50 Pa. Stat. § 4304
Except in cities of the first class, where the administrator shall be appointed under the merit system, the local authorities shall appoint a county mental health and intellectual disability administrator from a list of not less than two names submitted by the County Mental Health and Intellectual Disability Board. If, thirty days after the county board has submitted a list to the local authorities, an appointment has not been made because of a tie vote or other failure of the local authorities to make such appointment, the same shall be made by the secretary after consultation with the local authorities. The appointment of the administrator, by whomever made, may be terminated by the local authorities, provided, that no appointment made by the secretary under this section shall be terminated without the approval of a majority of the County Mental Health and Intellectual Disability Board.
50 P.S. § 4304