Proviso.

Funds, how provided.

Board of trustees.

Terms of office.

building or buildings to be erected: Provided, That no sanatorium hereafter erected under the provisions of this act shall be upon lands used by or controlled by a county poor commission, or used or intended to be used as a county poor farm, and no such sanatorium shall be erected having provision and room for less than fifty beds.

SEC. 2. The board of supervisors of any county, subject to the provisions of section one of this act, is hereby authorized and empowered to raise by taxation necessary funds for the purpose of constructing, equipping and maintaining a hospital or sanatorium for the treatment of tuberculosis. In no case shall the tax for the original construction and equipment exceed in any year one mill on each dollar of assessed valuation of said county. If deemed expedient by said board, money for construction purposes hereunder may be raised by taxation during successive years, not exceeding, however, a period of three years. All moneys raised by taxation within the county shall constitute a special fund for the construction and equipment of the sanatorium. Money raised by taxation in the county for construction purposes, and subsequently found not to be needed therefor, may be used to defray the expenses of operation and maintenance.

SEC. 3. A board of trustees for the management of any sanatorium created hereunder shall be appointed by the board of supervisors of the county in which such sanatorium is to be constructed. Said trustees shall be residents and taxpayers of the county. In the first instance, one of such trustees shall serve for a period of one year from and after the first day of January following his appointment. One shall serve for a period of two years and the third for a period of three years. Thereafter, each trustee shall hold office for a period of three years, beginning on the first day of January next ensuing and until a successor is appointed and qualifies. Each such trustee shall file his acceptance of office with the county clerk and shall also take and file with said clerk the constitutional oath of office. It shall be the duty of said board of trustees to cooperate and advise with the state health commissioner and with the board of supervisors of the county, or with any committee selected thereby, in the erection and equipment Control, etc. of the sanatorium. As soon as such sanatorium is completed and equipped the management and control thereof shall vest in said board of trustees, subject to the provisions of this act. Money for the construction of the sanatorium and for the purchase and installation of equipment shall be paid out by the county treasurer on the order of said board of trustees, countersigned by the chairman and clerk of the board of supervisors, or by any committee of said board selected by the board for that purpose. Said board of trustees may organize by the election of a president, a secretary and a treasurer and may adopt rules and regulations governing its procedure.

Joint county sanatoriums.

SEC. 4. Any two or more counties within this state may co-operate for the establishment, maintenance and operation

of a joint county sanatorium for the treatment of tuberculosis under the provisions of this act. The board of supervisors of any county may appoint a committee to confer with a like committee similarly chosen by the board in any other county or counties for the purpose of selecting a site for a joint sanatorium. At such meeting the committees present shall organize into a joint committee and shall select one of the members of such joint committee chairman and a second member secretary. A full report of the results of such meeting shall be made to the board of supervisors of each county concerned at the next ensuing meeting thereof. Thereupon each said board of supervisors shall have the same power to take action with reference to the establishment, maintenance and operation of such joint county sanatorium as is granted by this act with reference to the construction of a sanatorium by a single county in so far as such provisions are applicable.

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SEC. 5. In case the boards of supervisors of two or more Cooperation counties shall determine by separate action thereof that a missioner of joint sanatorium shall be constructed, it shall be the duty of health. each said board to appoint a committee of its members for the purpose of cooperating with the state commissioner of health and with the board of trustees of said sanatorium in the construction and equipment of the necessary building or buildings. Each board shall also select three residents and taxpayers of the county to serve as members of the board of trustees of the sanatorium. Said trustees shall be appointed for like terms and shall qualify in the same manner as is provided in section three for the appointment and qualification of trustees of a county sanatorium. It shall be the duty of the trustees so appointed to meet as soon as may be and to organize by the election of a president and secretary.

fund; pur

pose.

SEC. 6. The board of supervisors of each county becoming Special a party to the erection of a joint sanatorium under the provisions of this act may raise in any one year for construction or maintenance purposes a sum not exceeding one mill on each dollar of assessed valuation of said county. Such tax shall be regarded as a special tax and the moneys received therefrom shall be transmitted by the treasurer of the county in which it is collected to the treasurer of the county in which the sanatorium is to be constructed. All such moneys shall be and remain in a special fund and shall be used solely for the purposes for which the tax is spread: Provided, however, Proviso. That money raised for construction purposes and not needed therefor may be expended by the board of trustees for maintenance and operation. Money expended for the construction, equipment and installation of equipment of any joint county sanatorium shall be paid out by the county treasurer having such fund in charge on the order of the board of trustees of such sanatorium.

SEC. 7. Contracts for the construction and equipping of Contract for any sanatorium to be erected under the provisions of this act construction,

etc.

Commis

sioner to

shall be let by the board of trustees of said sanatorium, subject to the approval of the state commissioner of health. Such work may be let as an entirety or in sections as may be deemed most advantageous. In all cases where the cost of construction exceeds the sum of five hundred dollars, bids shall be advertised for in one or more newspapers published and circulating within the county or counties concerned not less than two weeks prior to the date when bids are to be received. Subject to the provisions of this act, the board of trustees concerned may adopt reasonable rules and regulations concerning the manner of advertising for bids and the letting of contracts. In all cases the right to reject any and all bids presented shall be reserved. Each contract let hereunder shall provide that the work shall be done subject to the approval of the board of trustees and the state commissioner of health.

SEC. 8. The state commissioner of health is hereby authorized and directed to adopt and publish, in the same manner etc., govern- as rules and regulations of the state department of health are

adopt rules,

ing.

For whom maintained.

Non-resi

dents, when may accept.

Monthly report.

published, rules and regulations governing the operation of county sanatoriums. It shall be the duty of the board of trustees of any such sanatorium to observe such rules and regulations. Wilful failure or refusal to do so shall constitute grounds for removal. Subject to this act and to such rules and regulations, each such board of trustees shall operate the sanatorium under its charge and shall employ a medical superintendent, a suitable number of nurses, and such other employees as may be necessary and may fix the compensation thereof. Such compensation shall be paid out of the maintenance fund of the sanatorium in the same manner as the salaries of other county employees are paid. Money to defray the expenses of maintenance and operation shall be paid by the county treasurer having such fund in his custody on the warrant of the president of the board of trustees of the sanatorium, countersigned by the secretary.

SEC. 9. Any sanatorium established hereunder shall be maintained and operated for the benefit of the residents of the county or counties establishing and maintaining the same. Any resident indigent person afflicted with tuberculosis may be admitted to the sanatorium on a certificate of the superintendents of the poor or the county physician of his county or a city physician. Such resident afflicted with tuberculosis who is not in indigent circumstances may be admitted for treatment and shall pay to the board of trustees, for the benefit of the institution, such sum per week as shall be agreed upon. If the facilities of the sanatorium will permit, the board of trustees may accept patients who are not residents of the county or counties establishing and maintaining the sanatorium, upon such terms and conditions as may be mutually agreed upon. On the first day of each month the board of trustees, or the medical superintendent of the sanatorium, whether organized and established under the provisions of

this act or any other act or acts permitting counties to erect and maintain sanatoriums for treatment of tuberculosis, shall report to the state commissioner of health the number of patients treated during the preceding month, with such detailed information as said commissioner may require. Such reports shall show specifically the number of patients treated, with the compensation and aggregate number of weeks of such treatment. Such report shall be verified by the medical superintendent or by the president of the board of trustees. If accepted and approved by the state commissioner of health, it shall be the duty of the latter official to certify to the auditor general that the sanatorium in question has treated without compensation patients for an aggregate specified number of days. Thereupon the auditor general shall draw his warrant on the state treasurer, in favor of the county treasurer having the funds of the sanatorium in his custody, for such an amount as will constitute compensation for such free patients on the basis of one dollar per day each, it being the intent hereof that the state shall contribute towards the cost of maintaining and treating free patients the sum of one dollar for each day of such care and treatment.

SEC. 10. No member of the board of trustees of any sana- Claims, torium established and maintained hereunder shall be en- approval of. titled to receive compensation for his services. Any such trustee, however, shall be reimbursed on account of any expense necessarily incurred by him in the performance of his official duties. All claims against the sanatorium shall be approved by the board of trustees thereof and paid in the manner hereinbefore indicated. Any vacancy occurring on a board of trustees shall be filled for the remainder of the term by the board of supervisors of the county represented by such trustee. Each said board shall constitute a body corporate and may sue and be sued. It may accept donations and bequests, may purchase and hold property, and make such contracts as may be necessary for the carrying out of the duties hereby imposed. All conveyances of real estate shall be taken in the name of the board of trustees in trust for the county or counties represented thereby.

Report to

SEC. 11. Prior to the regular October session in each year of the board of supervisors of any county establishing or supervisors. maintaining or assisting to establish or maintain any sanatorium hereunder, it shall be the duty of the board of trustees of such sanatorium to make and present to the board a full and detailed report of the operations during the preceding year and of the receipts and disbursements. At the same time an estimate of the funds necessary to be raised in such county for the ensuing year shall be presented. Thereupon, said board, subject to the provisions of this act, shall vote such amount as may be necessary to be raised by taxation. In the case of the joint county sanatorium, it shall be the duty of each board of supervisors concerned to vote its proportionate share of the cost and maintenance of operation during the

ensuing year, as estimated and determined by the board of Referendum. trustees. In case it is deemed expedient by any board of

Inspection.

Counties not desiring to construct.

supervisors to raise in any one year either for construction purposes or for maintenance purposes an amount in excess of one mill on each dollar of assessed valuation of said county, the question of raising by taxation or borrowing such additional amounts as may be deemed necessary shall be submitted to the electors of the county at any general election or at a special election called for that purpose. Said question shall be submitted and election held and conducted and returns thereof canvassed and declared in the same manner as is or may be provided by the general election law for the submission and determination of the question of issuing county bonds. If a majority of the electors of the county voting thereon authorize the raising of such additional sum or sums, the board of supervisors shall by resolution direct the raising of the same by taxation.

SEC. 12. The state commissioner of health either in person or by his deputy or other representative shall inspect each sanatorium constructed hereunder at such times as he may deem necessary. He may also require from the authorities in charge of such sanatorium reports from time to time concerning the operation thereof. It shall be his duty to make recommendations to the board of trustees and to the medical superintendent in charge of the sanatorium with respect to operation, treatment of patients, employees, and such other matters as affect the welfare of the patients and the general conduct of the institution. If any board of trustees, or medical superintendent, shall neglect or refuse to observe the rules and regulations of the state commissioner of health hereinbefore provided for, the state maintenance aid contemplated by section nine may in the discretion of said commissioner be withheld until such rules and regulations are complied with.

SEC. 13. The board of supervisors of any county of this state not desiring to construct a sanatorium or hospital for the treatment of tuberculosis is hereby authorized to raise money by taxation for the aid and assistance of any hospital or sanatorium within this state and may make agreements with the management of such hospital or sanatorium for the treatment of indigent patients afflicted with tuberculosis. No money shall be raised, however, for the assistance of any private hospital under this section, unless said hospital shall be inspected by the state commissioner of health, or by his duly authorized representative, and approved by him as a proper and suitable institution for the care and treatment of patients.

Approved April 30, 1925.