DEPARTMENT O F HEALTH, EDUCATION

AND WELFARE

Health Services and Mental Health Administration

Division of Regional Medical Programs

National Advisory Council on
Regional Medical Programs

Minutes. of the Meeting
-May 11-12, 1971

Parklawn Building
Conference Room G/H
Il.

uy

2/

DEPARTMENT OF HEALTIi, EDUCATION AND WELFARE
PUBLIC HEALTH SERVICE

National Advisory Council on Regional Medical Programs

Minutes of the Twenty-third Meeting 1/ 2/
May ll~12, 1971

The National Advisory Council on Regional Medical Programs convened
for its twenty-third meeting at 8:30 a.m., Tuesday, May ll, 1971, in
Conference Room G/li of the Parklawn Building, Rockville, Maryland.
Dr. Harold Margulies, Director, Regional Medical Programs Service,
presided over the meeting.

The Council members present were:

Dr. Michael J. Brennan Dr. Clark H. Millikan

Dr. Bland W. Cannon (5/11 only) Dr. Alton Uchsner

Dr. Michael £. DeBakey Dr. Russell 5. Roth (5/12 only)
Dr. Bruce W. Everist Dr. George &. Schreiner

Mr. tiarold H. Ilines, Jr. Mrs. Florence R. Wyckoff

Dr. Alexander M. McPhedran Dr. John D. Chase/for Dr. Musser

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

CALL TO ORDER AND OPENING REMARKS

The meeting was called to order at 8:45 a.m. on May 11 by Dr. itiarold
Margulies.

IWIRODUCTION OF NEW COUNCIL MEMBER

Dr. Margulies introduced Dr. George E. Schreiner, Professor of Medicine
and Director, Division of Nephrology, Georgetown University, Washington,
D. CC. tre also introduced Dr. John P. Chase representing br. Musser of
the Velerans Administration.

ANKOUSCEMENTS

Dr. Margulies made general announcements, and called attention to tue
statenent on ‘Conflict of Interest, ' in the information felder.

Proceedings of meetings are restricted unless cleared by the Uftice of
the Administrator, tiSMHA. 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 might
occur. This procedure does not, of course, apply to en bloc actions --
only when the application is under individual discussion.
IV.

VI.

CONFIRMATION OF FUTURE MEETING DATES
The Council reaffirmed the following dates for future meetings:

August 3-4, 1971
November 9-10, 1971
February 8-9, 1972
May 9-10, 1972

CONSIDERATION OF MINUTES OF THE FEBRUARY 2-3, 1971, MEETING

The Council considered and approved the minutes of the February 2-3,
1971, meeting as written with one addition:

“Council discussed the need for assurance of quality in health care
services and agreed to concern itself with problems of health care
quality control."

REPORT BY DR. MARGULIES

 

A. Appropriations

The Administration's 1972 appropriations request would hold RMP grant
funds at $70 million (the fiscal year 1971 apportionment) through fiscal
year 1972. In the House hearings the decision to maintain this level
was questioned closely. No House mark-up has been announced and the
Senate Committee will not hear testimony on the bill until September.

B. Health Insurance

Interest in Health Insurance remains high on all sides. The number
of bills before the Congress on this subject continues to grow, but
as yet there seems to be no clear trend toward the support of any
one proposal.

Cc. Area Health Education Centers

The concept of Area Health Education Centers, greatly stimulated by

the Carnegie Foundation report, is now embodied in gwo bills before

the Congress. One plans administrative responsibility for Area.

Health Education Centers in the Regional Medical Program, the other
would result in assignment of responsibility to the National Institutes
of Health.

The Area Health Education Center is as yet not fully defined, probably
will be a community-based, grant-eligible agency, built around health
care institutions and practitioners, affiliated with health educational
and training institutions, including a university health science center.
The AHEC would be a natural and important concern of the Regional
-3-

Medical Program. In turn the Regional Medical Program will under
any circumstances be associated with the center, because of their
common interest in enhancement of health care services.

D. Health Maintenance Organizations

RMPS is cooperating closely with other HiW efforts to develop Health
Maintenance Organizations. There has been established a national
clearinghouse in hS™MHA to keep recoris and oversee all iMO activitics,
but the basic responsibility for their development is in the likw
Regional Offices. RMPs will be especially useful in the early phases
by assisting in the convening of those who must meet together and by
obtaining for them necessary consultation and other required supporting
material, They will be of value later in the establishment of an
effective health care system particularly by assisting in HMO efforts
to monitor the quality of care being provided. RMPS has the specific
responsibility for developing guidelines and criteria for the monitor-
ing of quality and for developing a concept and guidelines for health
maintenance.

—. Physicians’ Assistants

 

 

The Civil Service Commission has established erades for Physician's
Assistants, most of whom will be employed by the Veterans Administration.
The Director of RMPS serves as a member of an executive committee
advising the Commission of the qualifications to be established for
the grades GS 7, 9, and ll. RMPS continues to have with NCHSR&D a
keen interest in Physician's Assistants development and will partici-
pate in the further definition of PAs, their functions, their legal
status and their limitations.

F. Recent Developments in the Regional Medical Programs Service

 

1. An expanded focal point for services to Council and Review
Committee is being developed. The charter of this Office of
Council and Committee Affairs will be circulated when the reorgani-

zation plan is completed.

 

2. The Operations Division is developing four geographically
organized "desks." Each of these will provide a spectrum of
services for a designed group of Regional Medical Prowrans.
Each will be served by designated liaison personnel cf the

Professional and Technical Division.

3. Since the last Council meeting, the qual Employment
Opportunity program in RMPS has been developing rapidly. Not
only because it is an agency of government, but also because
its mission is to the whole citizenry, RMPS cannot serve
Regional Medical Programs effectively if it in any way dis-
Vil.

criminates against minorities or women. Not only in RMPS but

in all the RMPs, both Equal Employment. Opportunity and minority
group access to health care are major concerns. Evidence of
adherence to these concepts will be sought in all program reviews.

REPORT OF THE SUBCOMMITTEE ON AUTOMATED HEALTH TESTING

 

Dr. Michael Brennan, Chairman of the Council's Subcommittee on
Automation, reported the following as the Committee's considerations
and recommendations concerning automated multiphasic health testing
as an RMP investment:

A. “At this time eleven Regional Medical Programs have funded pro-
jects that feature automated multiphasic health testing. The pur-
poses of these projects present a fair representation of the purposes
for which patient health status data are required.

B. “Automated Health Testing is very costly. The influence of the
projects in which it appears on regional deployment and utilization
of health care services is highly unpredictable. For these reasons
Council recommends that no new projects featuring automated health
testing be funded.

 

C. "The Council further recommends that the Director, RMPS, and

the appropriate Regional Medical Program, coordinating with the
National Center for Health Services Research and Development,

Community Health Services, the National Center for Health Statistics,
the National Institute of General Medical Sciences and other interested
agencies, institute consultation and investigation to:

1. Provide market and financial analyses and advice to avoid
loss in post-grant operations of projects currently funded by
Regional Medical Programs;

2. Build into RMP and other projects base line data, defined
goals and measures of progress for cohorts of persons whose
initial multiphasic tests were positive, negative and refused,
among such populations as urban and rural poor, employees’
groups, hospital and clinic patients, to help resolve jebate
about the effects of multiphasic testing on quality of and
access to health care services and the regional deployment and
utilization of health care resources;

3. Utilize systems analysis and all available epidemiologic
information to stimulate natural histories of diseases and
identify those for which secondary prevention might be feasible
and acceptable in cost; and
VIIL.

~5-

4. Conduct multi-variant analyses of the results of multi-
phasic testing to investigate the possibility that it could
improve diagnostic application of the tests."

COUNCIL ACTION: The Council unanimously adopted the above recommen~

dations of the Subcommittee on Automated Multiphasic Health Testing.

In this regard, please note that the recommendation in Section 5

establishes a new policy for Regional Medical Programs Service.
ADMINISTRATION OF REGIONAL MEDICAL PROGRAM GRANTS

Dr. Margulies reported briefly on a limited test by which our site
visitors or Review Committee have ranked Regional Medical Programs
in terms of their overall effectiveness. This type of activity
will become increasingly necessary if changes in levels of avail-
able prant funds are to be accommodated in a selective fashion
rather than across-the-board additions or reductions for all
programs.

A. The Professional Judgment Comparison

 

To date, very broadly conceived criteria of effectiveness have

been employed in the review of our grants. At the last meeting

of the Review Committee the programs of fifteen Regional Medical
Programs were considered, After the formal actions were completed,
the members of the Review Committee agreed to try informally to
rank those programs for overall effectiveness. The procedure con-
sisted simply of distributing the fifteen Regional Medical Programs
into "quartile" groups; the results were highly consistent. There
were several instances of identical quartile assignments, and in
almost all cases the differences in assignments were not more than
one quartile apart. This informal, no-record exercise was conducted
as an extension of the entire review process and appeared to be
workable.

B. The Grading Comparison

 

Another approach to comparison of Regional Medical Program effective-
ness can be made by grading or scoring the performance cf each on an
absolute scale. This approach has not been given a full trial.
Earlier this year numerical grading was used in a limited way on
several site visits to Regional Medical Programs. The results

of these trials have shown less consistency among the graders than
did the Review Committee's comparison of the fifteen regions.

C. Effects of Ranking Regions

 

In the long run, administrative actions and advisory group recommen-
dations which result from such determinations of relative merit pri-
marily will affect the least and most effective Regional Medical
Programs.
IX,

THE ADMINISTRATOR'S SESSION

Dr. Vernon E. Wilson, Administrator, HSMHA, discussed with the
Council events and trends that have implications for the future.

A. Consumer interest in quality determination

It is not unlikely that the basis of advisory council actions as
well as the actions themselves will become public records. In-
creasing consumer group interest in program processes reduces the
latitude for unsupported judgment. This Council seriously should
consider development of a rating system as a basis for its decisions
on grants. The interest of career consumer advocates in this field
is rooted in a widely held opinion that professional judgments
should be openly determined and intelligible to the lay mind.

There is need for a system that the consumer advocates can under-
stand and apply to reach the same results as does the Council.

There is also a widespread misunderstanding of RMP by people who
see it as an implement of Federal control of health care. It is
also said that RMP performance is spotty, does not yield true
national coverage, and that RMP is not as closely related to the
universities as it should be. We see the flaws in these arguments,
but their proponents are not easy to convince.

In RMP the Federal Government has a good channel for working with
the providers, but the relationship is not always easy to clarify.
We must continue to emphasize the process and not only the content
of RMP in our judgments. The need is for a foundation of under-
standable judgments on which credibility can grow.

B. Two bills to establish Area Health Education Centers have been
placed before the Congress. One would place the authorization in
Title IX (RMP) of the Public Health Service Act; the other, which
is the Administration's bill, would place the authority in the
National Institutes of Health. We must be prepared for either
eventuality, and in either case both the RMP and the Manpower
Bureau of the NIH will find their activities affected by the pro-
gram. The Department's proposal is being presented as part of the
proposal for extension of the Uealth Manpower Act.

C. The Willard Committee report has been circulated among a
limited number of administrators and advisors but has not been
published. The document was kept brief by design, and some of its
concepts are rather broadly stated’. Some of its ideas already
have been incorporated in testinony presented before Congressional
committees, and more will be presented, for example, in testimony
on Section 314 of the Public Health Service Act.
XI.

HAL MASPOWER

Miss Cecilia Conrath, Chief, Continuing Education and Trainins,

RMPS, spoke on Council and RMP policies and objectives concerning:
nealth manpower. At the turn of the century, 60 percent of health
workers were M.D.'s, now 64 percent of health workers are not M.D.'s.

About 70 percent of health workers are women, many of their jobs are
characterized by: low pay, little requirement for independent judg-
ment, special turnover and dropout problems, entry at the high

school level, and re-entry through established training or re-training.

One of every two health workers entered with less than three years
of college education.

One of every five had less than full high school education, Many jobs
are routine, narrow in scope, and severely limited in opportunities
for advancement.

Refresher training for re-entry of dropouts, once enthusiastically
advanced as a means of relieving shortages of help, has not succeeded
as hoped--too many of the trainees limit their availability to part-
time or intermittent work.

RMP is going to be involved in manpower problems because it is the

logical channel for provider concerns.

With regard to our relationship to CHP and NCHSR&D, Dr. Margulies
stated that it is important that RMPS retain its identity and avoid
assumption of CHP responsibilities. It is also important that RMPS

and NCHSR&D work more fully together. The basic guide to RMP develop-
ment now and in the coming years will be found in the Federal health
strategy. If it is to be a maximun service to this country, RMP will
work with increasing effectiveness through all of the mechanisms which
are available--CHP, R&D, local organizations, etc.--to maintain or
improve the quality of health care while emphasizing increased accessi-
bility, better distribution of manpower, greater productivity of health
system and increasing efficiency in the delivery of services.

EXECUTIVE SESSION

The Council in Executive Session met and endorsed the, RMPS mission
statement.
XII.

L/

REVIEW OF APPLICATIONS - RECOMMENDATLONS FOR ACTION 1/
ARIZONA REGIONAL MEDICAL PROGRAM - RM 00055 5/71 (Supplemental)

No additional funds are recommended for this Regional Medical
Program at this time.

The request for additional core support is specifically disapproved.

The Region may rebudget available funds into any of the projects in
line with its own priorities,

This action coincides with Review Committee recommendations.
BI-STATE REGIONAL MEDICAL PROGRAM - RM 00056 5/71 (Supplemental)

Additional direct cost funding in a reduced amount is recommended
as follows:

Ist Year - $16,750 2nd Year - $15,850 3rd Year - $15,850

While the Region may rebudget available funds into either of the

two projects included in this application, Council considers

Project #16 - To Develop a Model for Testing Physician Continuing
Education ~ innovative and Project #15 - A Public Education Program
on Harmful Effects of Cigarette Smoking - was considered low priority.

 

This action coincides with the recommendations of the Review Committee.

CALIFORNIA REGIONAL MEDICAL PROGRAM ~ RM 00019 5/71.1 & 5/71.2 (Supple-
mental)

Region may rebudget available funds into Project #41 ~ Patient
Monitoring (Area 1), in line with its own priorities. ,

Council defers consideration of Project #85 - Cooperative Planning
Effort of Regional Medical Programs and Model Cities for Training
in the Allied Health Professions - Area I - pending program site
visit of June 1971. -_

 

This action differs from the recommendations of the Review Committee
only in relation to Project #85.

All amounts are direct costs only and unless otherwise specified refer
to a 12-month period.
~9-

IOWA REGLONAL MEDICAL PROGRAM - RM 00027 5/71 (Supplemental)

Additional direct cost funding is recommended for the Iowa RMP as
follows:

lst Year - $43,500 2nd Year - $35,272 3rd Year - $36,719
Region may rebudget funds into any of the projects included in the
application except for Project #19 - Renal Failure Management Training ~

in line with its own priorities.

This action differs from the recommendations of the Review Committee
but incorporates the recommendations of the Ad Hoc Panel on Renal
Diseases.

KANSAS REGIONAL MEDICAL PROGRAM - RM 00002 5/71 (Triennial)

This Region is. approved for triennial review with direct cost funding ~
recommended as follows:

Ist Year - $1,800,000 2nd Year - $1,800,000 3rd Year - $1,800,000
The request for developmental funding is disapproved.

Project #40 - Development of a Comprehensive Nephrology Program - is
approved in line with the recommendations from the special review by
a renal specialist and the site visit team.

This action coincides with the recommendations of the Review Committee.
MAINE REGIONAL MEDICAL PROGRAM - RM 00054 5/71 (Supplemental)

Additional direct funds are recommended for this application as
requested: $27,896.

This action coincides with the Review Committee recommendations.
MISSISSIPPI REGIONAL MEDICAL PROGRAM - RM 00057 5/71 (Anniversary)

No additional funding is recommended for the Mississippi RMP at this
time. .

The request for developmental funding is not approved.

The Region may rebudget available funds into the projects in the
application, including Project #17 - Renal Disease Program - in line
with its priorities.
- 10 -

MISSISSIPPI RMP CONT.

A program site visit is recommended to help this Region's core
staff, RAG, and Planning Group focus priorities on health needs
of Mississippians; staff assistance is also recommended.

This action coincides with the recommendations. of the Review
Committee and incorporates the advice of the Ad Hoc Panel on
Renal Diseases.

MISSOURL REGIONAL MEDICAL PROGRAM — RM 00009 5/71 (Triennial)

This Region is approved for triennial review at the following direct
cost levels:

Ist Year - $2,500,000 Ind Year - $2,012,000 3rd Year - $1,425,000
The request for developmental funding is disapproved.

The recommendations of the Review Committee regarding funding,
allocations among the major program elements should be conveyed
to the Region.

This action differs from the Review Committee only in the level of
funding recommended for the first year. Council felt that $300,000,
rather than $250,000, would provide for more orderly phasing out of
the computer and pioengineeriny, activities.

MOUNTAIN STATES REGIONAL MEDICAL PROGRAY ~ RM 00032 5/71 (rrdenntal)

een na a re tA A I

This Resion is approved for triennial review with direct cost funding
levels as follows:

Ist Year - $1,741,000 2nd Year - $1,511,900 3rd Year - $1,366, 000
The request for developmental fundiny; is approved.

Funding for Project #3R - Mountain States Tumor Institute ~ ts approved
for two additional years only.

The interest in forming a separate Nevada RMP is recopnized; at such
time as an application is received and acted upon, the funding

recommended for the Mountain States RMP will have to be re-reviewed.

This action coincides with Review Committee recommendations.
- jl -

 

NASSAU/SUFFOLK REGLONAL MEDICAL PROGRAM ~ RM 00016 5/71. (Triennial)
Operational status is approved for the RMP.

Three years direct cost funding is recommended as follows:

Ist Year - $829,755 2nd Year - $868,408 3rd Year - $908,043
A site visit should be made to review progress during first year.

First continuation application should be reviewed by Committee and
Council, with idea of increasing funding level if progress permits.

This action coincides with recommendations of Review Committee except
that Council did not develop a policy on computerized EKG as requested
by Committee. Council requested a staff paper on this subject for
consideration at a later time. Therefore, the Region is not prohibited
from utilizing its funds for this activity if program priorities so
dictate.

NEBRASKA REGLONAL MEDICAL PROGRAM - RM 00068 5/71. (Triennial)

Status as a separate RMP. is approved for Nebraska.

Three years direct cost funding is recommended as follows:

jst Year - $790,070 2nd Year -— $790,070 3rd Year - $440,653

The Region should be advised of serious concerns about direction of
program.

A site visit should be made to assess progress during the next year.

First year continuation application should be reviewed by Committee
and Council.

This action coincides with Review Committee recommendations except for
level of funding recommended for third year. Council feels that Region
must provide more substantive information about plans to utilize funds
during third year.

NORTH CAROLINA REGIONAL MEDICAL PROGRAM - RM 00056 5/71 (Triennial)

This Region is approved for triennial review with the following direct |
cost levels recommended:

lst Year - $2,049,000 2nd Year - $2,049,000 3rd Year ~ $2,049,000

The request for developmental funding is approved.
-~12-

NORTH CAROLINA RMP CONT.

A specific exception is made to Council policy regarding support
of basic education for Project #32 - Career Ladder Nursing Education.

The funding level does not take into consideration funding for
Project #28 - A Proposal for the Care of Patients with Chronic

Uremia - which is deferred for further technical review.

This action coincides with recommendations of both the Review Committee
and the Ad Hoc Panel on Renal Diseases. ,

NORTHEASTERN OHIO REGIONAL MEDICAL PROGRAM ~ RM 00064 5/71 (Anniversary)

 

Funding is recommended at the committed level, $786,187 (Direct Cost),
for one additional year.

The Region may rebudget available funds into any of the proposed new
projects, except liealth Careers in Ohio, in line witn its own priorities.

RMPS staff should explore with this Repion, as well as other Regions
serving Uhio residents, ways to provide a more effective, efficient
organization for regional medical programming in Ohio. Council believes
it may be necessary to have at least two RMPs serve the State, but the
possibility for a unified RP should also be explored.

Site visits should be made as necessary.

This action differs from Review Committee recommendations in that an
alternative other than one Ohio RMP is suggested and that the number

of site visits may be negotiated.

NORTHWESTERN OHIO REGIONAL MEDICAL PROGRAM - RM 00063 5/7 1 (Anniversary)

 

Funding is recommended at the following level for one year only:

$637,304.

This recommendation provides for continuation of core and on-going
activities at present rate of expenditures, however, Region may rebudget
available funds into new projects in line with its own priorities, except
for Health Careers in Ohio.

RMPS staff should explore with this Region, as well as other Regions
serving Ohio residents, ways to provide a more effective, efficient
organization for regional medical programming in Ohio. Council believes
it may be necessary to have at least two RMPs serve the State, but the
possibility for a unified RMP should be explored.
-13-

NORTHWESTERN ONO RMP CONT.
Site visits should be made as necessary.
The request for developmental funding is disapproved.

This action differs from Review Committee recommendations in that
an alternative other than one Ohio RMP is suggested and that the
number of site visits may be negotiated.

OHIO STATE REGIONAL MEDICAL PROGRAM - RM 00022 5/71 (Triennial)

The request for triennial review status is denied; funding at the
committed direct cost level is recommended for one year only as
follows: $714,075.

The request for developmental funding is disapproved.

The Region may rebudget available funds into projects included in
this application, with the exception of Health Careers in Ohio in
Core, Project #29 - Home Dialysis Program and Project #30 - Program
for Hypertension Detection, in line with its own priorities.

 

RMPS Staff should explore with this Region, as well as other Regions
serving Ohio residents, ways to provide a more effective, efficient
organization for regional medical programming in Ohio. Council
believes it may be necessary to have at least two RMPs serve the
State, but the possibility for a unified RMP should also be explored.

Site visits should be made as necessary.

This Council action coincides with recommendations of Ad Hoc Panel
on Renal Diseases regarding approval of Project #27 ~ Cadaveric
Transplant Program and #28 - Pediatric Nephrology Center, but no
additional funds are recommended.

OHLO VALLEY REGIONAL MEDICAL PROGRAM - RM 00048 5/71 (Supplemental)
Additional direct cost funding is recommended as follows:

ist Year - $98,610 2nd Year - $95,419 3rd Year - $9,369

Reyion may rebudget funds into any projects included in this application,
except that Council questions the advisability of initating Project #24,
Intensive Coronary Care Unit Nurses Training, at this point in the Revton ‘Ss

development.

This action coincides with Review Committee recommendations.
~ 14 -

OKLAHOMA REGIONAL MEDICAL PROGRAM - RM 00023 5/71 (Triennial)

The request for triennial funding is disapproved; direct cost funding
for one year is recommended as follows: $913,500.

The request for developmental funding is disapproved.

A site visit is recommended to assist this Regional Medical Program
in developing specific goals and objectives, before it submits a
Triennial application next February.

This action coincides with Review Committee recommendations.

PUERTO RICO REGIONAL MEDICAL PROGRAM - RM 00065 5/71 (Anniversary)

Funding is recommended for Region's second operational year at the
following direct cost level: $989,762.

The request for developmental funding is disapproved.

Region may rebudget available funds into any project included in
this application in line with its priorities.

This action coincides with Review Committee recommendations.

SOUTH CAROLINA REGIONAL MEDICAL PROGRAM ~ RM 00035 5/71. (Triennial)

 

Region is approved for triennial funding, at the following direct
cost levels, pending a favorable site visit report on Project #55 -
Chronic Renal Disease Education and Service Program.

lst Year - $1,550,000 2nd Year - $1,550,000 3rd Year - $1,550,000

Request for developmental funding is approved.

Region may rebudget funds into projects included in this application

in line with its own priorities, except for those activities which

may be precluded by Council policy; i.e., Project #52 - Health Manpower
and the fellowships in #46 - Hematologic Malignancies.....

This action incorporates the advice of Review Committee and the Ad
Hoc Panel on Renal Diseases.

SUSQUEHANNA VALLEY REGIONAL, MEDICAL PROGRAM - RM 00059 2/71 & 4/71

(Weferred Supplement)

Approval of $100,000 supplemental funding is recommended for one year
with the following conditions:
-~15-

SUSQUEHANNA VALLEY RMP CONT.

 

1. The Region engage effective leadership on its core staff;
2. The Region study and make necessary changes in the RMP
organization to assure a viable Regional Advisory Group,

viable medical center involvement and a viable prantee;

3. RMPS make available sufficient, experienced staff resources
to assist Region in its study and subsequent program changes.

The request for developmental funding is disapproved.

This action essentially coincides with recommendations of the Review
Committee.

TRI-STATE REGIONAL MEDICAL PROGRAM ~- RM 00062 5/71 (Supplemental)

 

Action on the application for funding a New England Facilities for
End-State Kidney Disease is deferred, pending, Council study of a
technical site visit report.

This action coincides with the recommendations of the Review Comnittee
and the Ad Hoc Panel on Renal Diseases.

WESTERN PENNSYLVANIA REGIONAL MEDICAL PROGRAM - RM 00041 5/71 (Triennial)

 

Approval for triennial funding is recommended at the following direct
cost level:

Ist Year - $1,450,000 2nd Year ~— $1,450,000 3rd Year ~ $1,450,000
The request for developmental funding is approved.

Funds for Project #14 - Renal Disease — are disapproved as recommended
by the Ad Hoc Panel on Renal Diseases.

Region may rebudget available funds into any project included in the
application provided they are consistent with Council policy. Attention
is called specifically to policy issues related to activities in Project
#10 - Early Care for Suspected Coronary Patients - and Project #13 -
Bucktail Area Emphysema and Pulmonary Disease Project.

Council notes that the Region has not presented specific project plans
to utilize the funds requested in the second and third years of the
triennial period. If RMPS staff should find a disproportionate share

of the funds proposed in the second and third years are for activities
not previously studied by Council, the application should be reviewed

by Council at that time.

This action essentially coincides with recommendations of Review Committee.
e

XILL. ADJOURNMENT
The meeting was adjourned at 1:45 p.m. on May 12, 1971.

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

/ - a
Harold - rye,

Harold Margulfes,| M.D. |
Director “
Regional Medical Proprams Service

July 19, 1971
ATTENDANCE AT THE NATIONAL ADVISORY COUNCIL MEETING

RMPS STAFF

Miss Rhoda Abrams

Miss Mary K. Asdell

Mr. Kenneth Baum

Mr. Earle Belue

Mrs. Simone D. Biren
Dr. Edward T. Blomquist
Mr. Paul W. Boone

Mrs. Marilyn N. Buell
Mr. J. Edgar Caswell
Mr. Cleveland R. Chambliss
Mr. Richard Clanton
Mrs. Delarea T. Coley
Dr. Veronica L. Conley
Miss Cecilia C. Conrath
Mr. Emil Corwin

Mr. Thomas Croft

Mrs. Mary L. Dana

Mr. Roy L. Davis

Mr. Joseph L. De La Puente
Mr. Herbert P. Dunning
Miss Joan E. Ensor

Mrs. Eileen U. Faatz
Dr. John R. Farrell
Miss Judith Fleisher
Mr. Gerald T. Gardeil
Mr. Terrence T. Genz
Mr. Sam O Gilmer

Dr. James Gross

Mrs. Gloria Hicks

Mr. Charles Hilsenroth
Mr. George Hinkle

Mr. Paul Hoffstein

Dr. John Holbrook

Dr. Daniel Horn

Miss Dona E. Houseal
Miss Margaret Hulbert
Mr. Robert H. Hutchings
Mr. Frank Ichniowski
Mr. Joseph T. Jewell
Mr. James R. Jones

Dr. Alan S. Kaplan

Dr. Philip A. Klieger

MAY 11-12, 1971

Mr. Alfred B. Kline, Jr.
Mr. John M. Korn

Miss Julia J. Kula
Mrs. Lorrine M. Kyttle
Miss Carol M. Larson
Dr. Marian Leach

Dr. Harold Margulies
Dr. Gordon MacLeod
Mrs. Anne H. Mickelson
Mr. Ted C. Moore

Mr. Bob Morales

Miss Marjorie Morrill
Mr. Spero E. Moutsatsos
Mr. Frank S. Nash

Miss Elsa J. Nelson
Mr. Joseph J. Ott

Dr. Herbert B. Pahl
Mrs. Jeanne L. Parks
Dr. David Pearl

Mr. Roland L. Peterson
Mr. Eugene S. Piatek
Dr. Roger D. Platt

Mr. Michael J. Posta
Mr. Robert L. Quave
Mr. William S. Reist
Mrs. Estelle Remer
Miss Leah Resnick

Dr. Thomas J. Rice

Mr. Abraham Ringel

Mr. Morton Robins

Mr. Richard L. Russell
Mrs. Rebecca R, Sadin
Mrs. Jessie F. Salazar
Mr. Luther J. Szys
Miss Theresa Schven
Mrs. Patricia Q. 3choeni
Mrs. Mildred M. Selsky
Mrs. Mary L. Shovlin
Mrs. Eve S. Shuman
Mrs. Sarah J. Silsbee
Dr. Margaret H. Sloan
Mr. Dan M. Spain
RMPS STAFF CONT.

Mr. Matthew H. Spear

Mr. Jerome J. Stolov

Mr. Lee G. Teets

Mr. Francis L. Van Hee, Jr.
Mr. Lyman Van Nostrand

Mr. Lee E. Van Winkle

Mr. Frank G. Zizlavsky

RMPS REPRESENTATIVES
IN REGIONAL OFFICES

Mr. William A. McKenna Region I

Mr. Robert Shaw Region II
Mr. Clyde L. Couchman Region III
Mr. Maurice C. Ryan Region V
Mr. O. Dale Robertson Region VI
Mr. C. Ray Maddox Region VII
Mr. Daniel P. Webster Region VIII
Mr. Ronald S. Currie Region IX
Mr. Hugh S. Campbell Region X

OTHERS ATTENDING

Dr. Vernon E. Wilson, Administrator, HSMHA

Dr. Robert Van Hoek, Associate Administrator
for Operations, HSMHA

Dr. Margaret H. Edwards, NCI, NIH

Mrs. Frances H. Howard, NLM, NIH

Mr. Wendell Maddrey, NCHSR&D, HSMHA

Mr. Carl A. Taylor, OMB
NATIONAL ADVISORY COUNCIL ON

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

a President, Michigan Cancer 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

@. ton, Louisiana 71270
NES, Mr. Harold H., Jr. (74)

Senior Vice President

Marsh & McLennan, Inc.

231 South LaSalle

Chicago, Illinois 60604

HUNT, William R., M.D. (71)

Commissioner

County of Allegheny

101 Courthouse
Pittsburgh, Pennsylvania 15219

CHATRMAN

REGIONAL MEDICAL PROGRAMS
May 14, 1971

McPHEDRAN, Alexander M., M.D. (73)
Emory University Clinic
1365 Clifton Road, N. E.
Atlanta, Georgia 30322

MILLIKAN, Clark H., M.D. (72)
Consultant in Neurology

Mayo Clinic

Rochester, Minnesota 55902

OCHSNER, Alton, M.D. (73)
Ochsner Clinic

1514 Jefferson Highway

New Orleans, Louisiana 70121

ROTH, Russell B., M.D. (73)
240 West 4ist Street
Erie, Pennsylvania 16508

SCHREINER, George E., M.D. (74)
Director, Division of Nephrology
Georgetown University

School of Medicine

Washington, D. C, 20007

WYCKOFF, Mrs. Florence R. (72)
243 Corralitos Road
Watsonville, California 95076

EX OFFICIO MEMBER

MUSSER, Mare J., M.D.
Chief Medical Officer
Veterans Administration
Washington, D. C. 20420

Vernon E. Wilson, M.D.

Administrator

Health Services and Mental
Health Administration

5600 Fishers Lane

Rockville, Maryland 20852