Iowa Code § 347.9 (2026)

1. When it has been determined by the voters of a county to establish a county public hospital, the board shall appoint five or seven trustees chosen from among the resident citizens of the county with reference to their fitness for office. The appointed trustees shall hold office until the following general election, at which time their successors shall be elected, three for a term of four years and the remainder for a term of two years, and they shall determine by lot their respective terms, and thereafter their successors shall be elected for regular terms of four years each.

2. Upon approval of a majority of the current board of trustees, the board may reduce an existing seven-member board to a five-member board. The board shall establish how to reduce the number of trustees on the board and shall provide for a staggered election cycle for election to the five-member board, which election shall be for a term of four years. However, the manner of reducing the number of trustees shall ensure that the current trustees on the seven-member board may continue to hold office through the end of their respective terms. [S13, §409-c; C24, 27, 31, 35, 39, §5355; C46, 50, 54, 58, 62, 66, 71, 73, 75, 77, 79, 81, §347.9] 86 Acts, ch 1200, §3; 99 Acts, ch 36, §3; 2001 Acts, ch 65, §1; 2009 Acts, ch 110, §6; 2018 Acts, ch 1033, §2; 2019 Acts, ch 148, §1, 2; 2020 Acts, ch 1063, §183; 2025 Acts, ch 123, §25, 26 Referred to in §331.321 2025 strike of subsection 3 applies retroactively to persons elected to a county hospital board of trustees on or after January 1, 2024; 2025 Acts, ch 123, §26 Subsection 3 stricken\n\n 347.9A Trustee eligibility — conflict of interest.

1. The following persons shall not be eligible to serve as a trustee for a county public hospital:\n\nTue Dec 09 22:14:34 2025 Iowa Code 2026, Chapter 347 (35, 1) 3 COUNTY HOSPITALS, §347.11\n\n a. A person or spouse of a person with medical or special staff privileges in the county public hospital.

b. A person or spouse of a person who receives direct compensation in an amount greater than one thousand five hundred dollars in a calendar year from the county public hospital.

2. The transactions of a hospital trustee or a hospital trustee’s spouse shall be limited as follows:

a. A conflict of interest transaction is a transaction with the hospital in which a hospital trustee or a hospital trustee’s spouse has a direct interest of less than or equal to one thousand five hundred dollars or indirect interest in any amount. A conflict of interest transaction is not voidable on the basis of the conflict of interest if all of the following are true:

(1) The material facts of the transaction and the interest of the trustee or the trustee’s spouse were disclosed or known to the board of hospital trustees.

(2) The board of hospital trustees authorized, approved, or ratified the transaction. A conflict of interest transaction is authorized, approved, or ratified if it receives the affirmative vote of a majority of the disinterested trustees at a meeting where a quorum is present and where three or more trustees are disinterested in the conflict of interest transaction.

(3) The transaction was fair to the hospital at the time of the transaction.

b. For the purposes of this section, a trustee has an indirect interest in a transaction if either of the following is true:

(1) Another entity in which the trustee or the trustee’s spouse has a material interest or in which the trustee or the trustee’s spouse is a general partner is party to the transaction.

(2) Another entity of which the trustee or the trustee’s spouse is a director, officer, or trustee is a party to the transaction.

3. This section does not prohibit a licensed health care practitioner from serving as a hospital trustee if the practitioner’s sole use of the county hospital is to provide health care service to an individual with an intellectual disability as defined in section 4.1. 2009 Acts, ch 110, §7; 2012 Acts, ch 1019, §127 Referred to in §331.321 \n