, as
8 hereinafter provided.
9 (b) Each such board shall consist of nine members who shall
10 be elected at large and shall serve terms of six years, except
11 for those first elected, in which case, three shall be elected
12 for a term of two years, three for a term of four years, and
13 three for a term of six years: Provided, That if the first
14 election occurs in a general election year each such member
15 first elected shall add one year to the term for which he was
16 elected.
17 (c) Vacancies on the board shall be filled by appointment of
18 a qualified person by the board until the next municipal
19 election occurring at least 90 days after the vacancy occurs. At
20 such election a new member shall be elected for a full six-year
21 term.
22 (d) The first election of any such board shall occur at the
23 first municipal or general election occurring at least 90 days
24 after receipt by the administrative clerk of the county, city,
25 borough, township or town of the approval of the creation of the
26 medical district by the Secretary of Health. All elections
27 thereafter shall be at the municipal election.
28 (e) Candidates for the board shall be registered electors of
29 the medical district. They may be nominated by nomination papers
30 signed by 100 qualified electors of the medical district and
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1 filed with the county board of elections on or before the 60th
2 day prior to the general or municipal election.
3 (f) Each nominating paper shall set forth the name, place of
4 residence and post office address of the candidate thereby
5 nominated, and that the nomination is for the office of medical
6 district director and the signers are legally qualified to vote
7 for such candidate. Each signer shall add to his signature, his
8 place of residence, post office address and street number, if
9 any. No elector shall sign a nomination paper for more than the
10 number of candidates to be elected.
11 (g) Each nomination paper shall be verified by oath or
12 affirmation of one of the circulators of the paper that to the
13 best of his knowledge and belief the paper was signed by each of
14 the signers thereof in his proper handwriting and that each is a
15 qualified elector of the medical district. There shall also be
16 filed therewith an acceptance of such nomination by the person
17 named as a candidate therein.
18 (h) Any candidate may withdraw by filing a request in
19 writing, signed by the candidate, with the county board of
20 elections on or before the 50th day prior to the general or
21 municipal election.
22 (i) Nomination papers may be circulated no sooner than the
23 90th day prior to the general or municipal election nor later
24 than the 60th day prior thereto.
25 (j) The names of candidates duly nominated as hereinbefore
26 provided for the office of medical district director shall
27 appear on the general or municipal ballot.
28 (k) No such name shall be accompanied by any designation or
29 indication of partisan or other political affiliation. Each
30 elector shall be entitled to vote for the total number of
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1 candidates to be elected. The conduct of the election and the
2 computation of votes shall be in accordance with the provisions
3 of the act of June 3, 1937 (P.L.1333, No.320), known as the
4 "Pennsylvania Election Code," relative to other candidates.
5 (l) The candidates receiving the greatest number of votes
6 shall be elected and shall take office on the first Monday of
7 December immediately following such election. If two or more
8 candidates shall be equal in number of votes, they shall draw
9 lots to determine which one shall be elected.
10 (m) In the first election of any such board, the length of
11 the terms of the candidates elected shall be determined by the
12 number of votes each such candidate received, with the candidate
13 receiving the greatest number of votes getting the term of
14 greatest length and each of the others following in descending
15 order by the number of votes received.
16 (n) Board members shall receive no compensation for their
17 service except for expenses actually incurred in the performance
18 of official duties.
19 Section 7. Organization of board.
20 (a) Each board of medical district directors shall meet
21 annually on the first Monday of December to effect a permanent
22 organization by electing from their members a president, vice
23 president, secretary and treasurer, each to serve for one year.
24 The treasurer's term shall run from January 1 through December
25 30.
26 (b) Each such board may adopt reasonable rules and
27 regulations for its government and control.
28 (c) Each such board may appoint a solicitor and such other
29 personnel as it may deem proper.
30 (d) Each such board shall have specific times and places for
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1 meetings which shall be at least once every two months. All such
2 meetings shall be open to the public.
3 (e) Every person elected treasurer of any such board shall,
4 before entering upon duties of office, furnish a proper bond, in
5 such an amount and with such corporate surety as the board may
6 approve, conditioned for the faithful performance of his duties
7 as treasurer. The treasurer's bond may be paid for by the
8 medical district.
9 Section 8. Purpose and general powers of board.
10 (a) Each medical district is created for the purpose of the
11 fulfillment of public needs relative to the delivery of adequate
12 health care services and facilities for a community. Each board
13 of medical district directors has the responsibility to
14 accomplish such purpose.
15 (b) Every such board is hereby granted and shall have and
16 may exercise all powers necessary or convenient for carrying out
17 the aforesaid purpose including, but without limiting the
18 generality of the foregoing, the following rights and powers:
19 (1) To sue and be sued.
20 (2) To adopt, use and alter at will a corporate seal.
21 (3) To acquire, purchase, hold, lease as lessee, and use
22 any franchise, property, real, personal or mixed, tangible or
23 intangible, or any interest therein, necessary or desirable
24 for carrying out the purpose of the board and to sell, lease
25 as lessor, exchange, transfer and dispose of any property or
26 interest therein at any time required by it.
27 (4) To fix, alter, charge and collect rates and other
28 charges for its facilities and equipment at reasonable rates
29 to be determined exclusively by the board.
30 (5) To create and incur an indebtedness against such
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1 medical district and issue bonds to secure the same, payable
2 as provided by the act of July 12, 1972 (P.L.781, No.185),
3 known as the "Local Government United Debt Act," for any
4 authorized purpose of such medical district.
5 (6) To make contracts of every name and nature, and to
6 execute all instruments necessary or convenient for the
7 carrying out of its purpose.
8 (7) To accept grants from, and to enter into contracts,
9 leases or other transactions with the Federal Government, the
10 Commonwealth of Pennsylvania or agency thereof, any county,
11 city, borough, township and town, and any private agency or
12 foundation.
13 (8) To construct, erect or build facilities and building
14 to be used for the delivery of health care services.
15 (9) To have the power of eminent domain.
16 (10) To purchase or lease equipment to be used for the
17 delivery of health care services.
18 (11) To purchase or lease motor vehicles, motor buses,
19 ambulances or helicopters or other means of transportation,
20 for the purpose of transportation of persons in need of
21 medical assistance. No such use by the board shall come under
22 the jurisdiction of the Pennsylvania Public Utility
23 Commission.
24 (12) To enter into agreements with other medical
25 districts relative to facilities and equipment.
26 (13) To negotiate and contract with physicians and
27 others involved in the delivery of health care services for
28 the purpose of encouraging such physicians and others to
29 locate within the medical district and in furtherance thereof
30 to offer reasonable inducements in consideration of such
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1 location relative to charges and rates for facilities and
2 equipment and forgiveness thereof.
3 (14) To incur a temporary debt, or borrow money, and
4 issue an obligation therefore.
5 (15) To do all acts and things necessary for the
6 promotion of its purpose and the general welfare of the board
7 to carry out the powers granted to it by this act or any
8 other acts.
9 Section 9. Exemption from taxation.
10 The effectuation of the authorized purpose of medical
11 districts created under this act shall and will be in all
12 respects for the benefit of the residents of counties, cities,
13 boroughs, townships and towns comprising such districts by
14 improvement of their health care and general welfare and since
15 such medical districts will be performing essential governmental
16 functions in effectuating such purpose, such medical districts
17 shall not be required to pay any taxes or assessments upon any
18 property acquired or used by them for such purpose: Provided,
19 however, That in lieu of such taxes or special assessments in
20 medical districts, may agree to make payment to the county,
21 city, borough, township or town.
22 Section 10. Termination of medical districts.
23 Any medical district may be terminated in the same manner in
24 which such a district was created, except that the approval of
25 the Secretary of Health shall not be necessary for such
26 termination. Any outstanding indebtedness of a medical district
27 remaining upon the termination of such district shall be assumed
28 by and become the obligation of the county, city, borough,
29 township or town which created such district.
30 Section 11. Effective date.
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1 This act shall take effect immediately.
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