In counties having a population of less than 1,000,000 and having an approved county tuberculosis hospital, the board of supervisors, by a 2/3 vote of the members elect, may create and appoint a board of county institutions for the purpose of maintaining and operating a county tuberculosis hospital, a county medical care facility and a county psychiatric facility; or may operate and administer as a single medical institution. The board may be abolished by a 2/3 vote of the members elect of the board of supervisors.

     The members of the board shall be residents of the county. The board shall be composed of 7 members appointed for terms of 3 years each. Of the members first appointed 3 shall be appointed for a term of 1 year, 2 for 2 years and 2 for 3 years. Thereafter each member shall hold office for a period of 3 years beginning January 1 next ensuing and until a successor is appointed and qualified. Each member shall file with the county clerk the constitutional oath of office.

     The business which the board of county institutions may perform shall be conducted at a public meeting of the board of county institutions held in compliance with Act No. 267 of the Public Acts of 1976, being sections 15.261 to 15.275 of the Michigan Compiled Laws. Public notice of the time, date, and place of the meeting shall be given in the manner required by Act No. 267 of the Public Acts of 1976.

     Subject to the provisions of this act, the board of county institutions shall operate the hospital or institution for the care and treatment of persons suffering from tuberculosis or any physical or mental ailment or impairment, including the condition of senility. The board of county institutions shall employ an executive head and such other employees as may be necessary to carry out the provisions of this act. The compensation and expenses necessary to the discharge of official duties of the executive head and employees and the number thereof shall be within the funds made available therefor. The board shall be responsible for the establishment of an annual budget and all charges and disbursements shall be within the budget so prepared and approved by the board of supervisors. The board shall be responsible for establishing the policies covering the operation of the hospital or institution, including the conditions of admission and the rates to be charged for the care of patients. The board of county institutions shall cooperate with all agencies and departments of the state, particularly the public health department, the mental health department and the department of social services.

     Not more than 4 members of the county board of commissioners shall be members of the board of county institutions. They shall be entitled, for attending meetings, to per diem compensation and other expenses in the same manner as members of the county board of commissioners. The members of the board of county institutions who are not members of the county board of commissioners shall also be entitled to per diem compensation and other expense for attending meetings the same as members of the board of county institutions who are members of the county board of commissioners. The board shall meet at least once a month. However they may not claim reimbursement for attending more than 36 meetings a year.

     The powers and duties now vested in the board of trustees of the tuberculosis hospital are hereby transferred to and vested in the board of county institutions of those counties in which the county board of supervisors appoints such a board of county institutions.

     The powers and duties now vested in the social welfare board pertaining to the direction and administration of a county medical facility or county home are hereby transferred to and vested in the board of county institutions of those counties in which the county board of supervisors appoints a board of county institutions.

     The board of county institutions will be responsible to the board of supervisors for the administration and management of different county institutions placed under the responsibility of the board.

     The board of county institutions may not be required, if it operates as a single institution to prepare separate budgets for each hospital or institution, but may prepare 1 budget for the operation of the single institution.

     The county board of institutions, if eligible, shall qualify for any grants-in-aid, subsidy or other financial assistance granted by the state or the United States.