Chap. 152.—An ACT to authorize the establishment of a county hospital
by the counties of Prince Edward and Cumberland, or either of them,
and any contiguous county or counties, should the regular qualified
voters of each such county so elect, and to provide for the submission
of such question to the voters of the respective counties, and au-
thorizing the issuance of bonds by the counties so electing for such
purpose, upon the vote of the people so. directing. [H B 111]

Approved March 29, 1923.

1. Be it enacted by the general assembly of Virginia,
in manner and form as follows:

Section 1. Public hospitals; providing for the establishment
of public hospitals for Prince Edward and Cumberland counties
and any contiguous county or counties.—The counties of Prince
Edward and / or Cumberland, and / or any contiguous county
or counties, may establish a public hospital in the following
manner: A public county hospital may be proposed by a resolu-
tion of the board of supervisors, or by a petition signed by one-
fifth of the qualified voters of any county affected by this act.
A public inter-county hospital may be proposed by a resolution
of the board of supervisors or by petition signed by one-fifth of
the qualified voters of any two or more of the counties affected
by this act. The proposing resolutions and / or petitions shall
specify: (1) The place where the proposed public hospital shall
be located. (2) The maximum amount of money proposed to be
expended in establishing such hospital. (3) The amount of
bonds proposed to be issued by such or each county for this
purpose as hereinafter provided. (4) The proposed financial
plan of operation of such hospital, and if the proposed hospital
be inter-county, this plan shall include the proportion of the
general expenses as well as the proportion of the initial cost,
which each proposing county shall contribute, and the repre-
sentation of each county on the board of trustees; the propor-
tionate contribution and representation of each participating
county shall be based as near as may be upon the relative popula-
tion of the respective counties and the expected use which each
will make of the inter-county hospital.

All proposals to establish public hospitals provided for by
this act shall be transmitted to the judge of the circuit court
of the county where it is proposed to locate such hospital. If
the proposal be to establish a county hospital, such judge shall
direct an election as hereinafter provided. If the proposal be
to establish an inter-county hospital and the said judge find the
proposals to be substantially the same he shall certify such pro-
posal to the judge of the circuit court of each proposing county,
who shall direct an election as hereinafter provided. If the said
judge find the proposal to be materially different, he shall, after
hearing all parties, reconcile such differences and enter of
record such proposal as may be just, and the procedure shall be
as if each county concerned had submitted such proposal. |
Such judge of the circuit court of each county concerned
shall submit the question to the qualified electors of such county
or counties at the next general election to be held in the county,
or counties, or at a special election for that purpose, first giving
thirty days’ notice thereof in one or more newspapers published
in the county, if any be published therein, and by posting such
notices, written or printed, in each precinct of the county, which
notice shall include the text of the proposal and state the amount
of tax to be levied upon the assessed property of the said county,
which tax shall not exceed two mills on the dollar, for a period
of time not exceeding twenty years and whether it be for the
issue of county bonds to provide funds for the purchase of a site
cr sites and the erection thereon of a public hospital, and hos-
pital buildings, and for the support of same; which said election
shall be held at the usual places in such county for electing
county officers, the vote to be canvassed in the same manner as
that for county officers.

Section 2. Question submitted; hospital fund.—The judge
of the circuit court of such county shall submit to the qualified
electors thereof, at a regular or special election, the question
whether bonds shall be issued for the purchase of real estate for
hospital purposes, for the construction of hospital buildings,
and a tax levied for maintaining same, or for either or all of
such purposes. The ballots to be used at any election at whicr
the hospital question is submitted, shall be printed with a state-
ment substantially as follows:

For bond issue for establishment of public hospital and
tax for maintenance thereof.

Against bond: issue for establishment of public hospital
and tax for maintenance thereof.

If the majority of the voters cast at such election shall be
in favor of the bond issue for the establishment of public hos-
pital, the board of supervisors of each county so voting shall
issue the bonds so authorized, which shall be for a term not ex-
ceeding twenty years, and at a rate of interest not exceeding six
per centum, and which shall be sold for not less than par, and it
shall be the duty of the board of supervisors to levy a tax upon
all property not segregated by general law for State taxation
sufficient to pay the interest on the said bonds and to provide a
sinking fund for the payment of the same at maturity; and the
board of supervisors shall also levy a tax for the maintenance of
the hospital at a rate not exceeding two mills on the dollar on
all property liable to county taxes, which taxes shall be collected
in the same manner as other county taxes are collected, but
which shall be segregated and credited to the “Hospital Fund,”
and which shall be paid out by the county treasurer on the order
of the hospital trustees for the purpose authorized by this
chapter and for no other purposes whatever.

Section 3. Board of hospital trustees; term.—Should a ma-
jority in each county affected of all the votes cast upon the ques-
tion be in favor of establishing such county or inter-county pub-
lic hospital, it is made mandatory that the circuit court of the
county where each such hospital is to be established shall pro-
ceed at once to appoint seven trustees, unless for cause the
court determines on some other number, chosen from the citizens
at large with reference to their fitness for such office, but none
of whom shall be practicing physicians, three of whom may be
women, all residents of one of the counties affected, not more
than four of said trustees to be residents of the city, town or
village in which said hospital is to be located, who shall con-
stitute a board of trustees for said public hospital. The said
trustees shall hold their offices, two for two years, two for four
years, three for six years, and they shall by lot determine their
respective terms. Subsequent appointments shall be by the
judge of the court for terms of six years each, except that
vacancies shall be filled by the judge for the unexpired term.

Section 4. Organization of board; treasurer; expenses of
trustees; powers and duties.—The said trustees shall within ten
days after their appointment or election qualify by taking the
oath of civil officers and organize as a board of hospital trustees
by the election of one of their number as chairman, one as sec-
retary, and by the election of such other officers as they may
deem necessary, but no bond shall be required of them. The
county treasurer of the county in which such hospital is located
shall be treasurer of the board of trustees. The treasurer shall
receive and pay out all the moneys under the control of the said
board, as ordered by it, and shall receive as compensation a com-
mission not to exceed one and one-half per centum. No trustee
shall receive reimbursement for any cash expenditures actually
made for personal expenses incurred as such trustee, and an
‘temized statement of all such expenses and money paid out shall
be made under oath by each of such trustees and filed with the
secretary and allowed only by the affirmative vote of all the
trustees present at a meeting of the board. The board of hos-
pital trustees shall make and adopt such by-laws, rules and
regulations for their own guidance and for the government of
the hospital, as may be deemed expedient for the economic and
equitable conduct thereof, not inconsistent with this chapter and
the ordinances of the city or town wherein such public hospital
is located. They shall have the exclusive control of the ex-
penditure of all moneys collected to the credit of the hospital
fund, and of the purchase of site or sites, the purchase or con-
struction of any hospital building or buildings, and of the super-
vision, care and custody of the grounds, rooms or buildings
purchased, constructed, leased or set apart for that purpose;
provided that all moneys received for such hospital shall be de-
posited in the treasury of the county to the credit of the hospital
fund, and paid out only upon warrants drawn by the treasurer
of said county upon the properly authenticated vouchers of the
hospital board. Said board of hospital trustees shall have power
to appoint a suitable superintendent or matron, or both, and
necessary assistants and fix their compensation, and shall also
have power to remove such appointees; and shall in general
carry out the spirit and intent of this chapter in establishing and
maintaining a county public hospital with equal rights to all.
Such board of hospital trustees shall hold meetings at least once
each month, shall keep a complete record of all its proceedings;
and four members of said board shall constitute a quorum for
the transaction of business. One of said trustees shall visit and
examine said hospital at least twice each month, and the board
shall during the first week in January of each year, file with the
board of supervisors of said county a report of their proceedings
with reference to such hospital, and a statement of all receipts
and expenditures during the year. No trustee shall have a per-
sonal pecuniary interest, either directly or indirectly, in the pur-
chase of any supplies for said hospital, unless the same are pur-
chased by competitive bidding.

Section 5. Advisory board.—There shall be an advisory
board consisting of the county physician of the county where
the hospital is located and two or more practicing physicians
who shall be elected by the board of trustees for such terms of
office as it may fix.

The advisory board shall meet with the trustees when so re-
quested and advise the trustees with respect to such technical
matters as may be submitted to the advisory board by the
trustees. |

section 6. Hospital bonds.—Whenever any county affected
by this act shall have provided for the appointment and election

of hospital trustees and has voted a tax for a term not exceed-
- ing twenty years for hospital purposes, as authorized by this
act, the said county may issue bonds in anticipation of the col-
lection of such tax in such sums and amounts as the board of
hospital trustees shall certify to the board of supervisors of said
county to be necessary for the purposes contemplated by such
tax, but such bonds in the aggregate shall not exceed the amount
which might be realized by said tax, based on the amount which
may be yielded on the property valuation of the year in which
the tax is voted and such bonds shall mature in twenty years
from date and shall be in sums of not less than one hundred
dollars nor more than one thousand dollars, drawing interest at
a rate not exceeding five per centum, payable annually or semi-
annually; said bonds shall be payable at pleasure of county after
five years, and each of said bonds shal! provide that it is subject
to this condition and shall not be sold for less than par, and shall
be substantially in the form provided for county bonds, but sub-
ject to changes that will conform them to the provisions of this
chapter and be numbered consecutively and redeemable in the
order of their issuance; but the total amount of bonds to be
issued shall not exceed seventy-five thousand dollars.

Section 7. Condemnation proceedings for hosiptal sites.—
If the board of hospital trustees and the owners of any property
desired by them for hospital purposes cannot agree as to the
price to be paid therefor, they shall report the facts to the board
of supervisors and condemnation proceedings shall be instituted
by the board of supervisors and prosecuted in the name of the
county wherein such public hospital is to be located, by the at-
torney for the Commonwealth of Virginia, under the provisions
relating to eminent domain.

Section 8. Plans and specifications; bids advertised for.—
No hospital buildings shall be erected or constructed until the
plans and specifications have been made therefor and adopted
by the board of hospital trustees, and bids advertised for accord-
ing to law for other county public buildings.

Section 9. Annual levy for improvement and maintenance.
In counties exercising the rights conferred by this chapter,
the board of trustees of said hospital shall, at its regular August
meeting each year, determine and fix the amount necessary for
the improvement and maintenance of any such public hospital
so established, during the ensuing year, in addition to the tax
for the hospital fund hereinbefore provided for, and the presi-
dent and secretary of the board shall certify the same to the
treasurer of such county before April first of each year; and the
board of supervisors of said county shall, at its April session
following, levy a sufficient tax upon the assessed value of the
taxable property in the county not segregated by general law
for State taxation as will produce said sum for the ensuing year,
but said levy shall not exceed one mill on such assessed valuation.

Section 10. Who entitled to hospital benefits; compensa-
tion: non-residents.—Every hospital established under this
chapter shall be for the benefit of the inhabitants of such county
and of any person falling sick or being injured or maimed with-
in its limits; but every such inhabitant or person who is not a
pauper shall pay to such board of hospital trustees or such officer
as it shall designate for such county public hospital, a reasonable
compensation for occupancy, nursing, care, medicine, or attend-
ance, according to the rules and regulations prescribed by said
board, such hospital always being subject to such reasonable
rules and regulations as said board may adopt in order to render
the use of said hospital of the greatest benefit to the greatest
number; and said board may exciude from the use of such hos-
pital any and all inhabitants and persons who shall wilfully vio-
late such rules and regulations. And said board may extend the
privileges and use of such hospital to persons residing outside
of such county, upon such terms and conditions as said board
may from time to time, by its rules and regulations, prescribe.

section 11. Exclusive control by trustees.—When such hos-
pital is established the physicians, nurses, attendants, the per-
sons sick therein and all persons approaching or coming within
the limits of same, and all furniture and other articles used or
brought there shall be subject to such rules and regulations as
said board may prescribe.

Section 12. Donations to hospital; title vested in county.—
Any person or persons, firm, organization, corporation or sSo-
ciety desiring to make donations of money, personal property or.
real estate for the benefit of such hospital, shall have the right
to vest title of the money or real estate so donated in said
county, to be controlled, when accepted, by the board of hospital
trustees according to the terms of the deed, gift, devise, or be-
quest, of such property.

Section 13. Medical practitioners; no discriminations;
right of patient to employ.—In the management of such public
hospital no discrimination shall be made against practitioners
of any school of medicine recognized by the laws of Virginia,
and all such legal practitioners shall have equal privileges in
treating patients in said hospital. The patient shall have the ab-
solute right to employ at his or her own expense his or her own
physician and when acting for any patient in such hospital the
physician employed by such patient shall have exclusive charge
of the care and treatment of such patient, and nurses therein
shall as to such patient be subject to the directions of such
physician; subject always to such general rules and regulations
as shall be established by the board of trustees under the provi-
sions of this chapter.

Section 14. Training school for nurses.—The board of
trustees of such county hospital may establish and maintain in
connection therewith and as a part of said public hospital a
training school for nurses.

Section 15. Detention and examination cf ‘iInsane.—The
said board of trustees shall at all times provide a suitable room
for the detention and examination of all persons who are brought
before the commissioners of insanity for such county, provided
that such public hospital is located at the county seat.

Section 16. Department for tubercular persons; head
nurse.—The board of trustees of any hospital, either operating
now or in process of construction, or to be established in the
future under this chapter, is hereby authorized in connection
with said hospital, if deemed advisable, to provide as a depart-
ment of said public hospital suitable accommodations and means
for the care of persons afflicted from turberculosis. The board
of trustees may also establish as a department of said county
hospital a suitable building or buildings for the isolation or de-
tention of persons afflicted with contagious diseases, and who
are subject to the quarantine regulations of the law of the
State of Virginia and the rules and regulations of the state
board of health. The board of trustees may formulate such rules
and regulations for the government of such persons and the pro-
tection from infection of other patients, and nurses, and attend-
ants in such public hospital as they. may deem necessary and 1%
shall be the duty of all persons in charge of or employed in such
hospitals or residents thereof to faithfully obey and comply with
any or all of such rules and regulations.

Section 17. Compensation for treatment; subjects for
charity.—The board of hospital trustees shall have power to de-
termine whether or not patients presented at said public hospital
for treatment are subjects for charity and shall fix such price
for compensation for patients, other than those unable to assist
themselves, as the said board deems proper, the receipts there-
for to be paid to the treasurer of said county and credited by him
to the hospital fund.

Section 18. Hospitals may adopt appropriate name.—Hos-
pitals either operating now or in process of construction or to
be established hereafter under this chapter, instead of being
called the county public hospital, may be named by the use of
some appropriate title or appellation.

Section 19. Board of supervisors to provide care for
indigent tubercular persons.—The board of supervisors of each
county in this State may provide for suitable care and treatment
of persons suffering from tuberculosis and who are financially
unable to provide for themselves and who have no relatives
liable for their support.

Section 20. Indigent tubercular patients; contracts with
other hospitals.—The board of supervisors of any county, where
no suitable provision has been made for the care of its tuber-
culous residents, who are financially unable to care for them-
selves, may contract with the board of hospital trustees of any
public hospital for the care of such persons in the sanatorium of
said hospital, upon such reasonable terms as may be agreed
upon. |

Section 21. Board of supervisors to provide care for indigent
tubercular persons.—In compliance with the provisions of sec-
tion nineteen, the board of supervisors may arrange in said
county, or elsewhere in the State, with any institution main-
tained for the treatment of tuberculosis, or with a county public
hospital, or any other hospital not maintained for pecuniary
profit, where suitable treatment may be provided; and said
board of supervisors is authorized to construct or otherwise pro-
vide and equip suitable buildings in connection with such institu-
tion, or hospital, if in the county, for the proper segregation and
maintenance of such designated persons; and it is futher pro-
vided that any institution, hospital or place for the treatment
of persons afflicted with tuberculosis now established, or which
may be established in the future, shall be approved by the board
of control and inspected by said board. And said board shall
have the power to require any alterations in building or equip-
ment or changes in treatment as may be necessary to make such
institution conform to the modern and accepted methods for
the treatment of tuberculosis. |

Section 22. Allowance for support; appropriation for
buildings; election authorizing greater expenditure.—The board
of supervisors shall allow for the care and support of each
patient when in such designated institution a sum not exceeding
ten dollars per week from the poor fund, provided that in
counties of sixty-five thousand or over population, a sum not to
exceed fifteen thousand dollars; in counties of fifteen thousand
or over population, and less than sixty-five thousand, a sum not
to exceed five thousand dollars, and in counties of less than fifteen
thousand population, a sum not to exceed two thousand dollars
may be appropriated out of county funds for constructing, ac- _
quiring and equipping buildings without submitting the same
to a vote of the qualified electors. The board of supervisors may
submit the question of expending a greater amount than above
specified by a vote of the qualified electors of the county at
any general election and may for such purposes expend the
amount authorized by said vote.

Provided, further, that upon the establishment of any such
county hospital, any county contiguous thereto, or any district
or districts of such contiguous county, may obtain the same
rights and privileges for the use of said county hospital for its
citizens as the citizens of the said county so establishing the
said hospital upon making such agreement with the board of
Supervisors of the county establishing said hospital as to con-
struction and maintenance of the same as may be determined by
the board of supervisors of the said county establishing such
hospital.