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1~5 operate a health department, but does want to work with the local department by allowing students to participate and by rendering services and training. He added that the control should be with the '.local juris- diction. Chairman TnThitted stated that regardless of what arrangements are made with the School of Public Health, the health department should be identified as a community health department, with the primary purpose of rendering services to the community and not an arm of the University. In response to a question presented by Commissioner Gustaveson, con- ... cerning the position of a health director, Dr. Harper stated that he per- sonally felt that a physician with specialized training should not be in the role of an administrator, but an administrator should be prepared and `- qualified as an administrator. Another point Dr. Harper made is that an administrator does not have to be trained in clinical medicine along with administration in order to direct a health department. He added that there may be an individual wo qualifies in both areas, and he felt this would be good, however, fewer physicians today are going into public health. Commissioner Gustaveson asked what arrangements were possible for small health departments who could not affort both a full time health director and a full time administrator. What arrangements can be made to provide medical advise to certain medical problems? Dr. Harper replied that there were different arrangements. One model would be to hava a non-medical director whc is qualified in administration and at the same time, have an arrangement with practicing physicians to serve as consultants in medicine on a full or part-time basis. The idea is to rely on other specialists for consultation whether the problem be medical or non-medical. Further discussion ensued concerning a health director. Dr. Harper stated that North Carolina had two classes of positions of health directors One is a medical director, which had three classes, and the other is a non-medical director which has five classes. The classes~~are distin- guished by the size of the health department and the population of the county. He stated that since Orange County had a population of 80,000, a Health Director III or zV would probably be needed. Mr. Whitted informed the Boards that George Nelson, the Regional Manpower Director, had made a case where he said that in terms of money, it is least expense to have a non-medical health director. Dr. Harper advised the Boards to think in terms of the highest level of non-medical administrator it can employ and then contract to provide for clinical services threugh some other arrangement. Commissioner Gustaveson stated that with the goals which have been set out for the next few years, it will take someone that is competent and qualified for a unique situation. He added that the aim of the Health Systems Agencies is to incorporate their plan into the programs of the local health departments. Commissioner Pinney stated that he felt the first objective of the Health Board is to become established with a solid operation, and then to look at services to provide. Dr. Harper informed the Beards of an undertaking of the School of Public Health and the Division of Health Services to provide Board training to local health boards. Discussion ensued concerning additional staff personnel to work on an interim basis, until the administrative assistant comes to work. The County Manager was authorized to procede with securing such a person. Commissioner Gustaveson requested that an outline or an inventory of things which need to be done by July 1, 1977, be made, so that nothing is overlooked. He added that it is important to have a senior staff person involved during this transional period. The County Manager will meet with the health department staff to formulate such a list, and to