Hospital Commission


The Hospital Commission, through the Hospital Administrator, is to run the day-to-day operations of the Hospital and advise the Council on issues where the Charter specifically prescribes decisions that must be made by the Council. Decision-making latitude is given to the Commission from the Council to the extent permitted by the Charter.

Authority of the City Council:

The Hospital Commission cannot take actions that are not expressly provided for by the Charter or the City Council within the legal framework of the Charter. To do so would be contrary to the Charter and illegal.

1) Investment of funds

The Hospital Commission should make investment decisions of Hospital funds. The investment of such should be only at depositories previously-authorized by the Council and in accordance with the Council’s investment policies. The Council shall have the authority to modify investment decisions made by the Hospital Commission. The Hospital Administrator should keep the Council informed of Hospital investment decisions.

2) Budget-operating

The Hospital Administrator and Financial Services Officer should develop, on an annual basis, the proposed operating budget for the department to be presented to the City Administrator and Council Budget Committee. It should be approved by the City Council as part of the comprehensive budget adoption process. The Hospital Commission shall approve payment of bills to insure compliance with expenditures in accordance with the adopted budget. Expenses for maintenance and purchases of minor equipment shall be considered as part of the operating budget. The Charter requires all checks approved for payment to be signed/stamped by the Mayor and City Administrator.

3) Budget-capital

The Hospital Commission, upon adoption of an annual capital budget, should present it to the City Council for ratification. The Hospital Commission shall be authorized to expend funds for capital improvements that are identified in the capital budget. Any items over $25,000 must be bid under the Uniform Municipal Contract Law. Capital budget items between $10,000 and $25,000 must be secured by a minimum of two quotes. This includes all vehicles and major equipment. Items under $25,000 may be purchased by the Hospital Commission without Council approval. Minor equipment and tools should be purchased as authorized by the Administrator.

4) Personnel-staffing levels

The Charter reserves the hiring of all personnel to the City Council, but to have the Council ratify each hiring in an operation the size of the hospital would be awkward and cumbersome. To streamline this process and still meet the Charter requirements, the Council should ratify a staffing plan of the Hospital. As long as staffing levels and changes that are made are consistent with the approved staffing plan, the Council’s approval is implied for the Commission to make the hiring.

5) Personnel-salary levels and adjustment

The Charter and Code reserves the right to set salaries to the City Council. To have the Council consider individual salaries would be undue micro-management and inefficient. To streamline this process and still meet the Charter requirements, the Council should ratify a pay plan for the Hospital. As long as salaries and adjustments are consistent with the approved pay plan, the Council’s approval is implied allowing the Commission to make the final decision. This allows the Hospital to continue their own reporting requirements for pay equity compliance.

6) Rate Schedules

As part of the annual budget process, the Hospital Commission should develop a rate/fee schedule to be ratified by the City Council.

7) Contract Administration

The Hospital Commission should have the authority to enter into minor contracts-for-service deemed necessary for the operations of the hospital up to a certain amount. Major contacts-for-service should be ratified by the City Council. The Commission and Council should review current contacts and potential contracts and make a determination of what constitutes a “minor” contract and what constitutes a “major” contract.

8) Ability to write-off accounts

The Hospital Commission’s policy for writing off delinquent accounts should be ratified by the City Council. As long as the practice is consistent with the policy, the Hospital Commission should retain the authority to implement this policy.

9) Ability to hire consultants

The Hospital Commission should evaluate the need to hire consultants for specific purposes. To that end, theommission should review, investigate, study, develop, and thoroughly understand the purpose of any consultant’s study, proposal, scope-of-work, and the content of the consultant’s final report. The Commission should use such reports to further recommend policies to the Council. The final execution of consultant contracts must be with the City Council as prescribed in the Charter.