In 1960, pursuant to the Hospital Authorities Law of 1941 Ga. L. 1941, p. 241, Clarke County created the Clarke County Hospital Authority. The Authority was to be governed by a board of trustees. The resolution creating the Hospital Authority did not specify how vacancies on the board of trustees were to be filled. Beginning in 1961, it became the practice of the Hospital Authority and Clarke County to fill these vacancies via a two-step process: First, the Hospital Authority would nominate one or more candidates for a vacancy. Then, Clarke County would fill the vacancy by appointing one of the Hospital Authority’s nominees. In other words, Clarke County made the appointments to the board of trustees, but only from a list of nominees submitted by the Hospital Authority. In 1964 the Hospital Authorities Law was amended to require each hospital authority to “elect to have vacancies filled . . . pursuant to the provisions of this Chapter or in the same manner as such appointments were filled prior to the approval of this Act or its otherwise becoming law.” 1964 Ga. Laws, pp. 598, 600. In accordance with that amendment, the Clarke County Hospital Authority resolved to fill vacant board positions in the “same manner as such appointments were filled prior to the approval of the ‘Hospital Authorities Law’ of 1964.” Thereafter, with few exceptions,1 Clarke County and the Hospital Authority continued to follow the two-step process.
In 1991 the Unified Government of Athens-Clarke County Unified Government succeeded the former governing body of Clarke County. The Unified Government went along with the two-step appointment process until May of 2003, when it 1 refused to act on the Hospital Authority’s nominations to fill two vacancies on the board, and 2 decided to solicit applications and fill the vacancies from the applicant pool regardless of whether the applicants were nominated by the Hospital Authority.