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STATE DEPARTMENT OF HEALTH
[Authorized: NDCC Chapter 23-01]

Concern for public health in Dakota Territory was addressed by the Territorial Legislature in 1862 by passage of a law prohibiting adulteration of food and drugs and imposing a penalty for failure to properly label poisons (T. L. 1862 Ch. 45). In 1873, Boards of Township Supervisors were authorized to act as boards of health for "the preservation of the public health" (T. L. 1873 Ch. 51). And in 1881, Boards of County Commissioners were authorized to act as boards of health (T. L. 1881, Ch. 21) "to prevent the spread of any epidemic or contagious diseases as may prevail in or threaten their respective communities." This system of public health protection was augmented in 1885 by creation of the Territorial Board of Health (T. L. 1885, Ch. 63). The Territorial Board of Health consisted of three members, including the Attorney General as an ex-officio member and president of the Board, and two gubernatorial appointees serving two-year terms. One member was required to be a physician and served as the Superintendent of Public Health. The duties of the Territorial Board of Health included promulgating and enforcing rules for the prevention and cure of infectious diseases, establishing quarantines, destroying impure food and infectious animals, and supervising local boards of health. The Superintendent of Public Health, with two other physicians selected by the Territorial Board of Health, had the responsibility for examination of physicians practicing in the territory. The composition of the Territorial Board of Health changed in 1887. The new legislation removed the Attorney General as a member and required all members to be physicians. The new Territorial Board of Health consisted of three physicians appointed by the Governor and confirmed by the Council to serve two-year terms. One member of the Territorial Board of Health served as the Superintendent of Public Health. The same legislation creating the Territorial Board of Health in 1885 also provided for the composition of county boards of health. The law required the Territorial Board of Health to appoint two persons from each county to constitute the county board of health. The county district attorney served as the ex-officio member and president of the county board of health. One of the Territorial Board of Health appointees was required to be a physician and served as the County Superintendent of Health. The county boards of health had duties similar to those of the Territorial Board of Health and were required to report potential health hazards to the Territorial Superintendent of Health. Local public health legislation enacted during the territorial period formed the basis for later legislation for public health agencies on the local level.

Legislation in 1893 made the State Board of Health responsible for documentation of vital statistics in the state (S. L. 1893, Ch. 133). Legislation in the same year allowed for the creation of city boards of health and expanded the duties of county boards of health to include enforcement of state health laws. The State Board of Health was reorganized in 1899 (S. L. 1899, Ch. 30) and consisted of the Attorney General as president and two other members appointed by the Governor, one of whom was required to be a physician and serve as the Superintendent of Public Health. Another reorganization in 1923 (S. L. 1923, Ch. 227) created a State Department of Health governed by the Public Health Advisory Council. The Public Health Advisory Council appointed the State Health Officer to act as secretary to the Council and to head the State Department of Health. Divisions of the State Department of Health provided in the statute included Vital Statistics, Preventable Disease, Child Hygiene, Public Health Nursing, and Sanitary Engineering. Administration of the State Public Health Laboratories (created in 1907) located in Grand Forks, Bismarck, Minot, and Fargo were transferred from the University of North Dakota to the State Department of Health in 1933.
               
The functions and responsibilities of the State Department of Health increased substantially from the 1930s to the 1960s. By the 1980s, the State Department of Health had broad responsibility to provide services to maintain public health through numerous administrative divisions, including Local Health Services, Vital Statistics, Community Health Nursing, Dental Health, Disease Control, Emergency Health Services, Health Education, Maternal and Child Health, Environmental Health, Laboratory Services, Mental Health and Retardation, Health Planning, Alcoholism and Drug Abuse, the State Council on Developmental Disabilities, and the State Hospital. In addition, the State Department of Health developed standards for hospitals and other institutions and licensed hospitals, nursing homes, laboratories, and other health facilities. It had authority for administration of water pollution control laws, removal of abandoned motor vehicles, care of tuberculosis patients. It was responsible for licensing of electrologists and electrical hair removal technicians, licensing of uranium mining operations, radiation control, licensing of care facilities for developmentally disabled persons (with the State Board for Vocational Education) and licensing health maintenance organizations (with the Department of Insurance). Other programs included administration of the Hazardous Waste Management Program, Lake Rehabilitation Grant Program, and the Domestic Violence Victim Assistance Program. With creation of the Department of Human Services in 1981, several divisions were removed from the State Department of Health and transferred to the new agency for administrative purposes. Those divisions that came under jurisdiction of the Department of Human Services in 1981 included the State Council on Developmental Disabilities, Division of Mental Health and Retardation, the State Hospital, and the Division of Alcoholism and Drug Abuse. As of July 1, 1987, the State Department of Health and the State Laboratories Department were consolidated to form the State Department of Health and Consolidated Laboratories. The newly formed Department consisted of two branches:  Consolidated Laboratories and Health Services. The Department was further subdivided to include Laboratories, Consumer Protection, Preventive Health, Health Resources, Environmental Health, and Administrative Services. Within Administrative Services is the Vital Records section with the responsibility to register and preserve birth and death records and to file and maintain copies of marriage certificates, abstracts of divorces, abortion, and annulment of marriage decrees according to the law. 

In 1995 the State Department of Health and Consolidated Laboratories was renamed the State Department of Health and was designated the primary environmental agency for the state. The administrative head of the Department is the State Health Officer appointed by the Governor for four years. This person must be a physician who graduated from a (class A) medical school with additional training and experience in public health administration and licensed to practice medicine in North Dakota. The State Health Officer enforces regulations of the Health Council, develops and coordinates local health services, allocates health funds subject to approval of the Health Council. In carrying out its public health responsibilities the Department is required to inspect and license health facilities, hotels, motels, boardinghouses, and food establishments. It was also to certify hospitals, nursing homes, home health agencies, laboratories, and other health facilities for Medicare and Medicaid certification and register and preserve vital records. Additional responsibilities included training and licensing emergency health services, providing education and preventive health services to mothers, infants, and children including family planning and nutrition service. The Department also has responsibility to develop dental health education and tooth decay prevention service, coordinate and promote local public health service, provide communicable and chronic disease control programs, provide health education and promotion activities, and to coordinate a uniform program of public health nursing including home health care. Additionally the Department provides consultative, advisory, and enforcement service on all phases of environmental health encompassing water supply, water and air pollution control, public swimming pools and recreational facilities, solid waste disposal, radiation control, and noise and hazardous waste control. The Department also provides services for forensic analysis and registers and analyzes agricultural and petroleum products. In 2007 the Special Populations Sections was added to the Department for the purpose of addressing health issues related to people with special health-care needs and health disparities. The Section includes the Children’s Special Health Services and the Division of Health Disparities/Primary Care.

A summary of the complete list of the duties and responsibilities for the State Department of Health (as found in the 2011-2013 the North Dakota Blue Book) follows: 1) Administrative Support provides program and services from the Division of Accounting, the Office of Public Information, the Information Technology Coordinator, the Division of Vital Records, the Office of Human Resources, the Office of Education Technology, and the Public Health Liaison. 2) Emergency Preparedness and Response Section (formerly Bioterrorism). The divisions of this section have responsibility for improving and maintaining public health response to disasters and large scale emergencies. Divisions include Emergency Medical Services and Trauma, Public Health Preparedness, and Hospital Preparedness. 3) Community Health has a goal of improving the health of North Dakota citizens by providing services through local public health units. Divisions include Cancer Prevention and Control, Chronic Disease, Family Health, Injury Prevention and Control, and Nutrition and Physical Activity. 4) Environmental Health Section provides safeguards for the quality air, land, and water resources within the state. A primary function and responsibility is to coordinate communication with the US Environmental Protection Agency. Divisions are Air Quality, Laboratory Services, Municipal Facilities, Waste Management, and Water Quality. 5) Health Resources-has three divisions including Health Facilities, Food and Lodging, Life Safety, and Construction that work to promote quality care and services for the people of North Dakota. 6) Medical Services is to promote health and prevent illness and disease. The sections include Field Medical Officers, Office of the State Forensic Examiner, and Division of Disease Control.  

Health Council
[NDCC 23‑01‑02]
The Public Health Advisory Council consisted of a woman, a physician, and a dentist appointed by the Governor to serve six-year terms, and the Superintendent of Public Instruction and the president of the North Dakota Anti-Tuberculosis Association. It was transformed into the State Health Council in 1947 (S. L. 1947 Ch. 200). The State Health Council had essentially the same duties as the Public Health Advisory Council and consisted of nine members appointed by the Governor. The membership included two members from the North Dakota Hospital Association, two members from the North Dakota Medical Association, one member from the North Dakota Dental Association, one member from the North Dakota Pharmaceutical Association, one member from the North Dakota Nurses Association, and two laypersons. Members of the State Health Council served three-year terms. The State Health Officer, Attorney General, Superintendent of Public Instruction, State Fire Marshal, chairman of the Board of Administration, secretary of the State Board of Nurse Examiners, and director of the State Board of Public Welfare served as an advisory group to the State Health Council.  In 1973, one representative from the North Dakota Optometric Association and one additional layperson were added to the State Health Council. Later, the Superintendent of Public Instruction was removed from the advisory group.

According to the 2011-2013 North Dakota Blue Book the Governor appoints eleven members for three-year terms. These members include four persons from the health care field, five who represent consumer interests, one from the energy industry, and one from manufacturing and processing industry.  Any state agency may serve in an advisory capacity to the Council at the discretion of the Council. The Council establishes standards, rules, and regulations for the maintenance of public health, including sanitation and disease control, develops, establishes, and enforces basic standards for hospitals and related medical institutions, holds hearings related to licensing of medical facilities, and directs the State Health Officer to do all things required in the proper performance of the various responsibilities placed upon the State Department of Health.

CHRONOLOGY

1873       Creation of local public health agencies were in place until statehood.

1881       The Board of County Commissioners for several counties within the Territory and the respective counties were authorized to act as a Board of Health.  Duties included preventing the spread of any epidemic or contagious disease threatening their community (T. L. 1881, Ch. 21).

1885       The Territorial Board of Health was created and composed of a president, vice president, and a Superintendent of Public Health.  The Attorney General of the Territory was ex-officio president of the Board.  The Governor appointed the vice-president and also the Superintendent of Public Health with the consent of the Senate. The Superintendent served as the ex-officio secretary of the Board. Qualifications and duties were listed. Tasks for the first meeting were also listed (T. L. 1885, Ch. 63).       

1887       Qualifications for membership were changed requiring that the members be Territorial residents and graduates of a recognized medical college.  The Governor with the consent of the Board appointed the members who served two-year terms. The Board also appointed three physicians to constitute a Board of Medical Examiners (T. L. 1887, Ch. 61).

1889       At the time of statehood in 1889, the State Board of Health was established succeeding the Territorial Legislature that had established Territorial and county boards of health that were required by law to “provide for the protection of health of persons and animals”. The Territorial Board of Health was reorganized and the Superintendent of Public Health served as secretary of the Board and was required to be a resident and a physician. Appointed by the Governor the Superintendent served for two years (S. L. 1889, Ch. 22).

1899       Duties of the Board were amended and included enforcing regulations for the prevention, control, and cure of contagious diseases, establishing quarantines, removing dead bodies and potentially harmful substances. The Board was also required to investigate impure food, superintend local boards of health, and regulate the burial of dead bodies.  The Board was also to superintend several boards of health in cities, villages, and towns and also the county boards of health of several counties (S. L. 1899, Ch. 30). Legislation concerned amendments for the responsibilities of the county boards of health (S. L. 1899, Ch. 58).
               
1905       Legislation related to boards of health and who was to serve on the boards (S. L. 1905, Ch. 52).

1907       Located at the State University and School Mines was the newly established the Public Health Laboratory which was under the control of the University Trustees.  The Director was a Professor of Bacteriology and Pathology and the ex-officio State Bacteriologist (S. L. 1907, Ch. 238).  The Legislative Assembly created the Bureau of Vital Statistics at the request of the US Census Bureau for the purpose of immediate registration of all births and deaths throughout the state. This was to be accomplished through the use of standardized forms as recommended by the US Bureau of Census and the American Public Health Association.  Certificates of births and deaths, and burial or removal permits were provided to register districts by the registrar of the State Bureau located in the State Capitol.  Legislation required certain details on the form to be filled out in order for a death certificate to be issued. A list of duties had to be carried out by the local registrars and sub-registrars before they issue death certificates.  Requirements were established for burial of the dead, records were to be kept, and a local office was selected to keep the records. In the cases of births forms were created and procedures were listed and certified copies were available upon request (S. L. 1907, Ch. 270).

1911       Legislation concerned the duties of local school boards and sanitary regulations of school houses, churches, and public halls (S. L. 1911, Ch. 63).
               
1923       In 1923, the Legislative Assembly authorized the State Department of Health. The State Department of Health consisted of a Public Health Advisory Council, a State Health Officer, division directors, and other employees. The State Health Officer acted as secretary and executive officer of the Council.  Appointed by the Public Health Advisory Council the State Health Officer was required to be a physician with experience in public health administration. The divisions within the Department included vital statistics, preventable diseases, child hygiene, public health nursing, and sanitary engineering. Members of the Public Health Advisory Council served six-year terms and included a woman, physician, and dentist who were appointed by the Governor. The remaining two members were the Superintendent of Public Instruction and the president of the North Dakota Anti-Tuberculosis Association (S. L. 1923, Ch. 227).

1933       Among administrative changes made in 1933 was the transfer of Public Health Laboratories previously connected with the University of North Dakota to the State Department of Health. The State Public Health Laboratories operations formerly located at Bismarck, Fargo, and Grand Forks were transferred to the control of the State Department of Health at the Bismarck location. The State Health Officer was required to be the administrative officer of the Department and was appointed by the Public Health Advisory Council for a term of two years. The Attorney General was added to the membership of the Council replacing the president of the Anti-Tuberculosis Association. Duties of the Council were listed with an emphasis on enforcement of regulations for the prevention and control and cure of infectious diseases, establishing quarantines, setting up regulations for the disposal of dead bodies and dangerous substances, and investigating impure food complaints. Changes in titles appearing in the statutes included “State Board of Health” replacing with “State Department of Health”. The words “Superintendent of Public Health” were replaced with “State Health Officer” (S. L. 1933, Ch. 189). The first woman Executive Secretary and State Health Officer was Maysil M. Williams, MD, MPH who served until 1942.

1943       The term of office for the State Health Officer was expanded to four years (S. L. 1943, Ch. 207).  
               
1947       The Public Health Advisory Council was superseded by the State Health Council with an expanded membership but with duties essentially the same as the Public Health Advisory Council. Two standing committees for the Council were a health committee and a hospital committee. Other committees were formed as needed. The term of for the State Health Officer was four-years and the Officer was appointed by the Governor. Legislation spelled out the duties for the Council.  The duties for the State Health Officer were listed and the State Health Officer chose directors of the divisions. The working divisions of the Department included Vital Records, Preventable Disease, Sanitary Engineering, Maternal and Child Hygiene, Public Health Nursing, Administration, Health Education, Oral Health, and the Division of Public Health Laboratories with laboratories and branches in places selected by the Council. Working with federal programs and providing for registration and licensure of medical hospitals were responsibilities included in the legislation (S. L. 1947, Ch. 200).   

Series

30747 State Health Council Minutes
30748 Division and District Activity Reports to the State Health Officer
31915 Health Promotion and Education Division Files

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