« DEPARTMENT OF HEALTH, EDUCATION AND WELFARE Health Services and Mental Health Administration Regional Medical Programs Service National Advisory Council on Regional Medical Programs Minutes of the Meeting. August 3-4, 1971 ater Parklawn Building Conference Room G/H a —. . DEPARTMENT OF HEALTH, EDUCATION AND WELFARE PUBLIC HEALTH SERVICE National Advisory Council on Regional Medical Programs Minutes of the Twenty-fourth Meeting 1/ 2/ August 3-4, 1971 The National Advisory Council on Regional Medical Programs convened “for its twenty-fourth meeting at 8:50 a.m., Tuesday, August 3, 1971 in Conference Room G-H of the Parklam Building, Rockville, Maryland. Dr. Harold Margulies, Director, Regional Medical Programs Service presided over the meeting. . The Council Members present were: Dr. Bland W. Cannon - Mr. Sewall O. Milliken Dr. Michael E. DeBakey. . Dr. Alton Ochsner Dr. Bruce W. Everist Dr. Russell B. Roth Dr. William R. Hunt Dr. George E.Schreiner Dr. Anthony L. Komaroff Mrs. Florence R. Wyckoff Dr. Alexander M. McPhedran Dr. Benjamin W. Watkins Dr. John P. Merrill Mr. Edward Friedlander for Dr. Clark H. Milliken Dr. Musser A listing of RMP staff members, and others attending is appended. I. CALL TO ORDER AND OPENING REMARKS The meeting was called to order at 8:30 a.m. on August 3 by Dr. Harold Margulies. II. ‘INTRODUCTION OF NEV COUNCIL MEMBERS, COMMISSIONED OFFICERS, AND STAFF | Dr. Margulies introduced the following new members of the Council who were attending their first meeting: Dr. Anthony L. Komaroff, Dr. John P. Merrill,-Mr. Sewell O. Milliken, and Dr. Benjamin W. Watkins. Dr. Margulies noted that two new members of the Council, Mrs. Audrey M. Mars and Mr. C. Robert Ogden were unable to be present. om I/Proceedings of meetings are restricted unless cleared by the Office _ of .the Administrator, HSMHA. The restriction relates to all material submigted for discussion at the meetings, the supplemental material, ‘gil other official documents, including the agenda. anti d that roenhars absent themselves from the ~ “respective institurisons, or (bd) in which a conflict of interest might occur. This procedure does not, of course, apply to en bloc actions -- ij . , A ae iil. IV. 2. The following new Commissioned Officers and new RMPS staff members were then introduced: oO ‘Commissioned Officers Elvin E. Adams, M.D. Martin A. Greenfield, M.D. James I. Cleeman, N.D. Kenneth E. Joslyn, M.D. Paul E. Cohart, M.D. | Michael A. Newnan, M.D. Jeffrey B. Crandal, M.D. Daniel Nemzer Alan Kaplan, M.D. “Now Staff Members Charles Barnes Mrs. Glinter Johnson Richard Clanton Mrs. Nancy McGuire Mrs. Shirley Fairley Roger Miller John Farrell, M.D. Spero Moutsatsos Robert Handy, Ph.D. Jeffrey A. Passer Calvin Jackson Roland Williams ANNOUNCEMENTS Dr. Margulies made general announcements, and called attention to the statement on "conflicts of interest'' in the information folder. CONFIRMATION OF FUTURE MEETING DATES The Council reaffirmed the following dates for future meetings: November 9-10, 1971 February 8-9, 1972 Council then set the following subsequent meeting dates: May 9-10, 1972 August 15-16, 1972 CONSIDERATION OF ‘MINUTES OF THE MAY 11-12, 1978, MEETING The Council considered and “approved the minutes of the May 11-12, 1971 meeting with the following changes: 1. South Carolina Project #43, "A Regional Program for the Improved Therapeutic Management of Hypertension for South Carolina." The record should show that the renal disease panel recommended disapproval and that the Council concurred. 2. The addition to the minutes of a resolution concerning funds placed in reserve which was adopted in Executive Session at the 3 Council Meeting of February 3, 197] with a request that it be transmitted to the secretary. The full text of the resolution and the copies of the appropriate transmittal memorandum are appended as Attachment A. VI. REPORT By DR, MARGULTES A. Meeting with the secretary Dr. Margulies, several Council members , Coordinators, and others interested in Regional Medical Programs, met with the Secretary on May 24th. The meeting had the effect of correcting some prior misconceptions about RMP. The meeting served to identify all the Strengths which characterized Regional Medical Programs, During the meeting, strong support was elicited from the Secretary's professional staff, and the Secretary himself indicated that in the future RMP will be a key element in devel- oping mechanisms such as HMO's through which the Department will carry out ney initiatives, Hearing and Appropriations Both the Senate and the House have reported out marked increases in funds for Fiscal Year 1972. The House would add $30 million, and the Senate $70 million to the amount requested. In addition to this, $10 million supplementary appropriation for FY 197] increases the amount held in reserve for FY 1972, The marked increases plus the larger reserve indicate that greater amounts may possibly be available for grants in FY 1972, During recent Senate appropriation hearings, the Chairman expressed his determination that budget procedures would not block expenditure of a1] monies appropriated, . In response to questions concerning the possible use of Section 910, it was pointed out that Section 910 has not been implemented in the past because of restricted availability of funds. Use of this authority might have been misunderstood as a Signal that additional funds were available. I£ additional funds become available, however, RMPS will consider using the Section 910 authority. First consideration would be given to allocation of additional funds to Strong RMP's that have been hurt by cuts in the past. Area Health Education Centers The Congress is considering two proposals relating to Area Health -Education Centers. ‘The Administration's Bill which has passed 4 the House would place Area Health Education Centers in NIH. The other would place AHEC's in RMPS. The.Senate and House Bills are still in conference and it is still not certain whether Area Health Education Centers will go to NII or RMPS. The House Bill which makes NII responsible, requires that any Arca Health Education Center be developed in cooperation with a Regional Medical Program, so in any event, RMP will have extensive involvement.. In view of this RMPS has developed a very close working relationship with the Bureau of Health Manpower. The two organizations have been working well together, have a good understanding of what needs to be done, and will be able to cooperate effectively. Veteran's Administration has also exhibited a high level of interest in Area Health Education Centers. The VA in’ cooper- ation with RMP and NIH has mounted a series of site visits to. examine the potentialities for establishing Area Health Education Centers which would include an investment and involvement on the part of the VA. These visits have been conducted in areas having inadequate medical services, where good working relation- ships are already established with Regional Medical Programs. The VA has made it quite clear that RMP relationships would be very desirable, if not essential in all cases. Dr. Margulies asked Mr. Friedlander to comment on the VA's interest in AHEC's. Mr. Friedlander indicated that only those commmnities would be funded through VA where activities have a direct relationship to improved quality of care. VA funding would provide initial support which an Area Health Education Center would be expected to pick up once legislation has passed and funds have been appropriated. Equal Employment Opportunity Progress Report The Regional Medical Programs Service has developed a very strong Equal Employment Opportunity program. The Service has an EEO Council made up of RMPS employees which meets weekly. RMPS has established definite goals and targets for employment of minorities and women by January. 1972. RMPS expects similar EEO efforts to be undertaken by grantees and affiliates. Report on Orientation Sessions - August 2, 1971 An orientation session for new Council members was held on August 2, 1971. The staff discussed the general purposes, organizational structure and history of Regional Medical Programs. The kinds of matters that come before the Council 1 " were also discussed. The session was attended by Mrs. Wvckoff, sant pas Sopeet a bd Ob, if. At Mr. DilLibixen. . PM)!e 2 pe . . a4. IMO's - Progress Renort Regional Medical Programs throughout the country have developed an intense interest in Health Maintenance Organizations. RMP has been assigned tyo specific Tesponsibilities in relation to IMO's. These are (1) to set up guidelines for monitoring the quality of care and (2) to describe for monitoring or for guide- line purposes what is meant by "health maintenance." ‘These assigments are an outgrowth of increased awareness of the need for a more Satisfactory method of determining whether or not quality of care being provided and paid for with Federal or non-Federal funds js indeed adequate, Many units of the Federal government have been dealing with these and other issues relating to quality of care, RMpS is consequently working with other HSMMA units, NIH and Social Security to gain the benefit of their experience, In addition, RMP is setting up some meetings with coordinators and other individuals who are concerned with measuring and monitoring the quality of care. We will also be Calling on members of the Council to contribute their thinking and special Skills in relation to quality of care issues, Present Status of Section 907 ES OF pectin Section 907 of the Act requires that the Secretary annually publish a list of hospitals which possess the most advanced scientific techniques for dealing With heart disease, cancer, stroke, kidney and related diseases. Recent Congressional interest in Section 907 makes it highly undesirable not to proceed immediately with the preparation of the required list and RMP intends to do so. The list will not attempt to be all- inclusive or to include al] institutions where limited services are provided, but rather to list those institutions which demonstrate really superior and advanced performance. The list wil] be carefully selective aiy.Will be designed around criteria which have been derived £rom “Contracts to set up guidelines for cancer, heart disease and stroke, and some other information which has already been assemsxed in the Kidney Disease Program to identify institutions which would appropriately be included, The list will be compiled on the basis of a voluntary response to a survey of hospitals throughout the country. The list would identify those hos’ s5/> having characteristics associated with special quality, there would be no sense of accreditation oY regulation, nor‘: ‘a-sense of approval or disapproval be involved. The list Will constitute a Selection derived from CPCs comedic 7 cribowial tie TSS wid de atta Go ths Cee. Shee NL: £ ‘6 Secretary's decision, presumably be available to physicians and to the public in general and would provide information about where certain levels of medical care are available. There has been some question in the past as to whether the creation of such lists is a feasible endeavor, which has been one of the reasons for failing to proceed more rapidly with, this activity. General discussion followed, but no action was taken, VII. REMARKS BY MR. BENNY BOR HALL, DEPUTY ADMINISTRATOR, HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION Mr. Hall, representing Dr. Wilson who was unable to attend greeted the Council and read a prepared statement concerning the creation of a better health care system through the application of technolo- gical development to the health field. The discussion which followed indicated that the Council and the health field generally have long been aware of the potentialities of computer technology and fallout from the Aerospace program in the provision of health care. A number of Council members, however, strongly indicated that sub- 5 stantial additional funds would be needed to turn the interest into practical results. Mr. Hall also discussed impending changes in the organizetion of the HSMHA Administrator's Office and indicated the likelihood that in the near future a nusber of programs would be grouped under four eputy Administrators rather than reporting directly to Dr. Wilson. VIII. SPECIAL REPORTS A. RMPS Reorganization Dr. Pahl briefly outlined the current status of reorganization within the Regional Medical Programs Service. The reorganization is currently underway and it will probably be early September before all branches are able to get together and interact appropriately. — The reorganization will restructure the way jin which RPS inter- acts with the individual Regional Medical Programs. Four operational branches have been established on a geographical basis. These, together with the Grants Management and Grants Review Branches constitute the new Division of Operations headed “em by Mr. Robert Chambliss. Four Operations Branches have been set Jee + + up on a geographic. basis. Teans of professional and supporting Say 7 Wioywdfiied fer coch of thoue, and eatitions a co may aen “a, : staff heve been i aye POE A mh 7 individuals in ot:+° uivisions and offices, such as Planning and Evaluation anu erofessional and Technical Development have been identified to serve as joint appointees with the Operations Branches. Review | Criteria Dr. Pahl and Mr. Peterson discussed the new RMPS review criteria and rating system. The review criteria and rating system were developed by staff and employed for the {st time by the RMPS Revicw Committee as its July 1971 weeting. The criteria were derived from the RMPS “Mission Statement.'! Each criterion was weighted, and a 1 through 5 scoring system was employed for each. Reviewers were asked to circle the score for any criterion about which they were uncertain. In addition, the rating sheets included a place for each reviewer to indicate the basis for his evaluation. The reviewers appeared to feel comfortable with the overall process in which they had engaged. Members of the Review Com- mittee felt that the 17 criteria were comprehensive and that the sub-criteria raised in the form of questions were, in fact, useful in helping them to channel their thoughts. Some modi - fications and improvements were suggested, however. As a result of this initial experience, plans'are underway to rearrange and clarify a number of the criteria and to provide more adequate information about certain items with a view to increasing the reviewers confidence in their ratings. In general the initial trial indicates that the criteria and “ rating system are both workable and satisfactory. Council, Review Comnittce and Staff Responsibilities for Grants Dr. Margulies-read to the Council the material under VIII, C. in the Agenda Book entitled "Review Responsibilities Under the Triennial Review System." It was moved by Dr. Millikan and seconded by Dr. Roth that this statement be formally adopted. The motion was approved unanimously. The full text of the state- . ment is appended as Attachment B. ‘Watts-Willowbrook Dr. Margulies introduced Dr. Alfred M. Haynes, Chairman, Department of Community Medicine and Assistant Dean for Community Health Affairs, Charles R. Drew Postgraduate Medical School, Los Angeles, California. 8 Dr. Haynes narrated a slide presentation on the Watts-Willow- brook project which invelyes the concerted efforts of the Martin Luther King, Jr. Memorial Hospital and the new Charles R. Drew Postgraduate Medical School as well as other com- munity agencies. These organizations have combined in a concerted effort to establish a heaith service center in the Watts area to provide quality care to the residents. ‘The project is organized in such a manner that service to the commmity is regarded as equally, and perhaps more important, than educational and research activities. Status of RMPS Regulations Mr. Kenneth baun summarized the status of efforts to revise RMP policies and Regulations. The HEX General Counsel's Office has advised RMPS to completely rewrite the Program's Regulations to reflect the most recent changes in the Statute es well as new operational procedures. The General Counsel's Office is developing an jnitial draft of such Regulations in cooperation with RMPS. Considerable progress has also been made in developing a loose leaf policy manual for the use of grantees, affiliates and RMPS staff. Departmental, HSMHA and RMP policies have been assembled for inclusion, however, considerable editorial work still remains to be done. Comuter Assisted EKG Analysis Dr. John Farrell and Dr. Kenneth Gimble discussed a draft report .« on the subject of computer assisted EKG analysis that was prepared at the request of the Council. Technologically fully operational EKG analysis requiring no further reading by a physician has not been achieved. Development of a fully auomated system of that level of sophistication is problematical. Computers have been accurately and reliably used for screening normal and abnormal EKG's with less than 1 percent error. ~ The cost of automated IXG's is estimated at $2 to $4 per cardio- gram exclusive of the cost of rereading by a cardiologist and assuming a mininwna annual volume of input. Basic conclusions reached from the study were: (1) that computer assisted EKG analysis an effective and reliable screening technique: (2) that: definitive diagnosis must be done by a eeriled co lehp fap ue ca ena eon npc} tig fhig wars of w caruiulug.se, <2 tenoe Gu “he presele state of wc alt, it cannot replace hin. IX. EXECULIVE SESSION During the Executive Session there was a discussion of the status of efforts to consolidate three Ohio MP's. In view of progress that has been made it was proposed to permit these Regions to apply in February. It was also proposed that Council and other appropriate staff work with the Interim Committee and the Fiscal Agent. It was moved by Dr. Millikan and seconded by Dr. Komaroff that the Council go on record as supporting this initial plan including the proviso that NPS begin to work directly with Ohio RMP's on a staff basis. The motion was adopted unanimously. Other items discussed during the Executive Session included (1) the status of the Albany, Rochester and Central. New York RMP's; (2) the status of the Susquehanna Valley RMP; and (3) the possible separation of Delaware fron the Greater Delaware Valley RMP. No action was taken on these matters. 7 REVIEW OF APPLICATIONS A, Hawaii Regional Medical Program Motion made by Dr. Millikan - Seconded by Dr. Ochsner "Approval of the Hawaii application for one year funding at $1,072,000 plus an additional $50,000 with the strong recom- mendation that money be utilized for support of activities in the Trust region and with the additional advice as specified on page 1 of the Committee's report." (Transcript, page 20, line 20) The motion was unanimously approved. B. Northern New England Regional: Medical Program Motion made by Dr. Millikan - Seconded by Dr. Schreiner © Approve the recommendations of the Review Committee, including recording the six items of their critique, with these items to be kept strongly in mind when the triennial application is ultimately reviewed, and with advice that through strong admin- istrative leadership some of the real concepts of RMP should be included in the program. (Transcript, page 26, line. 3) The motion was unanimously approved after further discussion which suggested that the Region might profitably examine goals and objectives developed by other RMP's and develop a plan for. use of collected data. 10 Texas Regional Medical Program * Motion made by Dr. Everist - Seconded by Mr. Friedlander "Approval for two years at a funding level of $1,590,000 including the developmental fumding.'' (Transcript, page 29, line 25) The motion was unanimously approved. Virginia Regional Medical Program Motion made by Dr. DeBakey - Seconded by Dr. Everist , Concurrence with the Committee's recommendation with the proviso that if the site visit should indicate a need for additional funds, the request will be brought back before the Council, (Transcript, page 36, line 5) The motion was unanimously approved. In subsequent. discussion, it was agreed that there would be appropriate representation from staff and the Kidney Disease Panel on the site visit. Bi-State Regional Medical Program Motion made by Dr. Ochsner - Seconded by Dr. DeBakey Concur with what the Review Committee recommended, that there be an additional year instead of the three years requested, and that this be in the amount of $924,113, and further con- currence with the Committee's disapproval of the developmental component and the other funding relative to the project. (Transcript, page 37, line 16) | i The motion was unanimously approved. Georgia Regional-Medical Program fed o 2 Motion made by Dr. Cannon - Seconded by Dr. Millikan Approval in the amount of $2.9 million for each of the first two years and $1.9 million plus the requested amount for project 39 for the third year, the exact amount to be determined by staff on the basis of the intent of Council. In addition, the Council concurs in the recommendations of the site visitors with respect to the non-funding of specifically identified projects with the exception of kidney and the Stephens County ‘topes B23, line 72) : project. (Trevor The motion was unanimously approved. H. il Albany Regional ‘Médical Program Motion made by Nrs. Wyckoff - Seconded by Mr. Friedlander "Approval of the Review Committee's Recom rendation that this project be funded for only one year more for $900,000." (Transcript, page 57, line 14) The motion was unanimously approved. Central New York Regional Medical Prosram Motion made by Mr. Friedlander - Seconded by Dr. Cannon Approval for one year funding, contingent on a staff follow- up visit six months following the award of this-application to evaluate the progress that's been made in meeting the conditions. (Transcript, page 61, line 13) The motion was unanimously approved. Rochester Regional Medical Program Motion made by Dr. Mc Phedran - Seconded by Mr. Milliken Approval of the Review Conmittee's recommendation of $800,000 and deferral of any action until the next Council,meeting on the kidney project. (Transcript page 63, line 24 and page 68, line 15) . The motion was unanimously approved. Memphis Regional Medical Progran* fotion made by Mrs. Wyckof£ - Seconded by Mr. Milliken Approval of the Review Comittee recommendation for a funding level $1,627,000 for each of three years, or a total of $4,950,000 plus approval of suggestions in the blue sheet with deletion of the reference to Medical Association dues for project 39. (Transcript, page 76, line 7, and page 87, line 20) The motion was unanimously approved. Michigan Regional Medical Program Motion made by Dr. Mc Phedran ~ Seconded by Dr. Komaroff sect fF woe. .. funding jor tie fourth, firth and sixth years for each year, L. M. N. BY) including the requested developmental component. (Transcript, page 104, line 16 and page 105, line 8) The motion was unanimously approved. Motion made by Dr. Roth - Seconded by Dr. Mc Phedran Approval. as recomnended by..the Review Committee. (Transcript, page 106, line 13) The motion was unanimously approved. Maine Regional Medical Program Motion made by Dr. Hunt - “Seconded by Dr. Komaroff "Accept the requested levels for the three years and bring the Maine application before the Council again prior to funding the 05 year for Council reconsideration." (Transcript, page lll, line 14) The motion was unanimously approved. Metropolitan D.C. Regional Medical Program Motion made by Dr. Hunt - Seconded by Dr.. Ochsner Defer action on the application. Hold a site visit attended by the Ad Hoc Renal Disease Panel, and also include attendance by the Chief of Medicine, the. Chief Surgeon and the Chief Nephrologist of each of the applicant institutions. (Transcript, - page 128, line 7) The motion was unanimously approved. New Mexico Regional Medical Program Motion made by Dr. Schreiner - Seconded by Mrs. Wyckoff Approval for $850,000 for one year as recommended by the Review Committee with an additional $40,000. The additional funds are not earmarked and may be used for kidney or for other purposes at the discretion of the Region. (Transcript, page 134, line 12, and page 139, line -1) oo oe : . / : Tha Motion wee pune Temes dy avevercrnsd 13 P, Tri-State Regional Médical Program Motion made by Dr. Roth - Seconded by Dr. Cannon "Approval of funding at the rate proposed on page 5 of the - revised application." (Transcript, page 140, line 6) The motion was unanimously approved subsequent to some further discussion which indicated. that progress on this project might provide some examples that could be used in Metropolitan D.C. ~ - , Motion made by Dr. Cannon - Seconded by Dr. Roth Disapproval. (Transcript, page 144, line 17) The motion was unanimously approved. R. California Regional Medical Program** Motion made by Dr. Millikan - Seconded by Dr. Komaroff “Level finding for three years at $10,043,175 with exact amounts to be determined on the basis of negotiation by staff during that period, and for the sum to include the kidney project." (Transcript, page 16, line 17) The motion was unanimously approved. X. ADJOURNMENT The meeting was adjourned by Dr. Pahl at 1:20 p.m. on August 44, 1971. I hereby certify that, to the best of my knowledge, the foregoing minutes = and attachments are accurate and complete. f ly re A Iusre wing y Harold Margulies, MP Director Regional Medical Programs Service ate Weide: HOS dee piveent Guilng Consideration of this application. ‘“Mrs. Wyckoff was not present during consideration of this application. ATTACHMENT A Page April 26, 1971 cory Resolution from the National Advisory Council on Regional Medical Programs Service Roger O. Egeberg, M.D. Assistant Secretary for Health and Scientific Affairs Attached is a memo from the National Advisory Council for Regional Medical Programs which expresses their deep concern. It was issued without their having had a detailed chance to look at the report by the group of consultants. I would hope that we would have a chance to discuss this in the very near future. /s/ Vernon E. Wilson, M.D.. Administrator cc: Herbert B. Pahl, Ph.D. Harold Margulies, M.D. ’ SUBJECT: WHEREAS ¢ WHEREAS: "WHEREAS : RESOLUTION . . . ue URAVATLABILITY OF THOSE PROGRAM MONIES WHICH WERE APPROPRIATED BY THE CONGRESS FOR FISCAL YEAR 1971. AND WHICH SUBSEQUENTLY NAVE BEEN PLACED IN RESERVE - REQUESTS RECONSIDERATION. - The Regiona) Medical Programs Service was created and exists. for the puxposes of (1) improving for all citizens access to and utilizatic~ of their local health care systems, and (2) improving .the quality and effectiveness of the health services ‘provided within regions, particularly with regard to cancer, stroke and diseases of the heart and kidney, and the Regional Medical Programs Service during the five years of Sts existence has established viable, local organizational networks among the major health care providers, and improved ‘the number and quality of the linkages which now exist- between these providers and the consumers who. comprise the several repions; and For these dissase categories the Regional Nedical Programs Service was established to be a primary, functional arm of -the Department of Health, Iducation, and Welfare whereby the’ | RESOLVED: potential benefits which result from the nation's support of the biomedical research enterprise at the National Institutes of Health cen be realized from practical applications within communities; therefore be it - > m That the National Advisory Council for Regional Medical Programs wishes to express to the Administrator; Health Services and Mental Health Administration, and to the Assistant Secretary for Health and Scientific Affairs its deep concern that the unavailability of those program monies which were appropriated by the Congress for fiscal year 1971 and which subsequently have ‘been placed in reserve will result in serious curtailment in the momentum of the ovcrall program in meeting its objeclives and, therefore, requests reconsideration of this matter in terms of the Administrator's expressed national priorities for improving the health services and delivery system of the country, and be it further eo That as new systems for the delivery of health services to communities are devised and instituted, the Council respectfully submits that the Regional Medical Programs Service is the most expedient instrument to access tmprovements in the costity af cave Gyovided it boos. ayctel a by vivib Gf Glee ups. boo 4 to be the principal program which interrelates ali of the providers of health care within communities; and be it further RESOLVED: : 7 Ss Page 3 . € . ~2- . . That. in support of this request the Council assures the Administrator and the Assistant Secretary that specific effort “will be made Jmmediately and on a’ continuing basis to reinforce the liaison and collaborative efforts between the Regional Medical Programs Service and other Health Service and Mental Health Administration programs @s well as all relevant Institutes and program clements .of the Nationa] Institutes of Health in order that no opportunity be overlooked for bringing to the regions with the greatest possible speed those medical research advances which can form the basis for improving access to and “the overall quality of the health care available to the people of these regions. —_ In so doing the Council announces its intent to establish immediately for the Regional Medical Programs Service a set of sharpened prograéia priorities as determined. in consultation with Health Services and Mental Health Administration, the Nationel Institutes of Health and other leaders in the field of health. noe ATTACHMENT bs Page 1 Under the tricanial review syster, each Perional. Medical Program normally will be reviewed by the Maticnal Advisory Council only once cach three years. ‘The triennial review serves to recognize the Region as an “accredited” organization and to set a general Jevel of annual support for the three year peried, Thus, the, Council's favorable recovmendation constitutes a tine~limited approval for an THP as an organization having recopnized capabili- ties, rather than being approval for ¢ specific set of activities. In addition to recommending the general level of support, Council actions on individual applications may include advice to the appli- cant Regional Medical Program, or specific conditions for the grant. Prior to review by the Council, each triennial application will be reviewed by zssigned KiPS staff, 3 site visit team and the NPS Review Committee. , nn oO "Except as specified belov, the Director, RHPS, will make continu- ation avards, including support for new activities, for second and third (02 and 03) year support without further Council action insofar as the proposed activities are consistcut with relevant policies. The Council will be provided with a suriary of such awards. Specifi- cally, the Council's advice will be sought when: 1. Supplementary funds are requested in addition to the general. support recommended for the year in question. 2. Anew or increased Developmental Component is requested. 3. The Council, the Director, RMPS, or the Region requests Council review. 4, The applicant-has failed in a material respect to meet the reauirenents of the Program or applicable lavs, regulations or formally promulgated policies of the Department, HSSHA . or RPS. , The sumamary to be provided to the Council will include the folloving information concerning each Regior reviewed by staff, for continuation support: . ~. -1. The amount previously reecmmended by the Council for funding, and the amount avarded, . 2. A list of activities supported during the most recent grant year, identifying those which have been completed and those which have been supported through a developmental component. ; ATTACHMENT 5 . . Page 2 oe A summary of the RKepion's response to any advice specified by the Council or limitations upon or conditions of the award. A summary of any outstanding accomplishnents. A summary of any outstancing problems. Annual reports from the Regional Advisory Croup and from KRMPS staff. (Shese will be wade available on request by the Council. ): Approved + National Advisory Council an Regional Medical Programs August 3, 1971 WIA Oy, -ATTENDA! APPENDIX Fage 1 LIst National Advisory Council on Regional Medical Programs Auge Bah, COUNCIL EM ERS Bland W. Cannon Michae Bruce W. Everist William R. Anthony L. Komar rofe Alexander M. McPhedran John P. Merrill Clark H. Millikan Dr. Dr. Dr. Dre Dr. Dr. Dr. Dr. “RMPS STAFF Dr. Elvin Adams .Mr, Kenneth Baum Mr. Cleveland Chambilss Mr. Richard Clanton Dr. James Cleenan Dr. Paul Coha Myre Spencer Colburn Dr. Jef££ Crandal Mrs. Shirley Fairley De. John Farrell Mr. Gerald Gardell Mr. Terrence Genz Mr. Sanuel Gilmer Dr. Kenneth Ginbel Dr. Martin Greenfield Mrs. Eva Haandal Dy. Robert Handy Mrs. Gloria Hicks Dr. Edward Hinman Mr. Calvin Jackson” Mr. Joseph Jewell — Mrs. Glinter Johnson ~ Mr. Milton Jordan Dr. Kenneth Joslyn ~ Dr. Alan Kaplan Dr. Philip Kliesger Mrs. Lorraine Kyttle Miss Carol. Larson Dr. Marian Leach Dr. Harold Margulies. Dr. Gordon MacLeod 1971 Mr. Sewall O. Milliken | Dr. Alton Ochsner Dr. Russell B. Roth Dr. George £. Schreiner Mrs. Florence R. Wyckoff Dr. Benjauin W. Watkins Mr. Edvard Friedlander Dr. Harold Margulies Mr. Roger Miller Miss Ma x jorie Morrill ‘Mr. Spero Moutsatsos Miss Nary Murphy Mr. frank Nash Miss Elsa Nelson Mr. Daniel Nemzer Dr. Michasl Newman Dr. Herbert Pahl Mr. Roland Peterson Mr. Bugene Piatek Mr. Michael Posta Mr. Lawrence Pullen Miss Leah Resnick Mr. Morton Robins Mr. Richard Russell Mrs, Jessie Salazar Mr. Luther Says Miss Theresa Scheen Mrs Patricia Schoeni Mr. Thomas Simonds Mrs. Judy Silsbee Mr. Matthew Spear Mr. Sidney Stein Mr. Jerone Stolov Mr. Willian Torbert Mr. Lee Van Winkle Mr. Lyman Van Nostrand Mrs Margaret Welsh Mr. Richard White Mr, Roland Williams RMPS REGLONAL OFFICE REPRESENTATIVES | cece arene ap ae eae Tee Mr. William Mc Kenna, Region I Mr. Robert Shaw, Region IL Mr. Clyde Couchman, Region ITk Mr. Theoda Griffith, Region IV OTHER Dr. Margaret Edwards, NCI Mr. Peter Fox, OMS My. Howard Hilton, NHSC Mrs. Frances Howard NIM AVELAULA Page 2 Mr, Maurice Ryan, Region V Mr, Dale Robertson, Region VI Mr. Daniel Webster, Region VIII Mre Ronald Currie, Region IX Mr. David Lovenvirth, Consultant Miss Bettye Mobley, HSMHA Mr. Carl Taylor, OMB NATIONAL ADVISORY COUNCIL ON REGIONAL MEDICAL PROGRAMS Octeber 20, 1971 BRENNAN, Michael J., M.D. (72) President, Michigan Gancer Foundation 4811 John R Street Detroit, Michigan 48201 CANNON, Bland W., M.D. (73) _ 910 Madison Avenue Memphis, Tennessee 38103 CROSBY, Edwin L., M.D. (71) Executive President American Hospital Association Chicago, Illinois 60611 DeBAKEY, Michael E., M.D. (72) President and Chief Executive Officer Baylor College of Medicine Houston, Texas 77025 EVERIST, Bruce W., M.D. (71) Chief of Pediatrics Green Clinic Ruston, Louisiana 71270 HINES, Mr. Harold H., Jr. (74) Senior Vice President Marsh & McLennan, Inc. 231 South LaSaile Chicago, Illinois 60604 HUNT, William R., M.D. . Commissioner “ County of Allegheny n 101 Courthouse os Pittsburgh, Pennsylvania 15219 7), KOMAROFF, Anthony L., M.D. (72) Beth Israel Hospital _ Boston, Massachusetts 02215 MARS, Mrs. Audrey M. (71) Marland The Plains, Virginia 22171 McPHEDRAN, Alexander M., M.D. -(73) Emory University Clinic 1365 Clifton Road, N.E. Atlanta, Georgia 30322 MERRILL, John P., M.D. -(74) Professor of Medicine Harvard Medical School Cambridge, Massachusetts 02115 MILLIKAN, Clark H., M.D. (72) Consultant in Neurology Mayo Clinic , Rochester, Minnesota 55902 MILLIKEN, Mr. Sewall 0. (73) Chief, Office of Comprehensive Health Planning Ohio Department of Health 450 East Town Street Columbus, Ohio 43216 OCHSNER, Alton, M.D. (73) Ochsner Clinic 1514 Jefferson lighway New Orleans, Louisiana 70121° OGDEN, Mr. C. Robert (74) President and General Counsel North Coast Life Insurance Company 1120 Paulsen Building Spokane, Washington 99201 ROTH, Russell B., M.D. (73) 240 West 41st Street Erie, Pennsylvania 16508 os ~2- SCHREINER, George E., is... (74) Director, Division of Nephrology Georgetown University School of Medicine Washington, D, C, 20007 WATKINS, Benjamin W., D.P.M. (73) 470 Lenox Avenue New York, New York 10037 WYCKOFF, Mrs. Florenci::- <2) 243 Corralitos Road Watsonville, California 95076 EX OFFICIO MEMBER MUSSER, Marc J., M.D. Chief Medical Officer Veterans Administration Washington, D, C. 20420 CHATRMAN “Mernon E. Wilson, M.D. Administrator Health Services and Mental Health Administration 5600 Fishers Lane Rockville, Maryland 20852 National Advisory Council on Regional Medical Programs