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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. 46454 < ui Z a < o CO UI I- < I-CQ C3 CO 4?£ c ^ ^ ? aj o s = j3 i =4; mX c O C t; •r ft S o => M iL .^ - W -C Si K 5 a_' = > ? 0) u "3 a a oc >oO >> Xi m - DS = H I O PC >-3i ^ M Z si< aj a: 2 H < E 5 w S £.2 50 of Dm «> ;C n ?< 1 Ci o J. 0; ^ > - _• - z M - .0 . Kof >M•' VM gt-o K £ a: 2 > < < Q . ^ g X Z £ = = Z K Z c k: < &: -7 — "Tl-J P3 §•1 5 ft i o Ez^ W 4) C-g u 4) - .2- >. ^ C b£ 3 C O =51 to < K 23 W O O — 1! = r, 3 m ™ • "a-woi- Ox C3 « C C b£ J < = .. > O S >, >, iSt a.2x 3 >.- a 5;^ * a. < 1(1. ;i -J — a a ^ "c bci c S = = ft 3 u ~ 01 3 3 S 23 U ^b C :u Oh 03 w r 9 ~c C.2 c a X .2 c S K o S^ ii " 72 c Q fui o J! ^ 4) a 41 s-° S! -a a i! « .2 ^ '^ S = g « Q >> .2 t; -3 .« oj w m c E 5-0 -a c * w O CJ 3 3 4t 0/ <oodhH>> 3 ? Z r O Q S2 ^ a .2 " . S u _ o; 3 • * i r'^ se . £-5a =3 . 01 iJ 3 i .2 w - t -2 c « c isa|&.2 •^a|Qt3 i 1) o S C O -^ = i t- -.J 5z «o * = = ooSw ZZ c J; M Hh zo s 2 QQ cw 5 -ft eH 'I o .« o £ «; •J a •:: =* a " I. " „ a ^ 3 :- S^ o ' a a a : o c = = •- ; 4i K 3) ti ixQQQ g O 3 « o ti — j: !; 2 3u S ir, " t. a2 = a 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
Object Description
Description
Title | Biennial report of the North Carolina State Board of Health |
Other Title | Report of the North Carolina State Board of Health. |
Creator | North Carolina. State Board of Health. |
Date | 1960; 1961; 1962 |
Subjects |
North Carolina. State Board of Health--Statistics--Periodicals Public health--North Carolina--Statistics--Periodicals Public Health--North Carolina |
Place | North Carolina, United States |
Time Period | (1945-1989) Post War/Cold War period |
Description | Report covers two calendar years (13th-18th); (19th) covers Dec. 1, 1920-June 30, 1922; thence each covers July 1-June 30 years.; Printer: 13th (1909/10)-18th (1919/20) by Edwards & Broughton; 19th (1921/22)-20th (1923/24) by Bynum; 21st (1925/26)-<44th (1970/72)> unnamed. |
Publisher | Raleigh :The Board,1911- |
Agency-Current | North Carolina Department of Health and Human Services |
Rights | State Document see http://digital.ncdcr.gov/u?/p249901coll22,63754 |
Physical Characteristics | v. ;24 cm. |
Collection | Health Sciences Library, University of North Carolina at Chapel Hill |
Type | text |
Language | English |
Format | Reports |
Digital Characteristics-A | 7,112 KB; 158 p. |
Series | Biennial report of the North Carolina State Board of Health |
Digital Collection |
Ensuring Democracy through Digital Access, a North Carolina LSTA-funded grant project North Carolina Digital State Documents Collection N.C. Public Health Collection |
Digital Format | application/pdf |
Related Items | Printer: 13th (1909/10)-18th (1919/20) by Edwards & Broughton; 19th (1921/22)-20th (1923/24) by Bynum; 21st (1925/26)-<44th (1970/72)> unnamed. |
Title Replaces | North Carolina. Board of Health../1 |
Audience | All |
Pres File Name-M | pubs_edp_biennialreportboardofhealth19601962.pdf |
Pres Local File Path-M | \Preservation_content\StatePubs\pubs_edp\images_master\ |
Full Text |
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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