Sec. 121.041. ESTABLISHMENT. By a majority vote of each governing body, a public health district may be established by: (1) two or more counties; (2) two or more municipalities; (3) a county and one or more municipalities in the county; or (4) two or more counties and one or more municipalities in those counties. Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.