This chapter discusses the nature of public hospital districts: how they operate as governmental entities, how they are created, how they are expanded or reduced, and how they can be dissolved. The governance of public hospital districts is covered in Chapter Two under the discussion of “Commissioners.”

Public hospital districts, as municipal corporations, are governmental entities and political subdivisions of the state. They have been created by the Washington State Legislature to carry out certain limited functions as specified in the public hospital district and other statutes. As political subdivisions of the state, public hospital districts share some characteristics with other special purpose districts, including public utility districts, fire districts and port districts.

A primary focus of this chapter is the powers, duties and limitations of public hospital districts. It is critical to understand how the powers of public hospital districts are defined by statutory and constitutional provisions and interpreted by the courts.

This chapter concludes with a detailed examination of the procedures behind the formation of a district as well as district expansion, consolidation, reduction, and dissolution. The precise procedural steps are highlighted and, where possible, legal forms are suggested.