(a) The board consists of seven voting managers and one nonvoting manager as follows:
(1) one voting manager elected from each commissioners precinct of Titus County;
(2) three voting managers elected from the district at large; and
(3) the chief of the medical staff of the district’s principal hospital serving as a nonvoting ex officio manager.
(b) The election order must provide for clerks as in county elections and must specify:
(1) the date of the election;
(2) the location of the polling places;
(3) the presiding and alternate election judges for each polling place; and
(4) the form of the ballot.

(c) The board shall declare the results of the election.
(d) Voting managers serve staggered four-year terms.
(e) An election shall be held on the uniform election date in May, or another date authorized by law, of each even-numbered year to elect the appropriate number of voting managers.