In addition to the requirements for the establishment of a hospital district as set forth in section 48-261, no petition for the formation of a district shall be acted upon unless the area encompassed within the proposed district is first approved by the department of health services as an area needing additional hospital facilities. Notwithstanding section 48-261, subsection E, a hospital district may exclude natural geographic features such as watercourses.
A.R.S. § 48-1903