oe Ke BAM ois RM. Meld: Rockville, Maryland | Tuesday, 9 November. 197 ACE- FEDERAL REPORTERS, Bal re a e Official Reporters _ - we 415 Second Street, N.E. Ae : : oo Telephone:: Mashington, D aa 20002 — (Code 202) 547-6222 - NATION-WIDE COVERAGE CRE4157 GIBSON 3 ht DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE @ REGIONAL MEDICAL PROGRAM SERVICE COUNCIL MEETING ie as EXECUTIVE SESSION uhs Lo Conference Room GH . Parklawn Building Lo 5600 Fishers Lane é ; Rockville, Maryland Tuesday, 9 November 1971 & BS ao rhe Bd ut oD ~ Ca aw > te =F e DR. (ARGU raay bbs are three issy that we LTS : ilo consi thev all requ So py gee LOK them has to do with a continuation of the I think, the last to develon a more coherent Toledo ; Iniversity. Ohio proqran which we just Ohio Valley RMP, and that is because that seems to functioning Cart ce t ° has been abysmaliv bad, and has a Solved AS an as close to beind Yad some nrogram se of you wh the as you fortunately Sewall $ | ¥ because, as CHP A Agency cenerated by that in | cs that were pretty much confined to : tad al sO LO > ex Lo a 15 te hac a coordinator who Ru without a coord the Ohio State prodram has been at along, anc that's about all. What we did was to pull s, plus Ohio Valley RP, and tell senting all those proqre anter into a than we would like to have would lead to an effective consolidation of their which were t we were ily about a statewide progran, but Lt aL 1 that their programs had de- having th they were d or not, operatine within a ag we could, kent our hands of f and gave an oppor up to a certal conclusion. “ ooint anc then a few f ower ta present to you today, and IT don!’ - know whethe their conclusion -~ second so negotiate with one another and come to some reason~| ah « aroma. oy ea : z S an exte OL ons which are confusing runiocat ott ae be That the 40 bot ask Ohio progran, located in an he 2 G cof them to uni sonal 7 have united, Th able to 8 attract a similar sort of conjuncti os 4 * + 4“ Ss c J of Hortheast Ohio, which £0 better on our own, and in anv case 12 cacy east vy 2 at resnonse ko Was ne or a mandate from the Council ” a strong nudde on your ko qeth ho- 16 cether. anc my tentative response to then has ! thak we ~ wou Le this kind of An arrangement, iv reduc La ayicdenc: ~~ bnae -rodaram vO as evic rogram 9 iy te vi dive coordinator ical tearthat claims that comes out abeut the same as raining, because it rained on it lost the gane because it still not Pea Federal Reporters Se. 10 11 12 13 14 15: 16 49 18: 19. 20 21 22 23 24 e 85 5 What we did in practical terms at the meeting of the Council nefore last was to say that we would give them six months funding, which would carry them through December 31, and in-order to sharpen their attention to the issues, which it tended to do. We then, in extending the support for those pro~ grams beyond December 31, as we had to this late in the. year, agreed that we had to follow the relative ranking principles of the RMP's, and so they have been reduced from the level at which they are operating because they come clearly in at the bottom end of the scale. They protested a little but I said that they still were the same programs that they were, and no change had occurred. Now,what is before you is a consideration of what you would like to propose be done, about what is at the pre- sent time in their view a clear-cut application for a separate and new status for the new programs which want to combine, and a continuation of the status of the one which wishes to re- main as it was in Northeast Ohio. _ My immediate reaction to that, which I'd like to present for your consideration, is that the Coucil as yet, in fact, this staff has engaged in these discussions not at all, and that before we reach any kind of conclusion about whether they had gone as far as they should or could or whether’ this is an effective arrangement, we need to have on ae Proo-Fedevail Reporters, Gre. 10 11 12: 13 | 14 15 16 17 18 19 - ~ 22 22 a) B4 25° -establishment of the program under the aegis of the Ohio State tinct from the university and which would not therefore be 6 the part of staff, and I would like to think on the part of Council, some direct involvement with the decisions that they went through, how they reached them, and report back to Council based upon, in this case, a visit which would include representatives from the Council and probably from the review committee, to talk with them now about how satisfied they were with this solution. There are a lot of questions left unanswered in this whole series of events, and it has not come out with a complete consolidation of the programs in Ohio. I rather sus- pect at this point in the whole series of circumstances that there is not a likelihood that Northeast will in fact join the other groups. Now, the arrangement that Ohio is proposing is the Foundation, which is similar to ‘the Ohio Valley RMP, that is, a kind of separate corporate body which they believe is dis- controlled by Ohio State University. They have set up an in- teLin group which represents a kind of regional advisory g¥ouy of the combined programs, and they have an interim coordinator in the form of Dr. Pace, who currently is the official coordi-~ nator of the program at Ohio State. Now, Sewall, you may be able to add considerably to that account. Pree Federal Reporters, Gre. 10 li. o 12 13 14 15 16 17 18 19 20 al 22 23 24 25 7 MRS. MARS: What population factors are involved in each program? DR. MARGULIES: In fact, the area which Northeast”: Ohio serves represents a very large segment of the population, because that's the Cleveland area, and the contiguous regions. As a matter of fact, when you lop off the part that Ohio | Valley RMP has, it probably accounts for over 50 percent of the population of Ohio. Isn't that the case with Northeast? MR. MILLIKEN: It's 40 percent, actually, in about four counties. It's 50 percent if you add another ring of counties. | : ‘DR. BRENNAN: That would include Cleveland, Youngs- town, Dayton? : DR. MARCULIES : No, Dayton is different. DR. BRENNON: ‘I mean Akron. DR. MARGULIES:. Yes. MR. MILLIKEN: And 60 percent of the professional health manpower for the State. MRS. MARS : How does it compare as far as rural and urban? DR. MARGULIES: I think the Northeast area is pretty much urban. | MRS. MARS: Ohio really has very little rural. MR. MILLIKEN : Highly industrialized and high pers | centage of Labor involvement in health services, organized Pree Federal Reporters, Gne. 10 11 12 13 14 15 16 1? 18 19 20 21 22 23 24 25 labor. DR. MILLIKAN: How long have they literally been without a full-time coordinator? — DR. MARGULIES: ‘The Northeast Ohio program has beer without a full-time coordinator for about a year-and-a-half. They have an acting coordinator. : One of the problems there, and I think we all undey stand, is an extension over time of the internal warfare in the city of Cleveland, which is legendary, involving Case Western Reserve, the Cleveland Academy, and so forth, and they somehow don't seem to be able to resolve that, and the RMP is offering the opportunity to prove that they still haven't resolved it. The problem of getting a coordinator hag much more to.do with those issues, I think, than anything else MR. MILLIKEN : Dr. Robbins told me yesterday that they have three applicants, two of whom look very good, jand they are willing to come, and they expect a decision within a ' few days. DR. MARGULIES: Well, what they have asked for is a recognition of this new activity in the, two that are joined as of December 31st, and I can't see how the Council’ can re- spond to that request on the basis ‘even of the extensive correspondence which we have had... So what I would like is to have you accept and extend this period. of interim arrangement a little longer period, and for at: least tio nenbers ‘of the Ale Federal Reporters, Gre. 10 | 11° 12 13. one 15 16 | 17 18 19 20 22 22 23 24 25 council and others .to go out and spend some time with the various participants and get a clearer picture of what their expectations are, how. they reached their decisions, and then come to: the conélusion about what could be done. “My own impression of the Northeast program is that it does in fact have far greater potentiality as a total re- source than the rest of the group. People like Robbins, you've got some real leadership and some real imagination. I've been very disappointed in Toledo, that the dean of the medical school, who is a very imaginative person, has been relatively uninvolved in RMP, but I understand, Sewall, that recently he has become more involved. I don't know whether that's true or not. MR. MILLIKEN: This is a man who has resigned and left now. DR. MARGULIES: That's the president of the insti- tution, but the dean is a guy of some real competence. MR. MILLIKEN: Right. DR. MILLIKAN : You are talking about six months’ continuation, of the interim arrangement? “oR. MARGULIES : I am thinking about taking no action. until “there thas been an opportunity to come back -- but we je would have’ to extend them certainly for another six months as they are». into July 1, and then take any interim consideration in February when the Council meets again. 19 "3. 1 | DR. CANNON: So move. - 2 DR. MILLIKAN: Second. eo eT DR. MARGULIES: Any further discussion? a 4 All in favor say aye. 5 (Chorus of ayes.) 6 Opposed? ane (No response.) 8 I was going to try to find someone on the Council 9 | to go out, who had been there before, but interestingly 10 || enough no one on this Council has been in the Ohio program in 11 the past that I know of. | le. | DR. BRENNAN: It's probably a good thing. 13 : DR. MARGULIES: It probably is. So we will have td 14 get with somebody in the very near future and find out whose ® Arce Federal Reporters, Ge 15 schedule will fit in and work it out accordingly. 16 ‘es We have had people on the review committee who have End — 17 | been there in the past. Smith (The remainder of the executive session was 19° Baty not reported.) 20 - a BB 24 25