Biennial report of the North Carolina State Board of Health

              Cbe Hidtarp
of t|)e
O{t)t$ion of ^ealtb affair0
(^niliecisiitp of Botth Carolina
Thirty-Ninth Biennial Report
OF THE
NORTH CAROLINA
STATE BOARD OF HEALTH
V/ A
\
July 1, 1960-June 30, 1962
^^
MEMBERS OF THE STATE BOARD OF HEALTH
Appointed by the Governor
Lenox D. Baker, M. D.
Appointed 1956
Term expires 1965
Jasper C. Jackson, Ph. G.
(1st appointment 1945)—(2nd appointment 1947)
(3rd re-appointment 1959)
Term expires 1963
Ben W. Dawsey, D. V. M.
Appointed 1959
Term expires 1963
Glenn L. Hooper, D. D. S.
Appointed 1961
Term expires 1965
**D. T. Redfearn, B. S.
Appointed 1961
Term expires 1965
Elected by the Medical Society of the State of North Carolina
Charles R. Bugg, M. D., President
Elected 1957
Term expires 1965
John R. Bender, M. D., Vice-President
Elected 1949
Term expires 1965
Roger W. Morrison, M. D.
Elected 1957
Term expires 1963
***OscAR S. Goodwin, M. D.
Elected 1960
Term expires 1963
EXECUTIVE COMMITTEE
Charles R. Bugg, M. D., President
John R. Bender, M. D., Vice-President
Ben W. Dawsey, D. V. M.
J. W. R. Norton, M. D., Secretary
EXECUTIVE STAFF AS OF JUNE 30, 1962
J. W. R. Norton, M. D., M.P.H., Secretary and State Health Director
(Term expires June 30, 1963)
Jacob Koomen, Jr., M. D., M.P.H., Assistant State Health Director
(Term concurrent with the State Health Director)
J. M. Jarrett, B. S., Director, Sanitary Engineering Division
Fred T. Foard, M. D., Director, Epidemiology Division
Robert D. Higgins, M. D., M.P.H., Director, Local Health Division
E. A. Pearson, Jr., D. D. S., M.P.H., Director, Oral Hygiene Division
James F. Donnelly, M. D., Director, Personal Health Division
Lynn G. Maddry, Ph. D., M.S.P.H., Acting Director, Laboratory Division
Edwin S. Preston, M. A., LL. D., Public Relations Officer
Charles L. Harper, M.S.P.H., Director, Administrative Services
Mrs. W. Kerr Scott appointed to fill unexpired term of Mrs. J. E. Latta (3 mos.)
(Re-appointed 1961)—(Served 3 mos.—resigned).
*• Mr. D. T. Redfearn appointed to fill unexpired term of Mrs. W. Kerr Scott, 1961.
•*• Dr. Oscar S. Goodwin elected to fill unexpired term of Dr. Earl W. Brian, 1960.
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North Carolina Board of Health
LOCAL HEALTH DIRECTORS IN
NORTH CAROLINA
Department
Alamance
Alleghany-Ashe-
Watauga
Anson
Avery
Beaufort
Bertie
Bladen
Brunswick
Buncombe
Burke
Cabarrus
Caldwell
Carteret
Catawba-Lincoln-
Alexander
Cherokee-Clay
Cleveland
Columbus
Craven
Cumberland
Currituck
Dare
Davidson
Davie-Yadkin
Duplin
Durham
Edgecombe
Forsyth
Franklin
Gaston
Graham
Granville
Greene
Guilford
Halifax
Harnett
Haywood
Henderson
Hertford-Gates
Hoke
DECEMBER 31, 1962
Health Director
Dr. \V. L. Norville
Dr. Mary B. H. Michal
Dr. D. W. Davis, P.T.
Dr. Mary B. H. Michal
Dr. W. A. Browne
Dr. W. P. Jordan, P.T.
Dr. Caroline H. Callison
Dr. A. H. Elliot, P.T.
Dr. H. W. Stevens
Dr. G. F. Reeves
Dr. John D. Workman
Dr. William Happer
Dr. Luther Fulcher, P.T,
Dr. William H. Bandy
Dr. Z. P. Mitchell
Dr. J. R. Black
Dr. W. A. Browne
Dr. M. T. Foster
Dr. W. W. Johnston
Dr. W. W. Johnston
Dr. Dermot Lohr
Dr. A. J. Holton
Dr. John F. Powers
Dr. 0. L. Ader
Dr. J. S. Chamblee
Dr. Fred G. Pegg
Dr. B. M. Drake
Dr. James E. Stephens
Dr. J. U. Weaver
Dr. Joseph L. Campbell
Dr. E. H. Ellinwood
Dr. Robert F. Young
Dr. Melvin F. Eyerman
Dr. Raymond K. Butler
Dr. J. D. Lutz, P.T.
Dr. Quinton E. Cooke
Dr. Clifton Davenport,
P.T.
Address
Burlington, N. C.
Boone, N. C.
Wadesboro, N. C.
Newland, N. C.
Washington, N. C.
Windsor, N. C.
Elizabethtown, N. C.
Southport, N. C.
Shallotte, N. C.
Asheville, N. C.
Morganton, N. C.
Concord, N. C.
Lenoir, N. C.
Beaufort, N. C.
Hickory, N. C.
Murphy, N. C.
Shelby, N. C.
Whiteville, N. C.
New Bern, N. C.
Fayetteville, N. C.
Currituck, N. C.
Manteo, N. C.
Lexington, N. C.
Mocksville, N. C.
Kenansville, N. C.
Durham, N. C.
Tarboro, N. C.
Winston-Salem, N. C.
Louisburg, N. C.
Gastonia, N. C.
Robbinsville, N. C.
Oxford, N. C.
Snow Hill, N. C.
Greensboro, N. C.
Halifax, N. C.
Lillington, N. C.
Waynesville, N. C.
Hendersonville, N. C.
Winton, N. C.
Raeford, N. C.
Thirty-Ninth Biennial Report
Department
Hyde
Iredell
Jackson-Macon-Swain
Johnston
Jones
Lenoir
McDowell
Madison
Martin
Mecklenburg
Mitchell-Yancey
Montgomery
Moore
Nash
New Hanover
Northampton
Onslow
Orange-Person-
Chatham-Lee-Caswell
Pamlico
Pasquotank-Perquimans-
Camden-Chowan
Pender
Pitt
Randolph
Richmond
Robeson
Rockingham
Rowan
Rutherford-Polk
Sampson
Scotland
Stanly
Stokes
Surry
Transylvania
Tyrrell-Washington
Union
Vance
Wake
Warren
Wayne
Wilkes
Wilson
Charlotte, City of
Rocky Mount, City of
Health Director
Dr. W. W. Johnston
Dr. Ernest Ward
Dr. James T. Googe
Dr. Robert D. Phillips
Dr. L. E. Kling
Dr. L. E. Kling
Dr. W. F. E. Loftin
Dr. Margery J. Lord
Dr. Grover C. Godwin,
P.T.
Dr. Maurice Kamp
Dr. J. W. Willcox
Dr. J. S. Chamblee
Dr. C. B. Davis
Dr. W. R. Parker
Dr. Eleanor H. Williams
Dr. 0. David Garvin
Dr. L. E. Kling
Dr. N. C. Wolfe, P.T.
Dr. R. E. Fox
Dr. H. C. Whims
Dr. Clem Ham
Dr. E. R. Hardin
Dr. C. T. Mangum, P.T.
Dr. M. K. Holler
Dr. Ann B. Lane
Dr. Caroline H. Callison
Dr. Clem Ham
Dr. J. S. Taylor, P.T.
Dr. Robert Caldwell
Dr. John R. Folger, P.T.
Dr. Claudius McGowan,
P.T.
Dr. Conway Anderson
Bolt
Dr. J. U. Weaver
Dr. Lsa C. Grant
Dr. Joe A. Bain
Dr. A. J. Holton
Dr. Joseph Campbell
Dr. Maurice Kamp
Dr. J. S. Chamblee
Address
Swan Quarter, N. C.
Statesville, N. C.
Sylva, N. C.
Smithfield, N. C.
Trenton, N. C.
Kinston, N. C.
Marion, N. C.
Marshall, N. C.
Williamston, N. C.
Charlotte, N. C.
Burnsville, N. C.
Troy, N. C.
Carthage, N. C.
Nashville, N. C.
Wilmington, N. C.
Jackson, N. C.
Jacksonville, N. C.
Chapel Hill, N. C.
Bayboro, N. C.
Elizabeth City, N. C.
Burgaw, N. C.
Greenville, N. C.
Asheboro, N. C.
Rockingham, N. C.
Lumberton, N. C.
Spray, N. C.
Salisbury, N. C.
Rutherfordton, N. C.
Clinton, N. C.
Laurinburg, N. C.
Albemarle, N. C.
Danbury, N. C.
Mount Airy, N. C.
Brevard, N. C.
Plymouth, N. C.
Monroe, N. C.
Henderson, N. C.
Raleigh, N. C.
Warrenton, N. C.
Goldsboro, N. C.
Wilkesboro, N. C.
Wilson, N. C.
Charlotte, N. C.
Rocky Mount, N. C.
NORTH CAROLINA
STATE BOARD OF HEALTH
RALEIGH
J w R NORTON M D MPH Deccmber 1, 1962
CHARLES R BUGG M I
JOHN R BENDER, M D
BEN W DAWSEY, D V
LENOX D BAKER M C
ROGER W MORRISON
JASPER C JACKSON Ph
OSCAR S GOODWIN M
GLENN L HOOPER D D
D T REDFEARN
JACOB KOOMEN, JR , M D , M P H
The Honorable Terry Sanford
Governor of North Carolina
The State Capitol
Raleigh, North Carolina
Dear Governor Sanford:
Pursuant to the provisions of Chapter 130, Article II,
Paragraph 12, General Statutes of North Carolina, I herewith sub-mit
to you, and through you, to the General Assembly of North Caro-lina,
the Biennial Report of the North Carolina State Board of
Health for the fiscal years of July 1, 1960 - June 30, 1962.
Respectfully submitted,
'3
J. W, R. Norton, M. D.
Secretary and State Health Director
n/e
Thirty-Ninth Biennial Report
TABLE OF CONTENTS
Page
Report of State Health Director and Secretary-Treasurer
July 1, 1960-June 30, 1962 9
Conjoint Reports:
Highlights and Comments
By J. W. R. Norton, M. D., State Health Director, May 10, 1961 42
Progress in the Control of Poliomyelitis, Measles, and
Infectious Hepatitis
By Jacob Koomen, M. D., Assistant State Health Director
May 9, 1962 51
Division Reports:
Administrative Services 58
Epidemiology 63
Laboratory 82
Local Health 89
Oral Hygiene 113
Personal Health 119
Sanitary Engineering 130
Committee on Postmortem Medicolegal Examinations 136
Public Health Chronology 138
REPORT OF THE SECRETARY-TREASURER
AND STATE HEALTH DIRECTOR
July 1, 1960-June 30, 1962
Abridged report of the activities of the State
Board of Health as recorded in the Minutes:
September 6, 1960. There was a special called meeting of the North Caro-lina
State Board of Health held Tuesday, September 6, 1960, 12:00 noon
—
1:35 p.m., in the Cooper Memorial Health Building,—President Charles R.
Bugg, M. D., presiding.
Attending: Dr. Charles R. Bugg; Dr. Lenox D. Baker; Dr. Z. L. Edwards;
Dr. Ben W. Dawsey and Mr. Jasper C. Jackson.
On motion of Mr. Jackson, seconded by Dr. Edwards, the minutes of the
Board meeting held May 11, 1960, were approved as circulated.
Mr. J. M. Jarrett, Director of the Sanitary Engineering Division, pre-sented
a request for the extension of the boundary lines of the Royal Oaks
Sanitary District, Cabarrus County, North Carolina. He stated that all docu-ments
and transactions had been examined by his Division and also by the
Attorney General's Office and found to be in compliance with the law. Mr.
Jarrett recommended that the Board consider favorably the approval of
this annexation. The matter was discussed and upon motion of Dr. Baker,
seconded by Dr. Dawsey, the RESOLUTION OF THE NORTH CAROLINA
STATE BOARD OF HEALTH EXTENDING THE BOUNDARY LINES
OF THE ROYAL OAKS SANITARY DISTRICT IN CABARRUS COUN-TY,
was unanimously approved.
Mr. Jarrett also presented a request for the creation of the proposed
Rockland Sanitary District in Cabarrus County, North Carolina. He stated
that the transactions and documents pertaining to the creation of the pro-posed
Sanitary District had been examined and checked by his Division,
and discussed with a representative of the Attorney General's Office, and
were found to be in accordance with requirements of the General Statutes.
Mr. Jarrett recommended favorable action by the Board. On motion of
Dr. Baker, seconded by Dr. Dawsey, the RESOLUTION OF THE NORTH
CAROLINA STATE BOARD OF HEALTH CREATING THE ROCKLAND
SANITARY DISTRICT IN CABARRUS COUNTY, was approved.
President Bugg asked Secretary Norton to present and give a brief state-ment
relative to the budget for the biennium 1961-'63. He explained that
the "A" Budget was a continuation of services at the present level. The
"B" Budget is for new services or expansion of existing services. The "C"
Budget is for capital improvements. We are not making any requests under
the "C" Budget since the Board of Public Buildings and Grounds has charge
of State Buildings.
Dr. Norton also stated that the members of the Commission on Reorgani-zation
of State Government is considering where the Mental Health Au-thority
can serve best.
10 Thirty-Ninth Biennial Report
At this point, Dr. Norton presented Dr. Jacob Koomen, Jr., Assistant
Director of the Division of Epidemiology, and Mr. Charles L. Harper, Di-rector,
Administrative Services, and requested Dr. Koomen to present to
the Board the purpose and need for the "B" Budget for the biennium 1961-
'63 to be presented by priorities to the Advisory Budget Commission, and
Mr. Harper to present the requested amounts.
Dr. Koomen stated that 20 priority categories had been set up in accord-ance
with the relative needs and costs of public health in North Carolina,
and gave a brief statement of purposes and reasons for each request. Mr.
Harper followed each priority program discussion with a statement rela-tive
to details of personnel and costs.
In discussing the Department's "B" Budget, the Board considered the
request of the Asheville Orthopedic Hospital that $25,000 be added in the
Board's "B" Budget for the use of the :^ospital in addition to the $50,000
tentatively approved in the "A" Budgef at the request of the Asheville
Orthopedic Hospital. After discussion, it was the consensus of the Board
members present that the $25,000 should be recommended to the Advisory
Budget Commission, and that the recommendation should also be made that
the entire sum appropriated henceforth to the State Board of Health spe-cifically
for the Asheville Orthopedic Hospital be removed from the agen-cy's
appropriation and be made a direct appropriation to the Asheville
Orthopedic Hospital. A motion to this effect was made by Dr. Dawsey,
seconded by Mr. Jackson, and carried.
On behalf of the Board, Dr. Baker and President Bugg thanked Dr.
Koomen and Mr. Harper for their constructive and informative presenta-tion
of the Budget.
Dr. Baker moved that Dr. Norton be instructed to place a portrait of
himself in some appropriate place in the Health Juilding. Motion seconded
by Mr. Jackson, and carried.
The Board recommended that Secretary N(iton and Dr. Edwin Preston
be instructed to draft a resolution of respect for Dr. Earl W. Brian, who
passed away August 1, 1960, for presentation at the next Board meeting.
The meeting adjourned at 1:35 p.m., and members proceeded to Room
351, Agriculture Building Annex, for the Hearing before the Advisory
Budget Commission.
October 6, 1960. The quarterly meeting of the North Carolina State Board
of Health was held Thursday, October 6, 1960, 10:30 a.m. -12:30 p.m., in
the Board Room of the Cooper Memorial Health Building,—President
Charles R. Bugg, M. D., presiding.
Attending: Dr. Charles R. Bugg; Dr. John R. Bender; Dr. Z. L. Edwards;
Mr. Jasper C. Jackson; Dr. Ben W. Dawsey; Dr. Oscar S.
Goodwin.
Dr. Oscar Sexton Goodwin of Apex, North Carolina, newly elected mem-ber
of the State Board of Health, was present to take the Oath of Office.
Before the Oath of Office was administered. Dr. Bugg said he would like
to make an official statement concerning his good friend. Dr. Oscar Good-win.
He said, "Personally, and I am sure I am speaking for the Board, I
North Carolina Board of Health 11
am greatly pleased that Dr. Goodwin has been elected by the Medical So-ciety
of the State of North Carolina. He is going to make us a very valu-able
member. He has been practicing medicine for many years right down
at the ground roots."
Associate Justice Wm. H. Bobbitt of the Supreme Court of North Caro-lina,
administered the Oath of Office to Dr. Goodwin, to fill the unexpired
term of Dr. Earl W. Brian, deceased, the term expiring in 1963. Dr. Good-win
was elected to the vacancy by the Executive Council of the Medical
Society of the State of North Carolina on October 2, 1960.
The meeting was called to order by President Bugg. On motion of Mr.
Jackson, seconded by Dr. Dawsey, the minutes of the Board meeting held
on September 6, 1960, were approved as circulated to members.
In discussing the request in the "B" Budget for additional funds to coun-ty
health departments. Dr. Z. L. Edwards asked for information on the
plan or formula to be used in allocating these funds if they are made
available. Secretary Norton answered that up to this time the General
Assembly has referred the decision of allocation formulas to the State
Board of Health.
Secretary Norton reported the addition to our staflf of Dr. Ursula M.
Anderson to succeed Dr. Charles F. Williams, as Pediatric Consultant, in
the Personal Health Division. In addition to the duties of Pediatric Con-sultant,
Dr. Anderson is also very much interested in school health work,
and will serve as the Board's School Health Co-ordinator.
Also, in discussing changes in the Central organization, Dr. Norton men-tioned
that the Nursing Section which is now in the Local Health Division
desires a change in status, preferably to become a separate Division. This
question is under consideration but no decision has as yet been made as
to whether or not this would be the best arrangement. This matter was
brought to the attention of the State Board as information.
Dr. Bugg called on Dr. Edwin S. Preston, Public Relations Officer, to
read a previously distributed "Resolution of Appreciation and Respect"
in tribute to the late Dr. Earl W. Brian of Raleigh, who died on August
1, 1960. President Bugg moved that the "Resolution" be adopted by the
Board, all standing in silent tribute for a moment. The "Resolution of
Appreciation and Respect" follows:
RESOLUTION OF APPRECIATION AND RESPECT
Earl W. Brian, M. D.
"WHEREAS, the death of Earl W. Brian, Raleigh physician and a
member of the State Board of Health from July 15, 1958 to August 1, 1960,
has brought profound sorrow to his multitude of friends and associates, and
"WHEREAS, the State Board in recognition of his influence and in-valuable
service wishing to express its sense of personal loss in his pass-ing
and its grateful appreciation of his many virtues, does hereby set forth
this formal resolution of respect.
"A native of Arkansas, Earl W. Brian received his medical degree at
Duke University in 1934 and practiced medicine in Raleigh beginning in
1939. In Raleigh he plunged into the professional and civic life of the city
and became active as a member of the Edenton Street Methodist Church.
12 Thirty-Ninth Biennial Report
"Elected to membership on the State Board of Health in 1958 by action
of the Medical Society of the State of North Carolina, he brought to the
State Board a wealth of training and experience in medical care, years of
unselfish community services—civic, church and preventive medicine, and
above all a devoted motivation and gentleness of spirit in his every word
and action. In his work on the State Board he showed the same wisdom
and conscientious devotion to duty that he demonstrated in his private life.
His influence will be projected through each of his co-workers in the State
Board of Health for a long time to come.
"His deep interest in his fellow man and his acute sense of duty were
combined with his innate ability in a way that brought him into places of
principal leadership in many phases of the community's life—in the Wake
County Medical Society, the Raleigh Kiwanis Club, the Executive Club of
Raleigh, the United Fund of Raleigh, the Salvation Army, the Occoneechee
Boy Scout Council, the Wake County Cancer Society, the Heart Associa-tion,
the Wake County Tuberculosis. Association and in other organizations
touching helpfully the health and welfare of those about him.
"Ever the epitome of a gentleman, an ardent champion of the manly
art of chivalric demeanor, he moved among us with a quiet voice, a gentle
countenance and a noble bearing that reflected and bespoke the majestic
character from which they emanated. To know him was not only to love
him but also to join hands with him in living for others.
"BE IT THEREFORE, RESOLVED, that this expression of respect and
appreciation be formally enacted by the State Board of Health and spread
upon its official minutes, and that a copy be forwarded to the family of
our departed friend to convey, though inadequately, the heartfelt sympathy
of the members of the State Board, and
"BE IT FURTHER RESOLVED, that copies be also sent to the Editor,
North Carolina Medical Journal, the Editor, Journal of the American
Medical Association, the Editor, Journal of the American Public Health
Association, the Secretary, Medical Society of the State of North Carolina
and to the Secretary, North Carolina Public Health Association.
"This 6th day of October, 1960."
Mr. J. M. Jarrett, Director of the Sanitary Engineering Division, pre-sented
proposed Rules and Regulations Providing for the Protection of
Public Water Supplies. This material was distributed to members prior
to the meeting for information and study. Mr. Jarrett explained briefly that
these regulations had been revirritten and clarified in accordance with the
revised Public Health Laws as passed by the General Assembly in 1957
and 1959, and that much of the material contained in the revision is cov-ered
by existing regulations but has been revised to bring it up-to-date.
Mr. Jarrett, therefore, recommended that the State Board approve the
adoption of the revised rules and regulations for the protection of public
water supplies. Dr. Dawsey moved that the proposed revisions to RULES
AND REGULATIONS PROVIDING FOR THE PROTECTION OF PUB-LIC
WATER SUPPLIES, be adopted. Motion seconded by Dr. Edwards,
and unanimously carried.
Mr. Jarrett also discussed a request from the City of Greensboro, N. C,
asking the State Board of Health to grant permission to the City to per-mit
controlled fishing from boats owned and controlled by the City on
Lake Brandt and also to permit sailboating with privately-owned sailboats
on the Lake from April 1 to October 31. No fishing will be allowed within
200 yards of the water intake and no boats will be allowed within this
area except by Public Works employees on their assigned duties. Mr.
North Carolina Board of Health 13
Jarrett stated that due to strict regulations controlling fishing and boat-ing
he felt that no unfavorable effects would be experienced in the quality
of the water and that it would be safe from a public health standpoint.
On motion by Mr. Jackson, seconded by Dr. Goodwin, the RESOLUTION
OF THE NORTH CAROLINA STATE BOARD OF HEALTH AUTHOR-IZING
THE CITY OF GREENSBORO, NORTH CAROLINA, TO PER-MIT
CONTROLLEID FISHING AND HUNTING ON LAKE BRANDT,
THE CITY'S PRIMARY WATER SUPPLY LAKE, FROM BOATS
OWNED AND CONTROLLED BY THE CITY AND ALSO TO PERMIT
SAILBOATING WITH PRIVATELY-OWNED SAILBOATS ON THE
LAKE FROM APRIL 1 TO OCTOBER 31, ACCORDING TO THE RULES
AND REGULATIONS ADOPTED BY THE CITY COUNCIL ON AUG-UST
1, 1960, was carried.
Mr. Jarrett also presented a similar request as the above from the City
of Greensboro to the State Board of Health to permit privately-owned
power boats on Lake Higgins, the City's secondary municipal water supply
lake downstream from Carlson Dairy Road bridge, and also to allow fish-ing
from boats only, hunting from blinds and sailboating from April 1 to
October 31. He stated that this request also had been thoroughly investi-gated
by his Division, and in view of all the information, he recommended
approval by the Board. On motion of Mr. Jackson, seconded by Dr. Good-win,
the RESOLUTION OF THE NORTH CAROLINA STATE BOARD
OF HEALTH AUTHORIZING THE CITY OF GREENSBORO, N. C,
TO PERMIT PRIVATELY-OWNED POWER BOATS ON LAKE HIG-GINS,
THE CITY'S SECONDARY MUNICIPAL WATER SUPPLY
LAKE, DOWNSTREAM FROM THE CARLSON DAIRY ROAD BRIDGE,
CONTROLLED FISHING FROM BOATS ONLY, CONTROLLED HUNT-ING
FROM BLINDS, AND SAILBOATING FROM APRIL 1 TO OCTO-BER
31, ACCORDING TO THE RULES AND REGULATIONS CON-CERNING
RECREATIONAL ACTIVITIES ON LAKE HIGGINS
ADOPTED BY THE CITY COUNCIL ON AUGUST 1, 1960, was carried.
Mr. Jarrett then discussed a request from the City of High Point for
permission from the State Board of Health to permit privately-owned
boats on City Lake for fishing purposes and controlled bank fishing at
designated areas. He stated that documents and other pertinent data had
been examined by his oflfice, and in his opinion, provided the rules and
regulations pertaining to fishing, boating, etc., on City Lake were carried
out he could see no damaging effects to the quality of raw water, and
recommended that permission of the Board be granted. On motion of Dr.
Bender, seconded by Dr. Dawsey, the RESOLUTION OF THE NORTH
CAROLINA STATE BOARD OF HEALTH AUTHORIZING THE CITY
OF HIGH POINT, N. C, TO PERMIT PRIVATELY-OWNED BOATS
FOR FISHING PURPOSES ON CITY LAKE, THE MUNICIPAL WA-TER
SUPPLY LAKE, AND FISHING FROM THE BANK IN THE
LAKE AT DESIGNATED AREAS, was carried.
At this point, there was some discussion on fish and animal "rendering
plants" and President Bugg asked that Mr. Jarrett report on the plant
at Southport at the next Board meeting.
14 Thirty-Ninth Biennial Report
Dr. Jacob Koomen, Jr., Assisant Director of Epidemiology, was asked
to discuss the possible need for regulations on tattooing. He stated that
from time to time the question of the public health aspects of tattooing
has come to the fore. This spring Dr. Norton was requested to look into
this matter by officials of Fort Bragg, with the idea of gathering informa-tion
especially as affecting areas around military establishments. No state,
with the exception of Hawaii, so far as could be determined, has any
statewide regulations about this. Newport News has a licensing system with
a licensing fee of $600.00 Some coastal cities. New York, etc., have
specific requirements such as certain standards of sanitation. In the main,
they demand a waiting room and operating suite and sanitary techniques.
He quoted the North Carolina Law, which states that it is unlawful for
any person or persons to tattoo any person under 21 years of age. This
is generally in keeping with all states except Hawaii. This matter was
brought up for information only and possible future action by the Board.
Dr. Lynn G. Maddry, Acting Director of the Laboratory Division, was
present and discussed further consideration of Certification of Industry
Milk Laboratories which had been circulated to Board members for study.
Dr. Maddry stated that since the laboratory certification program was
started in 1953, extensive changes have been made in the milk industry.
Changes have been made in the way milk is delivered from the producers
to the processors since it is being delivered now by tank truck, and all
milk is mixed as it comes in. This necessitates collection of an official
sample to precede the truck, eight samples per year, which works a
hardship on local health departments. In the past, the Public Health
Service has allowed local health departments to use results obtained from
industry laboratories as a part of their official grading samples. This
summer the Public Health Service ruled that results of analyses from
industry laboratories could not be used unless the industry laboratory was
certified as examining milk in accordance with Standard Methods. The
1953 policy prevented the State Board of Health from certifying industry
milk laboratories. We have had a number of requests from local health
departments to certify industry laboratories. We could go ahead and
certify these industry laboratories if the first two paragraphs of the
policy of 1953 were modified. When the policy was adopted before, the milk
was moving to the processor by cans and the required number of samples
could be collected without moving from the plant. Dr. Maddry read the
first two paragraphs of the 1953 policy and the proposed amendments to
these two paragraphs. Dr. Dawsey moved that the regulation proposed
in the first paragraph be accepted, seconded by Dr. Goodwin. Mr. Jackson
moved that the proposed amendment to the second paragraph be accepted,
and Dr. Dawsey seconded. Both paragraph revisions were passed un-animously.
As amended, paragraph #1 and #2 of the September 1953, general
policies would read as follows:
"That only laboratories operated by local health departments or
by cities, counties or other state agencies be considered for
certification, except that industry milk laboratories be certified
upon the request of local health departments only."
"That the building housing the laboratory applying for certifica-
North Carolina Board of Health 15
tion be owned or operated by a county, city or the State of North
Carolina, except that milk industry laboratories, approved at the
request of local health departments, may be located on private
property."
Dr. Preston presented and discussed legislation on medical assistance
for persons 65 and over. The 1960 amendments to the Social Security Act
provide, among other things, available Federal funds for states desiring
to make available medical care for either or both of the following two
groups of persons over 65 years of age : —
1. Recipients of old age assistance.
2. Persons who are not recipients of old age assistance but whose
income and resources are insufficient to meet all the costs of certain
medical care.
Each state must work out a plan acceptable to the Secretary of the De-partment
of Health, Education and Welfare. This plan must designate
one agency or create a single agency to supervise the medical care in-cluded.
We are advised that present legislation in North Carolina is not
adequate to make these programs available in this State. The Executive
Council of the Medical Society of the State of North Carolina has passed
a resolution and forwarded it to Governor Hodges proffering the coopera-tion
of the Committee on Chronic Illness with whatever agency and
officials may be designated to formulate plans and policies concerning
the medical assistance provisions of these amendments. Dr. Ellen Winston,
Commissioner of the State Board of Public Welfare, has indicated that
that Board is studying the amendments and conferring with Washington
officials of the Department of Health, Education and Welfare to determine
appropriate opportunities and responsibilities of that Board with regard
to the old age assistance program and the pooled fund for hospitalization.
Following discussion. Dr. Dawsey moved, seconded by Dr. Edwards,
that the State Board of Health ask Dr. Norton and Dr. Bender to re-present
the State Board in conference with top officials of the Department
of Health, Education and Welfare so as to ascertain opportunities and
responsibilities which might properly be of concern to this Board and to
recommend such action as the facts and their judgment would indicate.
Secretary Norton discussed representation to the North Carolina Health
Council from the State Board of Health of two members to represent the
Board. On motion of Dr. Dawsey, seconded by Mr. Jackson, Dr. Jacob
Koomen and Mrs. Lula Belle Rich, were unanimously elected as voting
delegates to represent the Board of Health at meetings of the North
Carolina Health Council.
Dr. Norton gave a brief verbal report on poliomyelitis cases. As
information, President Bugg reported that Dr. S. F. Ravenel, Chairman
of the Committee on Salk Vaccine for the Medical Society of the State
of North Carolina, has requested from the Advisory Budget Commission,
a renewal of the $216,000.00 appropriation made available for purchase of
polio vaccine for the present biennium, that the Medical Society Execu-tive
Council has approved his committee action and he recommended
16 Thirty-Ninth Biennial Report
Board and staff support so that our program should continue on exactly
the same basis for the next two years.
Secretary Norton also announced that the Medical Society's Committee
on School Health is sponsoring a State Conference on School Health,
Saturday, October 22, at the Sir Walter Hotel and urged all who could
to attend. He also announced the Annual Conference of Local Health
Directors, December 5 and 6, 1960, Sir Walter Hotel, Raleigh, and ex-tended
an invitation to the Board members to attend. Adjournment
12:20 p.m.
December 2, 1960. There was a special called meeting of the North Carolina
State Board of Health held Friday, December 2, 1960, 1:30 p.m. - 3:30 p.m.,
in the Board Room of the Cooper Memorial Health Building, President
Charles R. Bugg, presiding.
Attending: Dr. Charles R. Bugg; Dr. John R. Bender; Dr. Z. L.
Edwards; Dr. Lenox D. Baker; Mr. Jasper C. Jackson;
Dr. Ben W. Dawsey; Dr. Oscar S. Goodwin.
The meeting was called to order by President Bugg. On motion of Mr.
Jasper C. Jackson, seconded by Dr. Ben W. Dawsey, the minutes of the
October 6, 1960, Board meeting were approved as circulated by the
Secretary.
Commissioner of Agriculture, L. Y. Ballentine, appeared before the
Board and discussed informally the increasing use of weight-reducing
products, either singly or in combination with other foods, including milk.
The Board of Agriculture is placed in a difficult position when their
use is accepted under the Pure Food and Drug Laws, and must be
reconciled with the definitions and standards for milk. As an example,
reference was made to a request that had been received, or was expected,
for the addition to milk of a product similar to Metrecal. A question was
also raised as to the public health justification for the fortification of
milk and other foods with various minerals and vitamins. Commissioner
Ballentine stated that he was quite concerned regarding this subject and
would like to have the views and recommendations of the State Board of
Health. The Board took the request under consideration but no action
was requested or taken at this time.
At this time President Bugg presented a plaque (An Appreciation and
A Resolution) to Dr. John H. Hamilton, who retired as Director of the
Laboratory of Hygiene and Assistant State Health Director, April 30,
1960. Dr. Hamilton accepted the plaque and expressed his appeciation
and thanks to the Board.
Mr. John Andrews, Chief of the Sanitation Section, Sanitary Engineer-ing
Division, presented a request from the North Carolina State Board
of Cosmetic Arts, to amend their regulations as previously adopted in
1959, to include their system of scoring as part of the regulations. Mr.
Andrews explained these changes and recommended the approval of the
amendments to the re^gulations. On motion of Dr. Dawsey, seconded by
Mr. Jackson, the revisions to be incorporated in the rules and regulations
of the State Board of Cosmetic Arts, were passed.
North Carolina Board of Health 17
Mr. W. S. McKimmon of the Engineering Section, presented a resolu-tion
for the dissolution of a portion of the Dare Beaches Sanitary District,
Dare County, North Carolina. He stated that in 1949 the State Board
of Health passed a resolution creating a proposed sanitary district to be
known as the Dare Beaches Sanitary District in Dare County for the
purpose of securing a good community water supply in that area. Since the
district was created they have had five different bond elections and every
one has failed due to the fact that the people living in this particular area
to be excluded have voted against the bond issue, and hence the water
system has not been installed at the present time. He stated that the
Sanitary District Board are of the opinion that if the proposed area is
dissolved that they will be able to get a bond election passed and will
then have finances to install a badly needed water system in the Sanitary
District. He further stated that a petition was circulated in the proposed
area to be dissolved and was signed by fifty-one per cent (51%) or more
of the resident freeholders. The petition was then presented to the Board
of Commissioners of the Dare Beaches Sanitary District with the request
that that portion of the Sanitary District be dissolved. The Sanitary
District Board of Commissioners determined that the Sanitary District
had no indebtedness against it, as required by law, and adopted a resolu-tion
approving the dissolution of that portion of the Sanitary District as
requested and that the boundaries of the remaining area be redefined.
The petition was then presented to the Board of Commissioners of Dare
County with the request that they approve the petition and call an tlection
so that all of the people in the newly proposed and defined District could
vote concerning the dissolution. The Board of County Commissioners
approved the petition and duly called an election to be held within the Dis-trict
September 10, 1960. The said election was held at the said time
and the people voted in favor of the dissolution by a large majority.
The Board of Commissioners of Dare County then had the vote in the
election certified by the proper authorities and adopted a resolution
certifying the election and requesting the North Carolina State Board of
Health to approve the dissolution of that portion of the Dare Beaches
Sanitary District as described in the petition and to redefine the remain-ing
area in the Sanitary District.
Mr. McKimmon pointed out that the Sanitary Engineering Division had
examined and reviewed in detail the procedure carried out for the dis-solution
of that portion of the District as described in the petition and
had discussed in detail the legal aspects of the procedure with Mr. Harry
McGalliard, Assistant Attorney General, and that Mr. McGalliard stated
that in his opinion the procedure was carried out according to Section
130-150, General Statutes of North Carolina, and that all documents were
in order. He then requested the State Board of Health to consider with
favor and approve the dissolution of that portion of the Dare Beaches
Sanitary District as described in the petition and redefine the boundaries
of the remaining area in the District.
On motion of Mr. Jackson, seconded by Dr. Dawsey, the following
resolution was adopted by the State Board of Health:—RESOLUTION
OF THE NORTH CAROLINA STATE BOARD OF HEALTH DIS-
18 Thirty-Ninth Biennial Report
SOLVING A PORTION OF THE AREA OF THE DARE BEACHES
SANITARY DISTRICT, DARE COUNTY, NORTH CAROLINA, AS
DESCRIBED IN THE ORIGINAL PETITION AND IN THIS RESOLU-TION
AND ESTABLISHING THE NEW BOUNDARIES OF THE DARE
BEACHES SANITARY DISTRICT.
Dr. Edwin S. Preston, Public Relations Officer, suggested that a con-gratulatory
telegram be sent to Governor Abraham Ribicoff, Hartford,
Connecticut, the newly appointed Secretary of Health, Education and
Welfare by President-Elect Kennedy. On motion of Mr. Jackson, seconded
by Dr. Edwards, the following message was dispatched to Governor Ribicoff
by the Board:
"The North Carolina State Board of Health extends felicitations
to you as the choice of President-Elect Kennedy for Secretary
of Health, Education and Welfare. We feel that your demonstrated
understanding in these areas and your outstanding state admini-stration
in Connecticut make this choice a happy one for the
Nation.
Signed: Charles R. Bugg, M. D., President
J. W. R. Norton, M. D., State Health Director"
At the request of President Bugg, Dr. Amos Johnson, President of the
Medical Society of the State of North Carolina, presented to the State
Board, as information, facts concerning the Medical Assistance for the
Aged provisions of the August 1959 amendments to the Social Security
Act (PL86-779) passed by Congress. Dr. Johnson gave a report on the
November 27 meeting in Washington sponsored by the American Medical
Association to consider this program. He also voiced the viewpoints ex-pressed
in a recent meeting of the Executive Council of the Medical
Society of the State of North Carolina. This law provides federal appro-priations
to be matched by the state on approximately a four federal
dollars to one state and one local dollar basis. Dr. Johnson stated that
the Medical Society recommends that this program be decentralized and
kept as far away as possible from politics, that fiscal management be han-dled
through the Blue Cross, Blue Shield companies who already have the
facilities and could administer it at a much lower cost than a state agency
could, and that a state committee be appointed as a part of the North
Carolina plan to work out the ground rules and regulations. As to
eligibility, the Medical Society recommends that the program be limited
to persons having less than approximately $1,000.00 per year income, with
not more than $1,000.00 in liquid assets for a single person, or $2,000.00
for a couple, and not over $7,500.00 in property.
Dr. Baker made a motion to the effect that this item was discussed and
it was the consensus of the Board that the purpose of this Board
is for education and for preventive medicine and not for the private
practice of treatment medicine. We, as a State Board, therefore, should
take no action since such laws are out of our domain, and any time our
services are needed, the President of the Board or the State Health
Director, if requested, will meet with any group to consider any sugges-tion
related to this matter. Dr. Edwards seconded the motion, and carried.
North Carolina Board of Health 19
Mr. Marshall Staton of the Sanitary Engineering Division, reported
upon an investigation of odors emanating from fish processing plants near
the bridge on Highway #40 near Youpon Beach in Brunswick County.
He described the process, the principal sources of odor, and possible remedial
measures. Since there are no State laws on air pollution at present, there
appears to be no way of requiring the plants to install ordor-control
devices; and, because of economic conditions in the industry it is likely
that the plants may shortly discontinue operations. However, Mr. Staton
stated that he would investigate the possibility of adapting a relatively inex-pensive
chemical odor-control treatment that has been used in some sewage
treatment plants. This report was presented to the Board for its informa-tion
as requested, and no official action was taken.
Dr. Dawsey raised a question regarding the "Rules and Regulations Pro-viding
Minimum Sanitation Requirements for the Dispensing of Foods and
Beverages Through Vending Machines," which had been adopted by the
Board on May 11, 1960, to become effective January 1, 1961.
Dr. Dawsey had received a letter from Dr. B. M. Drake, Local Health
Director of Gaston County, who felt that the regulations do not give
sufficient authority to the Local Health Director, and that the provision
for permit revocation is too cumbersome.
In discussing this matter, Mr. Andrews pointed out that the regulations
call for permits to be issued by the State Health Director, upon the recom-mendation
of the Local Health Director, and to be revoked by the State
Health Director, upon the recommendation of the Local Health Director.
Also, the vending regulations, unlike some of the older regulations, pro-vide
an opportunity for a hearing before revocation of permit. Mr. Andrews
stated that it is now quite customary to include such a provision for a
hearing in regulations which authorize an agency to revoke a person's
license to engage in a business which may affect the public Health. He
also stated that the fixing of responsibility for issuing and revoking per-mits
upon the State Health Director was included in the regulations
because many vendor companies operate and service machines in several
counties in addition to the county in which the commissary is located. For
this reason the vending machine industry representatives, who had re-quested
the adoption of regulations, felt that there should be State Health
Director review of the revocation of a permit for an operation involving
several counties.
Mr. Andrews expressed the opinion that it is difficult to know, before
the regulations are tried out, whether or not changes are needed, but
commented that it is to be expected that some changes will be found neces-sary
after the regulations have been tired out, and that appropriate
changes can be submitted for the Board's consideration at a later date.
It was decided that no action be taken at this time. Meeting adjourned at
3:50 p.m.
February 14, 1961. The quarterly meeting of the North Carolina State
Board of Health was held Tuesday, February 14, 1961, 10:00 a.m. -
1 :00 p.m., in the Board Room of the Cooper Memorial Health Building,
President Charles R. Bugg, M. D., presiding.
20 Thirty-Ninth Biennial Report
Prior to the meeting, Mrs. W. Kerr Scott took the Oath of Office in
Governor Terry Sanford's office, administered by Secretary of State, Thad
Eure. Mrs. Scott was appointed by Governor Sanford to the vacancy of
the unexpired term of Mrs. J. E. Latta, resigned, the term expiring May,
1961—with the additional announcement of his intention for Mrs. Scott to
serve for a four-year term then.
Following the oath-taking ceremony in the Governor's office, the Board
went into regular session in the Board Room. Mrs. Scott was introduced
and greeted as a new member of the Board.
Attending: Dr. Charles R. Bugg; Dr. John R. Bender; Dr. Z. L. Edwards;
Dr. Lenox D. Baker; Mr. Jasper C. Jackson; Dr. Ben W.
Dawsey; Dr. Oscar S. Goodwin; Mrs. W. Kerr Scott.
On motion of Dr. Lenox D. Bak'er, seconded by Dr. Oscar S. Goodwin,
the minutes of the December 2, 1960, meeting were approved as circulated
by the Secretary.
Mr. W. S. McKimmon, Sanitary Engineering Division, presented a re-quest
for the creation of a proposed Junaluska Sanitary District in
Haywood County, North Carolina. He stated that the petition had been
signed by at least 51% of the resident freeholders within the proposed
sanitary district,—that a resolution had been adopted by the Board of
County Commissioners approving the creation and requesting the State
Board to create the district, and that the various documents and trans-actions
had been examined and approved by the Sanitary Engineering
Division; also that the transactions and documents pertaining to the
proposed sanitary district had been discussed with the Assistant Attorney
General, who expressed the opinion the procedure was in accordance
with Chapter 130, Article 12 of the General Statutes of North Carolina,—
and therefore, the Sanitary Engineering Division recommended the
establishment of the creation of the Junaluska Sanitary District as re-quested,
be approved. Upon motion of Dr. Baker, seconded by Dr. Goodwin,
the RESOLUTION OF THE NORTH CAROLINA STATE BOARD OF
HEALTH CREATING THE JUNALUSKA SANITARY DISTRICT
LOCATED IN HAYWOOD COUNTY, NORTH CAROLINA, was un-animously
carried.
Mr. Frank Taylor of Goldsboro, N. C, Attorney for the North Carolina
Meat Packers Association, was present and discussed proposed legislation
for a compulsory State-wide meat and poultry inspection program to
be presented to the General Assembly and sponsored by the North Carolina
Agriculture Department. The purpose, objectives and need for this pro-gram
were discussed by Dr. Martin P. Hines, Chief of the Public Health
Veterinary Section, and Mr. Taylor.
Mr. Taylor stated that as soon as the proposed bill is drafted the State
Board of Health will receive a copy and would have the opportunity of
making suggestions for change in the proposed law. He solicited the
cooperation and approval of the proposal, in principle, by the State Board
of Health. Following the discussion. Dr. Baker moved that the Board
approve and support, in principle, the plan for mandatory inspection of
North Carolina Board op Health 21
meat and poultry as presented by Mr. Taylor. Motion seconded by Dr.
Dawsey, and carried.
Mr. Charles L. Harper, Director of Administrative Services, and Dr.
Jacob Koomen, Assistant Director, Epidemiology Division, made a report
on the recommendations of the budget of the Advisory Budget Commission
concerning the State Board of Health's appropriation for the biennium
1961-1963.
A brief statement of explanation of the "A" and "B" Budget was given.
The "A" Budget represents the amount required to continue the program
at the same level as in the current biennium, and the "B" Budget repre-sents
the amount required to develop new programs needed or expand as
needed, those which are already in existence.
Dr. Koomen presented a brief summary of the items in the "B" Budget
for which funds were requested and Mr. Harper followed giving the
amounts represented by the request in each program.
Dr. Norton advised the Board that he had reviewed the Advisory Budg-et
Commission's recommendations with the Division Directors and Sec-tion
Chiefs but had not attempted to make specific recommendations as to
which of the requested items should be appealed. He also presented the
items each Division Director and Section Chief indicated should be
appealed and also those which because of subsequent development, the
program directors involved did not feel that an appeal was indicated. Dr.
Norton asked for guidance from the Board as to the approach it wanted
taken in connection with an appeal to the Joint Appropriations Committee.
After discussion, on motion of Dr. Baker, seconded by Mr. Jackson and
Dr. Goodwin, Dr. Norton was instructed to counsel with the staff and
then to appeal to the Joint Appropriations Committee for such additional
funds as are needed in the programs of the State Board of Health beyond
the recommendations of the Advisory Budget Commission. Motion carried.
Mr. Harper reported that the appropriation for the biennium 1959-1961
for the State Board of Health did not include funds for the purchase of
polio vaccine,—the cost of such vaccine being paid for from the Contin-gency
and Emergency Fund in accordance with provisions of the com-pulsory
poliomyelitis immunization law. He stated that the same pro-visions
will apply to the 1961-1963 biennium budget.
Dr. W. L. Wilson, Chief, Occupational Health Section, was present
and discussed voluntary registration of radiation sources. He presented
a proposed form and instructions to accompany the form which, if ap-proved
by the State Board of Health, will be distributed to all professional
people in the State so that they might voluntarily register X-ray equip-ment,
isotopes, including radium, and other ionizing radiation in accord-ance
with the letter sent to Board members on January 4, 1961. Dr. Baker
moved, Dr. Dawsey seconded, and the Board approved unanimously the
distribution of the proposed registration forms for voluntary registration
of radiation sources.
For information, Secretary Norton distributed to the Board members a
copy of Senate Bill #13, entitled "BILL TO BE ENTITLED AN ACT TO
AMEND CERTAIN SECTIONS OF THE GENERAL STATUTES TO
22 Thirty-Ninth Biennial Report
PROVIDE FOR THE LICENSING OF NURSING HOMES BY THE
STATE BOARD OF HEALTH RATHER THAN BY THE NORTH
CAROLINA MEDICAL CARE COMMISSION AND THE STATE
BOARD OF PUBLIC WELFARE" as introduced by Senator Cook at the
suggestion of the present State Administration. The proposal by Senator
Cook is that the licensing of Nursing and Convalescent Homes be trans-ferred
to the State Board of Health rather than the continuance of licensing
by the Medical Care Commission and the State Board of Public Welfare. Dr.
Norton stated that this transfer had been discussed from time to time, and
that in principle, it is good, but nothing had been done prior to the intro-duction
of this bill. No action needed.
Dr. Jacob Koomen discussed the present status of communicable disease
regulations. He pointed out that the North Carolina regulations were
last revised in toto in 1944 and additional regulations have been written
from time to time to keep in line with modern communicable disease prac-tice.
The present discussion is related to the fact that Dr. Bugg received
a letter from one of the State's pediatricians pointing out that the regu-lations
for control of streptococcus infections needs further modernization.
In order to modernize our regulations they may be either re-written, or,
as determined in consultation with Mr. Roddey Ligon of the Institute of
Government, the regulations may be taken by reference from the APHA
Manual "CONTROL OF COMMUNICABLE DISEASE IN MAN." The
latter has much to recommend it since the Manual is revised regularly
every five years. Dr. Baker moved, seconded by Mr. Jackson, that the
Board modernize the Communicable Disease Regulations, Supplement No.
I, Volume 60. Motion carried.
Dr. Charles B. Kendall, Chief, Crippled Children's Section, discussed a
meeting of the Advisory Committee to that Section which is contemplated
late in March and recommended that the following members be designated:
"The heads of departments of orthopedic surgery in the three schools
—
with Dr. J. Leonard Goldner acting for Dr. Baker during the latter's
tenure of office on the State Board of Health.
Dr. William Roberts Orthopedics
Dr. Everett I. Bugg Orthopedics
Dr. Stanley S. Atkins Orthopedics
Dr. Hugh Thompson Orthopedics
Dr. Kenneth Pickrell Plastic Surgery
Dr. Eben Alexander Neuro Surgery
Dr. John Rhodes Urology
Dr. Paul Sanger Thoracic and Heart Surgery
Dr. W. Elliot White (Ped.) Rheumatic Fever and Heart
Dr. Roderick Ormandy . . (Speech pathology) Speech and Hearing
Dr. Melvin P. Hoot (ENT, Greenville)
Dr. Angus McBryde Pediatrics
Mr. Charles H. Warren Vocational Rehabilitation
Mr. James Barnes Medical Society of North Carolina
Mr. Joseph E. Barnes Hospital Administrator"
North Carolina Board of Health 23
Motion for approval was made by Dr. Baker, seconded by Dr. Bender,
and passed.
Dr. Kendall also presented a proposal concerning the adoption by the
Board of a program in support of convulsive seizures, a proposal which
had previously been circulated to Board members. By common consent the
Board authorized Dr. Kendall to proceed to formulate this plan for ap-proval
by the Children's Bureau with a view of implementation in the last
quarter of the current fiscal year if funds are found at that time to be
available for this purpose.
Dr. Lenox Baker made a motion that the present officers of the Board
continue to serve until the first meeting after July 1, 1961. This was
seconded by Mr. Jackson, and carried. Meeting adjourned 1:15 p.m.
May 10, 1961. The annual meeting of the North Carolina State Board
of Health was held, as required by law, during the annual meeting of the
Medical Society of the State of North Carolina, in the Sundial Room of
the George Vanderbilt Hotel in Asheville, N. C, Wednesday, May 10, 1961,
8:30 a.m. to 9:30 a.m.. Dr. Chai-les R. Bugg, President, presiding.
Attending: Dr. Charles R. Bugg; Dr. John R. Bender; Dr. Lenox D.
Baker; Dr. Roger W. Morrison; Mr. Jasper C, Jackson; Dr. Ben W.
Dawsey; Dr. Oscar S. Goodwin; Mrs. W. Kerr Scott.
On motion of Dr. Lenox D. Baker, seconded by Dr. Oscar S. Goodwin,
the minutes of February 14, 1961, were approved as circulated by the
Secretary.
Mr. R. F. Hill, District Engineer, Sanitary Engineering Division, pre-sented
a request for the creation of Charlotte College Community Sanitary
District. He stated that the various documents and transactions had been
examined and appi'oved by the Sanitary Engineering Division and were
found to be in accordance with the General Statutes of North Carolina, and
therefore, the Sanitary Engineering Division recommends that the estab-lishment
of the Charlotte College Community Sanitary District as re-quested,
be approved. Upon motion of Dr. Baker, seconded by Dr. Dawsey,
the RESOLUTION OF THE NORTH CAROLINA STATE BOARD OF
HEALTH CREATING THE CHARLOTTE COLLEGE COMMUNITY
SANITARY DISTRICT LOCATED IN MECKLENBURG COUNTY,
NORTH CAROLINA, was unanimously carried.
Mr. Hill also discussed a request for the creation of the Boger City
Sanitary District. He stated that all documents and transactions had been
thoroughly examined and investigated by the Sanitary Engineering Divi-sion,
and found to be satisfactory, and that in view of this, the Sanitary
Engineering Division recommends approval of the creation of the Boger
City Sanitary District as requested. On motion of Dr. Goodwin, seconded
by Mr. Jackson, the RESOLUTION OF THE NORTH CAROLINA STATE
BOARD OF HEALTH CREATING THE BOGER CITY SANITARY DIS-TRICT
LOCATED IN LINCOLN COUNTY, NORTH CAROLINA, was
carried,
A request from the City of Wilson that they be granted permission to
permit controlled fishing from boats and controlled fishing from designated
24 Thirty-Ninth Biennial Report
areas on the banks which are approved by representatives of the State
Board of Health; and also permission to permit water skiing and boating
on Winstead Mill Lake, the City's secondary or Class II reservoir, was
brought to the Board's attention by Mr. Hill. He reported that the lake
had been investigated by the Sanitary Engineering Division and they are
of the opinion that controlled fishing, boating, and water skiing, if the
controlling regulations are strictly enforced, will not adversely affect the
quality of the raw water to the point of rendering it unsatisfactory for
use as a public water supply and, therefore, approval by the Board was
recommended. On motion of Dr. Baker, seconded by Dr. Bender, the RESO-LUTION
OF THE NORTH CAROLINA STATE BOARD OF HEALTH
AUTHORIZING THE CITY OF WILSON, NORTH CAROLINA, TO PER-MIT
CONTROLLED FISHING AND OTHER RECREATIONAL ACTIVI-TIES
ON AND AT WINSTEAD MILL LAKE, WILSON'S MUNICIPAL
CLASS II LAKE, was carried.
Request of the City of Burlington, North Carolina, that they be granted
permission to permit controlled fishing, boating, water skiing and picnicking
on and at Burlington Lake, the City of Burlington's Class II water supply
lake was then discussed. Mr. Hill stated that the Sanitary Engineering
Division had investigated this request and is of the opinion that if the
recreational activities are strictly enforced, that the quality of the water
will not be adversely affected to a point where it would be rendered unfit
for use as a public water supply and that the Board consider with favor
the controlled recreational activities requested. On motion of Dr. Baker,
seconded by Dr. Bender, the RESOLUTION OF THE NORTH CAROLINA
STATE BOARD OF HEALTH AUTHORIZING THE CITY OF BUR-LINGTON,
NORTH CAROLINA, TO PERMIT CONTROLLED FISHING
AND OTHER CONTROLLED RECREATIONAL ACTIVITIES ON AND
AT LAKE BURLINGTON, THE CITY OF BURLINGTON'S CLASS II
WATER SUPPLY LAKE, was carried.
Mr. Hill then presented a request from the City of Durham, North Caro-lina,
that they be granted permission to permit controlled fishing from
boats and bank, boating, picnicking, archery and camping on and at Lake
Michie, the City of Durham's Class I water supply lake. Mr. Hill stated
that the Sanitary Engineering Division had thoroughly investigated this
request and recommended approval by the Board. On motion of Dr. Baker,
seconded by Dr. Bender, the RESOLUTION OF THE NORTH CARO-LINA
STATE BOARD OF HEALTH AUTHORIZING THE CITY OF
DURHAM, NORTH CAROLINA, TO PERMIT CONTROLLED FISH-ING
AND OTHER CONTROLLED RECREATIONAL ACTIVITIES ON
AND AT LAKE MICHIE, THE CITY OF DURHAM'S CLASS I WATER
SUPPLY LAKE, was unanimously carried.
Dr. Bugg discussed a proposed letter he had drafted as President of
the State Board of Health to Mr. D. S. Coltrane, Director of the Depart-ment
of Administration, a copy of which was sent to Board Members,
recommending a salary increment, effective July 1, 1961, from $17,000 to
$20,000, for the State Health Director. On motion of Dr. Bender, seconded
by Mr. Jackson, the recommendations of Dr. Bugg as contained in the
letter proposed to be sent were approved.
North Carolina Board of Health 25
Dr. D. F. Milam, medical director of the Nursing Home Section of the
State Board of Health, outlined rules and regulations being proposed for
the licensing of nursing homes by the State Board of Health. Licensing
responsibility was transferred from the Medical Care Commission to the
State Board of Health on March 17, 1961, by action of the 1961 General
Assembly. Dr. Milam indicated that the rules and regulations being pro-posed
at the present time would be a continuation of those in operation
by the Medical Care Commission until further study may indicate needed
changes.
Dr. Milam also gave the membership of a ten-member nursing home
advisory council which would be particularly helpful in the transition
adjustments, composed of the following:
A doctor of medicine licensed to practice in North Carolina and recom-mended
by the Medical Society of the State of North Carolina.
A doctor of dentistry licensed to practice in North Carolina and recom-mended
by the North Carolina Dental Society.
A registered pharmacist licensed to practice in North Carolina and
recommended by the North Carolina Pharmaceutical Association.
A registered nurse licensed to practice in North Carolina and recom-mended
by the North Carolina State Nurses Association.
An administrator of a general hospital in North Carolina and recom-mended
by the North Carolina Hospital Association.
The Commissioner of Welfare of the State of North Carolina or her duly
appointed representative.
Two representatives of the licensed nursing homes of North Carolina
and recommended by the North Carolina Association of Nursing Homes.
Two individuals representing the community and serving as represen-tatives
of the consumers of the services offered.
On m.otion of Mr. Jackson, seconded by Dr. Goodwin, the Temporary
Rules and Regulations of Nursing Homes in North Carolina, and the
membership of the Advisory Council, were approved.
Dr. W. L. Wilson, heading up the State Radiological Health program of
the State Board of Health, presented facts concerning progress made in
the State Radiological Health Program. Dr. Wilson set forth briefly the
program required under the 1959 Act, the considerable achievements to-date
made without any additional means having been provided, actions still
necessary solely due to lack of sufficient means to implement properly the
1959 Act, and handling of serious radiological accidents or emergencies.
He indicated that the North Carolina Act of 1959 sets forth not only
certain specific responsibilities of the State Board of Health, but in addi-tion
other actions authorized but not required. The act also authorized the
State Board of Health to "do any and all other acts deemed desirable in
providing an effective protection program" to preserve the public health
from ionizing radiation.
Upon Dr. Baker's motion, seconded by Dr. Dawsey, the Board supported
the State Health Director's interpretation of further actions essential to
protect the public health against dangerous ionizing radiation at the
earliest practicable time; the Board directed the State Health Director
to proceed with maximum speed to implement all desirable acts to protect
public health and safety in accordance with the North Carolina Act of
26 Thirty-Ninth Biennial Report
1959, and to seek assistance required in order to obtain any necessary
additional enabling legislation.
Dr. Bugg and Dr. Norton presented a proposed amendment to the rec-ommended
schedule of polio shots for the immunization of young children.
This schedule has the approval of the Chairman of the Poliomyelitis Vac-cine
Committee of the Medical Society of the State of North Carolina and
of Dr. Bugg, President of the State Board of Health. The Board approved
a recommendation for a dose every other year after the four doses already
recommended by the Board. On motion of Dr. Baker, seconded by Dr. Ben-der,
this schedule was approved.
Dr. Fred T. Foard, Director of the Division of Epidemiology, presented
as information, facts concerning the budget of the Venereal Disease Con-trol
Section. Funds for this work are provided 100 percent by the U. S.
Public Health Service. The budget will remain the same as last year
though the U. S. Public Health Service is assigning two additional venereal
disease investigators to the State. Dr. Foard also gave a report on the 1960
quadruple rise in cases of infectious hepatitis and indicated that the ex-perience
in North Carolina is similar to that which is being experienced in
other parts of the nation.
Dr. Norton reported to the Board, as information, the progress thus far
of the Bill, S. B. 244, providing for compulsory meat inspection. This Bill
is sponsored by the State Department of Agriculture and the State Board
of Health had previously taken action endorsing such a bill in principle.
Dr. Norton gave additional facts concerning provisions of the Bill and
indicated that in its present form, it merits continuing support by the
State Board of Health.
On motion duly made and seconded, the Board meeting recessed at 9:30
a.m. to meet in Conjoint Session with the Medical Society of the State
of North Carolina as required by law at which President Bugg presided.
There was recognition of Board members present and then Dr. J. W. R.
Norton, Secretary-Treasurer of the Board and State Health Director, pre-sented
his annual report.
September 29, 1961. At 9:30 a.m. the members of the State Board of
Health who were to be sworn in took the Oath of Office in the Senate
Chamber of the State Capitol Building. Secretary of State, Mr. Thad
Eure, called the occasion to order and presented Governor Terry Sanford.
The Governor called the five members forward and the Oath was delivered
by Associate Justice Emory B. Denny of the North Carolina Supreme
Court.
Those receiving the Oath of Office included the two elected in the May,
1961, meeting of the Medical Society of the State of North Carolina, all
4-year terms ending June 30, 1965:—Charles R. Bugg, M. D., Raleigh, and
John R. Bender, M. D., Winston-Salem.
Appointees of the Governor included Lenox D. Baker, M. D., Durham,
Glenn L. Hooper, D. D. S., Dunn, and Mr. D. T. Redfearn, Wadesboro.
Many friends including members of the staff of the State Board of Health
witnessed the ceremony.
North Carolina Board of Health 27
The Governor expressed appreciation for the leadership of Dr. J. W. R.
Norton as State Health Director, and commented on the constructive pro-gram
of public health which the State Board of Health is promoting with
limited funds.
After the above oath-taking ceremony, members moved to the Board
Room in the Cooper Memorial Health Building for the regular quar-terly
Board meeting.
The meeting was called to order by President Bugg who welcomed the
new members of the Board and stated that all were looking forward to
working together.
Attending: Dr. Charles R. Bugg; Dr. John R. Bender; Dr. Lenox D.
Baker; Dr. Roger W. Morrison; Dr. Ben W. Dawsey; Dr. Oscar S. Good-win;
Dr. Glenn L. Hooper; Mr. D. T. Redfearn,
On Motion of Dr. Dawsey, seconded by Dr. Bender, the minutes of the
Board meeting held on May 10, 1961, were approved as circulated to
members.
President Bugg announced that it was time for the election of officers
and a new Executive Committee member, and asked that Dr. Glenn L.
Hooper preside while he, as President, withdrew from the Board Room.
On motion of Dr. Bender, seconded by Dr. Baker, Dr. Charles R. Bugg was
unanimously re-elected President of the Board by acclamation. Dr. Bugg
returned and chaired as President, and Dr. Bender retired from the room.
Dr. Dawsey moved that Dr. John R. Bender be re-elected as Vice-
President. Motion seconded by Dr. Goodwin, and unanimously passed.
Dr. Oscar S. Goodwin moved that Dr. Ben W. Dawsey be nominated to
serve on the Executive Committee. Motion seconded by Dr. Hooper, and
unanimously carried.
Dr. Fred T. Foard, Director of the Division of Epidemiology, gave a
report on the poliomyelitis situation this year, 1961, so far. He stated we
have had the lowest poliomyelitis rate in the history of the State,—only 12
cases reported so far, of which five were paralytic. The vaccination record
of paralysis cases show that only one of these five individuals had re-ceived
the four recommended inoculations.
As further information for the Board, Dr. Foard discussed the hepa-titis
situation, since the State reported a total of 1,435 cases through
September 29, 1961, only five of which were suspected of being of the
serum type contrasted with the infectious type. After much discussion. Dr.
Baker moved that the Board, through the Attorney General's office, look
into the law, and possibly outline legislation, if needed, to require proper
sterilization of hypodermic needles and syringes used in administering
vaccine, drugs, or other parenteral injections. If found practical, this
legislation would be introduced in the next General Assembly. In the
meantime, he suggested that appropriate medical channel publicity be
intensified to guard against the dangers of inadequate sterilization. It was
recognized that only a very small fraction of cases could be prevented by
this approach. Motion seconded by Dr. Hooper, and unanimously carried.
Also, Dr. Foard reported on a food poisoning outbreak at Williamston
which occurred on September 6, the first day of school. A dinner was
28 Thirty-Ninth Biennial Report
given to the school children in one of the schools consisting of chicken
salad, pimento cheese and a salad with dressing as the three principal
foods. In addition milk was served. Feeding started at 11:00 a.m. and by
3:00 p.m. thirty children were seriously ill and seven were hospitalized
during that afternoon. Samples of the food served were obtained and sent
to the State Laboratory. Only one of the foods—chicken salad—showed
contamination which was by staphylococcus. An examination through cul-ture
taken of persons who prepared the food showed that the lady who
prepared the chicken salad was infected (nose and throat) with staphy-lococci.
Inadequate refrigeration, after preparation of the salad, increased
the danger. All children have recovered and were reported to be back in
school within a ten-day period.
Mr. J. M. Jarrett, Director of the Division of Sanitary Engineering,
presented proposed revisions to the regulations pertaining to submission
of plans, reports and specifications for water and sewerage system. He
stated that these regulations had been re-written and clarified in accord-ance
with the revised Public Health Laws as passed by the General
Assembly. Dr. Dawsey moved the adoption of the proposed REGULA-TIONS
PERTAINING TO SUBMISSION OF PLANS, REPORTS AND
SPECIFICATIONS FOR WATER AND SEWERAGE SYSTEMS. Motion
seconded by Dr. Baker, and carried.
Mr. Jarrett also presented a request for the extension of the boundary
lines of the East Marion Sanitary District. He stated that the documents,
as well as the various transactions relative to this matter had been ex-amined
by his office and with the Attorney General's office, and were found
in order, and he recommended favorable action by the Board. On Motion of
Dr. Baker, seconded by Dr. Goodwin, the RESOLUTION OF THE NORTH
CAROLINA STATE BOARD OF HEALTH EXTENDING THE BOUND-ARY
LINES OF THE EAST MARION SANITARY DISTRICT IN
MCDOWELL COUNTY, NORTH CAROLINA, was passed.
Mr. Jarrett presented a request by the City of Winston-Salem that they
be allowed to permit fishing from a pier constructed over a small portion
of Salem Lake, Winston-Salem's primary water supply lake. He stated
that an investigation had been made by the Division and with strict
regulations controlling fishing from the pier it will not affect the quality
of the water in an adverse manner. In view of all the information obtained,
Mr. Jarrett recommended approval by the Board. On motion of Dr. Daw-sey,
seconded by Mr. Redfearn, the RESOLUTION OF THE NORTH
CAROLINA STATE BOARD OF HEALTH TO PERMIT CONTROLLED
FISHING FROM PIER CONSTRUCTED OVER A PORTION OF SALEM
LAKE, WINSTON-SALEM'S CLASS I WATER SUPPLY RESERVOIR,
was passed.
Mr. C. M. White, Chief of the Insect and Rodent Control Section, pre-sented
and discussed proposed revisions of rules and regulations relating
to State aid to mosquito control districts or other local governmental units
engaged in mosquito control undertakings. These changes became necessary
by the new legislation passed by the 1961 General Assembly. After a full
discussion of these changes, Mr. White recommended the adoption of the
proposed amendments. Dr. Baker moved approval of the amendments en-
North Carolina Board of Health 29
titled NORTH CAROLINA STATE BOARD OF HEALTH RULES AND
REGULATIONS GOVERNING STATE AID TO MOSQUITO CONTROL
DISTRICTS OR OTHER LOCAL GOVERNMENTAL UNITS ENGAGED
IN MOSQUITO CONTROL UNDERTAKINGS. Motion seconded by Dr.
Bender, and carried.
Secretary Norton announced that he was happy to report that he had
been successful in obtaining approval of Dr. Jacob Koomen, Jr., to become
Assistant State Health Director, provided approval is given by the State
Board of Health. He presented, for the Board's information, a biographical
sketch and bibliography of Dr. Koomen's achievements and stated that he
had been a member of the staff here for the past five years. Also, he
said that the matter had been discussed with Governor Terry Sanford and
the Governor stated he would approve the appointment. Secretary Norton
recommended, if the Board approved Dr. Koomen's selection as Assistant
State Health Director, that his services begin as of October 1, 1961, and
that he be paid the maximum salary of the present range at $16,452.
Dr. Baker moved, seconded by Dr. Goodwin, that the Board employ the
services of Dr. Koomen as Assistant State Health Director at maximum
salary of the present range, effective October 1, 1961. Motion unanimously
carried.
A full report was made to the Board members by Dr. Bugg regarding
the letter he had sent to the Department of Administration at the Board's
direction May, 1961, recommending a salary increase for Dr. Norton, effec-tive
July 1, 1961, from $17,000 to $2€,000 per year. It appeared that the
consensus was that the Director's salary is not in keeping with, nor ade-quate
for, his position in the health field. Dr. Baker moved that President
Bugg write another letter to the Governor and Advisory Budget Commis-sion
pointing out the fact that Dr. Norton is to be named President-Elect
of the American Public Health Association and has received other honors
and what it means to our State to have such a leader, and to urge the
Governor and Advisory Budget Commission to make available the deserved
increase. Dr. Bugg was further asked to tell the Governor that he has the
wholehearted and unanimous approval of the Board in this request. Motion
seconded by Dr. Goodwin, and carried unanimously.
Secretary Norton also reported that (a) the Board is urgently in need
of a Director to head up the Mental Health Division and we have had an
outstanding applicant. The salary scale is not, however, sufficient to interest
a psychiatrist with the qualifications required in the job. Also, that a
properly qualified pathologist is not available at the present range set
for the Director of the Laboratory Division, (b) Mr. Jackson advised by
telephone that he would be unable to attend this meeting due to the fact
that he had already made plans to attend the American Pharmaceutical
Association in Miami but wished to be represented by proxy as favoring
Dr. Koomen as recommended and for the re-election of the President and
Vice-President of the Board.
Dr. Norton presented to the Board a certified copy of a document of
commendation from the "GENERAL ASSEMBLY OF 1961, COMMEND-ING
THE MEMBERS OF THE COMMISSION TO STUDY THE CAUSE
AND CONTROL OF CANCER IN NORTH CAROLINA TOGETHER WITH
30 Thirty-Ninth Biennial Report
THE NORTH CAROLINA DIVISION OF THE AMERICAN CANCER
SOCIETY, THE MEDICAL SOCIETY OF NORTH CAROLINA AND THE
STATE BOARD OF HEALTH, AND PROVIDING FOR THE CONTINU-ANCE
OF THIS COMMISSION DURING THE NEXT BIENNIUM."
At the request of Mr. Redfearn, Dr. William L. Wilson, Director of the
Occupational Health Section, explained the current status of State Civil
Defense Agency Guidance on Home "fall-out" shelters and promised to
obtain for each Board member the latest printed material being sent out
by the Agency.
Mr. Harper gave a progress report on the renovation of the auditorium
in the Laboratory Building. This year, beginning in July, we were able
to do several things which were long overdue, such as installing new ceil-ing,
lighting fixtures, sanding and refinishing flooring, new paint, new
blinds of the audio-visual type, and draperies. There is enough money to
purchase air-conditioning which we hope will be installed (within the next
few months). The only negative report was on 200 needed new chairs.
The Division of Purchase and Contract, and also the Board of Awards,
turned down the order for chairs which were selected as being the most
suitable for use in the auditorium. The difference in cost of those chairs
and the chairs on State contract was $794. For that reason the order was
cancelled temporarily. We are able to utilize federal general health money
for the purchase of chairs through an unencumbered balance, and if this
money is not used it will revert to Washington. However, it can be en-cumbered
for two years.
Dr. Norton had suggested that if the appropriate chairs are bought, the
State Board of Health staff would take care of half the $794 difference out
of their own pockets.
Dr. Baker thought that if a letter signed by Dr. Bugg was written to
the Board of Awards, they might reconsider, and other Board members
agreed the suggestion would be the proper approach and might be effective.
Dr. Preston read a proposed resolution for dedication of the renovated
and redecorated State Board of Health Auditorium in honor of Dr. John H.
Hamilton. After a few minor changes. Dr. Morrison moved that the follow-ing
resolution be adopted, seconded by Dr. Dawsey, and carried unani-mously.
"RESOLUTION DEDICATING REDECORATED STATE BOARD
OF HEALTH AUDITORIUM HONORING
JOHN H. HAMILTON, M. D.
'In 1933 Dr. John Homer Hamilton became the second Director of the
North Carolina State Laboratory of Hygiene. In 1942 he became Editor
of The Health Bulletin and in 1951 was named Assistant State Health
Director. He served in these relationships until his retirement April 30,
1960. Dr. Hamilton came to Noyth Carolina in 1920 as New Hanover
County Health Officer. In 1931 he came to the State Board of Health as
Director of the Division of County Health Work and Epidemiology.
Trior to these North Carolina responsibilities, Dr. Hamilton served as
Associate State Director, International Health Division, Rockefeller Foun-dation;
As Associate Professor of Preventive Medicine and Assistant Direc-
North Carolina Board of Health 31
tor, State Public Health Laboratory, University of Iowa; and as Associate
Bacteriologist, Division of Laboratories and Research, New York State
Department of Health.
'Dr. Hamilton is a native of Missouri. He received his undergraduate
degree from Oklahoma Agriculture and Mechanical College, now Oklahoma
State College. He is a graduate of the Harvard School of Medicine.
'Concurrent with his work in public health Dr. Hamilton has held office
in professional associations and been affiliated with various medical, public
health and cultural organizations. His outstanding leadership in promoting
the interests of the State Board of Health through building up the
Laboratory Division and his contributions to the program and staff in
other relationships are recognized hereby with deep appreciation.
'As an expression of this appreciation the State Board of Health formally
dedicates the newly redecorated and refurnished Auditorium of the State
Board of Health in the Laboratory Division in honor of Dr. Hamilton.
Hereafter, by action of the State Board, this Auditorium shall be desig-nated
as the 'John Homer Hamilton Auditorium'.
'This designation seeks not only to recognize Dr. Hamilton's leadership,
patience, wisdom and kindness, but also serves to challenge and stimulate
these same characteristics of dedication and unselfish service in the lives
of all who serve in any capacity in public health in North Carolina.
'September 29, 1961
J. W. R. Norton, M. D., Charles R. Bugg., M. D., President
State Health Director N. C. State Board of Health."
At Dr. Norton's request, Mr. Jarrett gave a report on the migrant labor
situation since there has been considerable newspaper and radio publicity
about it in recent months. He gave a history of the beginning of migrant
labor camps following World War IL In 1955 the Governor appointed what
is known as the Governor's Committee on Migrant Labor, composed of
representatives of Employment Security Commission, Health, Welfare,
Labor, Agriculture, Education, Council of Churches, and two or three
members at large. This committee has been working for several years
in an attempt to bring about better housing and sanitation facilities at
these camps. The committee prepared bills and submitted them to the
1959, and again to the 1961 General Assembly, asking that the State
Board of Health be given authority to establish and enforce minimum
rules and regulations regarding sanitation, but they failed both times, A
survey was made July 6-27, 1961 of 108 camps; 48 were found to be
operating without permits; 46 did not have approved water supplies; 37
camps had unsatisfactory sewage disposal. Following that, the Chairman
of the Governor's Migrant Committee asked various agencies to try to
get together some suggestions as to the minimum type of regulations that
we feel should be proposed to the next session of the General Assembly. He
is going to call a meeting sometime the middle of October, at which
time these suggestions will be presented. They are presently working on
development of minimum housing and sanitation regulations which would
not cause a hardship on the farmers but would help to provide at least
minimum type facilities for these people. He pointed out the very definite
need for more interest on the part of owners and crew leaders themselves
to provide supervision in order to see that these migrant workers do not
destroy property.
32 Thirty-Ninth Biennial Report
Mr. Brandt Ayers of the Raleigh Times, who has written a series of
articles on migrant labor camps, was called on for his comments and he
said he thought Mr. Jarrett has done a marvelous job and that he agreed
we should have minimum health regulations and that the key to improve-ment
lies with the farm operators and crew leaders.
On March 17 of this year, the Legislature transferred licensure of nurs-ing
homes to the State Board of Health form the Medical Care Commission,
and at the May meeting in Asheville the Board approved operating under
the regulations used by the Medical Care Commission. A Nursing Home
Section has been formed in the Personal Health Division and a team of
personnel has been employed to administer the examination and licensure
program. Dr. Fred Kittler, representing the Nursing Home Section was
present, and presented the following list of individuals recommended by
the Section to serve on the Nursing Home Advisory Council:
—
One-Year Term
—
M7-s. Edith Chance, Fayetteville, representing the
North Carolina Association of Nursing Homes
Mr. Seth Hollowell, Goldsboro, representing the com-munity
and serving representative of the consumers
of the services offered.
Dr. Jere Roe, Raleigh, representing the North Caro-lina
Dental Society.
Two-Year Term
Miss Ruth Current, Raleigh, representing the commu-nity
and serving as representative of the consumers
of the services offered.
Mr. William Hurley Randall, Lillington, representing
the North Carolina Pharmaceutical Association.
Mr. Travis Tomlinson, Raleigh, representing the North
Carolina Association of Nursing Homes.
Three-Year Term
—
Mr. Joseph E. Barnes, Rex Hospital, Raleigh, rep-resenting
the North Carolina Hospital Association.
Mrs. Nan B. Cummings, Asheboro, representing the
North Carolina State Nurses Association.
Dr. D. A. McLaurin, Garner, representing the Medical
Society of the State.
Ex-Officio Member—Dr. Ellen Winston, Raleigh, representing the North
Carolina State Board of Public Welfare.
The number and type of Council representation was previously approved
at the meeting of the Board in May. Dr. Dawsey moved that the Board
accept the nominations as the Nursing Home Advisory Council, seconded
by Dr. Morrison, and carried unanimously.
Dr. Maddry presented a written report on the custom built incubator
developed by two employees in the Laboratory which has saved the State
$2,000. After discussion. Dr. Bender moved that the Board express its
commendation and appreciation for the excellent job done in constructing
the incubator, and test tube holders, for the Laboratory Division which
has resulted in considerable savings to the State. Motion seconded by
Dr. Goodwin, and passed. Mr. Harper said he hoped a merit awards pro-gram
could be developed and adopted by the State to give an incentive to
workers of this type. Adjournment 12:30 p.m.
North Carolina Board of Health 33
January 18, 1962. The regular quarterly meeting of the N. C. State
Board of Health was held Thursday, January 18, 1962, 10:00 a.m.-4:00 p.m.,
in the Board Room of the Cooper Memorial Health Building, President
Charles R. Bugg, M. D., presiding.
The meeting was called to order by President Bugg, who introduced
Dr. Jacob Koomen, Jr., the new Assistant State Health Director, Dr. E. R.
Hardin, local Health Director of Robeson County and Mrs. Adler repre-senting
the Raleigh Times.
Attending: Dr. Charles R. Bugg; Dr. John R. Bender; Dr. Ben W.
Dawsey; Dr. Lenox D. Baker; Mr. Jasper C. Jackson; Dr. Oscar S. Good-win;
Dr. Glenn L. Hooper; Mr. D. T. Redfearn.
Dr. Goodwin moved that the minutes of the September 29, 1961 meeting,
be accepted as circulated. Motion seconded by Dr. Dawsey, and carried.
Dr. Bugg asked each member of the Board to accept a Division and to
familiarize himself with the duties of that Division and act as liaison. He
assigned Epidemiology to Dr. Goodwin; Oral Hygiene to Dr. Hooper; Local
Health to Dr. Bender; Personal Health to Dr. Baker; Sanitary Engineering
to Dr. Dawsey and Mr. Redfearn; Laboratory to Dr. Morrison and Mr.
Jackson, and Central Administration to Dr. Bugg.
For the orientation of new members on the Board, each Division Direc-tor
was called on for a brief description of the activities of his Division,
with Dr. Wilson substituting for Dr. Foard who is on a leave of absence.
Dr. James F. Donnelly, Director of the Personal Health Division, gave
a progress report on care of the eyes of the newborn for the prevention of
ophthalmia neonatorum. He called attention to a summary of the Board's
actions through the years and also an article from the Journal of the
American Medical Association, April 18, 1959, page 237 and to the Special
Report of the Committee on the Fetus and the Newborn, March 1958 on
this subject, both of which had been circulated to the Board members.
He specifically referred to items two and three in the article. Generally
speaking, considering the fact that we still have a considerable number of
midwife deliveries, it was his recommendation that the use of silver nitrate
should be continued as it has in the past years.
Mr. J. M. Jarrett, Director of the Sanitary Engineering Division, pre-sented
a preliminary report on proposed revisions of the State's vending
machine regulations which were presented to the Board at its May 11,
1960 meeting. These regulations were adopted at that time and it was
intended that they would become effective January 1, 1961 but after a
series of public hearings with local health directors the effective date was
postponed on account of opposition which had developed in connection
with the handling of permits and several suggested amendments. Mr.
Jarrett stated that the vending machine regulations were again revised
and that a series of hearings had been held and an effort made to correct,
revise and amend them so that they would be acceptable to all. This re-vision
has been distributed to local health directors in each county and
they were asked to submit their comments on the new proposed regulations
by January 15, 1962. So far, not enough replies have been received to
know whether or not the amended revisions are acceptable. Mr. Jarrett
34 Thirty-Ninth Biennial Report
stated that this was only a progress report on the matter; therefore, with
the Board's approval he would like to continue the consideration of this
matter until enough definite replies are received to meet the approval of
all.
Mr. Jarrett also discussed further progress relative to health protection
of migrant workers and the minimum sanitation requirements used in
inspection of migrant labor camps. He reported on a recent survey made
and stated that this information had been distributed to the various
agencies concerned with the suggested minimum housing and sanitation
requirements for this season. It is expected that another effort will be
made to have these requirements adopted by the next General Assembly.
Meantime, it is hoped that voluntary cooperation on improved living con-ditions
will be obtained.
He also discussed the relative effectiveness of sewage lagoons versus
conventional mechanical treatment processes, pointing out the necessity
for proper design of lagoons on an individual basis depending on the loca-tion,
water courses to be effected, construction and maintenance.
President Bugg announced that Mr. D. S. Coltrane, Consultant to the
Governor on Economy and Efficiency, and Dr. Eugene A. Hargrove, Com-missioner
of Mental Health of the N. C. Hospitals Board of Control, were
present and wished to discuss the present status and future plans for the
community mental health services, and that the Board would go into
executive session at 11:30 a.m. to the break for luncheon. A committee
of the Board was appointed to explore the matter further and report to
a called meeting of the Board to be held in February,—Chairman Dr.
Bender with Doctors Baker, Dawsey and Goodwin.
During the executive session Secretary Norton gave a brief summary
report which was prepared by Dr. Donnelly, on a birth control method
(Enovid) with no recommendation or action needed at this time other
than continuing to keep up with the developments. Possibly action may be
recommended later on dependent upon more extended interest in the use
of the contraceptive pills which are now being offered on a voluntary basis
by the Mecklenburg County Welfare Department to aid in preventing
increases in the number of illegitimate children receiving welfare aid.
At 12:40 p.m., the Board adjourned for lunch to reconvene at 2:00 p.m.
Mr. E. A. Pearson, Director of the Division of Oral Hygiene, gave a
progress report on fluoridation in North Carolina. Each member of the
Board was given informational material on fluoridation, including a map
showing the towns using fluoridated water—both natural and controlled.
Dr. Pearson gave the following facts and figures:
—
"The first town in North Carolina to adopt and use controlled fluorida-tion
was Charlotte, in 1949. Since that time thirty-five other towns in our
State have adopted and are using controlled fluoridation. These towns have
experienced opposition by small minority groups; yet, in the majority, the
governing bodies have proceeded to take positive action and to provide
their cities and towns with controlled fluoridation. Those towns which
have provided controlled fluoridation with the least amount of public
concern are those in which the city councils adopted the measure as a
North Carolina Board of Health 35
public health measure without a vote of the people. Raleigh, Wilmington,
Aberdeen and Greenville are the only towns in North Carolina, now
fluoridating, where a vote of the people on this issue was in the affirmative.
It has been defeated by referendums in Greensboro, Valdese, Asheville,
Statesville and Mt. Holly.
"In addition to the 36 towns using controlled fluoridation there are 17
towns in the State whose water supplies carry a naturally occurring
fluoride content of 0.7 ppm or more.
"The 36 towns now using controlled fluoridation serve a population of
1,005,418. The 17 towns which have naturally fluoridated water serve a
population of 36,142. The total population in North Carolina now drinking
fluoridated water is 1,041,560, or 57.8% of our urban population.
"The three towns which instituted fluoridation in 1961 are Goldsboro,
Newton, and Sanford. Towns presently working toward fluoridation are:
Elon College, Brevard, Banner Elk, Granite Falls, Chapel Hill, Mount Pleas-ant,
Rutherfordton and Spindale, Cornelius, Statesville, Burlington, Eliza-bethtown,
Graham, Jacksonville, Leaksville, Marshall, Canton, Clyde, North
Wilkesboro, Tryon, Asheville and Durham."
Dr. Pearson called attention to a recent letter prepared by Dr. Norton
which was mailed to the local health directors, dental members of the local
boards of health, and presidents of county medical and dental societies.
In this letter Dr. Norton stressed the opportunities that all people engaged
in health work have in the promotion of fluoridation. Dr. Pearson stated
that this letter has brought a tremendous response.
Dr. Pearson pointed out that the Division of Oral Hygiene works in
close cooperation with the Division of Sanitary Engineering in the State-wide
fluoridation campaign. He stated that it is his belief that the towns
which are adding fluoride to their water supplies are receiving even greater
benefits than just the reduction in dental caries because these towns, by
providing better trained personnel for their water plants, have improved
the quality of the water services to the people. Mr. Jarrett, Director of the
Division of Sanitary Engineering, indicated his agreement with this state-ment.
In conclusion. Dr. Pearson expressed the belief that, with the tremendous
interest and activity in the fluoridation program throughout the State,
within the near future all towns in North Carolina will be providing con-trolled
fluoridation for their citizens. Dr. Pearson announced that the
January issue of The Health Bulletin will be devoted to fluoridation.
In the discussion which followed Dr. Pearson's presentation. Dr. Glenn
L. Hooper, Dental Member of the Board, said that ever since Dunn has
had fluoridation, which was started in 1953, he has observed a definite re-duction
in the incidence of dental caries among the children. In response
to Dr. Hooper's suggestion that the State Board of Health take some
action to get more towns to adopt fluoridation. Dr. Norton stated that
the Board has previously taken specific action, first approving, and, later,
recommending the fluoridation of municipal water supplies.
Mr. Harold Mauldin of the Venereal Disease Control Section, presented a
written report on laboratory reporting of reactive serologies. The need
36 Thirty-Ninth Biennial Report
and utilization of these reports by health departments was discussed. A
summary of the outcome of visits to the 226 private and hospital labora-tories
was presented. The acceptance and participation of laboratories and
physicians in this control measure and its influence on venereal disease
control was also discussed. Dr. Koomen commented that this is a very fine
example of what is available epidemiologically in working out problems,
pinpointing a situation or specific need and taking the proper action to
effect a solution.
Dr. Lynn Maddry, Acting Director of the Laboratory Division, discussed
the certification of water plant laboratories as examining water in accord-ance
with the Standard Methods for the Examination of Water and the
U. S. Public Health Service Drinking Standards. Dr. Maddry stated that
this will be a new activity for the Laboratory and one that will involve
the issuing of a certificate of approval. This certification of the water
plant laboratories will be in addition to what the Sanitary Engineering
Division is now doing in certifying the supply as a whole, and will be
carried out in cooperation with the Sanitary Engineering Division. He
also pointed out that the laboratory personnel now certifying milk labora-tories
could do this certification of water plant laboratories with a mini-mum
of additional expense. On motion of Dr. Goodwin, seconded by Mr.
Jackson, the Board approved the certification of water plant laboratories
by the Laboratory Division for those water plants supplying water to
interstate carriers.
Mr. Herbert Toms, Attorney for the State Board of Embalmers and
Funeral Directors, gave a brief report on the need for more stringent and
broader legislation for funeral homes. He illustrated his point by referring
to the recent publicity on the Guilford County incident relative to shallow
graves, with possibly other irregularities incident thereto, and pointed
out why control over employees other than licensees was needed. He asked
that the State Board of Health, through its Sanitation Division, revise
and establish new rules and regulations under its authority. He stated his
Board was working closely with the State Board of Health on proposed
legislation to recommend to the next General Assembly. Mr. Toms stated
there were no State-wide rules or regulations regarding the depth of
graves for human bodies. It was a problem of local boards of health,
according to the location or situation, such as how far from sea level.
This was information for the Board and no action necessary. However,
Dr. Norton stated that the staff is working with a committee appointed
by him to draft proposed legislation for the next General Assembly. The
committee will consist of three physicians, three funeral directors, and
three local registrars.
At this point Dr. Donnelly presented a written report of a meeting he
had attended this morning at the request of, and with a committee of, the
N. C. Association of Nursing Homes and Homes for the Aged and the
State Board of Public Welfare. The State Board of Welfare took no action
on the request of the N. C. Association of Nursing Homes.
Dr. Wm. L. Wilson, Chief of the Occupational Health and Radiation
Section, presented a report on progress of the State Radiological Health
Program from its beginning when the Board approved a minimal program,
North Carolina Board of Health 37
the cost of such a program, and the cooperation and support of the Public
Health Service. He recommended that the Board reaffirm its interest and
its position by urging all possible rapid and reasonable expansion of the
radiological program. Dr Baker moved that the report be accepted,
seconded by Dr. Goodwin, and carried.
Dr. Jacob Koomen, Jr., the new Assistant State Health Director, was
present and expressed appreciation and thanks for the confidence the
Board had placed in his ability, experience, and training by appointing
him to his present position effective October 1, 1961.
Dr. Koomen then discussed the oral poliomyelitis vaccine (Sabin) point-ing
out its advantages and disadvantages. After noting the availability of
1 and 2 types of oral vaccine, he stressed the fact that type 3 oral vaccine
is not yet available. In its absence, complete immunization, using the 3
virus types is not possible. Therefore, at this time, Salk vaccine remains
the preparation of choice. He urged the program using Salk vaccine,
presently in effect, be continued.
Also, Dr. Koomen reported on a tetanus immunization campaign and
said that Dr. Goodwin has been a long time worker in the field of tetanus
prevention. In June Dr. Goodwin brought together interested people to
formulate an immunization program. The AMA in 1959 went on record as
supporting such a program. On September 30 the Rural Health Commit-tee
of the State Society met to discuss the ways of going about tetanus
immunization. The Executive Committee of the State Medical Society
adopted the recommendations of the Rural Health Committee with a goal
of immunizing one million North Carolinians to tetanus in the coming
year. Each local Medical Society has been asked to appoint a special
Committee for this purpose. With this as a key, perhaps further immuni-zation
campaigns can be undertaken. The Board has never been formally
requested to go on record as sponsoring such a program and Dr. Koomen
suggested it might be helpful for the Board to go on record as supporting
a State-wide program. Dr. Dawsey moved that the Board go on record as
supporting and urging people to accept the tetanus immunizations. Dr.
Bender seconded the motion, and carried.
Mr. Charles Harper, Director of Administrative Services, reviewed briefiy,
staff work underway on the 1963-1965 biennial budget. He reported that
the "A" budget request must be submitted by April 1, 1962 while the "B"
budget request must be submitted by June 1. An explanation of the
difference between the "A" and "B" budget was given. Intensive prepara-tion
of budget requests for all programs of the State Board of Health is
being carried out by Division Directors and Section Chiefs.
President Bugg reported to the Board that in accordance with its in-struction
at the meeting on September 28, 1961, he had written to Governor
Terry Sanford regarding a second request from the Board relative to the
increase for the State Health Director from the present salary of $17,000
to $20,000 and that at the January meeting of the Advisory Budget Com-mission
Secretary Norton's salary was increased to $19,000. At this point.
Dr. Norton expressed his appreciation and thanks to the Board for their
confidence, interest and cooperation in this matter.
38 Thirty-Ninth Biennial Report
It was moved by Mr. Redfearn, seconded by Dr. Baker, that the follow-ing
statement be entered upon the minutes of the Board in connection
with the honor recently conferred upon Dr. Norton, and unanimously
passed. "The State Board of Health takes proud and appreciative notice
of the election of the North Carolina State Health Director and Secretary-
Treasurer of this Board, J. W. R. Norton, M. D., who on November 15,
1961 at the meeting in Detroit, Michigan, was elected President-Elect of
the American Public Health Association. This recognition brings favorable
attention upon the public health work in this State and upon Dr. Norton's
outstanding leadership. As a Board we congratulate him on this honor
and go on record as supporting him in this responsibility throughout the
subsequent term of office as President of this organization which he will
assume at the close of the APHA annual meeting in Miami Beach,
Florida, October 15-19, 1962."
The Board also directed Dr. Norton to forego his customary modesty and
arranged for his picture to be hung in the Board Room. Adjournment
4:00 p.m.
February 18, 1962. There was a special call meeting of the North Caro-lina
State Board of Health held Sunday, February 18, 1962, in the Raleigh
Room, Sir Walter Hotel, Raleigh, President Charles R. Bugg, M. D., pre-siding.
Mr. D. S. Coltrane, Consultant to the Governor on Economy and Effici-ency,
and Dr. Eugene A. Hargrove, Commissioner of Mental Health, N. C.
Hospitals Board of Control, were present.
Attending: Dr. Charles R. Bugg; Dr. John R. Bender; Dr. Ben W. Daw-sey;
Dr. Lenox D. Baker; Mr. Jasper C. Jackson; Dr. Oscar S. Goodwin;
Dr. Glenn L. Hooper; Mr. D. T. Redfearn.
President Bugg opened the meeting and stated that it had been called
for the purpose of hearing the report of the special committee named
at the last quarterly meeting of the Board on January 18, 1962, to consider
matters concerning local mental health clinics as presented by Mr. Col-trane
and the committee—Dr. John R. Bender, Chairman, with Doctors
Lenox D. Baker, Ben W. Dawsey and Oscar S. Goodwin.
Dr. Bugg called on Dr. Bender, the Chairman of the Committee, who
asked Dr. Baker, a member of the Committee to read the report. The
report was as follows:
"In July 1949 the Community Mental Health Clinics were transferred
from the Hospitals Board of Control to the State Board of Health. Since
1949 local annual direct allocations for the clinics have increased by over
$500,000.00 and it is estimated those local health department staffs in the
past year contributed indirectly in service about half that amount in
support of the clinics.
"The State Board of Health has no recommendations concerning the
assignment of responsibility for the Mental Health Clinics. If their man-agement
remains under the direction of the State Board of Health the
Board will continue to administer the clinics in cooperation with its local
departments and all groups concerned therewith. The primary concern
North Carolina Board of Health 39
of the State Board of Health is the over-all health of the citizens of the
State.
"If the State administration deems it advisable to transfer responsibility
for the clinics to another agency the State Board of Health will abide by
any and all directions in making the transfer and will administer any
funds now assigned to the State Board of Health specifically for the sup-port
of the clinics until that time when the Legislature can reassign such
responsibility."
At the conclusion of the report Dr. Bender moved, and Dr. Baker sec-onded
the motion, that the report be adopted. In the discussion which fol-lowed,
Dr. Bugg called on Dr. Norton, Dr. Hargrove and Mr. Coltrane for
brief comments. A fully cooperative spirit in keeping with the committee's
report was evidenced in these brief discussions. The Committee's report
was adopted unanimously, and on motion of Dr. Baker, seconded by Dr.
Goodwin, the meeting adjourned.
May 9, 1962. The annual meeting of the North Carolina State Board of
Health was held, as required by law, during the annual meeting and con-jointly
with a general session of the Medical Society of the State of North
Carolina,—in the Reynolds Coliseum, State College, the Director's Office,
Room 105, Wednesday, May 9, 1962, 8:15 a.m. to 9:25 a.m.. Dr. Charles
R. Bugg, President, presiding.
Attending: Dr. Charles R. Bugg; Dr. Ben W. Dawsey; Dr. Lenox D.
Baker; Dr. Roger W. Morrison; Mr. Jasper C. Jackson; Dr.
Oscar S. Goodwin; Dr. Glenn L. Hooper; Mr. D. T. Redfeam.
The meeting was called to order by President Bugg. On motion of Dr.
Hooper, seconded by Mr. Jackson, the minutes of the Board meeting held
on January 18, 1962, were approved as circulated. It was moved by Dr.
Baker, seconded by Dr. Goodwin, that the minutes of the special Board
meeting held on February 18, 1962, be approved as circulated.
Mr. John Andrews of the Sanitary Engineering Division, presented a
report on the proposed revisions of the SANITATION REGULATIONS
ON FOOD AND BEVERAGE VENDING MACHINES which had been
adopted by the Board of May 11, 1960, and which had been circulated to
members. On motion of Mr. Jackson, seconded by Dr. Dawsey, the revi-sions
were adopted. The effective date of the revised regulations was estab-lished
as of January 1, 1963, on the motion of Dr. Baker, seconded by Mr.
Jackson.
Dr. James F. Donnelly, Director of the Personal Health Division, pre-sented
three proposed recommendations from the Advisory Council of the
Nursing Home Section of the State Board of Health which had previously
been circulated to members of the State Board of Health. These were in-dividually
discussed by the Board at length on a motion from Dr. Lenox
Baker. The first recommendation concerning the definition of a nursing
home was revised to read, "A nursing home is a facility which is designed
and equipped to provide nursing care and related medical services for
three or more persons unrelated to the licensee who have ailments for
which individualized medical and nursing care is indicated. These patients
40 Thirty-Ninth Biennial Report
do not require the special facilities of a general hospital but will require
services not usually found in the home for the aged (boarding home).
These patients will require continuing medical supervision; however, nurs-ing
care is their primary need". The motion to amend the definition was
made by Dr. Lenox Baker and seconded by Mr. Jackson. The second
recommendation was changed to read, "when possible and if feasible, a
registered graduate nurse shall be in charge of the nursing service of a
nursing home". This change was made on the motion of Dr. Lenox Baker
and seconded by Mr. Redfearn, and passed. The third recommendation,
which was accepted as stated, read: "There shall be a registered profes-sional
nurse or licensed practical nurse on duty in the home at all times
to insure that adequate nursing service shall be supplied for the patients,
effective January 1, 1963". It was moved by Dr. Baker, seconded by Dr.
Dawsey, that this regulation be accepted as stated. This also passed.
A progress report was made by Dr. J. W. R. Norton, State Health Di-rector,
on Mental Health Services Study Committee visit which had been
requested by Governor Terry Sanford and arranged through the Southern
Regional Education Board, April 13-15, 1962. Dr. Norton also acquainted
the Board with the fact that the Executive Council of the Medical Society
of the State of North Carolina had reversed its previous action and had
taken action recommending to the Governor that the Mental Health Com-munity
Services remain with the State Board of Health rather than be
transferred to the Hospitals Board of Control as this Council had recom-mended
on a previous occasion. It is possible that in making the change
the Executive Council considered the fact that there are only two physi-cians
of fifteen members of the Hospitals Board of Control whereas the
State Board of Health has five physicians in its membership of nine.
Dr. Jacob Koomen, Jr., Assistant State Health Director, made a report
on the Sabin Oral Polio Vaccine. He recommended to the Board that this
vaccine be made acceptable for school entrance since out-of-State students
might present themselves from states which already have had greater use
of oral vaccine. It was his recommendation that the vaccine not be recom-mended
for routine use during the summer because of other viruses in
the intestinal tract which would hamper its effectiveness. Dr. Koomen also
pointed to the possible effectiveness in control of outbreaks after deter-mining
type specificity. Motion passed.
Mr. Marshall Staton of the Sanitary Engineering Division, presented
an amendment to the watershed regulations. He stated that when the
watershed regulations were rewritten in 1960 a provision in Section 6,
Item (d) was omitted that would permit the watering of stock from Class
I or Class II reservoirs. Item (d) has been rewritten permitting the
watering of stock under controlled conditions at sites approved by the
State Board of Health in Class I and Class II reservoirs. Item (d) as re-written
is as follows:
"The watering, washing or wallowing of any horses, mules, cattle,
or other domestic animals shall not be permitted in or along the
margin of any Class I or Class II reservoir except watering of
stock may be permitted in cases where large volumes of water are
involved and the State Board of Health determines, after a thor-
North Carolina Board of Health 41
ough investigation, that the quality of the water, in the opinion
of the Board, will not be adversely affected so as to render it un-satisfactory
for use as a public water supply."
On motion of Dr. Goodwin, seconded by Mr. Redfearn, the above amend-ment
to the watershed regulations was adopted.
Mr. Charles L. Harper, Director of Administrative Services, made a
progress report on the 1963-1965 budget. He reviewed the various guide-lines
that govern the preparation of the "A" budget and listed those pro-grams
in which the larger increases were requested. It was noted that the
"A" budget proposal contains an increase of slightly more than $600,000,
or 8 percent over the budget for the 1961-'63 biennium. On motion of Mr.
Jackson, seconded by Dr. Goodwin, the Board adopted the 1963-1965 "A"
budget as presented. Time did not permit the discussion of the "B"
budget, however, a brief outline of tentative requests as prepared by pro-gram
directors, was distributed to the Board members.
Dr. W. L. Wilson, Chief, Occupational Health Section, made a brief
progress report on the State Radiological Health Program and asked that
the Board reaffirm three former actions stressing the importance of this
program. It was moved by Mr. Redfearn, seconded by Mr. Jackson, and
unanimously affirmed that the Board desires maximum feasible speed in
advancing the State Radiological Health Program. The details of Dr.
Wilson's report and the three major supports by the Board as listed in a
progress report to the Board was distributed by Dr. Wilson.
The meeting then adjourned in order that members of the Board could
attend the Conjoint Session of the Board and the Medical Society of the
State of North Carolina at which time Dr. Jacob Kcomen, Assistant State
Health Director, presented a report on PROGRESS IN THE CONTROL
OF POLIOMYELITIS, MEASLES, AND INFECTIOUS HEPATITIS.
42 Thirty-Ninth Biennial Report
CONJOINT SESSION REPORT, 1961*
By J. W. R. Norton, M.D., M.P.H., F.A.C.P.**
The customary detailed (63 Page) annual report of activities in state
and local public health work is provided to the Medical Society. Instead of
summarizing, we felt it would be more interesting, at this time, to touch
on some of the highlights and then mention a few of our problems of
general mutual interest. We take up the highlights by our divisional
organization.
LABORATORY DIVISION
Lynn G. Maddry, Ph.D., Acting Director
Among the achievements for 1960 were the offering of services for rapid
identification of beta hemolytic streptococci group A by the fluorescent
antibody procedure and the complement fixation tests for fungus diseases.
A serious problem is our inability to recruit and retain properly trained
personnel because of the low starting salary ranges. The clerical staff
is burdened beyond the point of being able to take care of the increased
volume and it is necessary that the technical staff perform some of these
duties which in turn reduces the number of specimens that could be
examined.
It was disappointing that due to limitation of state funds provided, we
are unable to meet the needs of the people in North Carolina in the field
of cancer cytology, virology and environmental health.
ORAL HYGIENE DIVISION
E. A. Pearson, D.D.S., Director
This marks the thirtieth anniversary of our Oral Hygiene Division. The
main emphasis is still on providing for children in the elementary grades
a program of dental health education which includes, insofar as funds and
staff will permit, the following:—classroom instruction and dental inspec-tions
for all; dental corrections for the under-privileged; and referrals
to private practitioners for the other children.
Of especial significance in the progress of the program during the past
year are the developments in the areas of recruitment, research, and
fluoridation.
The rapid turnover of staff dentists makes recruitment a constant prob-lem.
New approaches of a recruitment brochure, mailed to senior dental
students of eastern and southern dental schools, and visits to many of
these schools by the Division Director have brought a dramatic change to
our now having more applicants than openings. Eight new dentists will
begin work in July, thereby, enabling us to provide dental health programs
in many more counties than heretofore.
* Conjoint Session Report: Medical Society of the State of North Carolina and the State
Board of Health, Asheville, May 10, 1961.
** Secretary-Treasurer and State Health Director, N. C. State Board of Health, Raleigh.
North Carolina Board of Health 43
The Division's participation with the U.S.P.H.S. in the State-wide re-search
project, "The Natural History of Dental Diseases in North Caro-lina,"
is progressing nicely. Dental examinations have been completed for
twenty percent of the households in the total sample. The consummation
of this project will provide, for the first time, prevalence rates of dental
diseases for a state population. Such information will be invaluable in
helping us to define our problems and to measure progress.
Recognizing that fluoridation is the most effective method of preventing
tooth decay, we are glad to report progress in the fluoridation of municipal
water supplies. Since our last meeting, three cities have adopted this public
health measure, making a total of thirty-four North Carolina municipalities
now adjusting fluorides upward to the optimum amount (one part per
million) for dental development and health. The combined population of
these cities is 1,036,507 and represents fifty-five percent of the urban popu-lation.
Fluorides occur naturally, in amounts of 0.7 to 1.2 ppm, in the water
supplies of seventeen other North Carolina municipalities with a total
population of 35,569. Five also have natural fluorides in amounts beyond
1.2 ppm: Winton (1.4), Williamston (1.5), Wentworth (1.8), Rich Square
(2.1) and Windsor (3.0).
PERSONAL HEALTH DIVISION
James F. Donnelly, M.D., Director
1. Responsibility for setting standards and licensing of nursing homes
was transferred from the Medical Care Commission to the North
Carolina State Board of Health on March 17, 1961. The school health
program was also transferred from the Division of Local Health to
Personal Health on March 16, 1961.
2. Two new cancer detection clinics were added to bring to nineteen the
detection clinics now functioning. An additional 4,000 Papanicolaou
smears were examined by the Laboratory Division bringing the total
for 1960 to 35,514.
3. Physiotherapists were added to the heart programs in three counties.
We now have four physical therapists on the crippled children's and
chronic disease programs.
4. A stroke rehabilitation program was initiated in five counties empha-sizing
home nursing care.
5. A survey program for diabetes was initiated in 20 counties with par-ticular
stress on the nutrition of the pre-diabetic discovered in the
survey.
6. Nutritional programs in industry were expanded, and there was marked
expansion in consultation and review of architectural plans for insti-tutional
kitchens.
7. The Crippled Children's Section instituted changes in statistics report-ing
and recording financial and medical information on crippled chil-dren's
cases to provide a clearer basis for evaluation of these services.
In this Section also the age limitation was moved from 15 to 21 for
44 Thirty-Ninth Biennial Report
presentation to rheumatic fever and speech and hearing clinics and it
has assumed clinic observation, preoperative and postoperative, of con-genital
and other heart cases.
8. There was a continued reduction of midwife licenses with the number
reaching a new low figure of 294.
9. Follow-up study of prematurely born infants in Wake County was com-pleted,
and the results have been analyzed and reported.
SANITARY ENGINEERING DIVISION
J. M. Jarrett, B. S., Director
Two reports of state-wide significance were printed and distributed. One
summarized results of 1^/^ years study of background radiation in surface
streams used as sources of public water supplies. One hundred thirty-five
(135) sampling stations were established on major streams of the state
for periodic checking.
The second report shows results of the "Air Pollution Study of North
Carolina" made in 1958-'59 as a special project with the U. S. Public
Health Service. The survey indicates need for control activities generally
throughout the state. Additional funds from the legislature are being
requested to enable us to develop this program and provide protection
against the unfortunate development of hazards such as have occurred in
Donora, Pa., London and Los Angeles and to lesser degrees elsewhere.
Regulations for sanitary control of mechanical vending machines were
adopted but operation has been delayed until the necessary preliminary
educational program can be carried out.
In addition to continuing our participation in the air radiation surveillance
network. North Carolina was added to the Public Health Service surveil-lance
network for radioactivity in fluid milk supplies when Charlotte was
added to this list. Samples are examined at the Public Health Service
Radiation Laboratory, Montgomery, Alabama.
There are presently 650 public water supplies under supervision with 45
new supplies added during 1960. Water supply improvements costs last
year amounted to $3,609,372.0€.
This Division and local staffs now have 22 engineers and 248 sanitarians
providing environmental health protection.
LOCAL HEALTH DIVISION
Robert D. Higgins, M.D., Director
ADMINISTRATION—One of the primary objectives has been to con-solidate
wherever and whenever feasible the smaller single county health
units into district units of two or more counties. Some of our single county
units could provide only a part-time health program but by joining with
one or more neighboring counties, a full-time health program under the
direction of a qualified full-time health director could be provided at a
North Carolina Board op Health 45
salary commensurate with his duties and with improved services in each
participating county in the district. Sixty-nine departments serve the 100
counties since 18 district departments serve 49 counties.
Through an incentive (50% of cost up to $1,000 per county) offered by
the State Board of Health to counties which are under, or those which do
come under, the Local Governmental Retirement Plan has grown rapidly,
and 61 of the 100 counties now provide their local health employees with
this coverage.
PUBLIC HEALTH NURSING—The public health nurses have made
progress, in their goals to provide improved nursing care to patients re-ferred
by physicians in private practice or in local, state and regional
hospitals. The objectives of this service are to permit early hospital dis-charge,
assist family members in nursing techniques, and promote re-habilitation
and restoration.
1. Plans have been developed whereby physicians in the Veterans' Ad-ministration
Hospitals refer selected patients as discharged to local
health departments for nursing service. The public health nurses make
one visit to the patient, reminding him of the need for continuing local
physician care, and additional visits only if the patient is under the
care of his local physician. This service is provided in 96 of our 100
counties.
2. Additional health departments are now providing public health nursing
services to the patients discharged from our state and Veterans' Ad-ministration
mental hospitals and to their families (20 counties). The
state hospital medical staffs are enthusiastic about the service and only
the lack of personnel in the hospitals and the health departments pre-vents
extension of this valuable service which has decreased the number
of re-admissions in these counties.
3. The referrals from N. C. Memorial Hospital have increased in number
and urgency. Throughout the country, this is regarded as an outstanding
example of an efficient, well organized plan for referral between a
teaching hospital and local nursing resources.
4. Demonstrations of how limited nursing service to the chronically ill
may be provided by busy generalized public health nurses are encour-aged
and have been started in Halifax, Alamance, New Hanover, Per-son,
Mecklenburg, Guilford, Orange, Chatham and Lee health depart-ments.
These have had the enthusiastic support of the local medical
societies and the State Society Committee On Chronic Illness.
The chronically ill and aged in nursing homes and boarding homes have
received improved services through direct consultation and in-service
education for the staffs of these homes.
HEALTH EDUCATION—This Section promoted a three-day Workshop
on Communications in Raleigh for ninety professional employees for the
improvement of intra-agency communications. The staff consisted of peo-ple
with special skills in the fields of the behavioral sciences, business and
industrial personnel management, and public relations, as well as the dis-
46 Thirty-Ninth Biennial Report
ciplines of public health. A committee summarized the suggestions and made
recommendations for valuable innovations and modifications of practices.
These are being followed up by various staff members with encourage-ment
by the State Health Director, and improvement in communications is
expected.
We encourage local health departments to employ a full-time health
educator when the budget, size of staff and readiness for a health educator
make this feasible. Two additional health departments established health
education positions and one department increased its staff thus bringing
to twelve the health departments served by their own health educator.
Three position vacancies exist due to demand exceeding supply and salary
limitations.
MENTAL HEALTH—Due to program expansion, our State Board has
approved changing the Mental Health Section to Division status under a
qualified psychiatrist, to become effective as soon as such a director is
available.
During 1960 the number of mental health clinics remained at eleven (U)
and these held over thirty-eight thousand (38,000) interviews with 5,446
patients. Fifty-two per cent of these patients were children under fourteen
years of age. Five additional counties established evaluation, referral and
consultation services, an increase from three in the preceding year.
The professional staff in these programs increased by forty-six per cent
to now consist of twenty-three psychiatrists, twenty-four clinical psycholo-gists,
twenty-six psychiatric social workers, one epidemiologist and one
remedial reading specialist. As rapidly as feasible, we are working toward
having our eighty public health physicians and 550 graduate nurses be-come
as effective in decreasing mental and emotional disability as they
have been against communicable diseases. Consultation services were con-tinued
to doctors, ministers, nurses, schools, courts, industries, social
workers and other groups or agencies.
EPIDEMIOLOGY DIVISION
Fred T. Foard, M.D., Director
In the tuberculosis control program, we are operating five mobile X-ray
units, with one held in reserve. Follow-up activities have improved over
the past year under the leadership of two technicians. Seventy-three
counties are served by chest clinics, which are attended by qualified chest
specialists. This is an increase of six chest clinics during calendar 1960
and there were 168,000 persons X-rayed by our mobile X-ray units, and
32,000 miniature films were read in the central office for 12 other counties
which have their own units.
Nineteen laboratory-confirmed cases of animal rabies were reported
from four counties,—a record low. Also, the number of human antirabic
treatments dispensed by the Laboratory Division to physicians also reached
a new low of 155 complete treatments, indicating progress in the field
of veterinary public health and related areas.
North Carolina Board of Health 47
COMMUNICABLE DISEASE—There was a striking increase in infec-tious
hepatitis with 577 cases being diagnosed as co