Every public hospital district must have a superintendent, a position created by statute. By law, the superintendent is the chief administrative officer of the district, serving as the board’s direct representative in the management of the hospital (or other facility) and the district as a whole. He or she must attend and participate in board meetings, but has no vote. Duties include carrying out the orders of the commissioners, assuring that state laws affecting the district are duly enforced, and advising the board of the financial condition and needs of the hospital and its other facilities and services.

RCW 70.44.070 governs the appointment, removal, and compensation of superintendents.

A public hospital board of commissioners is authorized and required to appoint a superintendent or superintendents. The superintendent is appointed for an indefinite period and is removable at the will of the commissioners. Superintendents are appointed (and removed) by resolution of the board. These resolutions must be introduced at a regular meeting of the board and then adopted at a subsequent meeting by a majority vote.

The board sets the compensation of the superintendent and must do so by resolution. While these resolutions approve the compensation terms, it is also common to enter into contracts with the superintendent in the same manner as non-for-profit hospitals. The difference is that, by statute, the superintendent can be removed at any time by the commissioners. Nothing requires the payment of severance, although terms of an employment contract can dictate otherwise.

Where a hospital district operates more than one hospital , the commission may, in its discretion, appoint more than one superintendent — but no more than one superintendent per hospital.

Further Legal Background

What if the district operates a hospital and a clinic? May the board appoint a superintendent for each facility? The statute appears to disallow such an arrangement. There may be a second superintendent only if there is a second hospital.

Where the commission has appointed more than one superintendent, the commission must assign among the superintendents the powers and duties which are authorized by statute. How duties are assigned is purely up to the discretion of the commission.

The powers of superintendents are described in a surprisingly short provision of the public hospital district statute. [RCW 70.44.080]

This provision states that the superintendent shall be the chief administrative officer of the public district hospital and shall have control of administrative functions of the district. The superintendent is responsible to the commission for the efficient administration of all affairs of the district. The superintendent is entitled to attend all meetings of the commission and its committees and to take part in the discussion of any matters pertaining to the district. Superintendents may not vote in commission decisions, however.

As the preceding paragraph indicates, the statutory provision defining powers of the superintendent is rather broad in language and short on details.

In the case of an absence or temporary disability of the superintendent, the commission must appoint a “competent” person to assume the role.

A public hospital district superintendent has the following duties:

• Carry out the orders of the board of commissioners;

• See that all the laws of the state pertaining to matters within the functions of the district are duly enforced;

• Keep the commission fully advised about the financial needs of the district;

• Prepare an annual estimate for the ensuing fiscal year of the probable expenses of the district;

• Recommend to the commission what development work, extensions and additions should be undertaken during the ensuing fiscal year (with an estimate of the costs of such development work, extensions, and additions);

• Certify to the commission all the bills, allowances and payrolls, including claims due contractors of public works;

• Recommend to the commission a range of salaries to be paid to district employees. [RCW 70.44.909]

The above list of duties follows very closely the wording of the public hospital district statute. Below is a more complete list of the types of activities a superintendent is typically involved in (beyond the routine, day-to-day operations of a district). These activities flow naturally from the list of duties described above. They are not technically legislatively-defined duties but they represent prudent management duties that conform with the statute and foster its intended effect.

By and large, superintendents are expected to:

• Perfect and submit to the board for approval a plan of organization for the personnel concerned with the operations of the hospital and/or other facility and the district as a whole (the plan should be periodically reviewed);

• Prepare annually a complete budget or budgets showing anticipated receipts and expenditures for the ensuing fiscal year and submit this to the board (for more on budgeting, see Chapter Four, "Administration of Hospital District Finances: General Considerations");

• Select, employ, control and discharge all employees as authorized by the applicable budget;

• Assure that all buildings, equipment and other facilities are maintained in good repair;

• Furnish periodic recommendations to the board with respect to the acquisition, development and extension of desirable health care facilities, equipment and services;

• Supervise, through the treasurer and auditor, all business affairs including the disbursement of funds, recording of financial transactions, collection of accounts and purchase and issue of supplies;

• Cooperate with the medical staff;

• Submit regularly to the board of commissioners reports regarding the health care services and financial activities of the hospital and the district along with any special reports that may be requested by the commission;

• Prepare agenda for and attend all meetings of the commission and participate in the discussion of matters being considered;

• Execute on behalf of the district all contracts, agreements, and other documents and papers that the superintendent may be authorized by resolution of the commission to sign;

• Undertake on personal initiative the performance of such other duties consistent with law and the policies of the board of commissioners, as may be in the best interest of the district.

Keep in mind that superintendents are municipal officers. The term “municipal officer” includes all elected and appointed officers of a municipal corporation and their deputies and assistants. As such, superintendents are subject to the legal guidelines that apply to municipal officers such as conflicts of interest. They are also immune from certain types of liabilities. You should refer to the section of this chapter entitled “The Code of Ethics and Conflicts of Interest,” and the sections under the heading of “Commissioners” relating to “Conflicts of Interest, “Liabilities,” and “Immunities” for a further discussion of these topics.

Municipal Officer

See Chapter Two,
Section K