Annual report 1969-1970 [1970]

Georgia Oeparbnent of PtjJii: Health
Amual Report lB-1970

GEORGIA STATE BOARD OF HEALTH
B. W. Forester, M.D. Chairman John M. Martin, M.D. Vice-Chairman J. T. Mercer, D.V.M. Secretary Harrison Bray Wesley A. Carr, D.D.S. Lee Roy Claxton, R. Ph. William A. Dickson, M.D. P. K. Dixon, M.D. Roy L. Gibson, M.D. L. H. Griffin, M.D. John E. Garner, Jr. John D. Marshall, R. Ph. Earl T. McGhee, M.D. W. Frank McKem ie, M.D.
Lamar B. Peacock, M.D . Carl E. Pruett Richard H. Smoot, M.D. A. C. Tuck, D.D.S.

Georgia Deparbnent of Public Health Annual Report 1969-1970

TABLE OF CONTENTS

Page

From the Director

2

A Healthy Population- Physically

4

A Healthy Population- Mentally

6

A Healthy Environment

9

Payment for Medical Care

11

Profiles in Health

13

Appendices

Revenue Receipts and Expenditures

20

Expenditures by Program

20

Mental HAalth Institutions

21

Medicaid Expenditure Report

21

Morbidity Sampling

22

Selected Laboratory Tests

22

Chronic Disease Screenings

23

Rabies in Georgia

23

Medical Facilities

23

Organizational Chart

24

FROM THE DIRECTOR
Historically public health programs have been concerned mainly with the prevention of disease. During the past decade, however, the mission of public health has been dramatically and steadily widened until our responsibility in the Georgia Department of Public Health during the year ending June 30, 1970 included not only the prevention of disease but also the direct treatment of the state's mentally ill and mentally retarded; the reversal of the present trend in air, land, and water pollution; and the direct payment of claims to those providing medical services to the poor under various medical assistance programs. To better fulfill this expanded mission- in view of the state's shifting population patterns - we made significant administrative changes including the reorganization of the internal structure of the State Health Department. The number of public health districts in the state was reduced and district staffs strengthened to offer more comprehensive services to local health departments, while health planning and program evaluation received renewed emphases. Since the body of this report is devoted principally to a review of progress made within the programs of the Department, my introductory remarks are confined to a review of administrative changes.
The new State Health Department organizational structure which became effective on February 1, 1970 created two operational divisions, the Division of Environmental Health and the Division of Health Surveillance and Disease Control. At the same time, the old divisions of Epidemiology and Physical Health were gradually phased out as their functions were absorbed by the new divisions.
The Division of Environmental Health grew out of the need for emphasizing the environment and the accompanying desire to focus additional attention on that particular area of public health. Reorganization, we felt, would strengthen coordination among the various on-going environmental health programs within the Health Department. In addition, a Solid Waste Management Service was created to take positive steps toward solving the problems associated with mounting piles of garbage, trash, and industrial waste which mar our landscape and endanger our health.
Likewise, it seemed logical to group together all programs relating to preventive services of a medical nature. Thus, the branches of Dental Health, Epidemiology, Laboratories, Health Conservation, and Tuberculosis

were welded together into the Division of Health Surveillance and Disease Control. The division gave added emphasis to adu It health, as the concept of the old Chronic Disease and Geriatrics Service was expanded to include preventive programs for adults of all ages. A significant change in the organizational structure of the Tuberculosis Control Service occurred during the first half of the fiscal year, although the basic responsibilities and functions of the service remained essentially unchanged throughout the year. The service, with primary responsibility for providing technical consultation and advice to district and local health personnel through the Office of Local Health, continued monthly to provide complete information on all known cases of tuberculosis to each of the 159 counties.
Concurrent with the formation of these two new divisions, some basic changes were made in the Division of Medical Care Administration. The Branch of Certification and Licensure and the Branch of Health Facilities were combined under the direction of a physician experienced in this phase of health care. All programs in which the Health Department acts as a third party for payment were placed in a single administrative unit when the Cancer Control Section was shifted to this division.
Not only was the internal organization of the State Health Department restructured during the year, but also significant changes were made toward improving the delivery of community health services. A new public health district plan - under study by a number of ad hoc committees for more than three years- was finalized and the decision was made to reduce the number of health districts from 38 to an anticipated 13 or 14 (depending upon whether the nine-county metropolitan Atlanta area will be served by one or two health districts). The plan, adopted by the State Board of Health in January, 1970, became effective on the first day of the 1971 fiscal year; five of the proposed health districts had requested to be established on July 1, 1970. The reduction in the number of health districts was designed to close the gap between services provided and demand for the delivery of more complex health services brought about by significant technological advances, rapidly changing attitudes about health care, an increasing and mobile population, and shifting patterns of urbanization and industrialization. With fewer health districts and strengthened district staffs, we feel that there will be 2

more comprehensive coordination of health programs sensitive to a particular region, a stimulation of comprehensive health planning and the consideration of the health aspects in community planning, and better utilization of professional health personnel.
To help alleviate the current demand for health manpower, an innovative program was completed during the year. In an intensive, three-month course, 80 health program representatives - traditionally specialized health professionals trained in the detection and follow-up of a single disease or a few closely related diseases and assigned to a specific program area -were retrained to function in a wider range of activities. The chief health program representatives have been challenged to aid local health departments assess the needs of the community, stimulate other resources, innovate, and research to improve the general level of health in Georgia's communities.
Although public health, ideally, is concerned with the prevention of disease, the dramatic emotional appeal of illness has attracted state and federal funds away from prevention and into treatment and direct payment programs. This past year witnessed an even larger portion of the state's health dollar being spent for direct care programs. This trend in the delivery of health care, coupled with the increasing demand for health services, has underscored the necessity of health planning to utilize the health dollar in the most meaningful way. The Office of Comprehensive Health Planning, with an advisory council composed of health consumers and professionals, is responsible for determining the health needs of the state, evaluating resources, and setting priorities. During the past year several special task forces appointed by the advisory council provided in-depth investigation and consideration of special health problems in such fields as environmental health, and health facilities and services. A "Task Force Report on Physician Manpower in Georgia" containing 19 recommendations for better utilization of physicians' time, increasing medical school enrollments, and attracting, retaining and allocating physician manpower in the state was issued. Two areawide comprehensive health planning agencies were funded: the six-county Metropolitan Atlanta Council for Health and the seven-county Brunswick agency. Thus, at the end of the fiscal year approximately onehalf of the state's population was contained in an area with a health planning agency. In addition, a health plan-
3

ning coordinator was included in the projected staff for each new health district.
Health planning alone, however, is only one side of the coin. There is an equally valid need for program evaluation in order to concretely pinpoint program effectiveness in terms of a "health impact." During the year an Office of Operations Research was established within the Director's Office to determine whether a program is meeting its stated goals as quickly and as efficiently as possible. The office has begun program review and evaluation; devising more effective organizational patterns for the delivery of health services; and studying operational methods, systems, and procedures.
During the year July 1, 1969- June 30, 1970 these were the changes made in the vehicles for delivery of health care. Other changes made within program areas resulted in substantial progress in offering better health care to Georgians. For the most part these programs are carried out on the local level with administrative services, advice, and consultation from the State Health Department. Since it is impossible to detail in a readable form the specific contributions of each Health Department program and since each local health department compiles a detailed annual report of its activities, this report deals with health program highlights during the reporting period.
~0 ~ ~'"~::~,~:, .o Georgia Department of Public Health

A HEALTHY POPULATION --PHYSICALLY

More than anything else, public health is service. Its

the birth of their child. As the Health Department con-

goal is a healthy population living out its lengthening life

tinued to stress the importance of proper prenatal care

span in a healthful environment. One major impediment

and hospital deliveries the number of births attended by

to this goal, however, has been the birth of large num-

midwives dropped to 3,179 during 1969, a decrease of

bers of unwanted children, primarily in low income fam-

21.6 percent from the preceding year. Some 29 maternal

ilies with little or no knowledge of birth control mea-

deaths, or 3.2 per 10,000 livebirths, were reported dur-

sures. These children become both a drain on already

ing the year.

inadequate family income and a threat to the health of

Phenylketonuria (PKU) newborn screening was ex-

the mother and her children, as studies have shown that

panded with the public health nurse continuing to fol-

a large number of children born close together tend to

low-up on infants discharged from hospitals before PKU

have more birth defects and are more frequently crip-

screening was done. In addition, the Department pro-

pled or mentally retarded than those in smaller, well-

vided dietary consultation and the special milk sub-

spaced families. The Department's family planning pro-

stitute Lofenalac to the 55 families containing the 71

gram is designed to provide birth control information

known cases of PKU in the state.

and services to low income families, and, thus, to break

Primary efforts were made toward expanding services

the cycle of poor health and poverty which has gripped

to children, especially the younger child. Infant feeding

many Georgia families for generations.

schedules were developed to aid in counseling mothers

Providing modern methods of family planning in

about nutrition. Following an intensive six-months study

health department clinics has resulted in the steady de-

in DeKalb County last year and in-service education to

cline of children being born into families already having

aid nurses in improving their skills in the appraisal of

two children. During fiscal 1970 the Health Department

children, a program of increased nurse responsibility in

continued cooperative efforts with the Georgia Depart-

child health appraisal and evaluation was introduced in

ment of Family and Children Services and other state

12 health districts. Nurses, then, referred children with

and national agencies in order to provide family planning

medical complications to a physician. During the year

services for as many needy women as possible. In local

nurses examined 67,280 children, and 26,069 children

health department clinics across the state, the family

were seen by physicians. Some 55,814 children were

planning program reached 27,195 new patients, 28

given tuberculin skin tests, and 65 new cases of tuber-

percent more new patients than last year. Some 70,186

culosis were diagnosed.' Children were immunized against

patients - new and old - returned to family planning

diptheria, whooping cough, tetanus, poliomyelitis, mea-

clinics for services during the year. At the end of the

sles, small pox, and mumps.

year one out of every six women estimated to need

Prevention of rubella -a common communicable dis-

family planning services was receiving continuous, ade-

ease which occurs in epidemic proportions every six to

quate contraception in health department clinics com-

nine years- became possible in June, 1969 when a live

pared with one out of every eight during the preceding

virus vaccine was first licensed. Rubella can be extremely

year. In addition, assistance was given to Richmond and

devasting to an unborn child, particularly if the mother

Chatham counties in writing special family planning pro-

contracts the disease in the first three months of preg-

jects funded during the year and Department personnel

nancy. If enough children are vaccinated to prevent

participated in the formation of both a family planning

epidemics, however, women in the child bearing ages can

council for metropolitan Atlanta and a statewide volun-

be protected against rubella. Such an immunization pro-

tary family planning council.

ject -funded by the U. S. Public Health Service -was

Another important step in improving the health of

begun in Georgia and will continue through June 30,

mothers and their children was taken in local health

1971. As carried out through local health departments,

departments which provided prenatal supervision to

the two-year program goal is to immunize 80 percent of

pregnant women. During the year 14,771 women re-

Georgia's children ages 1-11, with children in day care

ceived prenatal care in health departments throughout

centers, kindergartens, and elementary schools the first

the state, and approximately 11,000 of these women

target of the program. During fiscal 1970, 292,974 chil-

returned to the clinic for postpartum examination after

dren (53,877 pre-school and 239,097 school children),

4

26 percent of the target group, were immunized in local

uate methods of reaching people, methods of referral to

public health clinics.

physicians, and resu Its of screening. Approximately

Public health reached out to children through local

4,000 people were screened and about 20 percent were

school health programs. In addition to contributing to

found to have high blood pressure; this finding strongly

health education in schools, public health nurses aided in

underscores the need for a massive public health effort

testing the vision of 246,890 children and the hearing of

in detecting and treating hypertension, thus reducing the

147,070 children, assisted children with known health

incidence of heart disease. The Department continued its

problems obtain appropriate care, and identified com-

efforts to organize classes in cardiopulmonary resuscita-

munity resources available to school age children, their

tion and train instructors in all Georgia hospitals; 907

families, and the schools.

instructors were trained so that 57 Georgia hospitals

Preventive and corrective services were provided for

now have in-service training and 97 counties have trained

more than 35,000 underprivileged children aged 3-14 in

instructors.

public health dental clinics in 68 counties. By the end of

Efforts were made to shorten the period of hospitali-

fiscal 1970 -the 25th anniversary of community water

zation of tuberculosis patients by treating an increasing

fluoridation - 68 water systems serving approximately

number of cases at home. Complete information on all

two million Georgians were adding fluoride for the pre-

known cases of tuberculosis was provided monthly to

vention of dental caries.

each of the 159 counties. At the end ofthe year, 5,016

Frequent pregnancies beginning at a young age not

non-hospitalized cases were on the State Tuberculosis

only result in a higher incidence of birth defects among

Register, a decline of more than 15 percent from the

infants but also seem to increase the possibility of cervi-

previous year. During the year a total of 983 new cases

cal cancer in the mother. Since many women from this

of active tuberculosis were reported. This represents a

high-risk, low income group are patients in local health

case rate of 21.2 per 100,000 population, a 7.4 percent

department clinics, a screening program for the early

decline from the previous year.

detection of cervical cancer using the Pap test was intro-

Patient admissions at Battey State Hospital and pa-

duced in 1967. The program has gained in strength dur-

tient stay in the hospital were significantly reduced dur-

ing the past year; 32,000 Pap smears were made in local

ing the year resulting in a decrease in the average daily

health department clinics and 344 women were referred

census. Of the 1,097 patients admitted, 942 were diag-

for diagnosis and definitive treatment.

nosed as having tuberculosis and 155 were proven to be

An acute health problem facing the state during the

non-tuberculosis. The average period of hospitalization

past year was the resurgence of venereal disease; Health

for all patients decreased from 116 days to 108 days,

Department investigations resulted in 2,840 previously

while the average daily census dropped from 370 in

unknown and untreated cases being treated. During the

1969 to 317 in 1970. The cost per patient day, however,

reporting period 3,488 cases of syphilis were reported

increased from $24.99 in 1969 to $29.54 in 1970 due

and treated, an increase of 27.6 percent over last year.

primarily to increasing cost of personnel.

Gonorrhea continued to be a major health problem as

During the year the Health Department continued to

23,911 cases were reported and treated, a 6.8 percent

work closely with voluntary agencies and local physi-

increase; 395 cases of other venereal diseases were re-

cians in conducting screening for diabetes, chronic

ported and treated, a 221.1 percent increase over the

obstructive pulmonary disease, and glaucoma and in sur-

preceding year. Some 54.9 percent of the syphilis cases,

veying to locate those with arthritis. Home health care

86.2 percent of the gonorrhea cases, and 94.2 percent of

programs were organized in Augusta, Athens, and

the other venereal diseases cases were treated in Health

Gainesville.

Department Area Diagnostic and Treatment Centers.

The Georgia Department of Public Health is respon-

Heart disease remains the leading cause of death in

sible not only for the prevention and treatment of dis-

Georgia and the nation. During the year the Health

ease but also for collecting and correlating information

Department offered consultation to a unique program

relating to the occurence of disease in the state. Health

designed to detect high blood pressure in the general

Department personnel continued to make epidemiologic

population of seven Atlanta neighborhoods and to eva I-

investigations of outbreaks of disease to determine the

5

A HEALTHY POPULATION- MENTALLY

cause and method of spreading from person to person.

The Georgia Department of Public Health firmly

An extensive epidemiologic study on the incidence of

believes that mental and physical health are as closely

salmonella in pet turtles sold by two large discount

intertwined as mind and body; therefore, the Depart-

stores was completed during the year, and Department

ment aims - through the three program areas of com-

personnel participated in an investigation of an outbreak

munity services, hospital services, and research and train-

of serum hepatitis among some 60 Savannah teenagers in

ing - to promote good mental health while providing a

late 1969. The cases of serum hepatitis among 41 boys

system of modern care and treatment for the state's

and 19 girls with an average age of 17 were among

mentally ill, mentally retarded, and those suffering from

adolescents who used heroin parenterally and frequently

alcohol and/or drug abuse. During fiscal 1970 the

shared needles. The investigation showed that hepatitis

Department continued to stress the expansion of com-

patients had shared needles with twice as many other

munity mental health programs, the decentralization of

patients as had individuals of a control group. Documentation of the illness was by clinical symptoms, incuba-

Central State Hospital, and the development of research and training programs.

tion period, liver function test abnormalities and/or

Georgia's mental health plan calls for the develop-

finding of Australia antigen or antibodies in 35 percent

ment of 33 all-purpose community mental health centers

of the patient's sera. Thirty-two of the 60 patients were

throughout the state, each to serve a population of

hospitalized and two youths died.

75,000 to 200,000 residents. During the past fiscal year,

Department personnel followed closely the move-

five Georgia communities submitted and had approved

ment of wildlife rabies, the chief source of human expo-

federal staffing grants for such comprehensive centers;

sure, and advised diagnosis, treatment, and control of this disease. As in previous years, raccoon rabies con-

however, due to limited federal funds and preference given to Model Cities areas, only those in Atlanta and

tinued its northern movement and during the past year reached populous Bibb County.

Savannah were funded. Six other communities which had received federal support for the construction of

The state's public health laboratories played a vital role in the detection of diseases during fiscal 1970 completing more than one million communicable disease examinations during this period. Initial steps were taken to automate the syphilis serology examination (more than 570,000 such examinations were performed during the year), and various techniques for tuberculosis specimens were tried with the goal of easier specimen collection, safer handling, and processing procedures as well as increasing the positive findings with improved media and concentration methods. The state laboratory also participated in an evaluation study of an improved media for the detection of gonorrhea.
The 1970 Georgia General Assembly passed a clinical laboratory licensure law which, when fully implemented, will require the State Health Department to visit each private laboratory and provide consultation regarding their internal quality control and to participate in a pro-

comprehensive centers - Atlanta (North Fulton), Thomasville, Athens, Macon, Decatur (Central DeKalb), and Augusta - began to develop staffing grant applications so that they can initiate services during fiscal 1971 if federal funds are available.
The number of counties participating in some type of public community mental health program increased from 67 to 76 during the fiscal year with the extension of aftercare services to those on convalescent leave from state institutions. Although state funds allocated for community mental health programs did not increase during the year, the Georgia General Assembly authorized the expenditure of $129,000 during the next fiscal year for a family care program which will permit residents of state institutions to return to their communities and reside with a foster family.
Community services for the retarded were expanded as 24 centers in 18 counties were approved to receive

ficiency testing program with these laboratories. During

financial aid through a state program for purchasing

this past year the Department participated in a federal

training for mentally retarded individuals in private day

and a private proficiency testing program as well as

facilities. The program reached an average of 490 retar-

assisted other state laboratories in their proficiency testing programs.

dates for 207 days at a cost of $1.50 per day. DeKalb, Thomas, Lowndes, and Ware counties initiated and

6 operated training programs for retardates not eligible for

or served by special education classes in the public

patient population of the Augusta hospital climbed from

schools; these centers served 164 retardates. The

34 to 114 during the reporting period. Basic administra-

Gwinnett County Association for Retarded Children

tive and professional staff was employed at the Savannah

obtained matching federal funds to build a new mental

Regional Hospital - under construction during the year

retardation training center in Lawrenceville, and the

- in anticipation of that institution's opening in

Department of Health, Education, and Welfare approved

December, 1970.

staffing grant applications for programs in Gwinnett

Capital improvements to existing buildings in older

county, Atlanta and DeKalb county. These grant appli-

state institutions made these hospitals more livable.

cations were prepared with assistance from the State

Physical profiles established on each of the Central State

Health Department.

Hospital buildings accommodating patients pointed up

As drug abuse emerged as a major health problem in

the need for renovation and modernization, and

Georgia, a Task Force on Drug Abuse was organized in

$300,000 in improvements were made to three patient

August 1969 and immediately began work on a Compre-

residences and to the patient dining rooms during the

hensive Plan for the Prevention and Control of Drug

fiscal year. In addition, the renovation and moderniza-

Abuse for Georgia. Alcoholism continued to be a prob-

tion of the central dental clinic and the provision of

lem throughout the state; during the fiscal year three

dental operations for each unit resulted in improved den-

day clinics and eight part-time alcoholism clinics main-

tal services to patients at Central State. Major contracts

tained an active caseload of 705 patients and 385 family

were let at Southwestern State Hospital for air condi-

members. In addition, intensive staff training was pro-

tioning buildings at Thomasville and Bainbridge, renova-

vided to personnel in Coffee and Clayton counties in

tion and improvement of the kitchen in Thomasville,

conjunction with the development of new alcoholism

and for construction of a new boiler plant at

clinics.

Thomasville.

Although community mental health programs can

Vocational rehabilitation programs at several institu-

prevent the hospitalization of many whose mental illness

tions aimed at preparing patients for their hospital re-

is not severe, the shortage of such community programs

lease. More than 2,400 patients at Central State partici-

and the severity of the disease in other individuals result-

pated in the vocational program which included counsel-

ed in thousands of Georgians requiring hospitalization

ing, training, and work evaluation; 237 patients trans-

for mental illness. The Georgia Department of Public

ferred to community vocational rehabilitation residences

Health continued to implement a long-range plan for

during the fiscal year. A work evaluation project was

building regional mental hospitals throughout the state

established at Bainbridge State Hospital in January

and, thus, reduce the large patient population at Central

1970, and hospital personnel at Thomasville constructed

State Hospital, the state's oldest and long-overcrowded

a greenhouse to be used for rehabilitation training of

institution.

residents. An active vocational rehabilitation program

During fiscal 1970 the average daily population at

was also developed at the Augusta hospital.

Central State Hospital declined from 9,645 to 9,060 pa-

In addition to treating the mentally ill, the State

tients although 6,625 patients were admitted to the hos-

Health Department is responsible for the care and train-

pital. Some 10,226 patients were on convalescent leave

ing of the mentally retarded who require institutional

on June 30, 1970. The addition of 182 employees, pri-

care. Gracewood State School and Hospital remained the

marily in the para-nursing field, provided a much more

primary institution for Georgia's mentally retarded;

satisfactory staff/patient ratio. The decline in patient

however, retardates were cared for at Central State Hos-

population at Central State was paralled by an increase

pital, Southwestern State Hospital, and the Atlanta

in patients at other institutions, The resident population

Regional Hospital. During fiscal 1970 the Georgia Retar-

at Southwestern State Hospital was 1,102 at the year's

dation Center in Atlanta - the state's primary training

end. Both Georgia Regional Hospitals at Atlanta and

and research facility in the area of mental retardation -

Augusta opened three new units providing additional

opened its doors.

beds at each facility. The Atlanta hospital maintained an

At the end of the fiscal year, Gracewood had 1,662

average daily patient census of 174 patients, while the

residents. More than 400 residents were enrolled in the

7

school program, while 746 residents were participating

gram for pre-school mentally retarded individuals from

in vocational training. Small group programming was

Fulton, DeKalb, Cobb, and Gwinnett counties. Twenty-

begun in several cottages and the infirmary. A sheltered

five children were being served in this program at the

workshop established during the year proved highly suc-

end of the fiscal year.

cessful in developing social and work skills of the

All professional departments at the Georgia Mental

severely retarded, and a grant was obtained to expand

Health Institute offered training for students with a

and further develop the program. Physical facilities were

bachelor's degree. Fifteen students were enrolled in the

also improved at Gracewood as four additional dormi-

hospital staff development course; and eight summer stu-

tories were air conditioned and improvements were

dents, 10 interns, and four residents were enrolled in the

made to bring housing areas into compliance with the

chaplaincy program. Also trained at the Institute were

State Fire Marshall's Code.

22 psychiatric residents and child fellows, 13 psychology

Admissions to the Georgia Retardation Center were

interns at pre-doctorate and post-doctorate levels, 21

begun in October 1969 with the transfer of 20 non-

graduate social work students, 14 graduate nursing stu-

ambulatory severely or profoundly mentally retarded

dents, two music therapy students, and four students in

individuals from Gracewood State School and Hospital.

occupational therapy. In addition to professional train-

Ambulatory retardates were first admitted in February

ing programs, the Institute offered short term training

1970, and at the end of the fiscal year 160 individuals

courses.

were in residence at the facility. Admissions to the day

At the beginning of the year, the Georgia Retardation

program of the Center's Athens unit were initiated in

Center had contracts with 28 departments in five

September 1969 and to the residential program in

colleges and universities to provide clinical experience

December 1969. At the end of the year the capacity of

for university trainees in 15 disciplines. The Georgia Insti-

40 day students and 40 residential students were being

tute of Technology and two additional departments at

served.

the University of Georgia - School Psychology and

The Georgia Mental Health Institute (GMHI) is the

Music Therapy - became affiliated with the Center dur-

state's primary teaching and research facility in the field

ing 1970. Some 389 university trainees received clinical

of mental health (including alcoholism and drug abuse),

experience at the Georgia Retardation Center - 136 at

paralleling the functions of the Georgia Retardation

Atlanta and 253 at Athens.

Center in the field of mental retardation. Significant pro-

Central State Hospital continued to offer accredited

gress was made at both institutions during the fiscal

training in psychiatry, pharmacy, psychology, social

year.

work, clinical chaplaincy, music therapy, occupational

Research at GMH I was intensified during the year as

therapy, and recreational therapy, The hospital trained

the research area was formally opened. Nine research

12 psychiatry residents during the year. In-service train-

sections - neurophysiology, sociology and social re-

ing for staff members was also provided at the hospital.

search, experimental psychopathology, social process

Other training programs were conducted at various

and human behavior, behavioral assessment and

institutions. The Georgia Department of Public Health

behavioral change, family research, child psychiatry,

joined with six other states to sponsor the Southeastern

human genetics, and sleep research - were in operation

School of Alcohol Studies attended by more than 60

at the end of fiscal 1970. The Institute received inter-

Georgians involved in the delivery of services to the alco-

national recognition with the discovery of "Atlanta

holic and his family. A cooperative program was

Bodies," a significant finding in human cytogenetics and

developed at the Georgia Regional Hospital at Augusta

basic biology.

whereby Medical College of Georgia psychiatric residents

Four research or demonstration projects at the

and medical students during their psychiatry rotation are

Georgia Retardation Center in Atlanta and three such

stationed at the regional hospital on a full-time basis;

projects at the Center's Athens unit were either begun or

this program goes into effect next year.

approved during the fiscal year. Among these was an

The first known teaching program between a mental

early childhood education development and research

retardation institution and a school of dentistry was

project which provides outpatient services in a day pro- 8 developed at Gracewood State School and Hospital. Dur-

ing March 1970, six students from the Medical College of Georgia's School of Dentistry enrolled in Gracewood's first elective course in dentistry for the handicapped and mentally retarded. The Gracewood Speech and Hearing Department was approved for clinical service in speech pathology by the American Boards of Examiners in Speech Pathology and Audiology, American Speech and Hearing Association.

A HEALTHY ENVIRONMENT
As Georgians became increasingly concerned about the environment and the unhealthy conditions resulting from its abuse, the Georgia Department of Public Health recognized the need for greater Departmental emphasis on environmental concerns and stronger coordination of effort among the various existing programs which affect it. The Division of Environmental Health was created in February 1970 to bring together into one organizational unit the major program activities having to do with the effect of environmental factors upon man's health and the changes in the environment resulting from man's activities. This division is concerned with such traditional health measures as food, milk and water sanitation as well as the more recent concerns of air and land pollution, radiation control, housing, and highway safety.
More stringent rules and regulations were proposed or adopted in several environmental health areas during the fiscal year. Proposed rules and regulations concerning solid waste collection and disposal were developed and await action of the Georgia Board of Health. A statewide reg u Iatory program for individual sewage disposal systems and a new set of rules and regulations for public water systems became effective, and rules and regulations for adequate, safe individual water supplies were drafted. Work was completed on recommended standards for public swimming pools, making it possible for governmental agencies to adopt these standards as regulations within their jurisdiction, and a revision of the rules and regulations for tourist accomodations was initiated.
A significant development in air quality control during the year was the designation of two federal air quality control regions - the Chattanooga region (including the Georgia counties of Walker, Catoosa, and Dade) and the Atlanta region (Fulton, Cobb, Douglas, Clayton, Henry, DeKalb and Gwinnett counties) -to be administered by the Georgia Department of Public Health. The Department must now develop ambient air standards to determine the level of pollution to be allowed in these areas.
The Department expanded its activities in testing and monitoring air pollution levels throughout the state. Data on gaseous and particulate pollutants gathered at monitoring stations in 12 cities throughout the state was supplemented with data collected in various parts of the state using a mobile lab. Testing for pollutants at the 9 source - stack sampling to evaluate sources of air poilu-

tion and gain evidence in determining compliance with

the closing of some waters for the gathering of shellfish

the Air Quality Rules and Regulations - was initiated

in the Brunswick area.

during the year. Special air pollution studies were con-

Before a local government can effectively plan an

ducted in five cities with individual air pollution prob-

attack on sub-standard housing, existing housing and re-

lems. Legal processes were initiated on 13 different

lated environmental problems must be evaluated. The

occasions and in each the alleged violator ceased

Department developed and improved techniques for con-

violation prior to a hearing; orders were issued to two

ducting statistical surveys and conducted, with local

counties and five cities to stop open burning dumps, to

health department personnel, eight such community en-

one city and one industry for failure to register, to one

vironmental surveys which resulted in the improvement

industry for smoke and fumes, and to one individual for

of public water supplies and individual sewage disposal

open burning. Air-lerts, warnings advising of approaching

systems in one community and the implementation of a

weather conditions conducive to stagnant air and pollu-

more than half-million dollar housing program in

tion build-up, were initiated to enlist voluntary support

another. In addition, surveys of Georgia's 159 counties

to reduce pollution at these potentially dangerous times. In this affluent society the throw-away level has

and 500-plus incorporated municipalities were completed; this data will be used in the development of ade-

reached the point of approximately 10 pounds of discard per person per day, thus a special service to handle problems associated with the collection and disposal of solid waste was created during the year. A sample survey of certain municipalities was conducted to

quate housing code programs to include such factors as electrical wiring, construction materials, plumbing, fire protection, and zoning and provision for mobile homes.
The historical program of food sanitation was revitalized during the year. A statewide food sanitation sur-

determine the locations and volumes of solid waste to be dealt with in the state and a register of authorized solid waste disposal sites in the state was begun.

vey indicated continued improvement in restaurant sanitation; the percentage of food service establishments having permits increased from 73 percent to 79.7 per-

The Department surveyed 121 manufacturing plants

cent and a food service establishment register was in iti-

for excess noise and found that in 46 plants at least one

ated.

area had noise levels above the recommended federal

An in-depth study of the milk sanitation program was

standards. Department personnel assisted the U. S. Pub-

begun. Also initiated during the year was a microwave

lic Health Service obtain air samples in card rooms of

oven testing program, and certain radiation regulatory

cotton mills using an experimental sampling device;

responsibilities were shifted from the U. S. Atomic

development of sampling method for cotton dust is part

Energy Commission to the Department in December

of a program to evaluate the extent of the byssinosis

1969. An "early warning" atmospheric radiation surveil-

(brown lung disease) problem in Georgia cotton mills.

lance continued to operate through the monitoring of

Nine plants that use asbestos in the manufacture of their

pasteurized milk and extensive network of stream water

products were investigated, but none were found to have

sampling stations.

dust counts above the presently established threshold

Georgia has recently experienced a massive growth in

limit value for asbestos.

tourist accommodations and in numbers of parks and

Closely allied with problems of the environment is

recreational areas including Stone Mountain and Jekyll

the Department's responsibility for assuring that

Island. Sanitation in these areas remained a respon-

Georgians have a good water supply. The Department's

sibility of the Georgia Department of Public Health. The

water laboratory performed some 163,021 tests during

tourist accommodations register was up-dated and a new

the year, including chemical and bacteriological samples

quarterly report on the environmental sanitation status

on water supplies, shellfish-growing waters, and stream

of each was initiated and sent to local health depart-

samples for water supplies. Sanitary surveys and hydro-

ments. These reports emphasized the specific areas of

graphic studies made in the Altamaha, Cumberland,

the program which required special attention in each

Ossabaw, St. Andrews, St. Simons, and Wassaw sounds

county. At the end of the year, 75 percent of the state's

provided up-to-date information concerning bacteri-

1,131 accommodations had been inspected; 53 percent

ological and chemical contamination which resulted in 10 complied with the State Fire Marshal's requirements and

52 percent had valid permits - a 19 percent increase over 1969. In addition, a complete environmental inspection was made of 89 recreational areas, plans were reviewed for 17 areas, 16 sites were inspected, 17 sewage systems approved, and 119 water supplies inspected.
Adequate ambulance service, provided by competent personnel trained in emergency medical techniques and procedures, is a goal of the Georgia Department of Public Health. During the year, as many funeral directors in the state discontinued ambulance service and others announced their intention of so doing, communities sought Departmental assistance in planning, organizing, and funding ambulance services. Projects to organize and train ambulance services were developed, approved and funded for 44 counties during the year, the construction of a heliport was approved and funded for another county, and additional projects were developed and approved in six counties with funding expected early in fiscal 1971.
In the radiological defense program efforts were directed toward broadening and improving the radiological monitoring, reporting, and hazard evaluating system. Approximately 500 monitors, 51 monitor instructors, and 37 radiological defense officers were trained, while 215 monitors attended refresher courses. Some 122 new fallout shelters were approved and stocked with emergency supplies and radiation detection equipment.
Environmental health programs in the state, with the exception of the enforcement of air quality control regulations, is dependent largely on the county and district health department personnel. The reorganization of the local health districts should enhance the facility with which this newly created division is able to function at a district and county level.

PAYMENT FOR MEDICAL CARE
During its third year as an organizational unit the Division of Medical Care Administration continued the administration of the medical aspects of the Medical Assistance Program (Medicaid), the payment of treatment for certain cancer patients and crippled children, and the expansion and improvement of health care facilities in the state. In addition, the Department assumed full responsibility for the processing of all claims and expanded its services with the introduction of the Intermediate Care Facility Program, a new health services payment program,
In the early stages of the Medicaid program the Department contracted with an insurance company to serve as an intermediary with physicians on billing for services to those covered under the Medicaid program. The insurance company reviewed bills to determine if the physician's fees were in line with his customary fees, coded the bill according to the illness for which the patient was treated, and certified the bill for payment. This responsibility was assumed by the Department at the beginning of the fiscal year so that physicians as well as hospitals and druggists billed the Health Department directly during the past year. This reorganization within the Department resulted in greater efficiency and less delay in the payment of claims, thus eliminating the long time lag between filing a claim and receiving payment, a problem which had plagued the program.
The number of Georgians eligible for Medicaid benefits continued to grow during fiscal 1970. Approximately 45,000 additional individuals were certified bringing the number of individuals eligible for Medicaid benefits to 352,062. At the same time the over-all costs of these services increased by $12,858,995 over the preceding year. As the number of Medicaid eligibles increased, so did the number of claims handled. The Department completed 3,179,817 transactions ... 433,798 more than last year; however, this increase also reflects a backlog of several months which was transferred to the Department in the changeover of fiscal agents.
The working relationship between the Department and providers of services (physicians, hospitals, nursing homes, druggists, and others) was improved when the Department published a Physician's Manual containing formalized policies concerning the Medical Assistance Program and began a quarterly report explaining program changes and clarifying areas commonly misunder11 stood.

Indigent cancer patients continued to receive finan-

Consultation and planning assistance was provided to

cial aid for diagnosis and treatment services through 20

68 prospective community projects sponsors relative to

tumor clinics in various parts of the state, and physically

the development of 108 potential health facilities. Plans

handicapped children continued to receive care through

and specifications for all health facilities construction in

a statewide network of out-patient clinics. Almost

the state were reviewed and recommendations made

13,000 children from all counties looked to the Health

regarding functional design; structural, electrical, and

Department as the major medical resource for a variety

mechanical engineering; air conditioning and ventilation;

of disabilities including orthopedic and neuromuscular,

equipment; fire safety; and maintenance. Two check lists

cardiac, central nervous disorders (seizures), hearing,

were developed to help eliminate mistakes commonly

plastic surgery, physical medicine, juvenile amputee, and

found in drawings and specifications of health facilities.

burn problems. Most illnesses treated were complex, and

The Department provided nursing, dietary and

many young patients had multiple defects.

laboratory consultation to health facilities. Directors of

The Department of Health continued its goal to up-

nursing in hospitals and nursing homes requested nursing

grade the quality of care in hospitals and nursing homes

consultation more often during the past year and were

by seeing that these institutions met state and federal

more selective in their requests for assistance. Visits

requirements. The Department certified these and other

made to facilities after nursing consultation indicated

facilities for participation in Medicaid, Medicare, and

that the quality of patient care improved significantly

Intermediate Care Facility Programs and helped with the

when special emphasis was placed on in-service training

planning of health facilities.

programs and effective utilization of nursing personnel.

The coordination of health facilities planning with

other planning agencies was emphasized during the year,

and effective working relationships - including the

exchange of information and statistics - were develop-

ed. Approval of three plans developed during the year -

the State Plan for Community Mental Retardation

Facilities, the State Plan for Hospitals and Related

Facilities (Hill-Burton), and the Community Mental

Health Centers Plan - enabled the state to qualify for

approximately $5,867,000 in federal grants for the con-

struction of health facilities.

During the past year 1,177 visits were made to par-

ticipating and potential Medicaid providers. The number

of beds in nursing homes, personal care homes, and hos-

pitals increased. An additional 24 nursing and personal

care homes with 3,308 beds opened during the year, as

six hospitals opened and two closed to bring the total

number of hospital beds available to 33,555 - an in-

crease of 2,331 over the preceding year. Some 213 nurs-

ing homes with 16,650 beds and 154 hospitals with

16,301 beds participated in the Medicaid program, an

increase of 3,157 nursing home and 583 hospital beds.

An Intermediate Care Facility Program, to pay expenses

of those who need less sophisticated care than that pro-

vided in nursing homes, was initiated in March 1969 and

transferred to the Georgia Department of Public Health

in July 1969; this program was providing 776 beds in 23

faci Iities. 12

The public health nurse directly helps people each day. This year she added child health appraisal and evaluation to her many duties.

Drugs were a major problem in Georgia. The Health Department offered coun-seling to drug dependents and those with other emotional problems.

Health Department personnel continued to work toward improving care of the elderly both in nursing homes and state institutions.

The Georgia Retardation Center in Atlanta opened its doors.

An emphasis on environmental health led to formation of a special service to begin the elimination of unsightly and unsanitary gargage dumps.

Dental health clinics in 68 counties provided preventive and corrective services for some 35,000 underpriviledged children.

In providing birth control information and services to low income families, the family planning program pre vented the birth of many unwanted children.

REVENUE RECEIPTS State Treasurer Federal Funds Other Revenue Receipts
TOTAL

REVENUE RECEIPTS AND EXPENDITURES
(July 1, 1969- June 30, 1970)

$103,142,724 73,579,201 5,231,633
$181,953,558

EXPENDITURES Personal Services Operating Expenses Grants
TOTAL

Excess revenue over expenditures TOTAL

$ 56,445,648.50 97,039,431.61 21,801,210.91
$175,286,290.02
6,667,267.98 $181 ,953,558.00

PROGRAM
HEALTH SURVEILLANCE AND DISEASE CONTROL
Program Administration Dental Health Maternal and Child Health Preventable Disease Control Battey State Hospital
TOTAL
MENTAL HEALTH Program Administration Institutions
TOTAL
ENVIRONMENTAL HEALTH Program Administration Air Quality Occupational Health Sanitation
TOTAL

EXPENDITURES BY PROGRAM (APPROXIMATE)
PERSONAL SERVICES OPERATING EXPENSES

GRANTS

TOTAL

$

24,430.55

104,734.34

222,010.33

2,444,828.36

2,971,974.42

$ 5,767,978.00

$ 367,004.11 44,245,281.89
$ 44,612,286.00

$

31,702.38

183,828.12

457,434.17

629,920.65

$ 1,302,885.32

$

697.47

5,352.09

85,224.56

739,908.06

640,488.82

$ 1,471,671.00

$ 59,737.23 16,349,647.77
$ 16,409,385.00

$

1,844.66

58,234.13

67,013.46

69,854.84

$ 196,947.09

-0-0-0-0-0-
-0-

$

25,128.02

110,086.43

307,234.89

3,184,736.42

3,612,463.24

$ 7,239,649.00

-0$ 4,563,134.00
$ 4,563,134.00

$ 426,741.34 65,158,063.66
$ 65,584,805.00

-0-0-0-0-
-0-

$

33,547.04

242,062.25

524,447.63

699,775.49

$ 1,499,832.41

MEDICAL CARE ADMINISTRATION Program Administration Medical Assistance Resource Development Medicaid TOTAL
GRANT-IN-AID Community Services Medical Facilities TOTAL
GENERAL ADMINISTRATION

$

69,966.86

735,167.60

517,910.97

350,781.57

$ 1,673,827.00

-0-0-0-
$ 3,088,672.18

$

1,808.62

2,755,265.66

68,909.99

73,841,950.73

$ 76,667,935.00

-0$ 343,063.00 $ 343,063.00
$ 1,950,430.52

-0-0-0-0-
-0-

$

71,775.48

3,490,433.26

586,820.96

7 4, 192,732.30

$ 78,341,762.00

$ 7'132,666.91 10,105,420.00
$ 17,239,076.91

$ 7,132,656.91 1 0,448,483.00
$ 17,581,139.91

-0-

$ 5,039,1 02.70

GRAND TOTAL

$ 56,445,648.50

$ 97,039,431.61
20

$ 21,801,210.91 $175,286,291.02

MENTAL HEALTH INSTITUTIONS EXPENDITURES
TYPE OF PROGRAM
Mental Illness Mental Retardation Alcohol and Drug Abuse Rehabilitation
TOTAL

EXPENDITURE
$32,821,065.00 22,449,483.00 4,029,252.00 5,856,035.00
$65,155,835.00

MEDICAID EXPENDITURE REPORT

TYPE OF SERVICE
Inpatient Hospital Outpatient Hospital Laboratory and X-Ray Physician's Services Ambulance Service Home Health Service Appliances Prothesis Durable Medical Equipment Other Professional Services Prescribed Drugs Nursing Homes Intermediate Care Buy-In Premium, Part B, Title XVIII Coinsurance and Deductible:
a. Inpatient Hospital b. Outpatient Hospital c. Physician Services d. Nursing Homes e. Ambulance f. Home Health g. Laboratory and X-Ray h. Othe.r
TOTAL BENEFITS

TRANSACTIONS
42,733 131,487
500 383,814
1,661 3,007
908 266 6,070 376 2,179,038 126,336 5,730 5
26,057 39,008 218,125
2,116 8,427 3,809
349
3,179,817 21

EXPENDITURES
$15,836,711.79 1,624,590.75 6,553.60 9,332,945.95 55,644.80 133,068.37 79,393.77 71,234.71 228,380.20 12,165.98 7,653,102.64
28,423,238.48 980,771.85
4,906,288.80
1, 179,399.70 287,525.91
2,645,568.19 177,871.45 80,395.24 49,526.40 2,384.92
$73,766,763.50

1965

MORBIDITY SAMPLING
(FiveYear Study")

1966

1967

1968

Amebiasis Conjunctivitis
infectious German Measles Infectious
Hepatitis Influenza Measles Salmonellosis Shigellosis Staphylococcosis
Pulmonary Superficial Wound Streptococcosis Rheumatic fever Scarlet fever Sore throat Whooping Cough

190
3,650 1,480
330 43,730
7,650 400 240
220 5,220 2,270
460 2,460 49,590
760

170
3,250 1,140
640 30,380
3,320 580 200
340 3,460 1,450
290 1,410 39,790
480

soURCE:

Georgia Department of Public Health Biostatistics Service

80
3,320 1,460
810 305,000
1,290 220 330
150 3,880 1,380
220 1,950 32,860
440

950
13,270 2,020
2,610 114,850
760 1,190
430
440 14,380 4,420
800 730 71,900 300

1969
220
10,880 3,550
3,240 90,470
890 1,220
580
600 13,840
4,490
1,310 1,700 63,140
3;30

5 Year Median
190
3,250 1,480
810 90,470
1,290 580 330
340 5,220 2,270
460 1,700 49,590
440

POSITIVE FINDINGS IN SELECTED LABORATORY TESTS (July 1, 1969- June 30, 1970)

Examination

Number of Specimens

Number Positive

Tests for Syphilis Premarital Non-premarital
Culture for Typhoid Culture for Salmonellosis Culture for Shigellosis Culture for Tuberculosis Microscopic Test for Helminth Ova Microscopic Test for Protozoa Miscroscopic Test for Gonorrhea Culture for Diphtheria Microscopic Test for Rabies Serologic Test for Viral Infections Culture for Viral Infections Serologic Test for Toxoplasmosis Serologic Test for Leptospirosis

547,364 64,695
482,669 23,656 23,656 23,656 41,919 77,531 36,069 19,947 342 2,139 13,406** 7, 180** 524 416

20,169 1,085
19,084 33
796 316 1,543 8,115 845 (5)* 3,047
35 120 4,165 1,283 244
3

* 5 E. histolytica
** Examinations
22

Percentage Positive
3.6 1.6 3.9 0.1 3.4 1.3 3.7 10.5 2.3 15.3 10.2 -5.6 31.1 17.9 46.6 .7

CHRONIC DISEASE SCREENINGS {July 1, 1969- June 30, 1970)

Type of Screening
Glaucoma Chronic Obstructive
Pulmonary Disease Diabetes

Number Screened
3,176
3,408 26,301

Referred
115
198 548

Percentage
3.6
5.8 2.1

New Cases
22
54 257

Percentage
.7
1.6 .97

Previously Diagnosed
0
6 34

Month
July August September October November December January February March April May June

Animals Positive
3 9 9 9 10 28 17 8 10 6 3 7

RABIES IN GEORGIA (July 1,1969- June 30, 1970)

Racoon

Bat

Fox

3

0

0

7

1

0

8

0

0

8

1

0

8

0

0

25

0

1

17

0

0

7

0

0

10

0

0

6

0

0

1

1

0

4

2

0

Other
0 1 1 1 2 2 0 1 0 0 1 1

Humans Treated
9 8 6 2 5 15 10 4 10 3 15 5

MEDICAL FACILITIES

HILL-BURTON CONSTRUCTION PROJECTS

Status as of June 30, 1970

Type of Facility

MEDICAL FACILITIES APPROVED FOR MEDICARE

Number of Facilities

Change from Previous year

Beds Available

Pre-construction stages 8

Under construction

59

Post-construction stages 3

JCAH OR AOA Hospitals Non-JCAH Hospitals Psychiatric Hospitals Tuberculosis Hospitals

83 80
3 1

Total

70

Extended Care Facilities

88

Home Health Agencies

20

Independent Laboratories

20

Portable X-Ray Services

1

Out-Patient Phys. Therapy Clinics 23

2

+ 12 +3
2 0 2 +3 +1 +1 +2

13,023 3,473 454 651 6,031

GEORGIA DEPARTMENT OF PUBLIC HEALTH

I 'I I COOMfPfiRCEEHEONFSIVE HEALTH PLANNING

GENERAL ASSEMBLY OF GEORGIAJ

_l

GOVERNOR

I

I STATE BOARD OF HEALTH

_l
DIRECTOR
DEPUTY DIRECTOR

.. I

I

l

WATER QUAtiTY CONTROl
SOARD~

J

I

I

OFFICE Of
LOCAL HEALTH

J

l
l l l

1 LOCAlKEAllHOISTRJ(TSSI 1LOCAl HEAlTH DEPARTMENTS

I I I ADMJNOJF~F~ICREATION

I
~ ACCOtJNTING
BJOSTATISTJCS
GENERAL STAff

I I
~ HfALTHEOUCATION AND TRAINING
PERSONNEL
VITAL RECORDS

I
SECTION
DATA PROCESSING
- - PATIENT ACCOONTS
BUDGET UNIT

I

OffiCE Of OPERATIONS
RESEARCH

I

I I I DIVISION OF CNVIRONMENTAL HEAlTH

I
BRANCH Of AII!OUAlln
CONTROL

I j_
BRANCH Of OCCUPATIONAl
HEAlTH

j_
BRANCH Of SA141TATION

SERVICE

HRVICf

SERVICE

AIR POllUTION CONTROL
AIR QUALITY EVALUATION

EMERGENO HEAlTH
INDUSTRIAL HYGIENE
RADIOLOGICAL HEALJH

ENVIRONMENTAL SANITATION
HOUSING H~GIENE
WAHR SUPPL~

STATE EMrtoms HEAlTH

SOLID WASH MANAGEMENT

I I I DIVISION OF MENTAL HEALTH

I
BRANCH Of COMMUNITY
SERVIHS
COMMUNITY MENTAL HEAlTH, RETAROA liON. AND ALCO HOLISM PROGRAMS

I
I
BRANCH Of HOSPITAL SERVICCS
HOSPITALS
CENTRAl STATE
ATLANTA REGIONAl
AUGUSTA REGIONAL
SAVANNAH REGIONAL
GRACEWOOO STATE SCHOO!. & HOSPITAL
SOUTHWESTERN SlATE

1
BRANCH OF TRAINI/ffi
ANO RESEARCH
GEORGIA MENTAL HEAlTH INSTITUH
GEORGIA RETAROAT!ONCENTER

I I I DIVISION OF MEDICAL CARE ADMINISTRATION

I

I

I

BRANCH OF MEDICAL
ASSISTANCE

BRANCH Of
llfALTH FACILITIES ANO LICENSURE

~

ill1!ll

MEDICAID

HEAUH fACIUTIES

CRIPPLEOCHilOREii
--
CANCEIISEOIOH

LICENSURE
--
CONSUlTING UNIT (NURSING, OJETfTICS. lABORATORY, ETC.)

J
BRANCH OF Of/HAL HEALTH
SERVICE
DEiiTAL PUBUC HEALTH

I

tiVISION OF HEAlTfll SURVEILLANCE AND DISEASE CONTROL

I

I

I

BRANCH OF EPIDEMIOLOGY

BRANCH OF
HEAlTH CONSERVATION

SERVICE

SERVICE

DISEASEINVESTIGA liON
VENEREAL DISEASE CONTROL

ADULT HEAUH
CARDIOVASCULAR DISEASE
CIHLOHEALTH

MATERtV.t HEALTH

J lDIVISION fOR GEORGIA WATER QUALITY CONTROL

I
BRANCH Of LABORATORIES
DIAGNOSTIC STAff REGIONAL LABORATORIES

I
BRANCH OF TUBERCULOSIS
SERVICE
TUBERCULOSIS CONTROl
--
BAnt~ SlATE HOSPITAL

chairman is also Director, Georgia Department of Public Health . .. Chief Nurse, Department Planning Unit, Hearing Examiner, Public Information Officer.

24