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Report of the Efficiency and economy committee created under the authoriy of the Forty-eighth General assembly, state of Illinois . online

. (page 70 of 110)
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free to physicians, midwives and coroners.

Previous to 1903, no compensation was paid to persons making the
required reports of births and deaths, and, partly in consequence of this
omission, the law was a dead letter. Under the law of 1903, however,
a fee of twenty-five cents is allowed for each report of a birth or death ;
and such fees, together with the cost of printing blank reports, con-
stitute a charge upon the counties. Many counties fail to make appro-
priation for such expenses, and in many localities the reports are frag-
mentary and lacking in accuracy.

The object of collecting vital statistics has been described as being
"to give warning of the undue increase of disease or death that is
presumed to be due to preventable cause, and also to indicate the locali-
ties in which sanitary efifort is most desirable and most likely to be of
use." This object cannot be attained without full and accurate statis-
tics running continuously over a considerable period of time, and such
statistics cannot be even approximately obtained when the collection is
dependent in certain essential particulars upon the voluntary action of
counties.

Reports of deaths are fairly complete from cities and villages
requiring the issuance of burial permits, but deaths in other parts of the
State and births nearly everywhere are very inadequately reported.
There would seem to be a need for a new birth and death Act, preferably
one meeting the requirements of the United States Census Bureau.

Investigations — In addition to collecting vital and mortuary statis-
tics the State Board of Health also conducts investigations into health
conditions in various parts of the State in order to discover the causes
of communicable diseases and to collect the necessary information as a
basis for taking measures for the suppression of epidemics. The board
maintains at Springfield a laboratory for the diagnosis of diseases and
for the examination of specimens of various substances involved in the
detection of disease. By special arrangement, the State Water Survey
at Urbana takes care of the examination of the sources of water sup-
plies and the study of the proper disposition of sewage. It makes
chemical analyses of samples of drinking water sent to it for that
purpose. The State Board of Health distributes diphtheria antitoxin



652 EFflCIENCY AND ECONOMY COMMITTEE.

free of charge to those who may be in need of it, and unable to pay
therefor. The board is empowered to appoint one or more agents in
each county for the sale or distribution of the antitoxin.

Publications — The State Board of Health issues a number of pub-
lications. P>om time to time official registers of physicians and mid-
wives are prepared and issued, together with lists of medical institutions
represented in the official register of physicians, a schedule of require-
ments for medical schools in good standing, list of certificates revoked,
etc. The board has also issued a number of special bulletins from time
to time, giving information of a popular character concerning the proper
precautions to be taken against certain diseases. In 1913 the board
issued a model health ordinance for adoption by cities and villages.
In 1903 the board began the issuance of monthly bulletins in which
topics of general health interest were discussed. They were soon dis-
continued, but the series was again taken up in 1906, but none has been
issued since November, 1912. The monthly bulletin for December of
each year contains the annual report of the board to the Governor.

Measures for the Prevention or Eradication of Disease:

Under this head would be included such matters as the establish-
ment and maintenance of quarantine, the abatement of nuisances, the
control of epidemics in cities, villages, and townships when local authori-
ties fail to take proper steps, the issuance of rules and regulations for
carrying into efifect the provisions of various Acts for the protection of
the public health, and the supervision of sanitary conditions in lodging
houses and hotels in cities of 100,000 population and over.

Among the rules and regulations issued by the board may be men-
tioned those dealing with the embalming and transportation of dead
bodies and with the draining, construction and plumbing of hotels and
lodging houses.

By Act of 1899, amended in 1901, the State Board of Health is
given supervision over lodging houses in Chicago, and the duty was
imposed upon it to have such houses inspected so as to see that the
provisions of the Act are complied with. . The Act deals with ventila-
tion, size of rooms in which persons are to be allowed to sleep, arrange-
ment of beds, etc. The proprietor or manager of every such lodging
house is required to file annually with the county clerk a statement
of various pertinent facts concerning the house upon blanks furnished
to the county clerk for that purpose by the State Board of Health.

An Act of June 25, 1913, gives the State Board of Health authority
to make rules and regulations concerning the drainage, construction and
plumbing of all lodging houses, having as many as ten rooms for the
accommodation of guests, not only in Chicago, but in all cities, villages
and incorporated towns in the State.

Methods of Enforcement.

To a large extent the State Board of Health is dependent upon
loc"al authorities and boards for the enforcement of its rules and regula-
tions. It is made the duty of all local boards of health, health authori-
ties and police officers, sherifi's, constables and all other officers and



PUBLIC HEALTH ADMINISTRATION. 653

employees of the State or of any county, village, city or township, to
enforce the rules and regulations that may be adopted by the board.
More specifically it is provided that persons guilty of violating any rule
or regulation of the board shall be liable to a fine not exceeding $200
for each offense and to imprisonment in the county jail not exceeding
six months, or both. At the instance of the board or its executive officer,
it is made the duty of the State's attorney in each county to prosecute
all persons in the county refusing to obey the rules and regulations of
the board.

In the Act of 1905 for the regulation of the embalming and dis-
posal of dead bodies, it is not only made the duty of the State's attor-
neys to see that the provisions of the Act are enforced in their respective
counties, but it is also made the duty of all sheriffs, deputy sheriffs, con-
stables, and police officers to inform against and prosecutrall persons
whom there is reasonable cause to believe are guilty of the violation
of any of the provisions of the Act.

The very considerable dependence which the State Board of Health
must place upon local officers, and particularly upon the State's attor-
neys, for the enforcement of its rules and regulations is undoubtedly a
handicap of a serious character upon their efficient enforcement. There
is much complaint by the State board regarding the inactivity of State's
attorneys, and it is well known that it is sometimes difficult to get
State's attorneys to bring prosecutions against persons who have local
political influence. Formerly the board was able to employ special
attorneys to prosecute violators of the medical practice Act out of the
proceeds of the fines collected from such violators, but under existing
law all moneys received from fees, charges, fines, and penalties are to
be paid into the State Treasury and cannot be used for the employment
of special attorneys in the counties. The board has an attorney, but
his time is occupied in prosecuting offenders in Chicago, and, in the
counties, whenever the State's attorneys fail to bring suit against viola-
tors of the law reported to him the board is powerless to act. The
prosecution of quacks in Chicago, as well as in the rest of the State,
is also seriously interfered with by the defect in the law, mentioned
above, whereby the State board is unable to revoke the licenses of per-
sons who received their licenses prior to 1899.

The inactivity of the State's attorneys in cooperating with the
State Board of Health by prosecuting violations of the IMedical Practice
Act causes the board to rely principally upon its special attorney to
prosecute such violations. The employment of special attorneys by
State boards, however, tends to split up the legal business of the State
in such a way as to cause conflict or friction between attorneys of
different boards. A solution of this difficulty might be worked out by
having the xA.ttorney-General assign an attorney to the State Board of
Health. Such an attorney would be attached to the Attorney-General's
office and subject to central supervision, though under the immediate
direction of the State Board of Plealth. It is probable that the State's
attorney would co-operate more readily with an attorney attached to
the Attorney-General's office than with a special attorney under the
State Board of Health.



654 EFFICIENCY AND ECONOMY COMMITTEE.

The decisions of the board, in revoking or refusing to grant licenses,
in refusing to recognize medical colleges as being in good standing and
in other instances, are subject to judicial review, and a number of cases
have arisen in the courts by way of appeal from the decisions of the
State Board of Health. '

Financial Summary.

The State Board of Health receives from the Legislature annual
appropriations and pays out by way of salaries of employees the sum
of %Z7,720. Other expenses are met from appropriations as follows :

Salaries of employees $ ^7,72-^

Farm and dairy investigations $ 5,000

Office and traveling expenses 5,500

Laboratory expenses 4,400

Epidemic fund 8,000

Emergency contingent fund 6,000

Purchase and distribution of antitoxin 29,000

Purchase and distribution of antitoxin (emergency) 7,000

Treatment of rabies in indigent 3.000

Expenses of State Board examinations 16,500

Expenses State Board examinations (emergency) 4.500

Distribution of typhoid vaccine 6,000

Prevention of blindness in children 3,000

Expenses of lodging house inspectors 1,700

99,600

Total annual appropriations $137,320

The State board collects fees varying in amiount from^ $1 to $10
for various services performed, such as admission to examination and
issuance of licenses. Under the Act of 1901 it was provided that the
per diem of members of the board should be paid out of such fees, and
not out of the State Treasury, but by Act of 1911, as already noted,
all such fees must be paid into the State Treasury, and it is therefore
provided that the compensation of members of the board may be paid
out of the State Treasury, upon appropriation being made ^therefor.
The board is required to make an annual report on September 30, show-
ing all items of receipts from all sources and disbursements for all
purposes.

Receipts and disbursements from October 1, 1912, to September
30, 1914, were as follows :

Receipts, October 1, 1912, to September 30, 1913 $ 25,187.35

Receipts, October 1, 1913, to September 30, 1914 29.722.20

Total receipts $ 54,909.55

Disbursements 216,212.54

2. STATE FOOD COiSrMISSIONER.

Introduction.

As early as the Revised Laws of 1827, the Criminal Code of Illi-
nois contained a provision that:

If any person or persons shall knowingly sell any flesh of any diseased
animal, or other unwholesome provisions, or any pernicious or adulterated drink
or liquors, every person so offending shall be fined not exceeding one hundred
dollars, or imprisoned not exceeding three months.



PUBLIC HEALTH ADMINISTRATION. 655

This section of the Criminal Law was re-enacted in the Revised
Statutes of 1845, and from time to time additional and more specific
legislation has been enacted regulating and prohibiting the sale of adul-
terated and dangerous foods and drugs, as follows :

1869_To prohibit making and selling poisonous candies; and to prohibit the
supply and use of diluted, adulterated or stripped milk for the manufac-
ture of cheese.
1871— To regulate the sale of abortifacient drugs.

1874-1877 Sections 7, 8, 9 and 10 of the Criminal Law to prevent fraud in the

coloring of grain. , . , , ,

1879— To regulate the sale of milk ; and to prevent fraud m the manufacture and

sale of butter and cheese.
1881— To prevent the adulteration of butter and cheese.

To prevent the adulteration of food, drink and medicine.
1883 — To prevent the adulteration of vinegar.
1885 — To regulate the sale of canned or preserved food.
1887 — To regulate the sale of veal; and to regulate the manufacture and sale

of substitutes for butter.
1889— To prevent fraud in the sale of lard; and to fix the standard of analysis

for milk.
1897— To regulate the manufacture and sale of substitutes for butter; and to fix

the standard of analysis for milk.
1889 — To prevent the adulteration of vinegar; and the State Food Commis-
sioner's Act.
1901— To prevent fraud in the branding and sale of process and renovated butter.
1905_To regulate the sale of commercial food stufifs.
1907 — Revised Food and Drugs Act.

1911_Sanitary regulation of food supplies; and amendments to Food and Drugs
Act and Stock Food Law.

Until the Act of 1899, these laws were classified as part of the
criminal code, and enforced through local officials, State's attorneys
and boards of health. The Act of 1899 was of much broader scope,
and also established the office of State Food Commissioner for its en-
forcement; but was not a revision of all the laws on the subject of pure
food. The Food and Drugs Act of 1907 is a general revision of the
laws pertaining to foods and food products, which were brought into
harmony with the United States Foods and Drugs Act. But some
provisions of the earlier laws not incorporated in the Act of 1907 appear
to be still in force: the Act of 1897 to regulate the manufacture and
sale of substitutes for butter is specifically exempted in the clause
repealing inconsistent legislation ; and the stock food law and sanitary
regulation law are separate Acts. The pharmacy law is also a separate
xA-ct enforced by the Board of Pharmacy. Under the Weights and
Measures Act (revised in 1913) the Secretary of State is ex-officio
State Sealer of Weights and Measures.

State Food Commissioner and Food Standard Commission.
The present law provides for a State Food Commissioner, to be
appointed by the Governor, for a term of four years, at a salary of
$3,600 per annum. This officer is charged with the enforcement, of
all laws regarding the production, manufacture, sale, and labeling of
food, and with the prosecution of any one violating any of such laws.

A. Food Standard Commission is also provided for the purpose of
determining and adopting standards of quality, purity or strength for
food products. This consists of three members, one of whom shall be



656 EFFICIENCY AND ECONOMY COMMITTEE.

the State Food Commissioner, or his representative, one shall be a
representative of the Illinois food manufacturing- industries, and one
shall be an expert chemist. The two members other than the Food
Commissioner or his representative, each receive $15 per day, for not
more than thirty days in any one year, and necessary expenses.

The Act of 1907 further provides for the following staff — to be
appointed by the commissioner, with the advice and consent of the
Governor :

1 Assistant commissioner $3,000

1 State analyst 2,500

1 Attorney 1.800

1 Chief clerk 1,800

1 Assistant clerk 1,200

3 Stenographers at $1,000 3,000

12 Inspectors at, each $1,200 to 1,800

To be appointed by tlie Commissioner:

1 Bacteriologist ^ 1,800

7 Analytical chemists, each $1,200 to 1,800

1 Janitor 720

The General Assembly in 1913 made the following appropriations
for the Food Commissioner :

, • Per annum.

Salaries of six stock food inspectors $ 7,200

Salaries of two chemists 2,400

Expenses of Food Commission 4,000

Expenses of analysts 4,200

Expenses of inspectors 12,000

Expenses of laboratory ". 3,000

For rent 5,000

For postage 2,000

Expenses of State food inspectors 7,200

Expenses of chemists 2,400

Expenses of attorney 500

Expenses, Food Standard Commission 1,500

Office expenses 2,500

Total $53,900

The above salaries and appropriations amount to over $100,000 per
year. The expenses of the office for the two years ending September
30, 1912, amounted to $164,098.38; and for the two years ending Sep-
tember 30, 1914, were $163,469.45. Some revenue is received from
licenses and fines, the receipts paid into the State Treasury for the two
years ending September 30, 1914, amounting to $34,610.65.

Poivers and Duties.
General Provisions:

The food and drugs Act makes it unlawful to manufacture for
sale within the State of Illinois any article of food or drink which is
adulterated or misbranded ; defines the terms "adulterated" and "mis-
branded" ; and provides for the condemnation and confiscation of adul-
terated or misbranded foods or drink. It also contains specific provi-
sions in regard to branding vinegar, labeling extracts and baking pow-
der, adulterated liquors, unclean or unwholesome milk, the sale of pre-
servatives, lard substitutes, and process butter. Other Acts regulate



PUBLIC HEALTH ADMINISTRATION. 657

the sale of commercial food stuffs, and require premises used for the
manufacture, sale or distribution of foods to be adequately lighted,
drained and ventilated and kept in a sanitary condition.

Standards of purity and strength are specified in the law for certain
articles, such as milk, pepper, extracts, olive oil and vinegars. All
articles not defined in the Act must conform to the definition and analyti-
cal requirements adopted and promulgated from time to time by the
Food Standard Commission.
Rules dnd Regulations:

The State Food Commissioner shall make rules and regulations for
carrying out the provisions of the food and drugs Act, and for analyzing
and reporting the results thereof of articles submitted by the State Board
of Health, or furnished under any law of the United States relative to
adulterated, misbranded or deleterious foods, etc.

Licenses:

By an amendment of 1911 no person may operate a milk or cream
testing apparatus to determine the percentage of butter fat in milk or
cream without first securing a license from the food commissioner, on
application and passing a satisfactory examination that he is competent
and qualified to properly use such tester. Licenses are issued for two
years ; and a fee of one dollar must be paid. The food commissioner
has authority for just cause to revoke any such license.

During the year 1911, the department issued 205 licenses to manu-
facturers, jobbers or dealers in concentrated commercial feeding stuffs.
For these, the amount received by the State Treasurer in fees was
$11,212.50. Receipts from such licenses for the two years ending Sep-
tember 30, 1914, amounted to $33,938.65.

Inspections: '

The State Food Commissioner and authorized inspectors are re-
quired to examine the raw materials used in the manufacture of food
products; and are authorized and required to examine and inspect all
premises where food is manufactured, transported, stored or sold ; and
to report any violations of the law or conditions detrimental to the
health of the employees or the quality of the food.

In the printed reports of the food commissioner for 1911 and
1912, examinations and inspections are reported to have been made
in several hundred places throughout the State. No data is shown as
to the time spent in each place or the number of premises inspected.
The reports describe more fully certain special investigations made on
complaint. At the time covered by these reports, the inspectors were
not assigned to permanent districts ; but different inspectors visited
some of the same places at different times.

The State has now been divided into eleven inspection districts.
Two inspectors are in Chicago ; and there is one for each of the other
districts, with headquarters at Chicago, Rockford. Champaign, Peoria,
Galesburg, Jacksonville, Springfield, East St. Louis, Centralia and Mt.
Carniel. Inspectors are required to spend eight hours a day; but there
seems to be no method for checking their activity, except by the reports



658 EFFICIENCY AND ECONOMY COMMITTEE.

submitted. A sanitary inspection report is made for each establishment
visited; a hst of places inspected each day is reported, and a general
report on conditions in a city or town is made when the inspection has
been completed. About one-tenth of the time of inspectors is estimated
to be spent on investigating complaints.

No inspection of stock yards or wholesale houses is made by the
food inspectors.
Analyses:

When the food commissioner or his agents have grounds for sus-
picion that any article of food is adulterated or misbranded, he may
seize such article, and shall forthwith cause a sample to be examined
and analyzed. Samples taken by the agents of the food commissioner
must be taken to the State analyst, or other competent person appointed
for the purpose of making examinations and analyses.

The State Board of Health may submit to the State Food Com-
missioner or any of his assistants samples of food or drink for examina-
tion or analysis and receives special reports showing the results of such
examination or analyses. The food commissioner is also required to
make analyses and examinations for the State charitable institutions of
foods, drugs and such other supplies as the laboratory is equipped and
prepared to examine and analyze.

It is unlawful for the State analyst or any assistant State analyst
to furnish to any person, firm or corporation, any certificate as to the
purity or excellence of any article manufactured or sold by them to be
used as food or in the preparation of food.

A summary of the analysis work of the department for the years
1911 and 1912 is shown below:

1911 1912

Samples taken 3,673 6,500

Number found to be adulterated or misbranded 1,123 2,091

Suits filed 239 236

In the latter part of 1913 and early months of 1914 most of the
inspectors were engaged in sanitary inspections, and less attention was
being given to taking samples for analysis.

Hearings — ^Prosecutions:

When it appears from examination or analysis that the provisions
of the food and drug Act have been violated, the food commissioner
is required to send notices of such fact, with a copy of the findings,
to the party from whom the sample was obtained, and to the manufac-
turer, packer or other dealer, if any, whose name appears on the label.
Such party or parties shall be given an opportunity to be heard, under
rules and regulations, the date, hour and place of hearing to be named
in the notices. The hearing shall be private, and parties interested may
appear in person or by attorney.

If, after such hearing, the commissioner believes that the Act has
been violated, he shall cause the party or parties wdiom he believes to
be guilty, to be prosecuted forthwith under the provisions of the Act.
No action or prosecution shall be instituted for a violation of the pro-
visions of the Act, unless commenced within six months after taking
the sample.



PUBLIC HEALTH ADMINISTRATION. 659

Hearings are usually held by the commissioner or the, assistant
commissioner ; and in most cases the proceedings are informal. Many
violations of the law are of a minor and technical character, and in
such cases and also in other cases of first instance, prosecutions are not
begun if the parties agree to comply with the law in the future.

The department attorney prepares the papers for prosecuting cases,
and sends them to the State's attorney of the proper county. If neces-
sary the department attorney attends court when the case is tried. The
Attorney-General is sometimes asked for a legal opinion as to the
rights of the department.

Educational Methods:

The food commissioner's department is giving attention to a cam-
paign of public education on the importance of pure foods and drinks.
In this it is working in co-operation with women's clubs, traveling
men's associations and other private organizations. Bulletins are issued
and distributed ; and a moving picture show is furnished, for example,
to illustrate the dangers from dirty drains.

Reports and Publications:

The food commissioner is required to make annual reports to the
Governor of his work and proceedings, and to report in detail the num-
ber of inspectors, with their salary, expenses and disbursements; and
he may from time to time issue bulletins of information.



Online LibraryUnknownReport of the Efficiency and economy committee created under the authoriy of the Forty-eighth General assembly, state of Illinois . → online text (page 70 of 110)