16 Pa. Stat. § 12006
The combined boards of county commissioners of the several counties participating in a joint-county department of health shall constitute the joint-county health commission for such joint-county department of health. As soon as possible after the creation of the joint-county department of health, and on the second Monday in January of each year thereafter, and at such other times as may be necessary, the said joint-county health commission shall meet for the purpose of exercising the powers and duties conferred upon it. The joint-county health commission shall from time to time elect from its members a chairman.
No action shall be taken by the joint-county health commission without the concurrence of a majority of the county commissioners of each participating county, except that the election of the chairman of the joint-county health commission shall be by the vote of a majority of all the members of the joint-county health commission.
16 P.S. § 12006