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DEPARTMENT OF HEALTH, EDUCATION
_ AND WELFARE
| Health Services and Nental Health Administration
Division of Regiorial Medical Programs

National Advisory Council on
Regional Medical Programs

Minutes of the Meeting
_ duly 28-29, 1979

Parklawn Building
Conference Room G/H
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_ DEPARTMENT OF EEALTH, EDUCATION AND WELFARE ae
7 _.* PUBLIC HEALTH SERVICE : : ~

_ National Advisory Council on Regional Medical Programs

| Minutes of the Twentieth Meeting 1/ 2/-

July 28-29, 1970 |

The National Advisory Council on ‘Regional Medical Programs convened
for its twentieth meeting at 8:3C a.m., Tuesday, July 28, 1970 in -
Conference Room G/H of the Parklawn Building, Rockville, Maryland.
Dr. Harold Margulies, Acting Director, Regional Medical Programs
Service presided over the meeting. : , .
The Council members present were:

Dr. Bland W. Cannon , Dr. Edmund D. Pellegrino

Dr. Edwin L. Crosby (7/28 only) - Dr. Alfred M. Popma

Ir. Michael E. DeBakey (7/29 only) Dr. Russell B. Roth

Dr. Bruce W. Everist Dr. Mack I. Shanholtz

Dr. William R. Hunt Mrs. Florence R. Wyckoff _

Dr. Alexander M. McPhedran

A listing of RMP staff members, and others attending is appended.

CALL TO ORDER AND OPENING REMARKS

 

The meeting was called to order at 8:30 a.m. on July 28 by
Dr. Harold Margulies. ; -

ANNOUNCEMENTS

Tre Council members were welcomed to the new Conference facilities in
the Parklawn Building and the general arrangements for the conduct of
the meeting in these facilities was explained. Dr. Margulies announced
his plans for an executive session with the Council at the close of the
first day of the meeting.

 

Proceedings of meetings are restricted unless cleared by the Office of
the Administrator, HSMHA. The restriction relates to all material submitted
for discussion at the meetings, the. supplemental material, and all other
official documents, including the agenda.

For the record, it is noted that members absent themselves from the
meeting when the Council is discussing applications: (a) from their
respective institutions, or (b) in which a conflict of interest mignt
occur. This procedure does not, of course, apply to en bloc actions --
only when the application is under individual discussion.
at the next meéting.

INTRODUCTION OF NEW MEMBERS

Dr. Margulies introduced two new members of the, Council who were in
attendance for this meeting. They are: William R. Hunt, M.D.,

-a Commissioner of the County of Allegheny in Pennsylvania and medical

practitioner in McKeesport, Pennsylvania; and Alexander M. McPhedran, M.D.,
Associate Professor of Internal Medicine (Neurology), Emory University —
School of Medicine, Atlanta. The recent appointment of Mr. C. Robert
Ogden was also announced. Mr. Ogden is President of the North Coast Life
Insurance Company in Spokane, Washington and Chairman of the Washington/
Alaska Regional Advisory Group. He will begin his regular attendance

REGIONAL MEDICS PROGRAMS AS A PART OF THE HEALTH SERVICES
AND MENTAL HEALTH ADMINISTRATION - Dr. Vernon Wilson

In his first meeting with the Council as Administrator of the Health
Services and Mental Health Administration, Dr. Wilson recalled his iong
interest and first-nand involvement in the development of Regional
Medical Programs. He assured the Council of his strong support of
Regional Mecical Programs as a part of the broader efforts of HSMHA.

He expressed his endorsement of the principles of decentralization of
the administration of HSMIA activities generally, and his’ belief that
the concept of Regional Medical Programs can relate well to these
principles. though the mechanisms will be worked out slowly, he is
confident that this can take place without dilution of effort,

_ either in the Regions or in the neadquarters office.

In recognition of the very formidable problems facing Regional Medical
Programs Service, Dr. Wiison expressed regret that he was not able

at the present time to resolve the major staffing problems. He
assured the Council this has very high priority on his working agenda
and the fact that he is as yet unable to report does not indicate
that he is not actively working toward a solution.

Dr. Wilson asked the Council to meet with him again in approximately
six to eight weeks, in a special one-day session. At that time he

4s assured he. will be abie to discuss his plans, as they are based on
those of Secretary Richardson, for the organization and administration
of the Department's efforts to strengthen and increase the nation's
capacity to deliver health services. {le indicated also that by that
time he would nave more definitive plans for the staffing and
organization of the Regional Medical Programs Service.

Althougn nis plans will include a general outline of the "mission"

of Regional Medical Programs as a part of the HSMHA effort, Dr.

Wilson said that he would rely heavily on the advice and guidance of

the Council for developing the policies and detailed program directions

that would lead to ever’ more efficient and effective cooperative arrangements

between the private sector, which they represent, and the Federal effort.

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Dr. ‘leon told the Council of the resignation of Mr. Irving Lewis

as Deputy Administrator of HSA, and about ilp. Lewis' appointment

as Professor ir. the Department of Community Medicine at Alpert
Einstein College of Medicine in New York. ir. Lewis addressed the
Council briefly, stating again his faith in the Regional Medical
Programs as representing "the only concept of true regionalization
of health services that can be expected to work" in the United States.
Mr. Lewis expressed his thanks to the Council for the many pleasant
working relationships he had had with them. Mrs. Florence Wyckoff
resporided for the Council, expressing their appreciation for his
assistance to them, especially in helping them to understand the
principles of Federal financing of health care and in the area of health
economics generally. en os

CONFIRMATION OF FUTURE MEETING DATES

Council was apprised of the necessity for reverting to a system of
fow meetings per year in order to accommodate the changeover to
Anniversary Review. Two new Council dates were set: November 9
and 10, 1970 and February 2 and 3, 1971!. oo!

In addition, September 30, 1970 was set for the special meeting
requested by Dr. Wilson. The Council accepted the invitation of
Dr. Edwin Crosby to hold this meeting at the American Hospital
Association headquarters in Chicago. . This will enable more of the
members to travel to and return home from the meeting in a single
day.

CONSIDERATION OF THE MINUTES OF THE MARCH 31-APRIL 1, 1970 MEETING

Tne Council unanimously recommended approval of the minutes of the
meeting of the Council on March 31-April 1, 1970.

A REPORT FROM THE DIRECTOR - Dr. Harold Margulies
A. Progress of HR 17570 and S3355 |

Dr. Margulies reviewed the contents of the two Bills very briefly

and referred the Council members to an analysis prepared by staff which
compares the Bills to one another and to the present legislation. This
was included in the agenda materials.

B. Appropriations for Fiscal Year 1971

Status of the Aporopriation Bill was reviewed and the Council was

reminded of the various circumstances which impinge on the total amount

of "new" funds to be available for major expansion of Regional Medical
Programs in FY 1971. Among these are the $1.9 million earmarked for
Model Cities activities; the 1% reserve of funds to be used for evaluation
ee

_ activities at DHEW, HSMHA, and RMPS levels; the possibility of

~” administrative “earmarking” of some funds for RMP participation in

VIII.

comprehensive regional kidney disease programs; all in addition to a
total amount slightly in excess of $77 million required to meet
minimal continuation requirements of ongoing regional activities.

C. Funding Strategy

Dr. Margulies made a brief introduction of a new management information
“System being implemented by RMPS. .

He also noted the effect of the 1969-70 strategy of permitting Regions
almost unlimited rebudgeting of unexpended balances for program
expansion. Dr. Margulies stated his intention to begin to apply

more stringently guidelines to this kind of rebudgeting and to
recapture some of these balances for reallocation among the Regional
Medical Programs in response to evidence of successful regionalization
ani program development.

D. The FAST Recommendations

 

In a brief review of the recommendations of the Federal Assistance
Streamlining Task Force and his pian for responding to them, Dr.

- Margulies emphasized the "liaison" role of the DHEW Regional Offices

in the development: of HSMHA programs generally, and in helping to
‘pelate Regicnal Medical Programs to both publicly and privately—funded
programs in the area served; but with the retention of the principal
management responsibility in the Regional Medical Programs Service ,

at the national level. He also mentioned especially the Service's
concern, antedating the Task Force study, for vetter delineation of
the multiplicity of activities now covered by the core budget in
Regional Medical Program grants.

Dr. Margulies explained the intent of RMPS in placing a Program

Representative in each of the ten DHEW Regional Offices and described
what he sees as the service role of these individuals.

PROGRESS NOTES FROM STAFF

 

A. Contracts under Section 907 - Dr. Margaret Sloan

Dr. Sloan gave a brief review and status report on the three contracts
made by the RMPS under the terms of Section 907 of Title IX of the
Public Health Service Act, which deals with the "...list or lists of
facilities in the United States equipped and staffed to provide the
most advanced methods and techniques in the diagnosis and treatment of
heart disease, cancer, and stroke...." .

. The contract with the American Heart Association in support
of the Intersociety Commission for Heart. Disease Resources, has
 

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begun serial publication of its report and will continue
to do so throughout the period of the contract.

| The Joint Committee for Stroke Facilities, supported
by. a contract with the American Neurological Association,
‘has chosen to withhold publication of its report until it
is entirely completed.

. The report of the Special Advisory Committee on Cancer ~
Care Facilities of the Cancer Commission of the American
College of Surgeons, which was supported under a contract
now completed, has been reviewed by the Regional Medical
Programs Service and was received by the National Advisory

' Council at the April 1970 meeting. Negotiations between the
American College of Surgeons ard the RMPS, preparatory to
completion and RMP approval .of this report, are now underway.
(This was discussed in more detail with Council during the
Executive Session). .

2B. Multi-Program Services Project Grants - Mrs. Martha Phillips

Authorized under Section 910 of Title Ix of the Public Health Service
_ Act, this program of project grants will be implemented for the first

time early in FY 1971. The Council was reminded of its original role
in the development of the basic guidelines and operating policies for
these grants. They were assured that these are reflected in the final
edition of the program documents which are now in clearance.

The Council expressed its persistent concern about the potential effect
of the funding of these. grants on the total funds available for Section
904 grants (operational support to Regions). Dr. Margulies said that he
expected to be able to present to the Council at its next meeting, a
plan for allocation of grant funds that would take into consideration an
appropriate distribution of the available dollars between these two major
grant activities.

C. Regional Medical Programs in Model Cities - Mr. Cleveland.Chambliss

The Council was reminded of the administrative earmarking of $1.9 million
of RMP FY 71 grant funds for use in projects which have direct impact

on certain designated Model Cities neighborhoods. Mr. Chambliss outlined
the procedure for determining the degree of such impact and obtaining

the certification of Model Cities officials in this regard. Although

this procedure includes endorsement of DHEW Regional officials, Mr.
Chambliss assured the Council that the procedure would entail no authority
for further reviev and approval of these projects beyond the local Regional
Advisory Group and the National Advisory Council.

Also in response to specific questions, Dr. Margulies explained that
Regional Medical Programs which are planning and submitting projects to
 

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serve urban populations need not plan them exclusively for Model Cities

". areas and need not seek any heel or concurrence beyond thelr own

review ard approval mechanism. .

D. Senior Clinical Traineeships - Mrs. Martha Phillips.

Mrs.: Phillips recalled to the Council the circumstances leading to the |
Departmental decision to place responsibility for the Senior Clinical
Traineeship program in Regional Medical Programs Service. She also
reported to the Council on the selection of the first group of Traineeships
to be awarded under RMPS sponsorship. This selection: process was carried
out by panels of non-Federal experts in the cancer field and was chaired
by Dr. Michael Brennan, to whom the Council delegated authority for

the selection of individual trainees to the total extent of $300,000 of

. FY 1970 funds. Thirty trainees were selected from among 80 applicants,

and represent the disciplines of medicine, gynecology, pathology,
pediatrics, radiology, and surgery. The training will be done in major

. medical centers throughout the United States.

E. Guidelines for Instructional Technology ~ Miss Cecilia Conrath

A second edition of these guidelines was before the Council for their

consideration. Dr. Pellegrino, who served as Chairman of the Subcommittee .

to prepare these guidelines, expressed his belief that they are now
ready for publication and implementation, with certain rewriting. This
is being done by RMPS staff, incorporating Dr. Pellegrino’ Ss Suggestions.

F. Evaluation Activities - Mr. Roland Peterson

In reporting to the Council, Mr. Peterson mentioned the fina? summation
and distribution of the Regional Progress Summaries which resulted from
the questionnaire developed and tabulated by his staff; on the Regional
Medical Program Evaluation Conference to be held at the University of
Chicago Conference Center in September; and on his plans for evaluation
activities in FY 71 which will be chargeable to the "evaluation earmark."

This earmark was explained to the Council by both Mr. Peterson and

Dr. Margulies as a 1% administrative reserve to be used for evaluation
activities not only at the program level, but also at the level of HSMHA
and DHEW. It is anticipated that something slightly under $1 million
could be set aside under these circumstances and could be used by contract
or by the Section 910 grant mechanism, at the discretion of RMPS, with
portions of the total withheld for HSMHA and DHEW evaluative activities.

The entire matter of evaluation sparked considerable discussion in the .
Council. It was the consensus that in order for these funds to be

effectively utilized, a much broader concept of evaluation must be developed.
There was a good deal of discussion of the contract with Arthur D. Little, Inc.
and expression of considerable doubt as to the real value of any findings
being reported. Several of the Council members have had individual experience
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with the conduct of the contract activities and feel that these have not

always been handled in the best interests of the Program. There was
unanimous agreement with the suggestion, made by Dr. Roth and Dr. Cannon,
that interim reports on the progress of such undertakings, either this
eurrent one or any future such contracts, be required and that they be
made available to the Council for review and discussion. The Council
requested a more definitive report from the staff on the results of the
contract, particularly as it relates to the purposes for which the contract
was originally let. They also asked to see the final report from the

Arthur D. Little, Inc. as soon as it is received by RMPS.

In summarizing the discussion, Dr. Pellegrino suggested that all
evaluation activities should, in the long run, serve to test the viability
of Regional Medicai Programs as they are developing; and if they are

found not to be viaole to aetermine wry they are not.

KIDNEY DISEASE ACTIVITIES IN REGIONAL MEDICAL PROGRAMS

‘Dr. Margulies reviewed for the Council the circumstances leading to

the addition, in both the House and Senate versions of the continuation .
legislation, of kidney disease as one of the specific disease zategorical

targets of Regional Medical Programs. He asked for guidance of the

Council in the development of a responsive and effective policy for
Regional Medical Programs participation in comprehensive regional kidney
Gisease programs throughout the Nation. He is aware that the final
definition of such a policy, especially as it would apply to the immediate
future, will not be possible until after Congressional action, on both

the continuation legislation and the appropriations, is complete.

In order to provide some backg-ound for their deliberation, Dr. Margulies
explained that he had asked the staff to prepare some basic information
and to draft some suggested policy guidelines. These were part of the
agenda materials presented to the Council. He then introduced

Dr. George Schreiner, Chief, Nephrology Section, Department of Medicine,
Georgetown University and Dr. Richard B. Freeman, Department of Medicine
(Nephrology), University of Rochester School of Medicine, whom he had
invited to the meeting to provide expert reference to the Council in
their deliberations.

Dr. Schreiner made a detailed presentation of the "state of the art"
of the management of chronic kidney disease. He included resume of the
techniques and methodologies of screening, diagnosis and therapy; and

- the shortcomings as well as successes in prevention, treatment, and .

rehabilitation.

Nephrology is,.Dr. Schreiner said, a new area of specialization. As

such it has the disadvantage of a severe shortage of trained specialists;

put has the advantage of having few established traditions, and is in

the enviable, position of being able to profit from the mistakes made

in establishing resources for open heart surgery, high voltage radiotherapy; etc.
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Organization fo “Was Selivery’ of servies to patients with kidney disease, °.
Dr. Schreiner bel’+.-:, lends itself so ideally to regionalization that

the development of =.:ch a program can and will serve as a framework for

regionalization of =-rvices in other more traditionally established
disciplines. i

Again, as in near’; +11 their past discussions of kidney disease, the
Council expressed «cern about the apparent lack of emphasis on
prevention as par ~° an overall kidney disease program. Dr. Schreiner
and Dr. Freeman o<.*-.-e that the only hope for real prevention will
come via prenatal “:-2 and "genetic engineering" and although work

in these areas 15 /:>=ressing, it will not have any significant impact
for fifty to sixty ;-srs. They also believe that the more traditional

" approaches to prev«-.ion generally will not be seen to be effective for
at least 20 years, :

Both Dr. Schreinez' ini Dr. Freeman spoke to the issue of the cost of
developing regionz.‘vad kidney disease services; and the way in which
the enormous numbe:: often used in this regard have been misleading and
discouraging to ir:itutions and communities. Both agreed that the

$15 m.llion mentic-.i in the pending legislation could make a
significant diffe:-:e in the extension of services of existing kidney
disease centers ox ‘n the establishment of some smaller number of ~
entirely new ones. itr, Margulies reminded the Council that the
$15 million to whi’, the Bill makes reference, is recommended as a maximum
assignment of Regi-,.,1 Medical Program grant funds to kidney disease
efforts, and in no wy earmarks or limits any dollars exclusively for
this purpose; nor “953 it provide, or even recommend the provision, |
of funds over and «::,;ye the grant funds to be otherwise available for
purposes of Regior::. “edical Programs.

Dr. Everist raise? ‘2 question of the mechanics of incorporating
kidney disease pruyv::%3 into the 55 Regional Medical Programs if the
principle of locai :: ,onomy and decision-making is to be maintained.
It is his belief tis.» unless and until Regions with appropriate
existing facilities -2n be "seduced" into. affording high regional
priority to kidney “-zease control, it will be necessary to use the
Section 910 author'!+), so that national directives may be used to
develop "sensible ,.:.rams in sensible places."

Accepting the appii-siy inevitable lag time before the results of

a planned program “." -reyvention can be felt, Dr. Pellegrino asked for
the advice of Dr. '-reiner and Dr. Freeman on what inmediate impact
Regional Medical !1~»--ams could reasonably have, considering the
provisions of the {,-rosed legislation and within the amount of funds
that are likely t« ix available within the next two or three years.
Responding first, ::. Schreiner recommends the strengthening of
existing facilitie: -articularly those which have committed themselves
to outreach beyom1 «-s confines of the medical center within which
they exist; and fu:i:er identifying those among this group that lend them- —
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selves to furthér interlinkage to provide a multiplying rather than
simply an additive e?fect. Dr. Freeman recommends the support of the
completion and extension to full services of a small number of
centers which can be developed,on the basis of existing, although
perhaps not entirely complete, resources; the use of RMP funds for

" support of planning, particularly in regard to increased effective

utilization of expensive resources; and the training of personnel,
principally physicians, who can serve to train others (other physicians

and paramedical personnel). i

The Council strongly endorsed Dr. McPhedran's point regarding the
importance of thoughtful integration of a kidney disease program into
an existing Regional Medical Program; particularly in planning,
sub-regionalization, continuing edication, and inter-professional
commnication activities. ,

In a subsequent discussion on the second day, the Council members
reflected on the recommendations of Dr. Freeman and Dr. Schreiner

as well as on the goals, objectives, and the basic operational concepts
which guide Regional Medical Programs at the present time. Since

these proscribe against the use of funds farthe direct provision of
patient services, and the total amount of funds likely to be available
will proscribe against making major contributions toward the establishment
of facilities, the Council agreed that the major focus of RMP involvement
will be (a) the encouragement of better and more effective cooperative
arrangements among carefully selected institutions and resources which
together might form a "decentralized center" and (bo) in the strengthening
of existing institutional resources competent and willing to develop
ouvreach, both in the demonstration of service and the training of
persomiel. Both of the above require national as well as regional
planning. ‘

In summary, the Council endorsed the general plan presented by the

staff; they also agreed, however, that to develop a workable overall
policy it will be necessary to have tasic data concerning the resources

in, and available to, each of the 55 Regional Medical Programs. This
should include (a) presently self-contained centers, (b) institutions
which have the capability of becoming an integral part of such a center,
and (c) institutions and resources which might participate in an inter-
regional arrangement for the provision of «idney disease services. An
assessment of the "size and shape” of the kidney disease problem in each
of the Regions would provide the other essential piece of basic information.
Dr. Margulies agreed to provide these data based on the existing geographic
pattern of the 55 Regional Medical Program. .

REVIEW OF APPLICATIONS

 

A. Issues identified '

1. In the matter of RMP support of short-term training projects, the
Council considered the history provided them oy staff, and a number of
sae xO , = 10 “

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‘specific projects included in the applications under review at this
meeting. They believe that under most circumstances it is not necessary
or appropriate for Regional Medica] Programs grant funds to be used to
cover the full costs of both the presentation of short-term training

projects and of stipends and expenses of the participants.

--——The majority of projects in this category provide opportunities for up=
grading and development of new skills in special techniques or procedures
NN and are directed to individuals presently employed in health care
~ institutions. Under the circumstances these institutions should, and
in most cases do, make regular provision for this kind of training for
their staffs.

The Council therefore recommended the following changes in policy -

~ guidelines regarding payments to participants in continuing education
and training projects (as defined in the Guidelines Addendum, February
1970, page 13) which are supported by Regional Medical Program grant
funds. ,

. Regional Medical Program grant funds may not be used for the

payment of stipends, either directly or on the "maintenance of

income principle," to participants in short-term continuing

education and training projects. This does not include training
8 for new careers for new types of health personnel.

. Other allowable costs of participant 's support may be
calculated according to the existing Guidelines. Regional Medical
Program grant funds may be requested and awarded for per diem and
travel to the extent of 50% of the total amount so derived. The
awarded funds may then be paid to the enrolled trainees as considered
appropriate by the project personnel , depending on the participants'
ability to provide these costs for themselves and/or the willingness
of their employers to provide them. No single individual may
receive per diem or travel allowance at a rate higher than that
prescribed by the present Guidelines.

. RMP funds may not be rebudgeted, from within or without the
project budget, to increase the total amount awarded for per diem
and travel above the 50% level.

2, The Council considered the present Guidelines regarding Regional
Medical Program funding of projects of long-term post-doctoral training,
at the senior resident and post-resident levels, particularly in the
@linical sub-specialties of importance in patient management in the
diseases targeted by Regionai Medical Programs. As has been pointed out
by both the Review Committee and the Council, requests for support for
training of this kind are appearing more and more frequently in Regional
Medical Program applications; because of the increasingly critical
shortage of. individuals trained in these fields, but also pecause of the
drastic reduction in NIH funding which has previously been available for
this purpose. . , .

 
“involved, for reinvestment in the project.

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The Council unanimously agrees on the importance of maintaining the training
programs in these fields in the major teaching centers throughout the nation.
They also agree tnat funding through Regional Medical Programs would serve

to strengthen the essential involvement ot these centers of clinical

excellence into the framework of cooperative arrangements which form the
basis of the Region of which they are a part. It is recognized, however,
that the allocation of an amount of Sunds large enough to make a significant

‘impact, if provided from the present RMP appropriation, would create a

serious and inappropriate imbalance in the RMP efforts to meet more their
varied and comprehensive goals. The Council, therefore, requested the

RMPS staff to forward to both HSMHA and DHEW its unanimous recommendation —

that arrangements be made to provide Federal assistance to clinical cepartments
in major teaching centers to offset the identifiable education costs (as
distinct from the costs identified wita orovision of patient services) of

the maintenance of tneir ciinical resicency and post-residency training
programs; that; tais mechanism oe orovided tnrougn the framework of Regional
Medical programs; and that runding, over and above the current grant funds

_appiooriatea to Regional “Medical Programs, oe sought for this purpose.

Accordingly, the Council recommends that until such funds are added to
the annual appropriation, the Regional Medical Program Guidelines for

-operational grants under Section 904 of Title IX of the PHS Act. be

changed to exclude the payment of stipends and other participant costs
for long-term training at the post-doctoral level.

3. The Council is keenly aware of the potentially crippling effect on
Regional Medical Programs of continotis investment in vrojects wnich were
initially acoroved for demonstration of, or training in, new vechniaues
of patient care, but_provice mhaL becomes an essential service to patients.
They continue to believe, nowever, that it would be unwise and indeed
impossible to develop a firm policy aroitrarily including or excluding
projects of this kind, and instead urge the RMPS staff to work closely
with Regions, as they develop projects, to be certain that other sources
of support for maintenance of the service involved be well in hand before
such a project is initiated; and also to encourage Regions to carefully
investigate every possibility of capturing the fees paid for the service

B. Special Actions

NORTHEASTERN OHIO REGIONAL MEDICAL PROGRAM | : :
In response to a special appeal for reconsideration of previous action

on Project #7 (A Comorenensive Out-patient Stroke Rehabilitation
Demonstration), the Council considered the additional information submitted

and recommended that the project be approved as requested.
01 - $48,233 02 - $50,145 03 - $26,076
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NORTHLANDS PEGIONAL MEDICAL PROGRA“

The National Advisory Council considered a request for the initiation
of interim support to the Diabetes Detection and Education Center in
Minneapolis with the understanding that (a) these funds will be made

available from the Region's unexpended balances and (b) that this

approval does not in any sense indicate commitment to approve the
forthcoming application for RMP participatton in the long-range basic
support of this Center.

- VIRGINIA REGIONAL MEDICAL PROGRAM

In regard to Project #4 (Stroke in a Small Rural Community) the Council
concurred in the staff's recommendation for a waiver of the restrictions
imposed as a condition of the original approval of this project,

subject to the satisfaction of RMPS that the purposes of the project are

‘being adequately achieved.

WESTERN NEW YORK REGIONAL MEDICAL PROGRAM

In regard to Project #10 (Western New York Tumor Registry) the Council
concurred with the Review Committee's recommendation for continuation
of the project as amended. .

Cc. Recommendations for ‘Action »: l/

 

- The Council recorded their recommendations in the format which was

adopted in the previous review cycle (Appendix I).

ALBANY REGIONAL MEDICAL PROGRAM

RM 00004 7/70.1 - Operational Supplemental - Approval with specific
conditions.

Project #7A(R) - Approval I with the conditions specified by
the Review Committee.

Project #7B(R) — Approval I with the conditions specified by
the Review Committee.

Project #18 ~ Non-approval II - Revision Required.

01 ~ $36,930 _ 02 - $36,930 03 - $0

 

All amounts are direct costs only and unless otherwise specified refer
to a 1é-month period.

The designation 01, 02, etc. relates to the first, second, etc., budget
periods of the subject aorlication, not necessarily the budget periods
that will actualiy be Supplemented.
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ARTZONA REGIONAL “EDICAL PROGRAM

 

RM 00055 7/70.1 - Approval with specific conditions.

Project #11 - Approval I with the conditions specified by the
Review Committee. a

Project #12 - Approval I with the conditions specified by the
Review Committee.

ol = $151,395 | 02 - $146 ,053 03 - $150,628

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ARKANSAS REGIONAL MEDICAL PROGRAM

 

RM 00052 7/70.1 - Operational Supplement - Conditional approval.

Project #35 - Approval I with the conditions specified by the
Review Committee. c

O01 - $88,149 02 = $82,769 ss 03 ~ $0

BI-STATE REGIONAL MEDICAL PROGRAM

 

RM 00056 7/70.1 - Operational Supplement - Approval with specific conditions.

Froject #12 - Approval I. The Couneil concurred in all the
conditions recormended by the Review Committee
except for the budget reductions inthe equipment
category. This item may be increased by a figure
not to exceed $15,000, after negotiations with
the Region concerning the University's ability to

“provide part of the equipment cost.

Project #13 - No action taken. The Council requests the Review
Committee to reconsider the project in the light of
several issues identified by them.

(01 - $68,000 i‘ sSs«2 = $58,425 03 - $61,023

CALIFORNIA REGIONAL MEDICAL, PROGRAM
RM 00019 7/70.1 and 7/70.2 - Approval with specific conditions.

Project #41 - Non-approval II. Revision recuired. The Council
considered the findings of the Review Committee and
of the technical site visitors whose report was
available to them. They specifically recormended
that the Region be given benefit of the advice of the
site. visitors and urged to revise the project along
those lines.
CALIFORNIA RUGIONAL MDICAL PROGRAM (cont)

 

© Project #56 - Approval I~
c--. ' Project #60 - Approvai I in the reduced amount
“ Project #61 - Non-approval I
Ol - $107,307 "02 = $117,248 03 - $121,393

CENTRAL NEW YORK REGIONAT, MEDICAL PROGRAM
RM 00050 7/70.1 — Operational Supplement - Conditional approval.

Project #15 ~ Approval I at a reduced level with the conditions
-. specified by the Review Committee. — .

01 - $40,000 02 - $50,000 — 03 - $53,000

COLORADO/WYOMING REGIONAL MEDICAL PROGRAM
RM 00040 7/70.1 ~ Overational Supplement - Return for Revision.
Project #13R - Non-approval II. Return for revision with the
clarification requested by the Review Committee.
8 | ‘FLORIDA REGIONAL MEDICAL PROGRAM
| RM 00024 7/70.1 - Return for revision.

Project 436 - Non-approval IT with recommendations for revision
as suggested by the Review Committee.

GEORGIA REGIONAL MEDICAL PROGRAM

 

RM 00046 7/70.1 - Conditional approval.

Projects #31 and #32 - Approval in the reduced amount of $100,000

to be used for the initiation of both projects
as seen fit by the Georgia RMP.

Project. #33 - Non-approval I.

01 - $100,000 02: - $100,000 03 - $0

 

GREATER DELAWARE “ALLEY REGIONAL MEDICAL PROGRAM

RM 00026 7/70.1 - Disapproval - inappropriate for RMP funding.

 

8 Project..#19 - Non-approval I
e . ve : . .
. e . :
7 2 . m : *
= . . ‘ .
of . . . .
- . « : . |
‘ :

HAWAII REGIOUAL MEDICAL PROGRAM
RM 00001 7/70.1 - Geerav ions Supplement - Approval .

Project #21 - Approval I
Project #22 - Approval I

01 - $202,743 "+ 92 ~ $99,168 =: «03 - $108,252

ILLINOIS REGIONAL MEDICAL PROGRAM

 

RM 00061 7/70.1 - Approval with specific conditions.

Project # 9 - Non-approval II with the recommendations for revision
suggested by the Review Committee.
Project #10 - Approval I
Project #i1 - Approval I with the conditions specified by the Review
, Committee.
Project_ #12 - Approval I
Project #13 ~ Approval I with the conditions specified by the Review
Conmittee; with second and third year funding contingent
upon progress in the first year to be assessed by the
8 . Council on the basis of a progress report, continuation

 

application, and the report of the technical site visit
to be held sometime toward the end of the first year.

01 - ($587, 412 7 02 ~ $661,237 03 ~ $341,883

INDIANA REGIONAL MEDICAL PROGRAM .
RM 00043 7/70.1 - Operational Supplement - Non-approval

Project #19. - Non-approval I inappropriateness for RMP funding based

on the Council's decision to defer approval of projects
proposing the clinical application of genetic counselling,
pending further scientific validation of the clinical
uses of this technique.

y

Project #20 - Non-approval II with the recommendations for revision
suggested by the Review Conmittee.

INTERMOUNTAIN REGIONAL MEDICAL PROGRAM

RM 00015 7/70.1 — Operational Supplement - Return al Revision

Project #27'- Non-approval II with the reconmeniations for revision
8 suggested by the Review Conmittee.
~ 16 -

oe”

". KANSAS REGIONAL MEDICAL PROGRAM

RM 00002 7/70.1 - Operational Supplement - Return for Revision

 

Project #39 - Non-approval ‘II with the recommendat:ions for revision
suggested by the Review Committee. ;

LOUISIANA REGIONAL MEDICAL PROGRAM

RM 00033 7/70.1 - Approval with specific conditions.

- Project # 8 - Non-approval II with the recommendations for revision
suggested by the Review Committee.

Project #9 - Approval I in a reduced amount and with the conditions
specified _by the Review Conmittee.

Project #10 - Approval I

Project #11 - Approval II

Project #l2 - Nori-approval II with the recommendations for revision
suggested by the Review Committee.

‘Project #13 - Approval II

Ol - $147,532 2 02 - $77,242 03 = $79,342

MARYLAND REGIONAL MEDICAL PROGRAM

- RM 00044 7/70.1 and 7/70.2 - Operational Supplements - “Approval with
speciric conditions.

 

Projects #25 and #26 - Approval I with both projects to be combined
. at a reduced amount and with the conditions
specified by the Review Committee.

Project #27 - Approval I

Project #28 ~ Non-approval II with the recommendations for revision
; suggested by the Review Committee. . Oo

Project #29 - Non-approval I :

Project #30 -— Non-approval I

01 - $94,975 02 - $144,475 03. ~ $145,975

MEMPHIS REGIONAL MEDICAL PROGRAM

RM 00051 7/70.1 - Operational Supplement ~- Disapproval. Inappropriate for
RMP funding.

Project #27 - Non~approval I. The Council was in agreement with the
Review Committee in recommending non-approval for the
Peripheral Vascular Clinic Project. They wish, however,
-l(-

MEMPHIS REGIONAL MEDICAL PROGRAM (CONT).

to be certain that the project, personnel and the
Memphis RMP understand that the recommendation in
no way reflects a disagreement with the inherit
service value of the Clinic nor suggests lack of
confidence in the staff and Institution. The action
does not preclude resubmission of a-request for RMP
funding for the continuing education aspects of this
project at sucn time as these are more thoroughly
planned and ready to be implemented.

Project #28 - Non-approval I

METROPOLITAN WASHINGTON, D.C. REGIONAL MEDICAL PROGRAM

RM 00031 7/70.1 - Operational Supplement - Approval with specific conditions.
Project #36 - Non-approval I- |
Project #37 -— Approval I at the reduced level and with the
conditions specified by the Review Committee.

O1 ~ $38,477 02 ~ $40,618 «03 ~ $44,928

MICHIGAN REGIONAL MEDICAL PROGRAM

“RM 00053 7/70.1 —- Operational Supplement - Approval with specific conditions.

Project #16R - Approval I 7 a

Project #27 — Approval I with the conditions specified by the Review
Committee. In concurring with all of the recommendations

. of the Review Committee, the Council urged the RMPS

staff to work closely in the development of this project
with the hope that it will come closer to a demonstration
of. comprehensive care, as promised by its title, than
it would presently appear to be.

Project #28 ~ Non-approval II with the recommendations for revision
suggested by the Review Committee.

01 ~ $550,970 02 = $454,574 03 - $477,459

MISSISSIPPI REGIONAL MEDICAL PROGRAM

RM 00057 7/70.1 - Operational Supplement - Approval with specific conditions.

Project #2R - Approvai in the reduced amount for 18-months with the
conditions specified by the Review Committee and with
the understanding that this will represent the termination
of RMP funding of this activity.
~ 18 - cre
a . . : . . . Co, -.
“ . . . ~ +

SSISSIPPI REGIONAL MEDICAL PROGRAM (CONT)

 

Project #13 - Approval I

Project #14 ~ Non-approval ‘II with the recommendation thatthe Region
be requested to reconsider their program in‘the light
of the National guidelines for RMP participetion in
comprehensive kidney disease programs. Couricil further
recommended that the Region be afforded direct help by
the staff of RYPS in making their decision in this
_ regard and in planning a revision if such is to be proposed.

01 ~ $213,420 02 = $125,946. 03 = $39,455

MISSOURI RAGIONAL MEDICAL PROGRAM

 

RM 00009 7/70.1 and 7/70.2 - Operational Supplement - Approval with specific
cond:.tions.

Project #€0'— Non-approvai II
Project Fol - Non-approval II. Although the Council agreed with the
Review Committee that these two projects, as presented,
are unacceptable for Regional Medical Programs support,
they recalled the recommendations of the recent indepth
site visit to MoRMP and suggested that with staff nelp
from both RMPS and MoRMP these "outreach" projects
. could be developed into important components of the Program.

Project #62 ~ Approval I in a reduced amount and with the conditions
specified by the Review Committee.

Projéct #63 - Non~approval II - The Council recommends that this

. project be integrated into the Region's overall continuing
education effort in the preparation of the Region's
Anniversary Review application.

01 - $330,213. 02 - $36,984 . 03 - $39,165

MOUNTAIN STATES REGIONAL MEDICAL PROGRAM

 

RM 00032 7/70.1 - Operational Supplerent - Approval

 

Project #12 - Approval I
Project #13 - Approval I

01 - $184,976 02 - $191,117 —-:«03: - $197,804

NEW MEXICO. REG TONAL MEDICAL PROGRAM

 

 

RM 00034 1/10. 1- Operational Supplement - aa with specific conditions.

Project #13 ~ Non-approval. II
-19- ee ,

NEW MEXICO REGIONAL MEDICAL PROGRAM (CONT )

 

Project #14 - Approval I in the reduced amount and with the
conditions specified by the Review Committee.

. Project #1 - Approval I with the conditions specified by the
Review Committee. . i .

01 - $92,100 02 - $99,900 03 - $101,765

NEW YORK METROPOLITAN REGIONAL MEDICAL PROGRAM

" RM 00058 7/70.1 and 7/70.2 - Operational Supplements - Approval with
specific conditions. an .

Project #16 — Non-approval II with the recommendations for revision
suggested by the Review Committee and with the advice
that the Region defer further planning for RMP
participation in kidney disease services in the New
York Metropolitan area until they receive the National
policy guidelines which are in preparation.

Project #17 ~- Approval I. The Council based its recommendation on the
findings of the site visit team which had visited the
project on the advice of the Review Commit lee.

Project #18 - Non-approval I
Project #19 ~ Approval I

01 - $876,475 02 - $494,965 03 - $350,000

NORTH CAROLINA REGIONAL MEDICAL PROGRAM
RM 00006 7/70.1 - Operational Supplement - Approval with specific conditions.

Project #3R - Approval I
Project #26 ~ No Action Taken. Site visit required.

01. — $89,908 5 02 = $62,550 03 -— $42,306

NORTH DAKOTA REGIONAL MEDICAL PROGRAM
RM 00060 7/70.1 ~ Ooerational Supplement ~ Approval with specific conditions.

Project #5 - Approval I
Project #6 - Approval I. Although Council was in general agreement
with the Review Committee concerning the shortcomings of
this project, it was their opinion, based on first-hand
knowledge of the Institution and personnel involved in
’. the project and on their experience in site visiting this
~20-

e@ "NORTH DAKOTA REGIONAL MEDICAL, PROGRAM (CONT)

fa Region, that Lhe approval of this project is
' essential for further development of the North
‘Dakota Regional Medical Programs. In recommending
7 approval, Council strongly urged RMPS staff to work
i : with the Region and with personnel involved in this
: project to correct some of the deficiencies and get it.
off to a good start. a

‘Project #7 ~ Approval I for essentially the same reasons given above.
a . The Council believes that the implementation of this
po "project is essential to regional development and
- suggested that it be approved at $35,000 (dco) for one
year only with continued support contingent upon revision ~
of the project with staff assistance, and reapplication
. to the Council. Do

_ Project #8 - Non-approval I
Project #9 - Approval I

01 - $115,383 02 ~ $79,772 03 - $79,549

 

8 NORTHWEST CHIO REGIONAL MEDICAL PROGRAM

 

RM 00063 7/70.1 and 7/70.2 - Operational Supplements - Approval with
specific conditions.

Project #01-S - Non-approval I
Project #13 — Non-approval II with the recommendations for revision
———————— __ suggested by the Review Committee.
Project #14 - Approval with the conditions specified by the Review
———————~ Committee, for one year only.
Project #15 - Approval I. Although the Council recognized this as
—————_ another of the "Council for Continuing Education" projects
which have been submitted by the Ohio State Region
and action upon which has been deferred pending the
outcome of the initially funded one. The Council
accepted the advice of the site visitors that the
project is of critical importance to the Northwest Ohio
Regional Medical Program and probably has an excellent
chance of success under the leadership proposed.
Project #16 - to be incorporated with project #14.
Project FIT - Approval in the reduced amount and with the conditions
~~ specified by the Review Committee.

The Council further considered the findings of the site
. visit team regarding the Region as a whole; its
organization, administration, and plans. It is their
. recommendation that the Region be urged to seek stronger
leadership but the Council agreed that any specific re-
commendation regarding personnel would be inappropriate.
q

8 .

”

34

~ 21 - a oe

NORTHWEST OHIO REGIONAL MEDICAL PROGRAM (CONT) .

The value of an assessment visit as recommended by
the visitors was questioned since it would probably

_ do no more than re-identify the problem. Council

suggested that perhaps direct and frequent assistance
from RMP staff and consultants would be more helpful
than further investigations of the situation.

01 - $145,830 02 = $70,525 03. - $21,250

OHIO STATE REGIONAL MEDICAL PROGRAM

 

RM 00022 7/70.1 and 7/70.2 - Operational Renewal and Supplement - Approval
with specific conditions.

Project #1R ~

Project #8R -
Project #22 -

Project #24 -

ol - $714

Approval I at the reduced level and with the conditions |
specified by the Review Committee

Approval I in the reduced amount and with the conditions
specified by the Review Committee. ,

Approval I (This project was considered by the Council in
the previous review cycle and action was deferred at that
tine). Os a
‘Non~approval II with the recommendations for revision
suggested by the Review Committee.

075 "02 ~ $778,731 03 - $847,944

OHTO VALLEY REGIONAL MEDICAL PROGRAM

RM 00048 7/70.1 - Operational Supplement - Approval with specific conditions.

Project #12 - Approval I in the reduced amount recommended by the
expert technical reviewer.

Project #13 - Approval I. To be funded only if not furted by other
Federal resources.

Project #14 - Approval II

Project #15 - Approval I

Project #16 - Non-approval II with the recommendations for revision
as suggested by the Review Committee.

Project #17 - Non-approval II with the recommendations for revision
suggested by the Review Committee.

Project #18 - Non-approval I

01 - $273,546 02 - $296,215 03 - $327,657
-~ 22 -

a

 

e _ OREGON REGIONAL MEDICAL PROGRAM

RM_00012 7/70.1 - Operational Supplement ~ Approval
Project #12R ~ Approval I
Project #16 - Approval I

- 01 ~ $59,375 02 = $28,829 03 - $14,843

 

i
“PUERTO RICO REGIONAL MEDICAL PROGRAM
RM_00065 7/70.1 - Operational Supplement - Approval with specific conditions.
Project # 9 ~ Approval I inthe reduced amount and with the conditions
specified by the Review Conmittee.
Project #11 - Approval I with the conditions specified by, the
Review Committee.

-O1 - $320,936 02 = $227,436 03 - $233,636

SOUTH CAROLINA REGIONAL MEDICAL PROGRAM
8 : RM 00035 7/70.1 - Operational Supplement -— Non~approval.
Project #35 - Non-approval II with the recommendations for revision
suggested by the Review Committee.
Project #35 - No action taken. Site visit is indicated.
Project. #37 - Non-approval I
SUSQUEHANNA VALLEY REGIONAL MEDICAL PROGRAM

RM 00059 7/70.1 - Operational Supplement - Approval with specific conditions.

 

Project #20 - Non-approval I

Project #21 - Approval I in the reduced amount to reflect the newly
. adopted policy cn training project participants.

Project #22 ~- Non-approval I —

Project #23 - Non-approval I ,

Project Foy ~ ilon-approval II with the. recommendations for revision

suggested by the Review Conmittee.

Project #25 - Non-approval II. ‘The Council was in general agreement
with the Review Committee reg-rding the specifics of the
project but believe that further development of this
“project along with #24 is in the best interest of the
the Region and has requested that the RMPS staff offer
assistance to the Region in a regard.

$ Project 426 - Approval I
01 - $92,134 © 02 - $78,915 _ 03 - $83,294

e
/ . oa 2 “ ' , 7 23 --: . . . 4 .
" " MBYAS REGIONAL MZDICAL PROGRAM : eo —
RM 00007 7/70.1 - Operational Stipplement - Approval with specific conditions.

Project #8R - Approval I contingent upon the satisfaction of a
technical site visit team regarding four specific
points set forth by the Review Committee.

Project #14R - Approval I with conditions specified by the Review Committee.
Project #15R - Approval I , . a
Project #48 - Non-approval I .

Project #49 - Non-approval I

01 - $460,640 - 02 - $296 ,595 : 03 - $240, 386 .

TRI-STATE REGIONAL MEDICAL PROGRAM
_ RM 00062 7/70.1'- Operational Supplenent - Approval

Project #9 - Approvai I ina reduced amount and with the conditions
specified by the Review Committee.

@ 01 - $105,300 _ 02 - $85,600 - 03 - $63,000

VIRGINIA REGIONAL MEDICAL PROGRAM
RM 00049 7/70.1 - Operational Supplement — Approval with specific conditions.

Project #10 - Approval I with the conditions specified by the
Review Committee. In discussing this project the
Council wished to stress the importance of the condition
for approval of this project and urges great care on the
part of the staff in adjusting the second and third
year amounts of RMP support by utilizing patient revenues
to offset costs of the project. .

01 - $268,532 . 02 — $480 ,479* 03 - $533, 504* |

¥ To be negotiated downward

WESTERN NEW YORK REGIONAL MEDICAL. PROGRAM

RM 00013 7/70.1 - Overational Supplement - Approval with specific conditions.

Project_#15.- Approval IT in the reduced amount and with the conditions

. specified.

Project_#16 —- Approval I in the reduced amounts and with the conditions

ee) ° specified by the Review Committee. Council expressed its
willingness to allow the Region to increase the funding
 

ee

WESTERN NEW YORK REGIONAL MEDICAL PROGRAM 1 (CONT)

of this project to a maximum of $100,000, providing
such a level‘of funding would be required t2 maintain
this valuable regional resource.

Project #17 - Non-approval I

01 ~ $350,000 02 — $350,000 03 - $350,000

WESTERN PENNSYLVANIA REGIONAL MEDICAL PROGRAM

RM 00041 7/70.1 - Operationa Supplement - Approval

Project #9 - Approval I

01 ~ $43,911 | 02 - $44,820 - . 03 - $46,995

WISCONSIN REGIONAL MEDICAL PROGRAM

RM 00037 7/70.1 and 7/70.2 - Operational Supplenent - Approval with
specific conditions.

Project #13A (R) - Approval II
Pro; ect #18A — Approval I

Project #158 - Non~approval I
Project #18I - Non-approval I

 

Project #i8K ~ Non-approval I

Project #19 - Non-approval I. Council based this recommendation on

the findings of a collateral review of the project
by the staff of Maternal and Child Health Service, HSMHA,
which was requested at the suggestion of the Review Committee.

Project #20 - Approval I
Project #21 - Non-approval I
Project #22 - Approval I - .
Project 23 #23 — Approval I in the reduced amount and with the conditions

specified by the Review Committee.

01 - $292,815 " ~ 02 - $167,807. 03 - $172,395
XE, ADJOURNMENT
The meeting was adjourned at 11:30 a.m. on July 29, 1970

I hereby certify that, to the best of
_my knowledge, the foregoing minutes
are accurate and complete.

rf —~)-
Harold Margulies, i. .
Acting Director 4

Regional Medical Programs Service
- 26 -
POLI it rae 9.4 ‘DATOS

ag

@... the _ Panels to the Re me eview Conini ttee
~ “(On’Projects Only)

Technically sound and capably directed
Feasible under specificd conditions
Unapprovable on technical grounds

__ From the Review Committee to the National Advisory Council.
(On Projects) ;

Approval I - Additional furds recomended .

Approval IT - No additional funds recommended

Nori-approval I - . Inapprogriate for Dap funding
Non-approval IT - Revision required

" No ection taken -— Necd additional information
Need site visit
Need Council decision’

“(On Entire Applications)

Deferral.
_ Return for Revision

. Approval Se
a | Approval with specific ‘conditions
Disapproval ~ Inappropriate for DRMP funding

From the National Advisory Council to the Administrator
Or: Entire Appit cations)

 

Approval.
Approval with specific conditions

(As reconmended by the Review Conn ittec or others)
Deferral
Return for Revision .
Disapproval - Inappropriate for Die AP funding
-27-

NATIONAL ADVISORY COUNCIL Qu ST

 

ReGIONAL vic.

BRENNAN, Michael J., M.D. (72)

~ President, Michigan Cancer Foundation
4811 John R Street .
Detroit, Michigan 48201

 

Professor of -Medicine
Wayne State University
CANNON, Bland W.; M.D. (73)
910 Madison Avenue -
Memphis, Tennessee 38103

 

Division of Neurosurgery ©

University .of Tennessee College
of Medicine ,

CROSBY, Edwin L., M.D. (71)
Executive Vice President and Director
American Hospital Association
Chicago, Illinois 60611

DeBAKEY, Michael E., M.D. (72)
President and Chief Executive Officer
Baylor College of ‘Medicine

Houston, Texas 77025

- Professor and Chairman
Department of Surgery
College of Medicine —

EVERIST, Bruce W., M.D. (71)

Chief of Pediatrics "
Green Clinic ,
Ruston, Louisiana 71270

HUNT, William R., M.D. (71)
Board of Commi ssioners
County of Allegheny

101 Courthouse oe
Pittsburpn, Pennsylvania 15219

McPHEDRAN, Alexander M., M.D. (73)
Emory University Clinic
1265 Clifton Road, N.E
Atlanta, Georgia 30322

CHAIRMAN

- MILLIKAN, Clark H., M.D.

" POPMA, Alfred M., M.D.
‘Regional Director
. Mountain States RMP

“TREEN,

DECAL 1 Ci! ae one ee)

(72)
Consultant in Neurology

Mayo Clinic

Rochester, Minnesota 55902

OGDEN, Mr. C. Robert (70)

President and General Counsel
Nortn Coast Life Insurance Company
Spokane, Washington 99201

' PELLEGRINO, Edmund D., M.D. (70)

Vice President for the Health
Sciences and Director of the Center
State University of New York

- Stony Brook, New York 11790

(70)
525 West. Jefferson Street
Boise, Idaho 83702

ROTH, Russell B. » M.D. (73)

~ 240 West 41st Street |
Erie, Pennsylvania 16508

 

Vice Speaker of the House
of Delegates, AMA
SHANHOLTZ, Mack I., M.D. (70)
State Health Commissioner
State Department of Health
Richmond, Virginia 23219

Mr. Curtis (71)

Director, Pension and Insurance Dept.
United Ruober, Cork, Linoleum,

and Plastic Workers of America
Akron, Ohio 44308

WYCKOF®, Mrs. Florence R. (72)

. 243 Corralitos Road
- Watsonville, California 95076

Dr. Vernon E. Wilson
Administrator, Health Services and
Mental Health Administration

5600 Fishers Lane

Rockville, Maryland 20852
- 26 -

t.-

/ WRENDANCE A'T THE NATIONAL ADVISORY COUNCIL

+ July 28-29, 1970

RMPS STAFF ATTENDING

 

Miss Rhoda Abrams

Mr.
- Dr.
Mr.
Dr.
Mr.
Mr.
. Dr.
. Mr.
Mr.
Mr,

H. Earle Belue
Edward T. Blomquist
J. Edgar Caswell
Donald R. Chadwick
’ Cleveland R. Chambliss
Clyde Couchman
Sam Fox, III -
Edward Friedlander
Sam O. Gilmer © ”
Charles Hilsenroth

Miss Dona Houseal

My,
Dr.

Frank Ichniowski
Anthony Komaroff

Mrs. Lorraine Kyttle

Mr.

John M. Korn, Jr.

OTHERS ATTENDING .

Dr.

Maurice Bender, OS

€

Dr. J.H.U. Brown, NIGMS,NIH

Dr. John Cashman, CHS, HSMHA

Mr. James Dunlop, A.D. Little, Inc.
Miss Sylvia Kesinger, CHS, HSMHA
Dr. Richard Levinson, Veterans Administration

Mr. Wendall Maddrey, NCHSR&D, HSMHA

Mrs. Sylvia Paymer, NCI, NIH
Mr. Norman Tucker, BHPEMT, NIH
Dr. T. M. Valega, NIAMD, NIH
. Dr. William Zukel, NH&LI, NIH

‘

SEER

‘ Dr. Marion E. Leach |
’ Mr. Gregory Lewis

Mr. Ray Maddox

- Miss Elsa Nelson

Mr. Roland Peterson
Mrs. Martha L. Phillips

. Miss Leah Resnick
. Mr. Donald Riedesel

Mrs. Jessie Salazar

'Mrs. Sarah Silsbee
. Dr. Margaret Sloan

Mr. James Smith

Dan Spain

Lee Teets

Francis Van Hee, Jr.
Lee Van Winkle

. Frank Zizlavsky