On November 5, 1949, Group Health Cooperative holds its first district-based election for its board of trustees. This is a crucial reform in Group Health's governance. The new policy provides for a board with five district-elected candidates and four at-large candidates. It will increase member participation and democracy in the health care co-op, and will also have the effect of increasing the clout of the Renton district, which represents one-tenth of the membership and includes some of the most active supporters.
Group Health had already created districts for the purpose of recruiting new members, something like a political campaign. Ad Shoudy, a cooperative movement activist and founding board member, recognized that a district organization might provide a better foundation for member democracy. The idea was endorsed in principle at a board meeting on November 17, 1948. (Later the voting districts were termed "nominating areas" to avoid confusion with the smaller membership districts.)
Before the election, the board of trustees resigned in order to clear the slate. The following board was elected:
- Virgil Chadwick (district-elected)
- George Hunter (district-elected)
- D. M. Johnson (district-elected)
- Bob Scott (district-elected)
- Bob Wells (district-elected)
- Tom Bevan (at-large)
- William Birnbaum (at-large)
- Jean Ross Cawley (at-large)
- John King (at-large)
The election of a West Seattle board member was delayed until 1950. In 1954 new lines were drawn to add a nominating area, and in 1955 two more areas were added to make a board of trustees with 11 members.