KENTUCKY.

Influenza and Pneumonia-Notification of Cases-Isolation-Placarding. (Reg. Bd. of H., Oct. 3, 1918.)

By virtue of the authority vested in it by law, and in order to meet the emergency of influenza now threatening to become widespread in Kentucky, the regulations of the State board of health are so amended as to provide that it shall be the duty of physicians, nurses, heads of families, and of all public Institutions to report to the county or city board of health of the jurisdiction, as may be, any case presenting any of the symptoms of influenza or pneumonia, Including especially coughs and sneezing, associated with temperature, during the period of the present epidemic; and

That it shall be the duty of such board of health, upon receipt of such report, to cause an immediate investigation to be made and to placard the house, ward, or subdivision of a public institution, and to give such instructions as will secure such an isolation of the case as will protect the family, other residents of the house or institution, and the public from influenza, pneumonia, or associated infection; the isolation to continue for a period of 10 days from the onset of the attack or of complications likely to extend the danger of infec tion from the case.

Venereal Diseases and Other Sexual Ailments-Advertisements Relating to, Prohibited. (Ch. 174, Act of 1918.)

SECTION 1. Advertisement relating to certain diseases prohibited.—Whoever publishes, delivers, distributes, or causes to be published, delivered, or distributed in a newspaper or otherwise an advertisement containing a statement, description, or discussion of or concerning a venereal disease or a disease, infirmity, or condition of the sexual organs caused by sexual vice, or referring to a person or persons as having suffered from such a disease, infirmity, or condition; which advertisement shall call attention to a medicine, article, or preparation that may be used therefor or to a person or persons who may or will treat or give advice concerning the same or to an office or place where such disease, infirmity, or condition may or will be treated or where advice may or will be given concerning the same, shall be punished by imprisonment for not more than six months or by a fine of not less than $50 nor more than $500, or by both such fine and imprisonment: Provided, however, That this section shall not be construed to apply to didactic or scientific treatises on sex conditions, diseases, or infirmities which do not advertise or call attention to any person or persons who will treat or advise concerning the same, nor to any office or place where the same may be treated or where advice will be given concerning the same, other than a person or an office or a place affiliated with a licensed hospital or dispensary or the State or county board of health of the State of Kentucky.

Tuberculosis-Powers and Duties of State Board of Health-Establishment. Maintenance, and Control of Tuberculosis Sanatorium Districts. (Ch. 65, Act Mar. 27, 1918.)

SEC. 4. That section 2061 [Kentucky Statutes, Carroll's edition of 1915] as amended and reenacted shall read as follows:

(1) The powers and duties of the State board of health in the study and prevention of tuberculosis shall be coextensive with the State, and the objects of its bureau of tuberculosis shall be as follows:

(a) The study of this disease in all its forms and relations, and to secure and disseminate information with reference to tuberculosis, to promote and carry on a campaign of education with reference thereto, and in general to pursue any other activities with reference to informing the public as to the nature of tuberculosis, its dangers, and the means whereby its spread may be prevented.

(b) Investigation of the prevalence of tuberculosis in Kentucky, and the collecting and publishing of useful information.

(c) Securing of proper legislation for the relief and prevention of tuberculosis.

(d) Cooperation with the public authorities, State and local boards of health, the National Association for the Study and Prevention of Tuberculosis, medical societies, and other organizations in approved measures adopted for the prevention of the disease.

(e) To encourage the establishment throughout Kentucky of local associations for the purpose of undertaking in their particular localities the work proposed to be carried on by this board.

(1) Encouragement of adequate provision for consumptives by the establishment of sanatoria, hospitals, and dispensaries.

(2) And they shall have full power and authority to carry out and execute all of the foregoing purposes, and, in addition thereto, it shall be the duty of the board to recommend to the proper authorities suitable persons for appointment by it as members of the boards of trustees of any sanatoria that may be established under the provisions of this act, and it shall further be their duty to visit at such periods as in their discretion may be sufficient, any sanatoria that may be established under the provisions of this act, and to recommend to the boards of trustees of such sanatoria any changes in management or in the employees that they may deem necessary and proper, and it shall be their duty, if in the opinion of such board any board of trustees or members of such board or employees under such board of any sanatoria, State, or county, are incompetent or neglectful of duty to prefer charges against such board or such member of such board or such employees under such board. All charges against a board of trustees or a member thereof shall be made to the officer authorized to make such appointment, and, if he deem such charges adequate and sustained, it shall be his duty to remove such board or such member thereof, and all charges against employees shall [be] made to the board by whom employed, and, if in the opinion of said board such charges are adequate and sustained, such board shall at once remove such employee or employees. It shall be the duty of the head of the bureau to visit all sanatoria, both public and private incorporated, at least once during each calendar year and to report and file with their records a statement of the condition and efficiency of each sanatorium.

(3) That sanatoria for the treatment of tuberculosis may be erected and maintained in and by districts in this Commonwealth in the following manner: A district for the erection and maintenance of a tuberculosis sanatorium may consist of one or more counties. The fiscal court of any county may by resolution declare that such county shall be a district for the erection and maintenance of a sanatorium for the treatment of tuberculosis, and said fiscal court, upon such resolution being passed, shall immediately take steps to provide for the construction, equipment, and maintenance of such sanatorium.

The fiscal courts of two or more counties may by resolution duly passed by each court, unite said counties into a district for the purpose of establishing therein a sanatorium for the treatment of tuberculosis. Upon the passage of said resolution, each court shall immediately take steps to provide for the

construction, equipment, and maintenance of said sanatorium, as is provided in this act.

(4) If the fiscal court of any county or counties shall fail or refuse to establish a tuberculosis sanatorium district, as herein authorized, the citizens of any county or of two or more counties may have such county or counties established as a tuberculosis sanatorium district in accordance with the provisions of this act, in the following manner: A number equivalent to 10 per cent of the votes cast at the last general election of such county may file their peti. tion with the county judge of such county asking that the proposition of establishing such county as a district for the erection of a sanatorium for the treatment of tuberculosis be submitted to the voters of said county at the next general election which shall be held in said county: Provided, That such general election does not occur within less than 30 days after the filing of said petition. Each voter signing said petition shall state his full name and address, Upon the filing of said petition with the county judge he shall enter an order directing the publication in full of such petition in the newspaper having the largest circulation in said county at least once a week for four consecutive weeks next preceding such general election, and shall further enter an order directing the clerk of the county court to have placed upon the ballot at such election the question, “Are you in favor of establishing a tuberculosis sana. torium district?" with underneath the words, "Yes," followed by a square, and "No," followed by a square for the placing of the stencil of the voter. If the majority of those voting on the proposition to establish such sanatorium district vote Yes," then said district shall be established. If the contrary, then it shall not. The vote on such question shall be canvassed and returned by the board of election commissioners for such general election, and such election may be contested as provided by law for other contested elections by a petition filed in the circuit court of such county by one or more qualified voters of said county who voted "Yes" or "No" as the contest may be had, and to which the members of the fiscal court of the county shall be made defendants, together with such other qualified voters as may have voted contrary to the contestants and desire to be made parties to the contest.

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Where the citizens of two or more counties desire to have such counties established into a district for the erection of such sanatorium, not less than a number equivalent to ten per cent of the votes cast at the last general election of each county shall file a petition in the county of their residence asking that such district be established and naming the several counties to be united in the district. Such petition shall be filed in each county of the proposed district and the method of proceeding in each shall be the same as hereinbefore provided for one county, except that the same proceeding shall be taken in each county for the general election to be held at the same time in each county. If any one county in the proposed district shall fail to vote "Yes" on the proposition, then said district can not be established unless by a contest of the election in such county it should be finally determined that such county had voted "Yes." At the time of filing the petition or petitions, #* the case may be, the petitioners shall deposit with the county judge a sufficient sum of money to pay the cost of advertising hereinbefore required.

(5) The result of any county or district election shall be certified to the fiscal court of such county or to the fiscal court of each of the counties composing said district to be established, and said fiscal court or courts shall, if the result of said election be certified to it or them as in favor of the establish ment of such district, forthwith proceed to declare such county or counties a district for the establishment of a sanatorium for the treatment of tuberculosis

and shall proceed to put same into effect in the same manner as a fiscal court or courts are authorized to do upon their own initiative as provided in this act, and the cost and expenses of erection and maintenance shall fall in all manners the same as provided in this act.

(6) When a county or counties desire to join an already established tubercu losis sanatorium district they can do so by proceeding as follows: The consent of the district board of trustees of the already established district shall be secured. Application for such consent shall be made by the fiscal court of each county desiring to join. Provided, That such fiscal court shall have already declared by resolution that said county shall be a tuberculosis sanatorium district, or a part of such a district; but in the event that a county shall have become a tuberculosis sanatorium district or part of a district by action of the voters thereof, the application shall be made by the board of trustees of the district embracing the county desiring to join; and in the event that a county shall not have become a district, or part of a district, the appli cation shall be made by a petition signed by not less than 20 qualified voters of the county. When it is necessary to take a vote to declare any county a tuberculosis sanatorium district to enable it to join an already established sanatorium district the ballot shall read as follows: Are you in favor of de claring this county a tuberculosis sanatorium district, for the purpose of joining the already established tuberculosis sanatorium district of

County (or counties)," and the result of the election shall be certified to the fiscal court of the county wherein the election was held, and if the result is favorable to the proposition submitted, the said fiscal court shall immedi ately declare such county a portion of the already established tuberculosis district and certify its action to the State board of health, whereupon said board of health shall determine the number of trustees to compose the board of said district, and the representation to be accorded each county on said board, according to the provisions hereinafter set forth.

(7) Upon the creation of a tuberculosis district, the fiscal court of the county or the fiscal courts of the several counties, where there are several counties in such district, shall at once notify the State board of health of the establishment of such district, and, thereupon, it shall be the duty of the State board of health to recommend to the county judge, or if more than one county, to the judge of each county, the appointment of suitable persons for such dis trict board of trustees. In a district of one county the county judge shall ap point as members of the district board of trustees seven persons, men and women, at least one of whom shall be a registered physician. Where the dis trict consists of several counties, the district board of trustees shall consist of not less than two nor more than four persons from each county: Provided, however, That no board shall consist of less than seven persons. Where any county in such district shall have a population in excess of 20,000, such county shall be allowed a trustee for each 10,000 in excess of said 20,000 population, subject, however, to the limitation hereinbefore set down. Said trustees shall consist of men and women and at least one shall be a registered physician. The State board of health in recommending names to the county judge or county judges for such appointments shall recommend twice as many names for each county as the county shall be entitled to have trustees appointed, out of which names the county judge of each county shall immediately make his selection for that county. Where a county or counties shall have joined an already established district the State board of health shall then recommend to the county judge of each county included in the new district double the number of names of persons eligible to the district board as there are trustees to be ap

pointed by such judge and from such list the county judge shall select the trus tees for his county. The trustees chosen shall, with additional members as are hereinafter provided for in case the district contains a city or cities of the second class, constitute the district board, which shall control and manage the sanatorium therein. The qualifications, length of terms and other details shall be as provided in other sections of this act. The terms of the trustees of the counties composing the previously existing district shall expire immediately upon the organization of the new board.

(7a) Provided, however, That in any tuberculosis district containing a city of the second class two persons shall be appointed trustees on the tuberculosis district board by the mayor of that city and that in a tuberculosis district containing cities of the second class one person shall be appointed trustee on the tuberculosis district board by the mayor of each city: And provided further, That each mayor shall appoint the trustee or trustees from a list submitted by the State board of health and containing the names of twice as many persons as such mayor shall appoint. The number of trustees appointed by mayor or mayors shall be in addition to the number allotted for appointment by the county judge in any county containing a city or cities of the second class.

(8) For the purpose of this act such district board of trustees and their successors in office shall be a body corporate under the name and style of district board of tuberculosis sanatorium trustees for

county or ---

counties, as the case may be, and they shall have all the powers necessary to carry into effect the purpose of this section of this act. Said trustees, as soon as possible after their appointment and qualifi cation, shall adopt a seal, organize by electing a president and a secretary and a treasurer to serve for two years and until their successors are elected and qualified, but the same person may be elected to serve both as secretary and treasurer and need not be a member of the board of trustees, and said treasurer shall give bond to the people of the State of Kentucky for the faithful performance of his duties and for the proper handling of all of the properties, assets, and moneys of the institution that may come into his hands at any time in such sum and in such form and with such sureties as said district board of trustees shall approve. Said treasurer may at any time be removed and a successor appointed by said district board of trustees in its discretion. A majority of said district board of trustees shall constitute a quorum.

(9) When a tuberculosis district shall have been created or enlarged by any of the methods herein above provided, and when the district board of trustees shall have been appointed and qualified as herein above provided, said district board of trustees shall annually estimate and lay before the fiscal court of each county in said district the needs of such district for the site, erection, and maintenance of a tuberculosis sanatorium, equitably determining as herein after provided the amount to be paid by each county, and the fiscal court of each county shall, at the next succeeding tax levy of said county, levy a tax in accordance with the estimate of the district board for such purpose of not less than 2 cents and not more than 8 cents on each $100 of assessed valustion of property in the county, and the sheriff shall then collect this tax as other State and county taxes are collected. The cost of site, Initial construe tion, and equipment may be covered in the first year's levy and said cost shall be covered in not exceeding three years' levy. After the cost of initial construction and equipment has been provided for by the tax levy as aforesaid, the said district board of trustees shall annually estimate and lay before the fiscal court of each county in said district the needs of such district for future construction and maintenance of said sanatorium, and the fiscal court