Biennial report of the North Carolina State Board of Health

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North Carolina State
Board of Health
Thirty-Eighth Biennial Report
OF THE
NORTH CAROLINA
STATE BOARD OF HEALTH
July 1, 1958-June 30, 1960
\
^^
MEMBERS OF THE STATE BOARD OF HEALTH
Appointed by the Governor
Mrs. J. E. Latta
Appointed 1953
Term expires 1961
Lenox D. Baker, M. D.
Appointed 1956
Term expires 1961
Z. L. Edwards, D. D. S.
Appointed 1957
Term expires 1961
Jasper C. Jackson, Ph. G.
Appointed 1959
Term expires 1963
Ben W. Dawsey, D. V. M.
Appointed 1959
Term expires 1963
Elected by the Medical Society of the State of North Carolina
John R. Bender, M. D., Vice-President
Elected 1949
Term expires 1961
Charles R. Bugg, M. D., President
Elected 1957
Term expires 1961
Roger W. Morrison, M. D.
Elected 1957
Term expires 1963
*Earl W. Brian, M. D.
Elected 1958
Term expires 1963
EXECUTIVE COMMITTEE
Charles R. Bugg, M. D., President
John R. Bender, M. D., Vice-President
Z. L. Edwards, D. D. S.
J. W. R. Norton, M. D., Secretary
EXECUTIVE STAFF AS OF JUNE 30, 1960
J. W. R. Norton, M.D., M.P.H., Secretary and State Health Director
(Term expires June 30, 1963)
**
, Assistant State Health Director
(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
Lynn G. Maddry, Ph.D., M.S.P.H., Acting Director, Laboratory Division
****
, Director, Personal Health Division
Charles L. Harper, M.S.P.H., Director, Administrative Services
•Dr. Earl W. Brian—deceased August 1, 1960.
••Dr John H. Hamilton served until his retirement, April 30, 1960.
***Dr. Ernpst A. Branch was Director until his death, December 3. 195S.
••••Dr. A. H. Elliot was Director until his retirement, June SO. 1959.
r» A /I f» O
^1
North Carolina Board of Health
LOCAL HEALTH DIRECTORS IN
NORTH CAROLINA
Department
6 Thirty-Eighth Biennial Report
Lenoir
McDowell
Madison
Martin
Mecklenburg
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
Dr. John Dillard Workman
Dr. W. F. E. Loftin
Dr. Margery J. Lord
Dr. W. A. Browne
Dr. Elizabeth C. Corkey
Dr. R. E. Fox
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. J. A. Johnson, P.T.
Dr. N. C. Wolfe, P.T.
Dr. Georgia V. Mills
Dr. H. C. Whims
Dr. Clem Ham
Dr. E. R. Hardin
Dr. C. T. Mangum, P.T.
Dr. C. W. Armstrong
Dr. Ann B. Lane
Dr. Clem Ham
Dr. R. E. Fox
Dr. J. S. Taylor, P.T.
Dr. R. B. C. Franklin
Dr. John R. Folger, P.T.
Dr. Claudius McGowan, P.T.
Dr. Conway Anderson Bolt
Dr. J. U. Weaver
Dr. Isa C. Grant
Dr. W. B. Jones, Jr.
Dr. S. B, McPheeters, P.T.
Dr. A. J. Holton
Dr. Joseph Campbell
Dr. Elizabeth C. Corkey
Dr. J. S. Chamblee
Kinston
Marion
Marshall
Williamston
Charlotte
Troy
Carthage
Nashvill©
Wilmington
Jackson
Jacksonville
Chapel Hill
Bayboro
Elizabeth City
Burgaw
Greenville
Asheboro
Rockingham
Lumberton
Spray
Salisbury
Rutherfordton
Clinton
Laurinburg
Albemarle
Danbury
Mount Airy
Brevard
Plymouth
Monroe
Henderson
Raleigh
Warrenton
Goldsboro
Wilkesboro
Wilson
Charlotte
Rocky Mount
NORTH CAROLINA
^
STATE BOARD OF HEALTH
RALEIGH
CHARUES R. BUaS. M. D.. PM« RALIISH
JOHN R ENDCR. M.O.. V1C«P«««. WlH»TOM.»ALM»
Z L EDWARD*. D D.». WA»MlMOTOH
MRS. J. E UATTA ... MILLMORO, RT 1
LENOX D RAKER, MB DURHAM
ROGER W, MORRI«ON. M.D. A»H«VIIXI
JASPER C. JACKSON. PH. O LUMSMTON
EN W. DAWSEY. D.V.M. OA»TONI<
OSCAR S GOODWIN. M.D APE)
R. NORTON. M D.. M.P.H.
December 1, I960
The Honorable Luther H. Hodgee
Governor of North Carolina
The State Capitol
Raleigh, North Carolina
Dear Governor Hodges:
PuTbuant to the provisione of Chapter 130, Article 11, Para-graph
12, General statutes of North Carolina, I herevdtb sutalt to you,
and through you, to the General Assembly of North Carolina, the Biennial
Report of the North Carolina State Board of Health for the fitical years
of July 1, 1958 - June 30, I960.
Respectfully submitted.
n/e
•'J. W. R. Norton, M. D.,
Secretary and State Health Director
Thirty-Eighth Biennial Report
TABLE OF CONTENTS
Report of Secretary-Treasurer
July 1, 1958- June 30, 1960 9
Conjoint Reports
Public Health and The Practicing Physician 48
Public Health Assists the Private Physician 51
Division Reports
Administrative Services 57
Local Health 63
Personal Health 85
Epidemiology 95
Sanitary Engineering 110
Laboratory 116
Oral Hygiene 123
Committee on Postmortem Medicolegal Examinations 129
Public Health Chronology 131
REPORT OF THE SECRETARY-TREASURER
AND STATE HEALTH DIRECTOR
July 1, 1958-June 30, 1960
Abridged report of the activities of the State
Board of Health as recorded in the Minutes:
July 17, 1958. The North Carolina State Board of Health met in regular
quarterly session, Thursday, July 17, 1958, 1:30 p.m. -4:30 p.m., in the
cafeteria of Rex Hospital, Raleigh. First, the Board members assembled
in room 440, where Associate Justice Emery B. Denny, of the Supreme
Court of North Carolina, administered the oath of office to Earl Winfrey
Brian, M.D., who was elected by the Executive Council of the Medical
Society of the State of North Carolina to fill the vacancy created by the
death of Dr. G. Grady Dixon, whose term expires May, 1959.
The Board members then adjourned to a room in the cafeteria of the
Hospital. The meeting was called to order by Vice-President, John R.
Bender, M.D., and Dr. Z. L. Edwards delivered the invocation. All members
of the Board were present.
On motion of Dr. Baker, seconded by Dr. Bugg, the minutes of the Board
meeting held on May 7, 1958 at Asheville, were approved as circulated.
Secretary Norton introduced Mr. Ben Eaton, Jr., who joined the staff on
April 28, 1958, as Director of Administrative Services. Mr. Eaton reported
on the progress of the work on air-conditioning of the Health Building,
stating that the installation work would begin on Monday, July 21, and
that it should be completed by the latter part of September. He also re-ported
on the progress of budget presentation before the Advisory Budget
Commission.
Dr. Baker discussed briefly the decision of the Executive Council and
House of Delegates of the Medical Society of the State of North Carolina
to ask the 1959 General Assembly to make vaccination against poliomyelitis
compulsory, and pointed out that a resolution was passed by the Board at
its last meeting in support of such legislation. He suggested that the
handling of this action be left to Dr. Norton who reported that the NCPHA
and North Carolina Congress of PTA had also passed resolutions favoring
support of the Medical Society in its request. On motion of Dr. Bugg,
seconded by Mr. Lutz, the Board went on record unanimously as approving
compulsory vaccination legislation.
Dr. Norton discussed an article which appeared in the June, 1958, JAMA
relative to chemical tests for intoxication. He stated that these tests seemed
to have reached a point where they are dependable and that during the
last Legislature the Motor Vehicle Department recommended this as one
means of cutting down on the cripplings and killings on the highways. After
discussion. Dr. Baker moved that the Board approve the passage of a law
in this State somewhat similar to that in New York to require persons
arrested for drunken driving to submit to a chemical test. Motion seconded
by Dr. Morrison, and unanimously carried.
10 Thirty-Eighth Biennial Report
Dr. John H. Hamilton, Chairman of a Committee composed of Dr. Z. L.
Edwards, Dr. Lenox D. Baker and Dr. J. W. R. Norton, submitted a draft
of a resolution of respect for Dr. G. Grady Dixon. Dr. Baker moved the
memorial resolution be adopted, and that a copy be recorded in the minutes
of this Board, that copies be sent to Mrs. Dixon and the two sons, and to
the North Carolina Medical Journal. Motion seconded by Mrs. Latta and
carried unanimously. Dr. Hamilton was thanked for preparing the well-written
resolution in memoriam and all stood for a moment in silent
memory of their departed friend. The memorial resolution reads as follows
:
"On May 7, 1958, while returning to his home in Ayden from Asheville,
where earlier in the day he had presided over the Conjoint Session of the
State Board of Health and the Medical Society of the State of North Caro-lina
and over a regular meeting of the North Carolina State Board of
Health, Dr. George Grady Dixon died in Hickory, North Carolina.
"George Grady Dixon was born near the Gardner's Cross Roads section
of Pitt County on April 29, 1890. His parents were John Mc Dixon and
Irene Buck Dixon. His education began in the graded schools in the com-munity
of his birth. He attended Winterville High School, from which he
graduated in 1908. From 1911 to 1915 he attended the Medical College of
Virginia, in Richmond, graduating in 1915. He served his internship at the
Grace Hospital, Detroit, Michigan. Following this he started the practice of
medicine with the late Dr. W. Harvey Dixon in Ayden, North Carolina.
The people of this community began to call him "Dr. Grady" to distinguish
him from the other Dr. Dixon. During World War I Dr. Grady Dixon
enlisted in the Army in 1917 as a lieutenant and was honorably discharged
in 1919 as a captain. His association with Dr. Harvey Dixon was severed
in 1925, when Dr. Harvey Dixon became head of the Caswell Training
School at Kinston. Even after Dr. Harvey was no longer in the office the
patients, as well as most of the people in that part of Pitt County, spoke
of "Dr. Grady" not for distinguishing purposes but as a term of affection.
"Dr. Dixon was married to Miss Julia Elliott of Hertford. They have two
sons, Grady, Jr., who is a student at North Carolina State College and
John Elliott, who graduated in medicine at Duke University early in June.
"Since 1931 Dr. Dixon served as a member of the State Board of Health.
He was selected by the Executive Committee of the North Carolina Medical
Society to succeed Dr. James M. Parrott, who resigned to become State
Health Officer in July of that year. In May, 1932, he was re-elected to that
position and has been re-elected since then. In 1949 he was elected President
of the State Board of Health, an office which he held at the time of his
death,
"Many times the medical profession has called upon Dr. Dixon for service
and has honored him on numerous occasions. One of the honors most prized
by him came in March, 1956, when he received from the School of Medicine
at the University of North Carolina the Distinguished Service Award for
'significant achievement and meritorious service in medicine.'
"In addition to his interest in the broad field of medicine, he felt a deep
sense of duty to other activities in his community. He was instrumental in
the organization of the Rotary Club 36 years ago. He was the first president
of the club. He was a devoted church member, an active member of the
Methodist Church, an assistant teacher of the Men's Bible Class for many
vears and a member of the Board of Trustees. He was active in the American
Legion, being Commander of Pitt County Post in 1921 and 1922. He was
president of the First National Bank in Ayden during the trying years
of the early 30's and until 1937.
"Because of his faithful service to his community, to his profession, to
the cause of public health and to the well-being of the State of North
Carolina, the North Carolina State Board of Health wishes to express its
appreciation of the life that he lived and the high service which he rendered
to his native State.
North Carolina Board of Health 11
"THEREFORE, be it Resolved, That a copy of this expression of appre-ciation
be published in the North Carolina Medical Journal; The Health
Bulletin; a copy placed in the minutes of the State Board of Health, and
that a copy be sent to Mrs. Dixon and his sons.
John H. Hamilton, M.D., Chairman
Lenox D. Baker, M.D.
Z. L. Edwards, D.D.S.
J. W. R. Norton, M.D."
Secretary Norton read and discussed a letter and resolution received
from the State Association of County Commissioners, whereby this Asso-ciation
offered at its June meeting a resolution of support and aid in
seeking an additional appropriation by the State for aid to local health
departments. Dr. Baker moved that Dr. Norton write a letter to the proper
official of the Association of County Commissioners expressing appreciation
for its interest in and support of an increased State appropriation and
that the Board solicits and will appreciate help in getting the increased
State aid to local health departments. Motion seconded by Dr. Edwards and
carried. Also, the Secretary-Treasurer of the Association, Mr. Alex Mc-
Mahon questioned Secretary Norton regarding the possibility of using some
trained business administrators to serve as local health directors. The Asso-ciation
was informed that it was the general feeling of the Board, through
the years, that so many duties of a local health director involved medical
professional responsibility rather than business administration, it is con-sidered
better to have a physician trained in public health as a local health
director.
Mr. Ben Eaton was called on to report on comparison of North Carolina
State aid to local health departments with those of neighboring states. He
discussed the comparative financial support by various states in this region
to public health, particularly to the local health departments. It was pointed
out that each state approaches the problem of administration and cost on
a somewhat different basis—some are highly centralized, some are in
between, and others, such as North Carolina, operate within the framework
of extensive local autonomy and strong financial contributions by the coun-ties.
This local contribution is considerably above most of the states in this
region and above the national average while Virginia and a few other
states make a larger state appropriation for local health services.
Looming large in the fiscal picture is that the State of North Carolina
has been committed, since the early 30's, to the operation of a nine-months
school plus the cost of schools of higher learning and for highways since
the early 20's. With steadily mounting expenditures through the years
for education and highways requiring a large proportion of the tax dollar,
a relatively small percentage has been appropriated for state health pro-grams
and for contributions by the State to local health departments. Al-though
the State support to local health departments is substantially below
the average of many states, it would appear necessary that this strong
financial support by the County Commissioners should continue, if standards
are to be maintained and be improved until additional sources of revenue
can be provided by the State.
As a matter of information, Dr. Norton discussed retirement of public
health workers. He stated that at meeting of the Governor's Committee on
12 Thirty-Eighth Biennial Report
Aging, of which he is Vice-Chairman, it was requested by Mr. Nathan
Yelton that each agency study the retirement regulations. He briefly re-viewed
the present regulations under which we operate of no physical
examination required and no compulsory retirement age. We have only the
one supervisor's recommendation at age 65 and after age 70 the recom-mendation
at two year intervals. He pointed out the variations and modi-fications
now used by different agencies. The State Board of Public Welfare
requires an annual physical examination and recommendation by the super-visor
for continued employment after age 65 and compulsory retirement at
age 70. He also stated that the subject might well be brought up for further
consideration by the Board for possible amendments and of course it may
be considered by the 1959 General Assembly. No action taken.
Secretary Norton reported on the "Public Health Bulletin" which was
recently prepared and distributed by the Institute of Government. This
Bulletin has no official connection with the State Board of Health, other
than to explain and help to bring about a better understanding of the
revision of our public health laws. There is no conflict whatever with our
regular monthly Health Bulletin. He stated further that this Bulletin would
probably be issued for a limited time only, until it has served its purpose.
Dr. Z. L. Edwards reported on the critical illness of Dr. E. A. Branch,
Director of the Oral Hygiene Division, and high tribute was paid to him
and his worl: in the State by the Board. Dr. Edwards introduced the follow-ing
resolution for the permanent record, and asked that a copy be sent
to Mrs. Branch. Dr. Baker seconded the motion and it was unanimously
carried, reading as follows:
"Having learned with deep regret of the illness of Dr. Ernest A. Branch,
Director of the Oral Hygiene Division, therefore, be it
"RESOLVED: That this Board go on record as expressing its serious
concern regarding the condition of this faithful public servant and the
earnest hope for his speedy recovery."
There was some discussion relative to a policy for sending flowers in the
name of Board members to deceased members. No action was taken but
members were asked to send in their wishes and suggestions to Secretaiy
Norton.
Mr. Charles R. Council, Chief of Public Health Statistics Section, reported
on the problems in registration of delayed birth certificates. This was
discussed briefly and no action taken. Dr. Norton was asked to investigate
the matter further with the appropriate officials.
Mr. E. C. Hubbard, Director of the Water Pollution Control Division,
presented a report covering an investigation of the needs of sewage works
improvements due to inadequate sewage collection and disposal facilities
in the Town of Troy, North Carolina, together with a resolution from the
Town requesting that the State Board of Health issue an Order requiring
the Town of Troy to proceed with the construction of sewerage system
improvements for the protection of public health. Mr. Hubbard stated that
these conditions had been thoroughly investigated and studied. And, in
view of these findings he recommended that the State Board of Health
Order the Town of Troy to make necessary sewer system and sewage dis-
North Carolina Board of Health 13
posal improvements in order to provide adequate disposal facilities. On
Motion of Mr. Lutz, seconded by Mrs. Latta, a RESOLUTION ORDER-ING
THE TOWN OF TROY, NORTH CAROLINA TO PROCEED WITH
THE NECESSARY SEWERAGE SYSTEM IMPROVEMENTS, was
unanimously adopted.
Mr. J. M. Jarrett, Director of the Sanitary Engineering Division, dis-cussed
the insanitary conditions existing in the Town of Princeton, which
have resulted from inadequate facilities for collection and disposal of sewage
from the Town. He stated that a thorough investigation had been made by
his department; and, for the protection of public health, it recommended
that the Board adopt a resolution ordering the Town of Princeton to install
adequate sewage collection system and treatment facilities. On motion of
Dr. Morrison, seconded by Dr. Henderson, an ORDER FOR THE TOWN
OF PRINCETON, NORTH CAROLINA TO MAKE NECESSARY SEWER-AGE
AND SEWAGE DISPOSAL IMPROVEMENTS, was unanimously
adopted.
Mr. Jarrett also discussed a request from the City Manager of Monroe,
North Carolina, to permit conti-oUed recreational activities such as fishing,
hunting and boating at the two municipal water supply lakes, which was
described in detail in the ordinance adopted by the Board of City Commis-sioners.
Mr. Jarrett stated that his division had investigated the situation,
and that in their opinion, the properly controlled use of the lake for such
purposes as stated would not cause any material hazard to the treated
municipal water supply, and he recommended approval of the request by
the City Manager. On motion of Mr. Lutz, seconded by Mrs. Latta, a RESO-LUTION
OF THE NORTH CAROLINA STATE BOARD OF HEALTH
AUTHORIZING THE CITY OF MONROE, NORTH CAROLINA, TO
PERMIT CONTROLLED FISHING, HUNTING AND BOATING IN
LAKE LEE AND THE NEW CITY LAKE, was unanimously passed.
A resolution regarding the creation of a Carteret County Mosquito Dis-trict
was read and presented briefly by Mr. Jarrett. The creation of such
districts was authorized by the 1957 General Assembly. The Carteret County
application is the first received under this law. When deemed advisable and
in the interest of public health, a County Board of Commissioners may adopt
a resolution favoring such a district and present the petition to the State
Board of Health. On motion of Dr. Bugg, seconded by Mr. Lutz, the RESO-LUTION
RE THE ADVISABILITY OF CREATING THE CARTERET
COUNTY MOSQUITO CONTROL DISTRICT, was passed.
Mr. Jarrett then discussed proposed rules and regulations governing the
disposal of sewage from any residence, place of business, or place of public
assembly. He brought out that the change in the Public Health laws re-written
and passed by the 1957 General Assembly required new rules and
regulations in view of the fact that the old "Privy Law" was i-epealed and
re-written in one new section. Items relating to "place of public assembly"
to be covered under the new regulations and exemptions were discussed.
The State Board of Health Bulletin #454 relating to the construction of
Privies and Bulletin #519 relating to Septic Tanks were also discussed. It
was pointed out that these bulletins had been corrected to conform to
the new regulations. Upon motion of Dr. Baker, seconded by Mr. Lutz, the
rules and regulations and the two bulletins referred to above, presented
July 17, 1958, were approved, to become effective August 15, 1958.
14 Thirty-Eighth Biennial Report
Also, Mr. Jarrett presented proposed revised rules and regulations gov-erning
the sanitation of restaurants, hotels and motels. He stated that his
Division had worked with the N. C. Association of Quality Restaurants,
N, C. Hotel Association and the N. C. Motel Association in the revision of
these regulations, and that committees of these three associations were in
accord with what was being proposed with the exception of two items, and
had requested that these two items be presented to the Board for discussion.
They were: (1) Item #17 relating to milk and milk products in which they
requested that reference to approval of bulk milk dispensers by local board
of health milk ordinance be deleted; and, (2) Item #18 relative to medical
health certificate changes. Mr. Jarrett discussed these requests in detail,
and recommended that reference to local milk regulations be deleted from
Item #17 of the restaurant regulations. Dr. Baker moved the adoption of
the regulation provided that the phrase contained in #17 "where permitted
by the regulations of the local board of health" be deleted; and that a
committee be appointed by the President to further study health examina-tions
and health certificates for employees of restaurants, hotels, and motels,
and to bring recommendations to the Board for revision. Motion seconded
by Dr. Edwards, and carried. Vice-President Bender appointed the follow-ing
to serve on this committee working with Dr. Norton and Mr. Jarrett:
—
Dr. Morrison, Dr. Edwards and Mr. Lutz. These rules and regulations are
to become effective October 1, 1958.
Dr. Baker discussed a proposed Sea Level Hospital addition for crippled
children as information for the Board. No action by the Board at this time
was considered necessary as adequate machinery has been set up previously
for the handling of this matter.
As information, and by request of Dr. Walter Hunt of Raleigh, Dr. Norton
discussed the use of tetanus toxoid instead of antitoxin in trauma cases.
There was much discussion but it seemed to be the consensus of the group
that this subject was not within the province of the State Board of Health
to suggest specific handling of these cases, in each of which the attending
physician uses his best judgment to fit the need.
At this point the meeting adjourned again to Room 440 in the hospital
for the election of a President to fill Dr. Dixon's unexpired term. The
following were elected:—President, Charles R. Bugg, M.D., and Member of
the Executive Committee, Z. L. Edwards, D.D.S. Adjournment.
December 18, 1958. The regular quarterly meeting of the N. C. State
Board of Health was held Thursday, December 18, 1958, 1:00 p.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, and an introduction
of Division Directors and Assistants was made.
On motion duly made by Dr. Baker and seconded by Dr. Bender, minutes
of the Board meeting held on July 17, 1958, were approved as circulated
to the members of the Board by the Secretary.
Secretary Norton made a further report on the retirement plan of public
health workers—reviewing the policy and regulations of the Highway Com-mission
and that of the State Public Welfare Department as compared to
the Board of Health. He pointed out the various methods used by different
North Carolina Board op Health IB
agencies; for instance, the Welfare Department requires an annual physical
examination after age 65 years and compulsory retirement at age 70. A
Highway Commission employee is retired at age 65 unless his department
supervisor requests that he be retained and this recommendation has to
be approved by the Director. The case of each employee retained after age
65 is reviewed each year and a thorough physical examination is required.
The cost of these examinations are borne by the Commission. There was a
discussion, and Dr. Norton was asked if he had any recommendations to
make. He stated none at the present except it might be well to consider
working out a plan for re-imbursement for State Board of Health em-ployees'
annual physical examinations after age 65 just as the Highway
Commission had adopted and an annual review and recommendation
regarding retention after age 65 rather than the one five-year recommen-dation
at 65 and each two years after age 70. No action taken.
In discussing the policy of sending flowers from the Board members to
deceased members, or establishing a memorial fund in the name of the
Board, it seemed to be the consensus that each member should make his, or
her, contribution in any way preferred. Dr. Baker moved, seconded by Dr.
Brian, that each member act according to his own wishes, and not as a
unit. Motion carried.
Secretary Norton reviewed, and gave a brief report on the "A" and "B"
Budgets of the Board for the biennium 1959-1961. The "A" Budget repre-sents
a continuation of existing functions and services. This has been
tentatively approved by the Advisory Budget Commission. The "B" Budget
represents requirements for expansion of activities, transfers from Federal
to State funds, or increases in services, not provided in the "A" Budget,
such as additional aid to local health departments, accident prevention,
mental health centers, veterinary public health, etc. The Secretary pointed
out that no definite action is indicated until the Advisory Budget Commis-sion
releases its report and recommendations early in February, 1959.
Dr. Robert D. Higgins, Director of the Division of Local Health, pre-sented
a proposed tentative allotment plan for the distribution of additional
state funds for county health departments as requested in the "B" Budget.
The present policy was explained by Dr. Higgins, and a discussion followed
by the members. Upon motion of Dr. Baker, seconded by Dr. Edwards, the
Board approved the formula recommended for increase in aid to counties
according to the "B" Budget. Motion unanimously carried.
Dr. Wm. M. Peck, Chief of Chronic Diseases-Radiation Section, made a
progress report on the Radiation Protection Study and Advisory Committee.
He pointed out that the Committee has completed an extensive set of rules
and regulations concerning the use of radioactive materials. These are
ready—except for minor changes—to be presented to the Board for its con-sideration.
On the legal advice of Mr. McGalliard the committee is also
preparing a proposal for enabling legislation which should definitely be
adequate to support these regulations. This is designed to give the State
Board of Health a measure of authority over radiation similar to that it
now exerts in the control of other environmental hazards. Dr. Baker made
a motion that the report be accepted; Dr. Bender seconded the motion, and
the motion was carried. The staff of the State Board of Health, together
with health physicists from State College, have organized an emergency
16 Thirty-Eighth Biennial Report
team for providing assistance in event of a radiation accident in North
Carolina, It is composed of health physicists, physicians, nurses and engi-neers
who are now meeting at regular intervals to rehearse emergency
procedures. The team will be transported by the Highway Patrol or by
aircraft of the National Guard.
Dr. Norton pointed out that the Board might wish to nominate a successor
to replace the late Dr. G. Grady Dixon as our representative on the N. C.
Health Council. The group is made up of organizational representatives
of agencies connected with public health. Dr. Baker moved that Dr. John R.
Bender be elected to represent the Board on the N. C. Health Council.
Motion seconded by Dr. Edwards, and unanimously carried.
Mr. J. M. Jarrett, Director of the Sanitary Engineering Division, pre-sented
a petition for the creation of a sanitary district in Cabarrus County,
to be known as the South Concord Sanitary District. Mr. Jarrett stated
that all documents and transactions had been examined by his office and
were, in his opinion, in order and in compliance with the law, and he recom-mended
that the State Board of Health act favorably on the creation of this
sanitary district. The matter was discussed, and upon motion of Dr. Baker,
seconded by Dr. Brian, the RESOLUTION OF THE N. C. STATE BOARD
OF HEALTH CREATING THE SOUTH CONCORD SANITARY DIS-TRICT
IN CABARRUS COUNTY, was carried.
Mr. Jarrett also presented a request for the extension of the boundary
lines of the Rural Hall Sanitary District. He stated that the documents, as
well as the various transactions relative to this matter, had been examined
by his office and were in order, and he recommended favorable action by
the Board. On motion of Dr. Baker, seconded by Dr. Brian, the RESOLU-TION
OF THE N. C. STATE BOARD OF HEALTH EXTENDING THE
BOUNDARY LINES IN THE RURAL HALL SANITARY DISTRICT
IN FORSYTH COUNTY, was passed.
Then, Mr. Jarrett presented a request for the issuance of an order to the
Town of Asheboro to construct a new sewage treatment plant and sewer
extensions. He pointed out that this request for an Order had come from
the town; that all documents and pertinent information had been carefully
reviewed and are in order, and he recommended that the Order for the town
to install adequate sewerage system and suitable treatment facilities be
adopted. It was moved by Dr. Baker, seconded by Dr. Brian that the RESO-LUTION
BY THE NORTH CAROLINA STATE BOARD OF HEALTH
ORDERING THE TOWN OF ASHEBORO TO MAKE NECESSARY
SEWERAGE AND SEWAGE DISPOSAL IMPROVEMENTS, be adopted.
Motion carried.
Also, Mr. Jarrett presented a request for an Order for the Town of
Huntersville to install a new sewage treatment plant and sewer extensions.
He reported all documents and transactions had been examined by his office
and were, in his opinion, in order and in compliance with the law, and he
recommended favorable action by the Board. Dr. Baker moved, seconded
by Dr. Brian, that the RESOLUTION BY THE NORTH CAROLINA
STATE BOARD OF HEALTH ORDERING THE TOWN OF HUNTERS-VILLE
TO MAKE NECESSARY SEWERAGE AND SEWAGE DIS-POSAL
IMPROVEMENTS, be adopted. Motion carried.
North Carolina Board of Health 17
President Bugg discussed chemical tests for alcohol in drivers. He stated
that the Motor Vehicles Department in the past, had suggested and recom-mended
to the General Assembly that a blood test for alcohol in the blood
be authorized, that there are a number of states that have different kinds of
laws at this time. He stated that it was his feeling that we have reached
a point where this test is reliable and dependable enough so that it would
be desirable to cut down on deaths and injuries on our highways by use
of this requirement and that he felt if the Motor Vehicles Department again
presents a proposal of this nature to the General Assembly it should have
the backing and support of the State Board of Health. After discussion.
Dr. Brian moved that the Board of Health, through Dr. Norton, notify the
Motor Vehicles Department that the Board is interested in and supports
any movement to reduce deaths and maiming of human beings by motor
vehicles in North Carolina occurring on our highways. Motion seconded
by Dr. Baker, and carried.
Dr. Z. L. Edwards asked that a discussion of the School Health Coordi-nating
Unit be arranged for a special meeting since he feels this subject
needs more time and thought than could be allotted at this meeting. Dr.
Baker suggested that members of the Dental and Medical Societies' Advisory
Committees on School Health and State Coordinating Service be invited.
These proposals by Dr. Edwards and Dr. Baker were agreeable to all
present.
Dr. Edwards read the following resolution for adoption by the North
Carolina State Board of Health, in memory of Dr. Ernest A. Branch, who
passed away December 3, 1958:
"RESOLUTION ADOPTED BY THE NORTH CAROLINA STATE BOARD
OF HEALTH, DECEMBER 18, 1958, IN MEMORY OF
DR. ERNEST A. BRANCH
'Whereas, death has removed from our midst a most illustrious Public
Health worker of the nation in the person of Dr. Ernest A. Branch, who
for twenty-nine years headed the dental health program of the North Caro-lina
State Board of Health, and
'Whereas, his professional skill, his deep sense of human value and his
love for his fellow beings, especially children, eminently fitted him to per-form
those services to which he had dedicated his life; now therefore, be it
'Resolved, by the State Board of Health, collectively and individually,
that, while we regret the passing of this great and good man, we take
special pride in the work he wrought and the secure foundation he laid for
continuation of the program he established; and be it further
'Resolved, that we commend not only the work he did among our chil-dren,
but also the great contribution he made in bringing our people from
ignorance to enlightenment concerning the protection afforded through
fluoridation of our public water supplies; and further, be it
'Resolved, that copies of this resolution be spread on the minutes of
the Board, furnished the press, published in the Health Bulletin and
given to the Executive Secretary of the North Carolina Dental Society
and to the members of Dr. Branch's immediately family.'
Signed: Charles R. Bugg, M.D., President
J. W. R. Norton, M.D., Secretary"
Dr. Edwards moved the adoption of the resolution, seconded by Dr. Ben-der,
and carried by all members standing in silent tribute.
18 Thirty-Eighth Biennial Report
Dr. Edwards then read the resolution in memory of Dr. Branch adopted
by the Raleigh Dental Society, December 6, 1958, as follows;
"RESOLUTION IN MEMORY OF DR. ERNEST A. BRANCH ADOPTED
BY THE RALEIGH DENTAL SOCIETY, DECEMBER, 6, 1958
'Whereas, the Lord has called unto Himself our loved one, Dr. Ernest A.
Branch, who gave his life for the welfare and happiness of the children of
our State and Nation and who exemplified in his living the teachings of
our Saviour when He said, 'Suffer the little children to come unto me,
and forbid them not: for of such is the kingdom of God'; and
'Whereas, Dr. Branch, more than any other public health worker, knew
our State, its people, and their needs and dedicated a life of service and
devotion to the cause of better dental health for the citizens of North Caro-lina;
and
'Whereas, Dr. Branch, recognizing with gratitude and appreciation the
contributions of others and never seeking acclaim for himself, accepted
the many honors bestowed upon him with humble and gracious thanks,
not only for himself, but also for all who had had a part in his achievement;
and
'Whereas, The dental profession of this State, collectively and individ-ually,
are the beneficiaries of his sincerity, wisdom, and zeal in promoting
and protecting the highest professional and ethical standai'ds, thus adding
immeasurably to the prestige and stature of dentistry in North Carolina;
"tViGrGforG be it
'Resolved, That while we, the members of the Raleigh Dental Society,
mourn the passing of our loved one whose endearing personality, unusual
gift of humorous expression, superior intellect, and sympathetic nature made
him a dominant figure among his fellows, we will cherish the memory of
Dr. Branch as a great leader, teacher, and counselor: as a good man; and
as a dear friend; and be it further
'Resolved, That we extend to the members of Dr. Branch's family and
to the State Health Department our heartfelt sympathy in the great loss
that they have suffered through his death; and be it further
'Resolved, That copies of this resolution be entered in the minutes of the
Raleigh Dental Society and be sent to the Director of the North Carolina
State Board of Health, the North Carolina Dental Society, and the members
of Dr. Branch's immediate family.'
Signed: Dr. James H. Edwards, President
Raleigh Dental Society"
Dr. Edwards moved approval of and concurrence with this resolution,
seconded by Dr. Baker, and passed.
Dr. Baker then suggested that a picture of Dr. Branch be obtained,
framed and appropriately displayed in the Cooper Memorial Health Build-ing.
Dr. Norton briefly reviewed the proposed legislative changes to be con-sidered
by the 1959 General Assembly. These proposals have been cir-culated
and contain information the Board should know about as the
Legislature goes into session.
Also, Secretary Norton stated that many boards meet on pre-arranged
dates, whereas the Board of Health meets at the call of the President,
and he said he would like to know if the Board wished to set definite times
to meet. It was the consensus that the present arrangement is all right
and no change was made.
North Carolina Board of Health 19
Mr. Jarrett reported briefly on air pollution control. He stated that there
was no set state law on air pollution. At present, the Board of Health is
carrying on a survey made possible by a grant from the Public Health
Sei-vice,—attempting to get a report on conditions throughout the State
by questionnaires and personal visits, and it is hoped that this report will
be available about April. He also pointed out that this study should be of
considerable interest and would probably indicate the type of problems we
have in this State and might help to determine whether we need legislation
on air pollution control.
Dr. Norton discussed briefly the limitation of state-federal funds to local
departments with part-time health directors after a specified period. He
stated that it was very difficult to employ qualified directors, and also that
a part-time health director is not able to devote regular time to health
work. No recommendation was made at this time due to lack of qualified
directors except that the subject should be considered later.
Dr. Norton discussed the status of the position of Assistant State Health
Director. The amount requested has been turned down (Salary grade 75
—
$12,132 to $14,232 with approval of Grade 67—$10,104 to $12,036) and he
asked the Board for instructions as to appealing to the Personnel Council
for approval of our request. Dr. Baker moved that the appeal be made.
Motion duly seconded by Dr. Bender, and passed.
Mr. Jarrett was asked to give a brief report on the recommendation of
the Philpott Committee (Committee on Reorganization of State Government
dealing with the subject of water pollution). Mr. Jarrett gave a brief
history of the creation of the Board of Water Commissioners by the 1955
General Assembly and also the activities of the Commission on Reorgani-zation
of State Government dealing with the overall picture of the State
Water Resources. He said that the Philpott Committee report issued in
December 1958 contained the recommendation that the State Stream Sani-tation
Committee be transferred to the new Department of Water Resources
and that this new Department of Water Resources would be designated to
act as the administrative agency of the Stream Sanitation Committee. This
would also mean that the Division of Water Pollution Control established
in the State Board of Health by Legislative Act of 1957 would also be
transferred to the new Department of Water Resources.
Mr. Jarrett also advised that the first rough draft of the Bill has been
prepared but that he has not had an opportunity to study it thoroughly.
There were some questions raised, however, which need clarification as to
the possible transfer of health functions from the State Board of Health
to the new Department of Water Resources should such department be
established. He plans to discuss this with representatives of the Institute
of Government v.'ho are working on the preparation of this Bill for Mr.
Philpott's Committee.
Mr. E. C. Hubbard, Director of the Water Pollution Control Division,
submitted a resolution passed by the Board of Aldermen of the Town of
China Grove requesting the North Carolina State Board of Health to
issue an order directing that certain improvements be made to the sanitary
sewer system of said Town, including the erection of a sewage treatment
plant, so that the said Town of China Grove may issue bonds for such
purpose which would result in exceeding the limitation of 8</r of the last
20 Thirty-Eighth Biennial Report
assessed valuation as prescribed in the Municipal Finance Act. In the
absence of such an order, the necessary bonds could not be issued. Studies
conducted by the Division of Water Pollution Control show that the popu-lation
has grown from 1,491 in 1950 to an estimated 1,700 at present. These
people live in 546 residences and are served by 60 business establishments
and three schools with an enrollment of 1,234 pupils. All are connected
to a sewer system discharging to four overloaded primary sewage treatment
plants which have resulted in conditions contravening established water
quality standards in classified receiving streams and complaints. The
Town in recognition of its responsibilities in these matters has caused
plans and specifications to be prepared for corrective facilities which have
been approved by the Division of Water Pollution Control and the Public
Health Service for a Federal grant under Public Law 660 in the amount
of $90,019. However, the Town cannot proceed further in this matter until
bonds can be issued. Mr. Hubbard, therefore, recommended that the Board
act favorably upon the request for an order to provide the required facili-ties.
Dr. Baker moved that a RESOLUTION ORDERING THE TOWN
OF CHINA GROVE TO MAKE NECESSARY SEWAGE DISPOSAL
IMPROVEMENTS, be adopted. Motion seconded by Dr. Bender, and
carried.
Dr. Fred T. Foard, Director of the Epidemiology Division, presented
the need for change in the General Statutes of North Carolina concerning
rabies vaccination and occupational diseases.
1, To provide that the County Commissioners of each county of the
State be permitted to set the fee to be paid for the vaccination of dogs
against rabies. He explained that the present fee of $1.00 per vaccination
has, in the past, been adequate to support the present anti-rabies program
by reason of the necessity for vaccinating dogs annually but with the recent
use of a new vaccine which will necessitate vaccination only once in three
years, the vaccination fee must be raised to provide for the employment
of dog wardens and other expenses incident to the Rabies Control program.
On motion of Dr. Baker, seconded by Dr. Bender, the Board voted to sup-port
the Association of County Commissioners in their movement to extend
anti-rabies control by granting freedom to counties from the limitation
to the $1.00 fee. Motion carried.
2. (a) Dr. Foard advised the Board that legislation enacted In 1935
placed the responsibility for providing occupational health services under
the State Industrial Commission but that these services must be performed
by the State Board of Health. He pointed out that in 1935 and for several
years thereafter an allotment of $10,000 per annum was made by the In-dustrial
Commission to the State Board of Health but this allotment has
been discontinued. The law, however, has never been changed to make this
service a direct responsibility of the State Board of Health rather than
through the Industrial Commission. Dr. Foard recommended that the State
Board of Health consider approval of legislation which would transfer
occupational health services directly to the State Board of Health and to
solicit similar approval for such legislation by the Industrial Commission.
2. (b) Dr. Foard stated to the Board that under the North Carolina
law twenty-seven (27) diseases are mentioned as occupational diseases and
suggested that for a broader coverage of occupational diseases or hazards
North Carolina Board of Health 21
the State Board of Health give consideration to endorsement of a change
in existing compensation laws to include all disabling conditions, the
origins of which are traceable to industrial employment, so that they will
become compensable. No action taken.
2. (c) Dr. Foard stated to the Board that to enable the Occupational
Health Section of the State Board of Health to establish preventive meas-ures
in the control of occupational diseases or hazards it is necessary to
know where, when and under what conditions these diseases or hazards
are occurring. He further pointed out that in most industrial states all
compensable diseases or accidents occurring in industry are routinely
reported to the State Board of Health or other agency responsible for
industrial preventive medical services. Dr. Foard recommended that the
State Board of Health give consideration to the endorsement of legislation
which would require routine reporting by the Industrial Commission to the
State Board of Health of all diseases or conditions for which compensation
claims are made, or in the event legislation is not sought, that an agree-ment
be entered into between the State Board of Health and the Industrial
Commission under which complete reporting will be routinely carried out.
Upon motion of Dr. Baker, seconded by Dr. Brian, the Board voted to
authorize Dr. Norton personally to notify the Chairman of the Industrial
Commission that if and when the list of compensable diseases and hazards
is extended the State Board of Health personnel will render any assistance
it can. Motion carried.
Reporting for the Orthopedic Credentials Committee (consisting of the
professors of orthopedic surgery at each of the medical schools, one repre-sentative
of the N. C. Orthopedic Association and the head of the N. C.
Orthopedic Hospital), Dr. Baker explained that in the past when an ortho-pedist
wanted to get on the cripplea children's program his application was
referred to the Credentials Committee. This Committee saw that the appli-cant
met such requirements as special training in orthopedic surgery and
had passed the specialty board, but actually knew very little about the
individual surgeon's ability. The Credentials Committee now proposes that
one or more of its group observe applicants perform several operations in
an effort to learn what kind of work the applicant does, what kind of
judgment he uses and what kind of results he gets. Dr. Baker asked for
and received the Board's approval for this observation and evaluation of
an orthopedist before he is accepted on the crippled children's roster. (This
paragraph amended by Board meeting held on January 18, 1959, Sir Walter
Hotel, Raleigh)
Dr. Jacob Koomen, Jr., of the Communicable Disease Section, reported
on a meeting of the Committee to Study Plan A For State Employees
Health Services. He stated that the North Carolina Health Council ap-pointed
a Committee in 1955 to study a plan to supply certain preventive
medical services to state employees. This matter was discussed before the
Board in 1956. Recently the Committee consisting of Dr. J. W. R. Norton,
Dr. Ellen Winston, Dr. William Richardson, Dr. Logan Robertson and Mr.
James T. Barnes was reactivated for the purpose of re-exploring the
possibility of preventive medical services for state employees. At a recent
meeting of the Committee a plan was advanced to set up three units of
four rooms each. The individual ynit was to have a full-time nurse and a
22 Thirty-Eighth Biennial Report
private physician. Dr. Koomen reported on a meeting of the Committee
held with Mr. Paul A. Johnston. Mr. James T. Barnes discussed the nature
of the preventive services. Mr. Johnston suggested that a one room unit
might be appropriate for a pilot study of the use of such services. Initially,
first aid and medical screening vi^ould be expected of the unit; later pre-employment
physical examinations and placement examinations might be
envisioned as functions. Mr. Johnston indicated that he would discuss the
plan with Governor Hodges. It should be emphasized that administration of
such a unit would likely be under the Personnel Department and that the
State Board of Health is not being asked to play any role in administration,
medical or nursing support, supervision or guidance.
Dr. Bender mentioned to the Board that he thought it would be a good
idea to have a Legislative Committee to study proposed laws and legis-lation
and report to the members of the Board of Health. After discussion,
the President ruled that the Executive Committee should serve as a Legis-lative
Committee to study any outstanding health measures or proposed
legislation and report to the Board, either pro or con.
On motion duly made and seconded, the meeting adjourned at 4:30 p.m.,
and designated the next Board meeting to be held Sunday, January 18, 1959,
10:30 a.m. to 3:30 p.m., Sir Walter Hotel, and inviting the members of
the Dental and Medical Societies' Advisory Committees on School Health
and State School Coordinating Service to meet jointly. Adjournment.
January 18, 1959. A joint meeting of the School of Health Committees
of the Medical Society of the State of North Carolina and the North Caro-lina
Dental Society was set for 10:30 a.m., Sunday, January 18, 1959, Sir
Walter Hotel, Raleigh.
The President called the Board members present together, but since at
that time there was not a quorum, the group was adjourned in order that
the members present could as individuals attend the joint Committee meet-ing
on School Health work.
At about 1:30 p.m. and since Dr. Earl Brian had arrived completing the
quorum, a short Board session was held.
The minutes of the December 18, 1958 meeting were approved as cir-culated
with the exception of a correction made by Dr. Lenox D. Baker
regarding a report for the Orthopedic Credentials Committee as follows:
"The Credential Committee now proposes that the applicant shall
:
1. Be certified by the American Board of Orthopedic Surgeons, Inc.
2. Have practiced orthopedic surgery in the State of North Carolina for
a minimum of one year.
3. Have attended one or more of the regular State crippled children's
clinics under the supervision of a qualified Clinic Director for at least
one year, a minimum of twelve clinic visits including at least six
attendances at one clinic.
4. Carry out a clinical review to the satisfaction of an Examining Board
appointed by the State Board of Health or its agent and consisting
of three qualified orthopedic surgeons from outside his community
who will visit the applicant in his home town for a period of one or
two days. The clinical review to consist of:
(a) The demonstrating of a group of pre-operative cases and post-operative
results,
North Carolina Board of Health 23
(b) Of performing two to three operations the general nature
of which must have been agreed upon previously by the Board,
(c) Presentation of operative notes of all cases for the past year, if
asked for by the Board.
5. Agree to have the State Board of Health or its agents obtain, from
whatever local persons or agencies they deem necessary, letters in
regard to the applicant's moral character in all aspects of his pro-fessional
relationships within his community."
The above motion for correction was made by Dr. Baker, seconded by
Dr. Bender, and passed.
In view of the services that have been rendered by the State Health
Director and in view of his expanding responsibilities and his value to the
State Board of Health, the Board discussed the advisability of an increase in
his salary to $18,000 per year. Dr. Brian moved and Dr. Edwards seconded
the motion that the President of the Board be requested to make for the
Board a request to the Advisory Budget Commission that such a change in
the salary of the State Health Director be made. Motion passed.
There was some discussion of the possible desirability of having a good
physical checkup on State Board of Health employees annually beginning
at age 65. Dr. Bake:; moved and Dr. Bender seconded a motion (1) that an
annual physical checkup—not a complete clinical survey running into many
dollars—be required of State Board of Health employees beginning at age
65 when, in the opinion of the State Health Director, this appeared desir-able;
(2) that a summary of such checkup be provided to the State Health
Director, and (3) that the State Board of Health provide $10.00 toward
the cost of each such required physical checkup. Motion was passed.
The various proposals regarding the establishment of a Department of
Water Resources were discussed and the State Health Director was in-structed
to keep the Board informed as this proposal of the Commission on
Reorganization of State Government makes its way in the 1959 General
Assembly.
A progress report was made and discussion followed on the work of the
Board Committee to study and advise on radiation protection—Dr. R. J.
Reeves, Chairman, and the Governor's Committee on Nuclear Energy, Mr.
William D. Carmichael, Chairman. A proposed bill has been drawn up by
the Office of the Attorney General and copies distributed to Board members.
The State Health Director was instructed to also keep Board members
informed on the progress of such proposed legislation so that hearings could
be attended and the Board's views heard if this should become desirable.
Meeting adjourned at 2:00 p.m.
March 3, 1959. There was a special meeting of the North Carolina State
Board of Health held Tuesday, March 3, 1959, 11:00 a.m. - 1:00 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. The minutes of the
Board meeting held on January 18, 1959, were read by Secretary Norton,
and on motion of Dr. Bender, seconded by Dr. Edwards, were adopted.
Secretary Norton announced that Dr. Baker was ill in Duke Hospital
with pericarditis. The members expressed their regrets at his absence and
24 Thirty-Eighth Biennial Report
illness and a telegram was dispatched to Dr. Baker extending best wishes
for a speedy and complete recovery.
President Bugg reported that a request had been made for a hearing
before the Advisory Budget Commission relative to the salary of the State
Health Director. He said he would be notified when the hearing can be
held. Dr. Norton informed the Board that the Commission already had
allowed the Head of the State Mental Hospitals to be raised to $18,000 a
year and that the unit hospital directors in the System had been raised to
$16,000.
Mr. J. M. Jarrett, Director of the Division of Sanitary Engineering,
presented and discussed a request for the extension of the boundary lines
of the Parkwood Sanitary District in Cabarrus County. He recommended
favorable action by the Board on this request, stating that all documents
and transactions had been carefully examined and found in order by his
Division. On motion of Dr. Bender, seconded by Dr. Edwards, the RESO-LUTION
EXTENDING THE BOUNDARY LINES OF THE PARK-WOOD
SANITARY DISTRICT IN CABARRUS COUNTY, NORTH
CAROLINA, was so ordered.
Mr. Jarrett also reported on the request for approval for the creation
of the Meadow Greens Sanitary District, Rockingham County, North Caro-lina.
He stated that the necessary procedures had been completed for this
sanitary district, that the various documents and transactions had been
carefully examined and approved by his Division, and he recommended
favorable action by the Board. Dr. Brian moved that the Board give its
approval of the RESOLUTION CREATING THE MEADOW GREENS
SANITARY DISTRICT, ROCKINGHAM COUNTY, NORTH CAROLINA.
Motion seconded by Mrs. Latta and unanimously carried.
Mr. E. C. Hubbard, Director of the Division of Water Pollution Control,
presented a request for consideration by the Board filed by the Town of
Weldon for an Order requiring it to improve its sewage collection system
and construct a sewage treatment plant. He said the total cost would amount
to approximately $400,000. Mr. Hubbard recommended that the Board issue
the Order required to permit the Town of Weldon to make the necessary
sewerage improvement. Motion seconded by Dr. Edwards, and carried.
Dr. Norton brought to the Board's attention the desirability of defraying
the expenses—transportation, per diem and hotel—such as allowed by the
State, to Board members attending national public health meetings pertinent
to their work. Dr. Brian pointed out that he thought this was a good move
in that it might induce more Board members to attend and participate in
such conferences as would be of interest to them and assist in a fuller
understanding and carrying out their responsibilities in public health. On
motion of Dr. Bender, seconded by Mrs. Latta, reimbursement of Board
members attending national public health meetings was unanimously
carried. Following this motion, Dr. Z. L. Edwards was appointed by Presi-dent
Bugg to attend the National Dental Health Conference to be held in
Chicago, 111., April 27-29, 1959, as the Board of Health's representative.
Mr. Ben Eaton, Jr., Director of the Division of Administrative Services,
made a report on the recommendations of the Advisory Budget Commission
concerning the State Board of Health's appropriation for the biennium
1959-'61. Members of the Board had before them copies of the detailed
North Carolina Board of Health 25
budgets which were explained. The Board went on record as holding the
opinion that the proposed budget would be insufficient to insure adequate
and necessary health services. After discussion, and on motion of Dr.
Brian, seconded by Dr. Edwards, the Board unanimously adopted a STATE-MENT
concerning the budget and the needs of public health in North
Carolina.
Following Mr. Eaton's explanation and the discussion of the Advisory
Budget Commission's recommendation for the State Board of Health for
the biennium for the "A" and "B" Budgets, Dr. Norton discussed an appeal
from the recommendation of the Advisory Budget Commission, and an-nounced
that the Board of Health would have its hearing before the Joint
Appropriations Committee at 2:00 p.m., Tuesday, March 17, 1959, Room 513
of the Revenue Building, to discuss its budgetary needs. All members are
invited to be present. It is planned that there will be special representation
at the hearing consisting of President Bugg, Dr. John R. Bender, Dr.
M. B. Bethel, Dr. Robert F. Young, representatives of the N. C. Association
of County Commissioners, Mr. John A. McMahon and Mr. Ben Haigh, also
Secretary Norton, each to speak from various angles of needs for State
support of public health work.
Dr. Jacob Koomen, Jr., Assistant Director of the Division of Epidemiology,
reviewed briefly the present status of poliomyelitis, poliomyelitis vaccine
and the bill before the General Assembly requiring poliomyelitis vaccina-tion
of North Carolina children. He stated that in 1958 thirty-seven cases
of paralytic poliomyelitis were reported in the State. Twenty-five or
approximately two-thirds received no vaccine, two received 1 dose; six, 2
doses and four, 3 doses. Twenty-two of thirty-seven cases occurred in
children less than five years af age. All "Federal" vaccine has been shipped
to local health departments. The amount supplied was 3,435,975 cc;
National Foundation supplied 362,261 cc. (to October 10, 1955) making
almost 3.8 million cc. of Salk vaccine available without cost to North Caro-lina.
Of the 0-19 year age group, approximately 78 per cent have received
1 dose, 68 per cent 2 doses and 52 per cent three doses. Physicians in private
practice administered an undetermined number of doses of vaccine.
The bill relating to compulsory poliomyelitis vaccination has been acted
upon favorably by both Senate and House Health Committees. The Board
of Health is among the sponsors of this legislation. The vaccination bill
had previously been sent to the Appropriations Committee for review
relative to making State funds available for purchase of vaccine. It was
made known that the Governor appeared to be sympathetic to use Con-tingency
and Emergency funds for this purpose. The great advantage of
the latter approach is that funds could be immediately used for buying
vaccine; if legislative appropriations were required funds would not become
available until July 1, 1959.
Dr. Koomen reported that the bill removing restriction on a maximum
charge of $1.00 by County Boards of Commissioners for rabies immuniza-tion
had been acted upon favorably. This bill is also sponsored by the
Association of County Commissioners.
Mr. Jarrett reported that the Bill creating a Department of Water Re-sources
had been introduced in the General Assembly by Senator Morgan
of Cleveland and by three representatives in the House. He said copies of
26 Thirty-Eighth Biennial Report
the Bill were now being studied and that a public hearing would be held.
Mr. Jarrett went on to say that there seemed to be some opposition especi-ally
from the Western part of the State and that industry was unhappy
over the proposal that the Stream Sanitation Committee be not only trans-ferred
but abolished as of 1965. Mr. Jarrett said that: "The other comment
that I think is in line is the transfer from the State Board of Health to
another Department of health functions and responsibilities." He continued:
"The important thing that I see here is by transferring our Division of
Water Pollution Control, they are taking with that Division certain health
functions, and as you take away functions you have to give to whomever
takes those functions some responsibility of the State Board of Health. The
thing that disturbs me as much as anything else is that it may be estab-lishing
a precedent of taking from the established recognized State health
agency its responsibility for the protection of health and vesting this re-sponsibility
in another department. Also in the Bill as presented which
establishes the new Department of Water Resources there is no representa-tive
of health on the proposed Board."
Mr. Jarrett was asked to get printed copies of the Bill from the Institute
of Government and the statement explaining it and pass on to Board
members. Dr. Bender asked how many members would be on the Board. Mr.
Hubbard said there would be seven and Mr. Jarrett explained the proposed
setup of the Board.
Dr. William M. Peck, Chief of Chronic Diseases and Radiation Section,
spoke briefly on the proposed Bill for controlling radiation hazards. He
said that he had several copies of the proposed Bill but it had not been
introduced. He said the Board's Study-Advisory Committee recommends
that the State Board of Health develop regulations which would encompass
radiation protection standards. Dr. Bugg asked for suggestions as to what
action the Board should take. It was agreed that radiologists should be
assured of representation on the new Board to carry out radiation legisla-tion.
Dr. Norton is to prepare a rough draft of a letter to the Governor for
editing and signature by President Bugg.
Secretary Norton reported on the desirability of participation by all
counties in the Local Government Retirement System. He pointed out the
many advantages which can be provided at relatively small local cost.
Dr. Norton also reported briefly on the status of the position of Assistant
State Health Director. So far, two qualified physicians have declined for
various reasons. The salary range is $11,604-$13,704. It was decided that a
Board meeting should be called when a specific recommendation can be
made so the members would have an opportunity to confer with the appli-cant
proposed. Adjournment.
May 6, 1959. The North Carolina State Board of Health met in the Sun-dial
Room of the George Vanderbilt Hotel in Asheville, Wednesday, May 6,
at 8:30 a.m., Dr. Charles R. Bugg, President, presiding.
The meeting was called to order by President Bugg. The minutes of the
Board meeting held on March 3, 1959, which had been circulated, were
approved.
Upon motion of Dr. Brian, seconded by Mr. Lutz, Dr. J. W. R. Norton,
State Health Director and Dr. John H. Hamilton, Assistant State Health
North Carolina Board of Health 27
Director, were unanimously re-elected for a term of four years—1963. This
Board action requires confirmation by Governor Hodges to become effective.
Dr. A. H. Elliot, Director of the Personal Health Division, made a report
on tentative plans for the Regional Conference on Health of the School Age
Child to be held in Chapel Hill, September 8-12, 1959.
Dr. Fred T. Foard, Director of the Division of Epidemiology, explained
the provisions of the compulsory poliomyelitis vaccination bill, also the
new schedule of administration and price of vaccine. All members of the
Board agreed with a comment by Dr. Bugg that the people should be fully
informed that State purchased vaccine is intended only for the indigent
and medically indigent and that a directive to this effect should be prepared
and sent to local health departments. Secretary Norton was instructed to
prepare a rough draft of a letter to be sent to Local Health Directors with
copies to Chairmen of Local Boards of Health and Chairmen of County
Commissioners. The rough draft is to be sent to Board members for com-ment
and the final draft is to be edited by Drs. Brian and Baker and signed
by the President and Secretary.
Dr. Baker moved, Mr. Lutz seconded and the Board approved, charging
cost of distribution to the State cost of polio vaccine for which reimburse-ment
is made.
In the absence of Dr. R. D. Higgins, Director of the Local Health Divi-sion,
who was slated to present the subject, the State Vision Testing Study
supported by the North Carolina Optometric Society, v/as explained by
Secretary Norton. The matter was referred to Drs. Baker and Bender to
serve as a study committee with the Committee for the Blind and report
back to the Board at a later meeting.
Mr. William McKimmon of the Sanitary Engineering Division, reported
on the proposed Paw Creek Sanitary District in Mecklenburg County. He
said all preliminary requirements had been complied with. On motion of
Dr. Morrison, seconded by Dr. Bender, the Board approved creation of the
District.
Mr. McKimmon then explained the proposed extension of the boundary
lines of the Catawba Heights Sanitary District in Gaston County. On motion
of Mr. Lutz, seconded by Dr. Brian, the extension was ordered.
Mr. McKimmon then presented data designed to clarify the extension of
the boundary lines of the Haw River Sanitary District in Alamance County.
On motion of Mr. Lutz, seconded by Dr. Baker, the extension war, ordered
as recommended.
The question of allocating funds to the Local Health Departments as an
incentive for Local Government Retirement was next in order. Dr. Baker
made a motion to the effect that when a Local Health Unit joins the Local
Government Retirement System the State Board of Health participate in
proportion, limited to $1,000 a year per county. It was decided that the
matter of allocating incentive funds for local retirement be held in abeyance
until a conference would be held by Drs. Bugg, Brian and Norton with
Mr. Nathan Yelton, Executive Secretary, Teachers and State Employees
Retirement System, and considered at a subsequent special meeting to be
called during this nionth.
Priorities for the "B" Budget were again approved as presented to the
Advisory Budget Commission with these to be presented to Senator David J.
28 Thirty-Eighth Biennial Report
Rose of the Senate Health Committee and the Joint Appropriations Sub-committee
at a breakfast meeting the following morning. Changes increas-ing
requests over those prepared a year ago for salaries of the State Health
Director and Assistant Director and the four medical Division Directors
were approved on the basis of merit and that a change would necessitate
paying new personnel more. Meantime, it has been found that recruitment
is more difficult than anticipated a year ago.
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 which was slated to convene at 10:20 a.m., in the
Asheville City Auditorium.
May 21, 1959. There was a special called meeting of the State Board of
Health held Thursday, May 21, 1959, 2:00 p.m. -4:30 p.m., in the Board
Room of the Cooper Memorial Health Building, President Charles R. Bugg,
M.D., presiding.
Associate Justice Emery B. Denny, of the Supreme Court of North Caro-lina,
administered the Oath of Office to the following for four-year terms,
—
re-elected by the Medical Society of the State of North Carolina at its May,
1959 meeting in Asheville, North Carolina:
Earl W. Brian, M.D., Raleigh
Roger W. Morrison, M.D., Asheville
The meeting was called to order by President Bugg, and all members of
the Board were present.
On motion of Dr. Baker, seconded by Mr. Lutz, the minutes of the May 6,
1959 meeting were approved as circulated with the following amendment:
He moved to amend the minutes of the May 6 meeting by adding after
his motion for an incentive payment limited to $1,000 a year per county
the following: "proportion should be clarified to mean in proportion to what
we are contributing to payment of the salaries of those conecrned, and no
more."
Dr. Norton introduced Mr. Nathan Yelton, Executive Secretary of the
Teachers and State Employees Retirement System. Before calling on Mr.
Yelton, he explained the problem. He said he was not concerned so much
with people moving from county to county as with those who are leaving
the State. One of the things that was discussed in Asheville, May 6, was
some equitable method of adjusting the allocation formula so as to give
recognition and provide incentive to counties to set up and maintain the
Local Government Retirment Seystm.
Mr. Yelton explained the setup of the different retirement systems and
how the Local Government System in the counties would work. It would not
have to include all county employees, he said. Public Health and Welfare
workers have shown a lot of interest in a Local Government Retirement
System, he pointed out. The State Employees' Retirement System, the State
Teachers' Retirement System, and the Local Government Retirement System
are all different systems, he explained.
Mr. Yelton answered several questions asked by members of the Board.
After some discussion, Dr. Baker moved that the State Board of Health
North Carolina Board of Health 29
approve participating in the allocation formula for local health departments
in order to provide incentive for joining the Local Government Retirement
System, not to exceed $1,000 a year to any county. The motion was seconded
by Mr. Lutz, and carried.
Dr. Brian moved that the Board express appreciation to Mr. Yelton for
his kindness in bringing this information to the Board. Motion seconded
by Mr. Lutz and carried.
The Board voted to strengthen its directive to Local Health Directors,
with copies to Chairmen of Local Boards of Health and Chairmen of the
County Commissioners, relative to State purchased poliomyelitis vaccine
for the indigent and medically indigent. The directive originally was adopted
at Asheville, May 6, but today's action pointed out, in specific language,
that those not indigent are not entitled to free vaccine which is provided
only for those unable to pay. The Board also strengthened its statement
as to how a person can be classified as unable to pay. It was pointed out
that if the parent states he is unable to pay, the Local Health Director
ordinarily would accept such statement at its face value, unless the Director
has personal knowledge or could easily obtain information leading him to
believe that such free vaccination would not be in order.
Dr. Fred T. Foard, Director of the Division of Epidemiology, reported
on the polio situation, stating that through May 20 of this year six cases of
polio had been reported as compared to none on the same date in 1958. He
said a copy of the Attorney General's ruling on distribution of vaccine
with reference to use of State purchased polio vaccine had been sent to
all Local Health Directors. Dr. Foard further stated that there was a rise
in paralytic polio over the Nation in 1958 over 1957 and that according
to this early trend it is probable that we are going to have more polio in
1959 than in 1958.
During Dr. Foard's appearance before the Board, he presented a letter
from Dr. Fred R. Klenner, Reidsville, North Carolina, requesting Board
approval for his use of live polio vaccine. Dr. Foard added that the use of
live vaccine has not been approved by the National Institutes of Health.
Dr. Brian moved that Dr. Norton, as State Health Director, write a tactful
letter to Dr. Klenner declining his invitation to experiment with this vaccine
at this time. Motion seconded by Dr. Morrison and Mrs. Latta, and unani-mously
carried.
Dr. Edwards cited the wording of a sentence in the minutes of the last
meeting concerning a salary raise for four medical division directors which
might indicate a lack of merit on the part of the three non-medical division
directors. Dr. Bender suggested leaving out "four medical" and Dr. Mor-rison
agreed. Dr. Bugg suggested a motion under new business in this
meeting to omit those two words. Dr. Bender moved that the minutes of
this meeting show that we have amended that statement to read "salaries
of the State Health Director, Assistant State Health Director and the
Division Directors." Dr. Henderson seconded, and the motion carried.
President Bugg read letters from Governor Hodges approving the Board's
re-election of Dr. Norton as State Health Director and Dr. Hamilton as
Assistant State Health Director,—four-year terms, expiring June 30, 1963.
Dr. Norton made a brief report on the status of the appropriations. A
joint appropriations subcommittee of twenty-five has been appointed, in-
30 Thirty-Eighth Biennial Report
eluding Dr. D. J. Rose, Senator from Wayne County. Dr. Norton said he
had had several conferences with Dr. Rose, who thought, in general, thai-he
could go ahead and recommend some increases in salaries, an increase
for Accident Prevention, an increase for the Laboratory, particularly f
o
the early finding of cancer, occupational health and on food and lodging.
He felt that the larger appropriations for local health departments couV'
not get any support, all of which would amount to about $175,000 for the
two years. Representative Carl Venters, of Onslow, who is on the com
mittee, recommended $25,000 increase for mosquito control, and Represen-tatives
James G. Stikeleather of Buncombe, urged that the $25,000 that the
Asheville Orthopedic Hospital receives out of our $90,000 for crippled
children be increased another $25,000 making another $50,000, but they did
not recommend that it be increased over the approximately $175,000 but
to be taken out of the $175,000. Dr. Norton said Dr. Rose was also going
to request an increase for veterinary public health but did not know if it
would go through. Dr. Morrison suggested that the proposed increase for
cytology be put in something else, such as veterinary public health. He
explained that on April 9, 1959, the North Carolina Division of the American
Cancer Society mailed to all physicians of the State a list of thirty (30)
pathologists in 19 cities in North Carolina who were equipped to do
cytology on all specimens submitted to them. Because of the widespread
availability of this service in North Carolina, Dr. Morrison thought it
unwise to increase the expenditure of taxpayer's money for cytology at
the State Laboratory of Hygiene when public funds could probably be
better utilized in other health department activities. There was no action
taken on this. Dr. Norton said Dr. Rose considered early diagnosis of
cancer of major importance and that he had received more letters requesting
his support than for all other items—and that these letters were mainly
from rural doctors. Adjournment.
July 16, 1959. The North Carolina State Board of Health met in regular
quarterly session, Thursday, July 16, 1959, 10:00 a.m. -1:30 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. On motion of Mr.
Lutz, seconded by Dr. Baker, the minutes of May 21, 1959 meeting were
approved after an amendment by Dr. Morrison regarding cytology speci-ments
as follows to be added just before the last two sentences of the last
paragraph
:
"Dr. Morrison explained that on April 9, 1959, the North Carolina Division
of the American Cancer Society mailed to all physicians of the State a
list of thirty (30) pathologists in nineteen (19) cities in North Carolina
who were equipped to do cytology on all specimens submitted to them. Be-cause
of the widespread availability of this service in North Carolina, Dr.
Morrison thought it unwise to increase the expenditure of taxpayer's money
for cytology at the State Laboratory of Hygiene when public funds could
probably be better utilized in other health department activities."
Mr. J. M. Jarrett, Director of the Sanitary Engineering Division, pre-sented
a request for the creation of Riegelwood Sanitary District in
Columbus County, North Carolina, for the purpose of providing an adequate
North Carolina Board of Health 31
water supply. He pointed out that the various documents and transactions
had been examined and approved by the Sanitary Engineering Division
regarding the proposed sanitary district and had also been discussed with
a representative of the Attorney General's office. Dr. Baker moved that the
RESOLUTION OF THE BOARD OF HEALTH CREATING THE RIE-GELWOOD
SANITARY DISTRICT be approved. Motion seconded by Mr.
Lutz, and carried.
Mr. Jarrett also presented and discussed, at length, the proposed changes
in the Rules and Regulations Governing State Aid in Mosquito Control, a
copy of which had previously been sent to each Board member for review
and study prior to presentation to the Board. In the discussion. Dr. Baker
suggested that the following amendment to the last paragraph "C", Zone
III, page 6 be changed to read:
"If the present appropriation for aid to local governmental units engaged
in mosquito control is increased or decreased by a subsequent General
Assembly, the maximum allocations to local health departments in Zones
II and III shall be increased or decreased in accordance v/ith needs or lack
of needs by the same percentage that the additional or smaller appropria-tions
increase or decrease the existing appropriation."
After discussion. Dr. Baker moved that the RULES AND REGULATIONS
GOVERNING STATE AID TO MOSQUITO CONTROL DISTRICTS, etc.
be accepted as amended. Motion seconded by Dr. Edwards, and carried.
Dr. Robert D. Higgins, Director of the Local Health Division, presented
a very informative and interesting report on the status of county Health
Directors for the last two-year period, 1957-'59. He pointed out that at the
present time, there are 73 local health departments, 52 full-time Health
Directors, 13 part-time involving 17 counties and 8 vacancies involving 13
counties or a total of thirty (30) counties without full-time Health
Directors.
Dr. Higgins also reported that much interest had been shown and progress
made among local health departments in the Local Government Retirement
System. Since July 1, 1959, the following counties have joined the Retire-ment
System:—Hoke, Pamlico, Orange-Person-Chatham-Lee, Greene and
Bladen, and these are in addition to the 44 counties involving 36 depart-ments
previously operating under it.
Dr. Fred T. Foard, Director of the Epidemiology Division, made a prog-ress
report on the current poliomyelitis situation in North Carolina. He
stated that of a total of 34 cases of polio reported through July 14, 1959, 31
cases were paralytic. Only 4 cases of paralytic polio were reported through
July 14, 1958. The increase in paralytic cases to-date, he said was 27 or
675.0 per cent over the same period last year. Of the 31 cases of paralytic
polio so far reported this year 20 had had no vaccination, 2 had one
inoculation, 3 had two inoculations, 4 had three inoculations, and for 2 the
record is unknown. So far, there have been 3,708,521 inoculations given by
local health departments since April 1955 through June 30, 1959.
For information to the Board, Dr. Foard made a detailed and interesting
report on the staphylococcal disease outbreak in a Greensboro Day Nursery
in which approximately 100 infants and children were lodged. The nursery
was closed for the month of May and was completely renovated and re-admissions
of children were taken only after careful physical examination
32 Thirty-Eighth Biennial Report
and culturing of applicants. No new cases have been reported from June 1
to the present time.
Mr. Ben Eaton, Jr., Director of Administrative Services, reported on
the highlights of legislation pertaining to health measures and allied serv-ices
passed by the 1959 General Assembly. He pointed out especially SB 5
which requires the vaccination of young children against poliomyelitis
from two months to six years and to have received their first shot before
being allowed to attend any public, private or parochial school, and stated
that North Carolina was the pioneer state in this compulsory poliomyelitis
vaccination law. The appropriation of $216,000 from the Contingency and
Emergency fund is particularly helpful.
Mr. Eaton also called special attention to SB 496 which in cases of self-inflicted
injuries upon an inmate of the State Prison System authorizes the
local health director, or if unavailable, the health director of an adjoining
or nearby area to give or withhold consent for further treatment. Dr. Norton
discussed the bill in detail, explaining the unreasonable responsibility placed
on the local health directors. He said it was passed the last day of the
session and that neither he nor any member of his staff was consulted. He
discussed an exchange of letters between him and Attorney General Mal-colm
Seawell. Dr. Baker made a motion that Secretary Norton continue to
work on this matter to the best of his ability as to just what responsibilities
and rights are involved in the matter, and whether the bill is constitutional.
Motion seconded by Dr. Bender, and unanimously carried.
Mr. Eaton reported briefly on the appropriations for the State Board of
Health for the fiscal years 1959-1961 and pinpointed the slight increases.
This information had previously been circulated, in detail, to the Board
members.
Dr. Lenox D. Baker moved that the State Board of Health go on record
as expressing appreciation to Dr. Samuel F. Ravenel of Greensboro, N. C.
for his activities and helpfulness in promoting the passage of the compul-sory
poliomyelitis immunization law; also to Dr. D. J. Rose, Dr. Rachel D.
Davis, the Association of County Commissioners, and any others who served
the interest of the Board of Health during the recent General Assembly.
Dr. Norton was requested to write letters of appreciation to those named
and any others who were instrumental in securing the passage of helpful
legislation. Motion seconded by Mr. Lutz, and carried unanimously.
Secretary Norton reported the following changes in personnel : Dr. A. H.
Elliot, Director of Personal Health, retired, effective June 30; Dr. D. Frank
Milam, formerly with the Board, had returned to work and is Chief of the
Cancer and Heart Sections; Dr. Robert D. Coler, Chief of the Occupational
Health Section, had resigned on account of ill health and that Dr. William L.
Wilson, a very highly qualified person who has held a similar position in
Texas is coming to the Board to fill the Occupational Health Section posi-tion.
Dr. Norton also paid high tribute to Mr. Ben Eaton who has re-quested
a 2-year leave of absence from the State for overseas duty, effective
August 1. He has received an appointment from the Public Administration
Service of Chicago, 111. which is sponsored and financed by the International
Cooperation Administration of the State Department and will perform
technical assistance in the administrative field during this period.
Dr. Z. L. Edwards reported briefly on his trip to the 10th National Dental
Health Conference held in Chicago, 111. at the American Dental Association
North Carolina Board of Health 33
headquarters on April 27-29, 1959. He stated that the conference was of
great value to him and the seriousness which all members attending ex-hibited
at this Conference was an indication of their desire to improve
dental health education and sei-vice throughout the United States. Adjourn-ment.
October 29, 1959. A quarterly meeting of the North Carolina State Board
of Health was held Thursday, October 29, 1959, 1:00 p.m. -4:00 p.m. in the
Board Room of the Cooper Memorial Health Building,—President Charles
R. Bugg, M.D., presiding. All members of the Board were present including
the two new Board members appointed by Governor Hodges,—Mr. Jasper C.
Jackson, Ph.G. of Lumberton and Dr. Ben W. Dawsey, veterinarian of
Gastonia. Mr. Jackson and Dr. Dawsey took their Oaths of Office in the
Hall of the House, Capitol Building, September 1, 1959, for four-year terms
each.
The meeting was called to order by President Bugg. On motion of Dr.
Bender, seconded by Dr. Edwards, minutes of the Board meeting held on
July 16, 1959, were approved as circulated to Board members.
Dr. Jacob Koomen, Jr., Assistant Director of the Division of Epidemiology,
was called on to give the present status of leprosy in North Carolina. In
the first twenty-six (26) years of the reporting system there was no case
of leprosy in North Carolina. Since 1944 there have been five cases, four
soldiers and ex-soldiers, and one missionary. So far as we can determine,
there has been no case of indigenous leprosy in this State. The 1944 regula-tions
said, "Patients shall be isolated until all the lesions are healed or
arrested." Since then a considerable amount of new knowledge has been
accumulated. In 1951 the United States Public Health Service removed
interstate quarantine. Now practically all states permit home visiting of
Carville patients, eleven require only reporting of cases and one state
does not require even that. Many of these states have leprosy patients under
home treatment.
The problem at the moment is the return of a confirmed leprosy patient
to the State. Dr. Koomen read the action taken by the Board in 1956 as
follows
:
"It was the consensus of the Board that no leprosy case, in an infectious
stage, should be admitted to North Carolina, and it was moved that the
N. C. State Board of Health disapprove of individuals under treatment in
the Carville Leprosarium, infected with leprosy, returning to the State until
they are certified by the proper authorities of the U. S. Public Health Serv-ice
as being non-infectious."
The point at issue is our present regulation, which perhaps is in need of
some change or modification.
Dr. Bugg brought up the case in Surry County, in which Dr. D. A.
McLaurin, a private physician, and Dr. R. B. C. Franklin, County Health
Director, have a special interest. Dr. McLaurin and Dr. Franklin had been
invited to present any matters they liked to the Board.
Dr. McLaurin said that the diagnosis of a case of leprosy came as some-thing
of a shock and brought about a considerable amount of reading and a
feeling of guilt at sending him away from his family. Further reading
34 Thirty-Eighth Biennial Report
brought out the feeling that perhaps after a fair amount of treatment
that it would be quite in order for the patient to return home. Then he
came up against the State regulations. For five years he failed to diagnose
the case and his colleagues failed to diagnose it. On Dr. McLaurin's return
from the Air Force, the man came into his office and the change was strik-ing.
The change in his condition under treatment is truly remarkable. He
has been home on visits on several occasions. He has been well accepted
in the community, his family is most anxious to have him home, and he
feels that he is able to accept his treatment. They find little reason to
think that Surry County would object to his returning home. He asked
the Board to change the regulation something in line with what is done
in other states, such as California. He had already mailed a copy of a letter
he had received from the U. S. Public Health Service. The patient could
be trusted to carry out the prescribed treatment and he would be isolated.
Dr. Franklin said it was he who brought on the law as it stands now.
After this case developed, he started looking through our public health
laws of North Carolina and did not find much of a rule or regulation that
would guide him in handling this case. He wrote Dr. Norton that he thought
we needed a revision in the public health law to give him a little more
guidance. In the law of 1956 he got a little more than he asked for in that
the law conflicts with Carville recommendations. They say that they know
the man is safe to come home.
Dr. Bugg remarked that this delay in accepting Carville approval by
our objection could go on all his life.
On the other hand, Carville wants the man to come home and they do
not think there is any danger. He is a good man, with a good family, very
honorable and trustworthy, and the 1956 regulation might put him away
for life. Dr. Franklin said he had no doubt that he would be accepted in
Surry County. He is persistent in only one thing, to have the same privileges
as he would have had he been a soldier of California or some of the other
states.
Dr. Foard commented that the laws of California are much more broad
and he thought this man is perfectly safe. The American Public Health
Association comes out periodically with changes in regulations, they have
been lenient all along, and he thinks they will be more lenient this year.
Dr. Morris moved that the Board rescind the 1956 leprosy regulation.
Mr. Jackson seconded the motion, and it carried.
Dr. Koomen said that no cases of leprosy had occurred in the professional
staff at Carville, one possible case in the non-professional staff.
Dr. Fred T. Foard, Director of the Division of Epidemiology, gave the
Board members a written summary of polio vaccination. Against 62 cases
last year at this time, with 26 paralytic and 4 deaths, there have been 250
cases, 210 paralytic, and 17 deaths this year, most of them among people
not vaccinated. He feels that the polio situation this year has occurred
principally because of negligence on the part of the public. This happens
to be a high year and a lot of people have not been vaccinated.
Dr. Bugg called attention to the fact that physicians are not reporting
cases that are not paralytic. They are doing more lab work now.
Dr. Koomen commented on the portion of the poliomyelitis immunization
law which reads:—"an adequately immunizing dose as determined by the
North Carolina Board of Health 35
North Carolina State Board of Health of a prophylactic agent against
poliomyelitis . . ." The matter of "adequately immunizing dose" has raised
some questions as to amount, spacing, need for booster inoculations, route
of administration, etc. Dr. Koomen briefly discussed these items and noted
that a number of changes had taken place since poliomyelitis immunization
programs were begun.
Dr. Baker mentioned a meeting he attended in Pittsburgh at which it was
brought out that adequate dosage depends on sufficiently lai-ge doses being
given in the first series of doses to create adequate antibody response. If
a child is tested and there is inadequate response then a fourth dose should
be given. Dr. Salk feels that the first dose should be made adequately large,
2 cc, and then rather than trying to run titres, eventually a fourth dose
of a pretty good size be given.
Secretary Norton pointed out that it is less than a year now before the
Board must have its budget proposal for the next biennium, 1961-1963 pre-pared
for presentation to the Advisory Budget Commission, and that it was
not too early to begin thinking and considering budgets, new legislation or
desirable amendments to present legislation.
Secretary Norton also reviewed a number of recent staff personnel
changes in the Department as follows:
Dr. E. A. Pearson, Director, Oral Hygiene Division, replacing Dr. E. A.
Branch, deceased.
Dr. Wm. L. Wilson, Chief, Occupational Health Section, has replaced Dr.
Robert Coler, resigned because of ill health.
Dr. A. H. Elliot, Director of Personal Health Division, retired.
Mr. Ben Eaton, Jr., Director, Administrative Services, was granted a
leave of absence from the State to accept a position with the Public Admin-istration
Service in Afghanistan.
Mr. Wm. H. Richardson, Publicity Specialist, retired and that E. S. Pres-ton,
LL.D. would assume the position of Public Relations Officer on Decem-ber
1 and that Mr. Charles Harper of the Regional Office, Children's Bureau,
Charlottesville, Va. would assume the duties of Director of Administrative
Services, January, 1960,
Also, Dr. Norton announced that Dr. Wm. M. Peck, Chief, Chronic
Diseases-Radiation Section, had been invited to accept the position of Di-rector
of Public Health on Guam, January 1, 1960, and would be terminat-ting
his services about December 31, 1959. Dr. Norton paid high tribute
to Dr. Peck, stating that he had been a most useful member of the staff,
had done a superior job and wished him success and happiness in his work.
At this point. Dr. Bugg also stated that he wished Dr. Peck the best of luck
and success.
President Bugg read a Resolution which had been adopted by the House
of Delegates of the Medical Society of the State of North Carolina, May 4,
1959, in tribute to Dr. G. Grady Dixon. Dr. Baker moved that the Resolution
be made a part of the records of the State Board of Health. Motion
seconded by Dr. Edwards, and carried unanimously. Copy of Resolution
follows
:
"WHEREAS Dr. G. Grady Dixon was a long and useful member of the
Medical Society of the State of North Carolina, exemplifying the finest
36 Thirty-Eighth Biennial Report
of personal qualities in manifesting a responsibility for public service to
his patients, and
"WHEREAS he had lent distinction and service to the Medical Society
of the State of North Carolina as a leader, as an officer and as a represen-tative
of the Society upon other organizational structures and programs,
and
"WHEREAS he exemplified concern for the problems of medicine and
loyalty to the professional organizations which implemented such concern
of the medical profession, even to the last hours of his life during the
course of the 1958 Annual Sessions of the Medical Society of the State of
North Carolina, now
"THEREFORE BE IT RESOLVED that this House of Delegates record
for posterity the high regard of his fellow physicians and organizational
leaders in North Carolina medicine in profound appreciation for the con-tributions
which he has made to the profession of medicine and to this
Society, and
"BE IT FURTHER RESOLVED that a copy of this resolution be spread
upon the proceedings of this Society and that a copy be sent to the surviv-ing
members of his family and for the records of the North Carolina State
Board of Health upon which he served long and dutifully and finally as its
President."
Dr. Norton reviewed briefly the very helpful cooperation of the North
Carolina Association of County Commissioners to public health from the
standpoint of State and local problems, budgets and legislation. He pre-sented
a letter from Mr. Carson Bain, President, offering the assistance
of the Association to the extent of designating a liaison member or commit-tee
to work with the State Board of Health on problems of mutual con-cern,
and that he would like to suggest, with the approval of the Board,
that he be given authority to write the President of the Association that
the Board of Health would appreciate and welcome their designation of a
liaison committee to work with a liaison committee of the Board. On motion
of Dr. Edwards, seconded by Dr. Dawsey, Secretary Norton was authorized
to write and accept the assistance and cooperation of the North Carolina
Association of County Commissioners by their appointment of a liaison
representative to work with a State Board of Health liaison representative
on problems of mutual concern. Motion carried.
Dr. Baker moved that President Bugg appoint a member of the Board
to act as liaison representative from the State Board of Health to the North
Carolina Association of County Commissioners. Motion seconded by Dr.
Edwards, and carried. Whereupon, President Bugg designated Dr. John R.
Bender to serve as liaison officer of the Board of Health with the Commit-tee
from the North Carolina Association of County Commissioners.
Mr. J. M. Jarrett, Director of the Division of Sanitary Engineering, pre-sented
a copy of revised Rules and Regulations Governing the Sanitation
of Beauty Shops recommended by the North Carolina State Board of Cos-metic
Arts. Regulations proposed by the N. C. State Board of Cosmetic
Arts must be approved by the State Board of Health prior to their becom-ing
effective. Mr. Jarrett read and discussed the regulations in detail and
it was the consensus of the Board that there should be a slight modification
or clarification in Item 8 in regard to the requirement that separate toilet
facilities for each sex be provided in every establishment which might include
North Carolina Board of Health 37
very small operators where possibly a man and wife would be the only em-ployees.
After discussion, Dr. Baker moved that the words "it is suggested
that" be added. Motion seconded by Mr. Jackson, and passed.
Mr. Jarrett also presented and discussed proposed amendments to the rules
and regulations governing the sanitation of restaurants, temporary restau-rants,
food stands, drink stands, and temporary food or drink stands for
outdoor dining. He pointed out that he had received a number of requests
from establishments desiring to operate such dining areas, and that under
careful supervision of sanitary conditions, that there was no particular
health hazards, and that the Division recommended the adoption of such an
amendment to the present Regulations. On discussion, there were slight
changes in wording, after which Dr. Baker moved that the AMENDMENT
TO THE RULES AND REGULATIONS GOVERNING THE SANITA-TION
OF RESTAURANTS, TEMPORARY RESTAURANTS, FOOD
STANDS, DRINK STANDS, AND TEMPORARY FOOD AND DRINK
STANDS, ESTABLISHING STANDARDS FOR OUTDOOR DINING, be
approved. Motion seconded by Dr. Edwards, and unanimously carried.
Dr. E. A. Pearson, Director of the Division of Oral Hygiene, presented a
request for a revision of the dental section of the "Contract with County,
City and District Health Departments" to become effective July 1, 1960,
and to read as follows:
"That in counties not having a full-time public health dentist funds
are to be provided in their health department budgets to defray one-half of
the expense of a Dental Health Program furnished through the Division
of Oral Hygiene of the State Board of Health; that for each county with a
population of not more than 10,000 funds shall be provided in the local
health department budget for one-half of the expense for a minimum of
six weeks' dental service; that for each county with a population of 10,000
to 25,000 funds shall be provided in the local health department budget
for one-half of the expense for a minimum of ten weeks' dental service;
that for each county with a population of 25,000 to 60,000 funds shall be
provided in the local health department budget for one-half of the expense
for a minimum of twenty weeks' dental service; and that for each county
with a population of more than 60,000 funds shall be provided in the local
health department budget for one-half of the expense for a minimum of
thirty weeks' dental service.
"That, inasmuch as the Division of Oral Hygiene is defraying one-half
of the expense of the dental program in each county and the dentists are
employed for the entire year, it is understood and agreed that at least one-fourth
of the allocated time in any county may be furnished while schools are
not in session; and that, while the Division of Oral Hygiene cannot
guarantee to deliver this service, it is impossible for the Division to employ
dentists, when available, unless funds are budgeted by the counties to defray
their half of the expense of the dental program."
In explaining the requested changes. Dr. Pearson stated that in the recent
revisions of the contract, changes in wording have resulted in misunder-standing
as to the unit on which the local dental health appropriation is
based, that is, as to whether the county is the unit or the health depart-ment
is the unit. Dr. Pearson pointed out that in former years the contracts
with the counties stipulated that each county not having a full-time dentist
was to appropriate funds for a dental program to be furnished through the
Division of Oral Hygiene of the State Board of Health and stated that
he believed this still to be the policy of the State Board of Health in regard
38 Thirty-Eighth Biennial Report
to dental programs in the counties of the State. He stated further that,
with the growing tendency toward consolidation of county health depart-ments
into district health departments, the application of the formula to
districts rather than to the counties in the districts would reduce the
number of weeks of dental service to the point of great inadequacy in view
of the dental needs manifested throughout the State.
Dr. Pearson called attention to the fact that in the proposed revision two
steps would be added to the population-dental weeks scale: The first step in
order that no hardship be imposed on the few counties having a small
population ; and the fourth step in order that the larger counties may provide
for a more equitable amount of dental service in relation to their population.
President Bugg called on Dr. Edwards as dental member of the Board
to express his opinion regarding the proposed changes. Dr. Edwards stated
that Dr. Pearson had studied this matter carefully and had discussed it
with him. Dr. Edwards stated that he was in favor of the recommended
changes.
Dr. Norton expressed his approval of the changes as being a definite
improvement and as providing for a better and fairer allocation of rela-tively
limited services.
Dr. Edwards moved the adoption of the above dental revision. This
motion was seconded by Mrs. Latta and was passed unanimously by the
Board.
Dr. Wm. M. Peck, Chief of the Chronic Disease-Radiation Section, was
called on to give a progress report on a preliminary draft of regulations
for uses of radiation sources. Over a year ago the State Board of Health
appointed a committee to develop regulations concerning radiation under
chairmanship of Dr. Robert J. Reeves. Dr. Z. L. Edwards represented the
State Board of Health. That Committee developed a rough draft of regula-tions
but also made recommendation that these not be brought to the State
Board of Health for its approval until two events had transpired: First,
the passage of legislation establishing the right for the State Board of
Health to make regulations. This took place last May and the State Board
of Health now has undisputed right to adopt and enforce such regulations
with certain important limitations. The other event—publication of the
National Committee on Radiation Protections' revision of their rules ccn-cerning
radiation—has not yet occurred but we do have a tentative draft
of this document. Two limitations are attached by law to the State Board
of Health regulations. One is that the State Board of Health cannot pass
regulations more restrictive than AEC regulations. This, in practice, means
that our regulations for AEC licensees must be identical with AEC regula-tions.
The other stricture is that the regulations must be approved by the
Governor. We have brought the proposed N. C. Regulations into confonnity
with these documents and are now circulating this second draft for criti-cism.
It is rather long because of inclusion of AEC regulations and charts.
Perhaps we could shorten it if this is considered desirable. Another point
for policy decision is the detail that should be used in specifying require-ments
for x-ray machines. Our feeling is that to attempt to specify regula-tions
for each type of equipment may be too restrictive for the sake of good
medical practice. We believe that it is better public health practice to make
these somewhat general and work out the details with medical societies
North Carolina Board of Health 39
and individuals. This second draft has been sent to a number of people for
criticism, including the President of the State Radiological Society, Dr.
Reeves, the Attorney General's Office, the AEC, the Public Health Service,
and the National Committee on Radiology. Dr. Peck invited suggestions.
Dr. Baker suggested that the second page, paragraph six, which reads:
"If the ability of a qualified expert is questioned, the N. C. State Board
of Health shall be the judge of his qualifications, etc.", should read "If the
ability of a qualified expert is questioned, the N. C. State Board of Health,
after consultation with the state licensing board concerned therewith, if
any, shall be the judge of his qualifications."
Dr. Morrison discussed and recommended that the Board give more
publicity regarding tetanus immunizations and that the public be made
aware of its importance. He suggested booster immunizations every five
years. A suggestion was made that more health education emphasis be
given to this important matter. Adjournment.
March 17, 1960. The regular quarterly meeting of the North Carolina
State Board of Health was held Thursday, March 17, 1960, 1:00 p.m.-4:00
p.m., in the Board Room of the Cooper Memorial Building,—President
Charles R. Bugg, M.D., presiding.
On motion of Dr. Brian, seconded by Mr. Jackson, the minutes of the
Board meeting held on October 29, 1959, were approved as circulated.
Secretary Norton made a progress report on the liaison with the North
Carolina Association of County Commissioners who have expressed willing-ness
on the part of the Association to cooperate with State and local health
departments in mutual problems for State and Federal Budgets and legis-lation,
but have not announced their representative to work with Dr. Bender
of the Board.
For the Board's information, Dr. Norton made a progress report on the
Local Government Retirement System. The following counties have been
added since July 1, 1959:—Bladen, Duplin, Greene, Hoke, Orange-Person-
Chatham-Lee, Pamlico and Rutherford-Polk, making a total of 43 depart-ments,
58 counties and one city. All departments have Social Security. The
local government retirement is similar to our State Retirement System.
As background information. Dr. E. A. Pearson, Jr., Director of the Divi-sion
of Oral Hygiene, reviewed the action of the Board on October 29, 1959
in revising the section in the "Contract with County, City and District
Health Departments" pertaining to dental programs in the counties. This
revision again designates the county as the unit upon which the local
appropriation for a dental program is to be based. It also establishes the
minimum requirements for the number of weeks' dental service to be pro-vided
for, on a county basis, in the local health department budget in rela-tion
to the population:
Population Number of dental weeks
Under 10,000 Six
10,00-25,000 Ten
25,000-60,000 Twenty
Over 60,000 Thirty
40 Thirty-Eighth Biennial Report
Dr. Pearson stated that this change in the contract necessitated some
adjustments in the policy for administering the dental incentive which is
included in the State Board of Health Aid to Counties Funds. Dr. Pearson
traced the changes which have taken place in the allocation to the counties
of the dental incentive.
He pointed out that inasmuch as:
1. The policy clearly states that in order to receive maximum State aid
funds each health department must meet the requirements for a mini-mum
standard health department;
2. One of the requirements is a dental program approved by the State
Board of Health;
3. The revision pertaining to dental program, as passed by the Board
October 29, 1959, defines an approved dental program;
there will, of necessity, have to be some withholding of State aid funds from
any county failing to meet this standard for a minimum public health
program.
Dr. Pearson reminded the Board that since the dental program is concerned
with the school-age child, it would seem reasonable that any withholding
come from that part of the State aid funds allocated to the counties on the
basic of per pupil in average daily membership. He expressed the belief that
a withholding based on child population would be fair and realistic, affecting
each county in accordance with the differences in average daily member-ship.
He suggested that four of the forty cents per pupil in average daily
membership presently being allocated be withheld from a county failing to
meet the minimum requirement for a dental program as set forth in the
revised contract.
From examples, showing how the withholding of four cents per pupil in
average daily membership would affect counties varying in population from
5,000 to 96,000, given by Mr. McCary and Mr. Reep of the Local Health
Division, it seemed evident that the proposed deductions would be less than
under the present policy in the smaller counties but greater in the larger
counties.
Following some discussion, the Board went on record as approving the
recommendation with the following provisions:
1. That the maximum, deduction would not be more than $750.00 in coun-ties
appropriating for a minimum of thirty weeks dental program;
2. $500.00 in counties appropriating for a minimum of twenty weeks
dental program;
3. $250.00 in counties appropriating for a minimum of ten weeks dental
program, and
4. $150.00 in counties appropriating for a minimum of six weeks dental
program.
That figures be compiled for all of the counties for Dr. Norton's and Dr.
Pearson's consideration and that they be authorized to work out a formula
which would be reasonable and uniformly applied on a State-wide basis.
Dr. Baker moved, seconded by Dr. Edwards, that deductions be made by
the formula recommended. Motion carried.
Mr. J. M. Jarrett, Director of the Sanitary Engineering Division, pre-sented
a request from the Cities of Thomasville and Lexington, North Caro-lina,
to permit controlled fishing in the joint municipal water supply lake.
He stated that the request had been thoroughly investigated, that proper
North Carolina Board of Health 41
ordinances had been adopted, and he recommended that the Board consider
the request with favor—that with proper sanitary facilities and control
fishing would have no unfavorable effect on the quality of the water. On
motion of Dr. Baker, seconded by Dr. Edwards, the request of the Cities
of Thomasville and Lexington to permit controlled fishing in the municipal
water supply lake, was passed.
Mr. Jarrett also discussed a request adopted by the Board of Commis-sioners
of the Haw River Sanitary District regarding a correction in the
description of the boundaries of the sanitary district as it now exists, in-cluding
additional areas annexed thereto. He stated that the correction of
the boundary lines of the Haw River Sanitary District had been discussed
with the Assistant Attorney General and were found to be in order. Because
it will be necessary for the State Board of Health to establish the present
boundaries of the district before bonds can be issued for sanitary improve-ments
to be made, he recommended that the Board consider with favor the
establishment of the proposed new boundaries of the district, including the
additional territory annexed thereto. Dr. Baker moved that the request
from the Haw River Sanitary District, including the corrected boundaries
for the additional territory to be annexed, be accepted by the Board. Motion
seconded by Dr. Dawsey, and carried.
Also, Mr. Jarrett presented and discussed a resolution to dissolve the
present Riegelwood Sanitary District in Columbus County. He stated that
all documents, as well as customary transactions, had been followed in
accordance with the requirements of the law for dissolving the Riegelwood
Sanitary District, and in his opinion were in order. The reason for the
dissolution was a discrepancy in the engineering description of the boun-daries
of the Riegelwood Sanitary District as originally created, and that
the Bonding Attorneys had refused to allow the District to issue bonds for
the installation of water and sewage facilities. Dr. Baker moved adoption
of the resolution to dissolve the present Riegelwood Sanitary District in
Columbus County. Motion seconded by Dr. Dawsey, and carried.
At this point, Mr. Jarrett presented and discussed a 7iew resolution for
the creation of the proposed Riegelwood Sanitary District, Columbus
County, North Carolina. He stated that all documents and customary
transactions had been examined by his office, and in their opinion, were in
order. This Sanitary District is being recreated under correct boundaries
so that the District can issue bonds for needed sanitary improvements. Dr.
Baker moved, seconded by Dr. Dawsey, that the proposed resolution be
adopted to recreate the Riegelwood Sanitary District in Columbus County
under the correct boundaries. Motion carried.
Mr. Jarrett then discussed a resolution creating the Ocracoke Mosquito
Control District. He pointed out the mosquito situation in Hyde County
and Ocracoke and the urgent need of this request, and recommended favor-able
action by the Board on the request from the County Board of Com-missioners.
Dr. Baker moved, seconded by Mr. Jackson, that the resolution
notifying the County Commissioners that the creation of the Ocracoke Mos-quito
Control District is advisable and approved. Motion carred.
Mr. Jarrett discussed a recent survey of private water supplies providing
water for food and lodging places in the coastal area of the State, particu-larly
on Ocracoke Island and the Dare Beaches. He pointed out the neces-
42 Thirty-Eighth Biennial Report
sity of requiring disinfection of water supplies used at food and lodging
places where potential and actual contamination of ground water sources
exist. After discussion, Dr. Baker moved that where the State Board of
Health or local health department determines from reasonable bacteriologi-cal
evidence that well water supplies serving public eating and lodging
establishments is unsafe for drinking or other culinary uses that such places
be notified to install and operate necessary equipment to effectively disinfect
said water supply and that in places where satisfactory ground water sup-plies
are not available that cistern water or bottled water from approved
sources be served the public at such food or lodging places. Motion seconded
by Mr. Jackson, and carried.
Mr. Jarrett next presented the need for a revision of Bulletin No. 519,
Residential Sewage Disposal. He discussed the revision and changes brought
about by a new method of drain field construction which should be incor-porated
in the rules and regulations regarding sewage disposal, and recom-mended
the approval by the Board on the revision of this Bulletin. He also
requested that Section III—B—Item I, of the rules and regulations adopted
by the State Board of Health July 17, 1958 be amended by changing the
date July 17, 1958 to March 17, 1960. Dr. Dawsey moved that Bulletin No.
519 be revised and that the proposed amended regulations be adopted as
requested. Motion seconded by Dr. Baker, and carried.
Dr. John H. Hamilton, Assistant State Health Director, in presenting a
proposed resolution on approved laboratories, requested the Board to approve
a statement expressed as follows:
"It is the policy of the North Carolina State Board of Health that every
laboratory (within the State) which is approved or retains approval for
the making of serological tests for syphilis under the State Marriage Law
shall be under the supervision of a physician licensed to practice medicine
in North Carolina, who signs an agreement stating that he or she assumes
responsibility for the ethical conduct of the laboratory."
Dr. Baker reported that Dr. Morrison had called him to say he is in
favor of adopting this resolution. Dr. Baker moved that this resolution be
adopted as a policy of the State Board of Health. Dr. Edwards seconded,
and the motion was carried unanimously.
Dr. Hamilton announced that he is going to retire within the next two
months, and this was simply for support of his successor. Dr. Dawsey said
he thought Dr. Hamilton should be complimented for the job he has done
in the past. Dr. Baker moved that the Chair appoint someone, preferably
Dr. Norton, to draw up a resolution as an expression of appreciation and
summarize the career of Dr. Hamilton to be released to the press at the time
of his resignation. Dr. Dawsey seconded, and the motion was carried
unanimously.
Mr. McCary of the Local Health Division referred to the list of health
directors which had been distributed to the Board members. This is an
up-to-date, revised list which gives, first, the part-time health directors now
serving in the local health departments ; second, the full-time positions filled
;
and third, the vacancies now in existence without any health director serv-ing.
To give a better understanding of this report, we have 53 single county
units in the State, 18 district units, and 2 city departments, with a total
of 73 departments serving the one hundred counties of the State. To date,
North Carolina Board of Health 43
there are 13 part-time health directors. It is felt that at least eight of these
local health departments: Bertie, Bladen, Franklin, Henderson, Pasquotank-
Perquimans-Camden-Chowan, Rockingham, Tyrrell-Washington, and Union,
should have full-time men. There are also three departments without any
health director: Jackson-Macon-Swain, Sampson, and Warren. The total
vacancies include part-time health directors and vacancies without any
directors, which equals 13 part-time directors and 3 vacancies, or a total
of 16 departments filled with part-time directors or without any directors.
Mr. McCary asked the Board to study this list and determine if there is
anything they can do as individuals to get these positions filled. Dr. Bender
asked if salaries are adequate. Mr. McCary explained the different classes
of health directors with their salary ranges, and stated that the salary
ranges may be adequate in many respects, but the salaries for these health
directors depend also upon the Local Board of Health and the County Com-missioners.
Dr. Norton commented that since January 1, vacancies have been
filled in Avery-Yancey-Mitchell, Cherokee-Clay-Graham, Granville, Greene,
and Wilson. Asked if the School of Public Health is usually filled, Dr. Nor-ton
replied that it is not and this is a regional school, health workers come
from other states and are obligated in most instances to their home states.
As a preliminary to discussion of the proposed "A" Budget, Dr. Norton
explained that the budget is divided into three parts, "A", "B", and "C".
The "A" Budget is considered to be continuation of services theoretically
at the same level to the people in the State. The "B" Budget consists of
any new services or expansion of presently existing services. The "C"
Budget is for capital improvements, such as new buildings or new equip-ment.
Mr. Charles L. Harper, Director of Administrative Services, dis-tributed
budget information and explained the increases in each program
by item of the tentative request for 1961-'63 biennium, showing a total in-crease
of $633,399. The actual appropriations for 1959-'61 were $5,907,084,
as opposed to tentative request of $6,540,483 for 1961-'63 biennium. Certain
items are applicable rather uniformly for all State employees, such as
increments in salaries. The proposed increases are to provide the same
volume of service, such as the increases in cost of hospitalization, clinics,
in sanitation services required by law or replacement of equipment.
Dr. Norton thought it would be helpful, if the Board considers advisable,
to be instructed to go ahead and present what we recognize as needs in
order to carry on the program at the present level. Dr. Baker so moved,
and Dr. Bender seconded the motion. The motion was carried unanimously.
Dr. Norton reported that Stream Sanitation had been transferred to the
Department of Water Resources, and requests have been made and con-sideration
given from time to time to changing sections or divisions. One
section change, when Dr. Peck left, was that radiation was put in Occupa-tional
Health under Dr. W. L. Wilson and chronic diseases was put in with
cancer and heart under Dr. D. F. Milam in the Personal Health Division.
Nutrition Section has requested that they be made a division. The Nursing
Section has requested repeatedly change from a section to a division. The
Mental Health Section has requested change to a division. Dr. Norton recom-mended
that mental health work, which is an enormous problem and a
growing problem, be changed from section status to a division, headed by a
psychiatrist, and supporting staff which they already have. Mr. Jackson
44 Thirty-Eighth Biennial Report
moved that the Board go along with Dr. Norton's suggestion that mental
health be made a division with a psychiatrist as its head at a time deter-mined
by Dr. Norton. Dr. Dawsey seconded, and the motion carried unani-mously.
Dr. Baker called attention to the importance of the polio vaccination
program with the suggestion that any publicity that could be given to the
program would be a great service especially to the children. This is the
time of year to get vaccinations. Dr. Bugg announced that Dr. Sam Ravenel,
Chairman of the State Medical Society Committee, has had a meeting of
his committee, stimulated by the National Congress of Parents and Teachers.
The Junior Woman's Clubs are going to undertake to run clinics at various
places soon in order to get increased immunizations, assisted by lay groups
with full cooperation of the medical profession. Each County Medical
Society has such a committee. Dr. Norton reported that Dr. Ravenel had
written Dr. Ellen Winston, urging that polio immunizations be stressed in
day care nursery centers. He said he had written Dr. Winston that he was
heartily in accord with Dr. Ravenel's request. Dr. Baker suggested that
Dr. Norton write a letter to Dr. Winston showing interest of the Board,
expressing hope of her positive interest in this problem and pointing out
the importance of her cooperation.
Dr. Norton made a progress report on the poliomyelitis cases and the
immunization program. There was much discussion and Dr. Baker suggested
that he thought it might be a good idea to ask the Attorney General for a
re-study and interpretation of the meaning of the word "admitted" used in
the statute. In 1959, a total of 313 cases of polio were reported. Of that
number, 270 were paralytic cases. Two cases, both paralytic, have been
reported through March 16, 1960.
For information of the Board, Dr. Norton reported on a letter received
from Dr. T. T. Jones of Durham, N. C, regarding alcoholism as a public
health responsibility ; alcoholism, a disease and alcoholism, a reportable
disease. There was much discussion of the problem. The Board expressed
appreciation to Dr. Jones' services as a physician, and particularly in the
field of alcoholism. On motion of Dr. Baker, seconded by Dr. Edwards, Dr.
Norton was instructed to reply to Dr. Jones' letter saying that the members
felt that they are interested in pursuing the matter further and requesting
suggestions on some way in which the Board can specifically be of help.
Motion carried. Adjournment.
May 11, 1960. The annual meeting of the North Carolina State Board of
Health was held, as required by law, on the second day of the annual
meeting of the Medical Society of the State of North Carolina, in the
Reyno