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rate subdivisions of the State, these being self-governing bodies in local affairs.
It was found that in the most populous of these civil units, namely, the City of St. Louis, that a rate of one cent per annum from each person according to the census enumeration would yield the sum of $3,500. As the present salary of the sanitary executive of the city named is $3,000 per annum, with, in addition, the services of a considerable number of paid assistants and subordinates, the test showed that the rate was not far wide of a fair scale of compensation for such services.
On applying the same test to other populous portions of the State where the support of health officials is provided for, it was happily found that the proposed minimum was generally exceeded.
In testing three or four of the least populous counties it was found that by the proposed rate the pay of health officers would range from twenty-five to fifty dollars annually — pittances scarcely worth considering, but these counties being rather mountainous, with few towns, and with family domiciles generally well scattered, would have comp:ratively little need of such officials.
There is no statute in Missouri at present requiring the formation of boards of health in counties, or the appointment of health officers; and it is only in older and more populous portions of the State that such bodies or officials are to be found.
The State Board of Health has been embarrassed and inconvenienced in the performance of sanitary work in the State by this defect, and the collection and recording of vital and mortuary statistics, as required by law, has been found to be practically impossible.
In order to cure this fault and effect a thorough sanitary organization of the State our Board framed a bill to create and establish county and other local boards of health and providing for the appointment of a health officer in every county who should be the secretary and executive officer of the county board, and who should be in close relation with and make regular reports to the State Board. This bill, framed and matured after much consideration, contained the provision that the minimum rate of his compensation should be on the basis of one cent per capita per annum of county population as determined by the latest State or United States census ; this being decided on in order to prevent the practical nullification of the law -- if the bill was passed — hy county courts refusing to provide means for the pay of such officers, or fixing the rate so low that proper and competent persons could not be had for the position.
The bill was recommended for passage to the General Assembly last winter, and was passed by the Senate with the provision referred to intact; but failed to be called up for final passage in the House. At the next session, however, it is hoped better success will be obtained.
While the suggested rate must appear ludicrously small to a person of even limited intelligence, but who is able to appreciate health and the benefits that flow from the detection and removal of conditions that make for disease, still its very insignificance as the thin end of the wedge constitutes an advantage in dealing with legislators of a certain class, prone to captious cheese-paring on the slightest provocation; as the most close-fisted and short-sighted law-naker could hardly raise against it the objection of extravagance, and it commends itself accordingly as a means of avoiding a rock in the legislative channel on which many good measures have been wrecked.
To summarize :-(1) The fixing of a minimum rate is of importance to public health officials as defining a limit below which compensation shall not go, and by placing this at a living figure prevent the virtual abrogation of sanitary laws through the mistaken and foolish economy of county courts and other local bodies. (2) The suggested minimum basis establishes a rate of compensation in strict relation to the population extent of a health officer's duties. (3) The rate while low is still sufficient to fairly compensate such an official for the performance of his purely sanitary work. (4) The basis suggested is so low as to be unlikely to provoke legislative opposition to its adoption. (5) The adoption of some such provision as a legislative enactment would, in an educational sense, be a distinct step toward a more general recognition and acknowledgment on the part of the public of the fact that the benefits and advantages of population good health can orly be had by hard work, and maintained by eternal sanitary vigilance with a liberal outlay of means to retain the services of competent officials trained and skilled in all the lines of public hygiene.
NotE. — See text of proposed law, referred to above, on succeeding pages.
PROPOSED LEGISLATION TO ADVANCE THE PUBLIC HEALTH INTERESTS:
OF THE STATE.
A BILL for an act to create County and other local Boards of Health,
defining their duties and powers, and providing for the compensation of their members and officers.
Be it enacted by the General Assembly of the State of Missouri as
SECTION 1. It shall be the duty of the county court of every county in Missouri to create a county board of health as hereinafter provided after receiving notice so to do from the State Board of Health. The Secretary of the State Board of Health shall notify in writing the clerk of said court in any county where no county board of health exists, and thereupon at the next regular term after notification said court shall proceed to create and establish a county board of health in the following manner : The county court, or a majority thereof, shall choose by ballot two reputable citizens who have been residents of the county for not less than five years next preceding their appointment, who shall not be holders of any State or other county office, and whose residences shall be in different parts of the county. They shall hold office for a term of four years, unless removed for cause by a unanimous vote of the county court sitting in regular session, and they shall be required to take an oath to faithfully perform all the duties of their office.
Sec. 2. The two citizens appointed as aforesaid, together with the presiding justice of the county court, shall constitute and be a board of health, of which the presiding justice shall be ex-officio president, and they shall have power to make rules for the government of the board and for the performance of all the duties hereinafter prescribed. The board shall meet at least once every three months and the appointive members shall be entitled to receive a per diem compensation for actual attendance at such regular meetings and at other meetings, if such may be found necessary, the amount of which compensation shall be fixed by the county court and allowed and paid on its order out of the county treasury. The time and place of the meetings shall be fixed by the board, and it is hereby made the official duty of the prosecuting attorney of any county in which a board of health is created, as herein provided, to act as the legal adviser of such board, and as their counsel in any and all litigation wherein the exercise of their powers and performance of their duties as a board of health are concerned.
Sec. 3. It shall be the duty of a county board of health created as provided by this act, to constantly exercise a watchful supervision over the health and sanitary interests of the people of the county, and to co-operate with other local boards and with the State Board of Health in the promotion of public health, the prevention of disease, the proper reporting and registration of births and deaths and all other statistical reports required to be made to the State Board; and, further, to assist in the sanitary survey of the county, and in the local performance of any general or special duty which is devolved by law upon the State Board of Health. A special meeting of the county board of health may be called by the president upon a written request to that effect signed by the other members of the board.
Sec. 4. It shall be the duty of the county board of health as soon after its creation and organization as possible, to appoint a health officer for the county, who shall be a legally qualified physician in good standing, and who shall have been a resident medical practitioner of that county for not less than three years next preceding his appointment. He shall give a bond conditioned for the faithful performance of his duty, the amount of which shall be fixed by the board, and said bond, after its approval by the board, shall be filed with the clerk of the county court. He shall hold his office for the period of two years, shall be eligible to reappointment and shall be subject to removal for adequate cause as determined after a fair hearing by the appointing power.
Whenever a vacancy from whatever cause occurs in the office of health officer, if the said vacancy be not filled by the country board within sixty days after its occurrence, the State Board of Health may designate a physician of the county to act as such officer until the vacancy is regularly filled as provided in this section.
Sec. 5. It shall be the duty of the health officer as aforesaid to attend all the meetings of the county board of health and act as its secretary and executive officer, keeping a correct account of its proceedings, conducting its correspondence, and performing such other duties as may be required by the board and this Act. He shall take cognizance of and keep himself fully informed concerning the condition of general health among the people of the county, and the character and type of the disease or diseases prevalent or occurring therein, and he shall promptly report all ascertained facts in regard thereto to the county board of health with such recommendations and
suggestions in regard to means or measures for the prevention or control of such disease or diseases as may be deemed by him necessary or expedient. Whenever, in his opinion, any dangerous disease threatens to become epidemic in any part of the county, upon his report to that effect in writing and upon his written request therefor, the presiding justice shall at once call a meeting of the county board of health which shall promptly convene to consider the situation as reported by the health officer and to adopt such measures to meet the threatened danger as they may deem necessary; and any action or measures so decided on shall be promptly reported to the State Board of Health. The health officer shall receive as compensation for his services a salary to be fixed by the county board of health, payable monthly on the order of the county court in the same manner as is provided by law for the payment of the salaries of other county offi
The minimum rate of such compensation shall be one cent per annum per capita of the county population as ascertained by the latest State or United States census.
Sec. 6. It shall be the duty of the health officer to regularly make a monthly report of the condition of public health in his county together with an abstract of the proceedings of the Board of which he is secretary to the State Board of Health, and to keep the State Board fully advised in regard to all matters relating to the sanitary interests of the people of his county. He shall promptly lay before the county board all communications received by him from the State Board of Health that may be intended for the information and guidance of that Board, and to aid it in the performance of its duties as prescribed by law.
SEC. 7. No quarantine powers shall be exercised or restrictions on business or travel be imposed or enforced by any health officer, or county board of health, or other local health organization, by which any other county or town would be injuriously affected until a full report from the board so desiring to act, of all circumstances that appear to render such restriction or quarantine necessary shall have been made to the State Board of Health, and the consent of that body to the proposed restrictions or quarantine has been obtained.
Sec. 8. The mayor of any incorporated city or town, not already provided with a board of health or health officer, shall within thirty days after having been notified in writing so to do by the Secretary of the State Board of Health, nominate two citizens to serve as members of a board of health, whose qualifications and length of residence in suid city or town shall be as prescribed in section one of this Act. These nominations shall be subject to confirmation by the