The merger of Kokomo’s Howard Regional Health System into Indianapolis-based Community Health Network received final approval Tuesday night when the Howard County Board of Commissioners and County Council voted unanimously for the affiliation of the hospitals.

The integration will take effect July 1, when the Kokomo hospital will change its name to Community Howard Regional Health, according to Community spokeswoman Lynda de Widt.

The two hospital systems signed a letter of intent to merge back in January, less than four months after Howard Regional broke off a merger deal with Indiana University Health.

Howard and Community officials said at that time the decision was driven by “dramatic changes” spurred by the 2010 federal health reform law.

The letter of intent called for Howard Regional to join its finances with Community’s, yet retain a local board with at least two-thirds of its members living in Howard or contiguous counties.

Indianapolis-based Community Health has similar affiliations with Community Hospital of Anderson and with Westview Hospital in Indianapolis.

A year ago, Howard Regional announced that it would merge with Indianapolis-based IU Health, in large part because deteriorating employment in the Kokomo area had pinched the hospital’s operating margins. But, in October, the two hospitals called off that deal—although they promised to continue to work together.

Indianapolis-based hospitals—including Community, IU Health and St. Vincent Health—have been active in acquiring county-owned hospitals throughout Indiana. These smaller hospitals say they need help recruiting physicians, particularly specialists, as well as help in bearing the costs of sophisticated electronic medical record systems, which the federal government is now effectively mandating.

The Indianapolis hospitals also are interested in securing a steady stream of patients to support their flagship campuses, as well as earning profits at outlying hospitals.