NEW FILE BEGINS Doc #35 B&B INFORMATION & IMAGE MANAGEMENT 300 Pence Seoruer'’s Beui_revard UPPER MARLEORD, Maryland 2ZO772 © USA ° (351) 249-BD11D FRRODGA » rs NIH -DEMP-CMO Luvgecc Gopiga Fe . woptsy lire st . on Darector, NIR etch 22, Lys Associate Director, NIH, and Dire: .or, Division of Regicsal Medical Progr. 3 Reporting Highlights of the Seventh Meeting of the National Advisory Council on Regtors] Medical Programs, February 19-21, 1967 At the seventh meeting of this Council, eight new planning grant applications, two supplements 2o planning grants, three revised planning grant applications, end four operational grant applications were reviewed. The Council made the following recommendations: - New Planning Grent Applications Planning grant applications for the following seven regions were recommended for approval: Memphis, Arkansas, Michigan, Maine, Arizona, Hissouri-Illinois (St. Louis and adjacent areas), and Metropolitan New York. The :pproval for the Metropolitan New York region is conditional upon «u satisfactory Council site visit which-will .lso determine the amount of the «ward to be recommended. The Council recommended that the application from Misgissippi be returned for revision, The Council recoumends ‘approval of the revised ‘application £ from Ohio. . State. The spplicatioa from Philadelphia was given conditional approval pending a satisfactory site visit by Council members, The Oregon application was given ec conditional: approvals “ae Counct1 ‘recommends. approval. of ‘the. Vermont at supplemental a ‘planning | grant applic.ition, and conditional approval, contingent upon a sutisfactory site visit by Council members, of the California supplemental wpplication. Operitiona?l Grant “pplications Four operational applications, one of which contained two supplemental requests, were considered. These same four ipplications had been given preliminary consideration at the November 27-29, 1966, Council meeting. At that time, the Council recommended that the staff examine the _ oe poseibility of taking favorable: action prior to the February Council Meeting tm nurts of these ipplications for tie Intermountain, Missouri, and Kangus regions, if the stait encountered no sdministrutive problem. On the busis of chie preliminary favoreble ra.ction, the Division staff undertook un intentive analysis of the applications. waich ineluded specific contacts with many other components of the Public Health Service to obtain the advice and comment of other exnertise within the Public Health Service on specific aspects of thee2 complex applic stione, On the bagis of staff anilyéis, comments from otner parte of the Public Health Service, teports of site vieltea, recommendations of the Regional Medical Proprame “eview Committee, anc two reviews by the Councti! of applications suouitted, the Council recommended epprova: “of operational «wpplications iur the Kineas-Hissouri, Albany, and Interuguntain Regions. All applications were recommended in reduced amounts with the precise amount of the grant award to he determined within 10 percent of the amount recomended by Council on the basis of staff negotietions with the applicants, The Council recommends approval of the Kinsas and Missouri applications. It also recommends approval of the Albany application fin the amount of $750,000 for the first year; the amounts for the two additional years are to be negotiated. The Utah application was recommended for conditional approval. Discussion of Contract Proposals A proposal from the American College of Surgeons to umertake a study of the mechanisms for developing a list of centers with outstanding diagnostic treatment and training capabilities in the field of cancer had been discussed at the November 1966 Council meeting. Thia study would provide assistance in carrying out the purposes of Cection 907, which calle for the Surgeon Ganeral to develop such lists in the fields o£ heart disease, cancer, and stroke, At the time of discussion, the Council felt that the' application was too brief, that the methods to be followed were not spelled out adequately, and that the budget waa excessive in light of the justification given. This was, therefore, communicated to the \merican College of Surgeons, and a revision was submitted. The Division of Regional Medical Programs, on the basis of discussion and favorable recommendation by the Council, will pursue more detailed negotiations of the contract. Another proposal which hud been discussed at the November Council meeting was a contract for a task force and regional diugnostic and treatment centers in the area of choriocarcinoma., The Council, in November, had given its general approval to this activity. However, in further discussion, realizing that one such liboratory was alre.dy being supported 7 pe tue farce Sestre? “oa vee las vi. ot bad me Vacioial Hecier’ Provcame hela diseugeiome woth the Lateonr: Ueneter fur Chromic wiseuse Gontrol. An agreement was reached that this was an appropriate activity for the Cancer Control Program to carry cut, and the Cincer Control Program agreed to extend its support beyond the initial laboratory already supported. Further, it was agreed that it would be more reasoneble to have the Nationei Cmcer Inetitete provide support for all of the ~linical trials activities involved in the choriocarcinoma program and te have the Cancer Control Program provide support for all of tne Laboratories involved in thie program. The Division of Fegicnal Medical Programs, therefore, will not be duvelved with surporting this activity, exceph in the stea cf continuing education of physicians regarding the availability of these services amd the need to utilize these services for all patients where the possibility of choriecarcinom, is indicated. , Conference on Regional Medical Programs, January 15<1?, 1967 The Council discussed the Gonference on Regional Medical Programa held in January in Wa:hington, D.C. and attended by 6506 persons. This Conference was held to obtain ideas for the Surgeon General's rep rt to the President and Congress on P.L. 89°239 from a representative group of kuowledgeable persons from throughout the country. The Conference also provided the opportunity for interchange of information among organizations, institutions, ind individuals concerned with the regional medical programs. It is believed that the Conference was an excellent mechanism for achieving these purposes. It also served a useful communications function for other segments of the Public Health Service and other parts of the Government. Surgeon General's Report to the President and Congresa Concerning Regional Medical Programs . — a ~ A progress report was made on the activities concerning the development — of this Report. The ad hoc Advisory Committee, which is working on the Report, has two more meetings scheduled before submitting the final Report. The Council members will be consulted prior te the completion of a final draft of the Report, after the ad hoc Advisory Committee completes their recoomendations, , | faktut- Uf, Mier Robert Q. Mirston, M.D. ces DRMP Branch Chiefs © EHandal :KYordy:Jfh ee. NLH-DRMP-GMO March 23, 1967 Poa en wre ASsucvdate DBirescvor. SER. and Direcues, Division of Regional Medical Programs Grants to be avurded by the Division of Regional Medical Programs The standars policy ke to aarevm you af orr trian jes tr avers pramts in @xecess af $259,000. Be are informing yor abo.t the foilowang grarie emder (250.900 becasac Af Four particuiar 2utererh 2s bu. program, ime Sativnel Advicery Coun if on Bi giorsi liedicaa Preyrams, at its seyenrh aueting on February 19-21, 1967, recommends approval of these erants. After mcgotiation with the applicants, we anrieipate notifying thas that their grante.wili be awarded, Following are the direct costs ancieipated to be awarded, plus appropriate indirect costs: Applicant Amount of ; tnstitution Region Direct Costs Years University of Tennessee Memphis Medical $ 155,056 ol College of Medicine Region 148,600 02 73,100 03 Medical Care Development, State of Maine 201, 344 o1 Inc., c/o Department of 204, 709 02 Health and Welfare Augusta, Maine Ohio State University ' Ohio State 99,634 o1 College of Medicine : Regional Medical Program University of Oregon Oregon Regional 166,494 01 Medical School , Medical Program 177,998 02 73,464 03 : ols Mitrebng—_ - Robert Q. Marston, M. D, ee: DEMP Branch Chiefs EHandal: jfh , 3/15/67 a“ ” - The Council recommended that the advisory group be broadened to include _ . " 4.803 BM-00004-01, Albany Medical College of Union University, Albany, MY. | NWIH~DRHP-CMO Surgeon General, FES Director, NIH _ Mareh.23, 1967. Associate Director, NIH, and Director, Division of Regicnal Medicul Progr-uss Resume Report of any grint where funds to be awarded for any one yeur exceed $250,000, exclusive of new construction or alteration, renovation, or repair funds. At its meeting on February 19-21, the Nutional Advisory Council on Regional Medic .l Programe recommended that upplicutions Listed below be approved. The Division of Regional Medical Programs intends to proceed with the uctivation of thase grants after carrying out the instructions of the Council . described below: 1 $03 BM-00002-01, University of Kinsus Medical Center A joint site visit was made by representatives of Council, Review Comittee and Staff in November. This provided an opportunity to obtain first-hand a feeling for operational activities proposed and problems related ta the region. os The Council agreed with the recommendstion of the Review Committee that this fs an ares with considerable experience fn cooperative arrangements, and would be favorable toward the development of a strong regional medical program. - There was consensus that a reduction in snounts would not jeopardize the : . program, and the .pplicant could easily restructure its priorities withia the recommended §1 million (+ or @10%). . nat stp 7 Yepresentation from minority groups. - . The omounts requested ures. $2,521,177 first yesr; and $2,450,000 second year, plus appropriate indirect costs. Approval was recommended tn the amount of $1 million (+ or -10%) for the first year. Two additional years are recommended for spproval, but the amounts will be negotiated i the , time of renewal, These amounts ire in addition to indirect costs. - nd ee hat Prior to the presentation of this application to full membership of Council, a site visit by representatives of Council, Review Committee, and Staff was made to Albeny on Movember 7, 1966. The overall program was tederd te be reas ais the region's past exeerfence with the censzopt of a regatail TecLeal progres necengebonse Che retetnshsas ta 74 Rare reyiewing groups thit the proposal has mich merit smi promise. The mount to be awirded for the First year ic 9750,090, (: or ~10% subject tc staff negotiation), plus appropriite indérect costs, and the additional two years ure to be negotiated. The mounts requested sre: $1,126,435, first year (includee direct costs for specific pilot projects ind other general support) and excludes imount the upplicunt proposes to transfer from their planning grant; $936,729, second yeur; and $613,340, third year, plus imifrect costs. | 1 $03 BN-0G0009-02, 3 $903 RH-00009-03S1, und 3 503 RM-00009-O182, University of Missouri School of Nedicine A three-year planning grant was awirded to the Missouri Region on June 9, 1966. The first operational grant applicution, consisting of three pilot projects, was submitted on October 1, 1966. The two supplemental ipplica~ tions were submitted Later, The application was considered it the November Council meeting following a site visit. The Council wae encouraging and instructed Staff to proceed with a more detailed analysis of the application. Council recommends that the Advisory Committee needs to broaden its representation to include the Negro comamity, such as the MN .tional Medical issociation and the Lincoln University of Missouri. Also, the involvement of the Ellis Fischel Rospital in Columbia needs to be clarified. Council recommends approval in the amount of §2.5 mizlion (+ or ~10% subject to staff negotiation) for the first year, plus appropriate indirect costs. Two additional years are recomended for approval, with amounts to be negotiated at the time of renewal. The mounts requested for each yeart $3,249,261, first year; $3,754,614, second yeur; and $1,787,526, third year, plus appropriate indirect costs. | 803 BM-00015-01, Utah, Intermountain Regional Medical Program A efte visit by representatives of Council and DRMP staff was made in November after tha application was evaluated by the Review Committes.. Council recommends approval. The affirmative action on #10 is conditional pending satisfactory evidence from a technical comittes, made up in consultation with the National Heart Institute, as to the techniques of evaluation of tha program, and justification of the cost by experts in the biomedical application of computers and computer techniques. It is anticipated that the grant will be awarded in two etages; firet a grant of $820,000. Following additional review und a site visit for the computer based physiological monitoring (requested $929,000) it is anticipated that an appropriate award be made. The smounte reqresct® s2u: £2,852 ,589, firat years $1,222,923, reeend yeat; and $903,524, Ghion yaar. 1 S32 BM-GOO52-01, University of Ackansas Medics] Center This application was considered by Council to reflect a genuine desire to undertake u planning study to ascertain the health care needs fn each of the 75 counties of the State of Arkansas. The grassroots uature of the prooosed program wes viewed ss being u major strength of thie application. The existing facilities und progrums, with prop. planning, can be extended throughout the state, and it fs ipparent that much thought was given to the outlying areus. The suggestion was made that the advisory group :smld well include representation from the neurological sciences, The Council recommends approval of this application, The «mounts requested avez $394,620 first year; $421,682 second year; and §$$7,300 third year, plus appropriate indirect costs, The amount of the award for the first year will be established following staff negotiation. 1 S02 RM-00053-01 and 1 802 RM-00053-0181, State of Michipan The two-purt planning proposal, the first of which requeats support for the central group, the Michigan Association for Regional Medical Programe, Inc., and the second, which is a supplement, proposes planning activities for each of the three medical schools and for the State Departuent of Health. In its entirety the application reflects a comprehension of whut a reglaoal - medical program should be, and the initial proposal mikes the needs wif overall objectives in the state of Michigun clear. The lines of ae aority " and communication are well drawn and the upproach to planning is compeabensive, | However, the Wiyne St ite section of the application is unclear as to oo a numbers und types of personne!) requested, and the recommendation of «covet by Council included the condition that this be clarified, as well as inclusion on the aviewt group of a menber of the BRstional Medical Association or sowe similar representative of a ainority group. The total amount requested in the original and supplemental application ie: $1,040,639, plus appropriate indirect costs. Tha «acount of the 2ard will be determined by Staff following clarification of the Wayne State portion of the personnel budget. _ 1 802 RM-00055-01. College of Madicine, Univers of Ax The College of Medicine fe new with only a few faculty on hand, and 96 has limited experience as an organized unit in the rendering of medical care. The concomitant development of the School of Medicine and the Regional Medical Program will be ur interesting study. The application rcflecta the concerna ubout the neede of the regior and ft fs believed Ghat the applicant's fdeas ha-e been forrutated into 4a reasonable proposal at a modest cost. Council was in agreement that the proposal is werthy of support, with the conditions as follows: (1) the advisory group shewld be established as the owerall authority, and should be broadened to include representatives of var tous hospitals und minority groups; and (2) further exploration is needed on the adequacy of eoxce of the requested salerties, The amounts requetted are: $214,106, firet year; $296,725, secend year; ind $143,363, third year, plus apsropriate indirect ceste, The weount of the award will be determined by Staff after the conditions are wat and salary levels ire negotiated. 1 S02 RK 00056-01, St. Louis, Minsouri-lilinois Bi-State Medical Program There was agreement by Counci) that this Bi-State proposal, which wus suimitted on behalf of three applicants (St. Louis University School of Medicine, Southern Illinois University, and Washington University School of Medicine) is well thought-out and organized. Their pians for continuing evaluation: will define weaknesses in planning, and provide a opportunity to make simultaneous adjustments with development of the program. The possible overlap with the Central Missouri Region was recognized, and it wis agreed that the planning grant activities will delineate the regional boundaries. The Council recommends approval with the condition that additional mouber (2) ofminority groups be appointed to the advisory committee. The aeounts requested are: $546,751 first year; $547,989 second year; and $543,972 third year, plus appropriate indirect costs. The amount of the award wilt be determined following necessary negotiation by Staff. 02 8-0. ‘ork Met Re There was consensus by Council that this complicated area is couing to grips with existing problems common to all lurge urban centers, and that a4 great deil of progress his been made in recent months in the deve lopment of a coordinated program. However, some reservations and concerns were identified and fit was agreed that a site visit (or visits) will be necessary for their solution and exploration of possible ways to assist fin the planning phase. . The amount of the avard will be determined at the time of the site visit, but will not exceed $l-million. The amounts requested are: $1,401,365, first year; and $1,311,150, second year, plus appropriate indirect costs. 7) = 7 sees . - eee Sn ne eh PETE, 1 892 BM 000260012. Greator Delawire Villey Repion, Phii weluhts While a mummber of complexities have been removed from the present revision, and it is evident that the institutions are now willing to explore cooperative arrangements, Council identified a muaber of areas in need of clarification, and agreed that this could be accomplished by one or more site visits with representatives of Council and staff in attimdance. Among the problems are: position of the University City Science Center (UCSC) governing body vis-a- vis regional medical program planning; identification of on-going prograns; UCSC’s respoasibility for data collection and analysis; et tus of the advisory committee; key people.in the program, budget, e%:._ The Council recomecads approval with certain conditions to be presented in a site visit to be mada by Staff and members of Council. The amount vequasted for the first year is $31,862,421, plus appropriate indfrect costa, The amount of the award will be negotiated by Staff either during or iumediately following the site visit. 1 S02 RM-00019-01S1, State of California The application, which represents a supplemental planning grant request was approved with the condition that the region be site visited by representatives of Council and stat, 2 and funded in accordance with site visitors‘ determination. Council expressed an avareness of influences which have tended to slow down the planning process, and agreed that the recent ly appointed Dine Po needs encouragement and sympathetic guidance. It was the consensus thaG <= the region now needs to come to grips with the concept of « regional ee medical progran for this complex area, and that the best way of achievidg — this ts by strengthening the central Playning samiprrmhicastneel - ' The Council recommends approval. with a site visit by Councti. ‘and suast ad clarify the concerns, including evidence of involvement of Negro and Mexican physicians in the project arid on the Advisory Comittee. The amounts requested ares $1,039,643, first year; $1,513,018, second mere and $745,014, third ‘year, plus appropriate indirect costs. —— The amount to be avarded will be determined imendtataly Following the site visit. It is the intention of this Diviston to award the above proposals. i Robert a. Marston, M.D. ec: DRMP Branch Chicfs Elandal: JSalazar? jfh 3/23/67 THROUGH ; NIH-DRMP-CuD Surgeon General, t35 ; Director, NIH March 23, 1967 Agsociate Director, NIH, and Director, Division of Regional Medical Programs Reporting Highlights of the Seventh Meeting of the Natfonal Advisory Council on Regional Medical Programa, February 19-21, 1967 At the seventh meeting of this Council, eight new planning pgrent applications, tw supplements 4a planning grants, three revised planning grant applications, and four operational grant applications were reviewed. The Council made the following recommendations: - New Planning Grant Applications Pianning grant applications for the following seven regions were recommended for approval: Memphis, Arkansas, Michigan, Maine, Arizona, Missovri-Illinois (St. Louis and adjacent areas), and Hetropolitan New York. The upproval for the Metropolitan New York region is conditional upon a satisfactory Council site visit which will olso determine the amount of the sward to be recommended. The Council recommended that the application from Mississippi be returned for revision. ; ke Revisions of Planning Grant Applications Previously Considered The Council recommends approval of the’ revised application from Ohio State. The application from Philadelphia was given conditional approval pending a satisfactory site visit by Council menbers. The Oregon - application was given conditiotial. approval. oo . Supplemental Plinning Grant Applicat{ons ; The Council recommends approval of the Vermont supplemental planning es grant applicition, and conditional approval, contingent upon 4 sutisfactory site visit by Council members, of the Culifornia supplemental upplication Operutional Grant ipplications Four operational applications, one of which contained two supplemental requests, were considered. These same four zpplications had been given preliminary consideration at the Noveaber 27-29, 1966, Council meeting, At that time, the Council recomended that the staff examine the possibility of taking favorable action prior to the February Council fe, wre mecting on purts of thers application: for the Intermauntain, Missouri, aml Kansas regions, if th: stalft eaccuntered no sdministr.utive problem. On the basis of this preliminary favorable reaction, the Division staff “uindertock an intentive asnalyeie of the applications, which included specific contacts with many other canponents of the Public Health Service to obtain the advice and comment of other expertise within the Public Hecith Service on specific aspects cf these complex applications. On the basis of ¢.aff anulyein, coments from othe: sacte of the Public Health Service, reports of site visite, recomencuaiions of the Regional Medical Programs Seview Committee, and two ravievs by the Council of applicatican suecitted, the Joumcil recommended approvel of sperational applications for the Kinsas-tilesourl, Albany, and Intermountain Regions. AXl applications vere recommended in reduced cmounts with the prectse amount of the grant award to be determined within 10 percent of the amount recoumended by Council on the basis of staff negotiattons with the applicantec. The Council recommends approval of the Kansas and Missouri applications. Zt also recommends approval of the Albany application {n the amount of $750,000 for the first year; the amounts for the two additional years are to be negotiated. The Utah application was recommended for conditional approval. Discussion of Contract Proposals A proposal from the American College of Surgeons to umlertake a stndy of the mechanicms for developing a List of centers with outstanding diagnostic treatment and training capabilities in the field of cancer had been discussed at the November 1966 Council meeting. This study would provide assistance in carry{ing out the purposes of Gection 907, which calls for the Surgeon General to develop such lists in the fields of heart disease, cancer, and stroke. At the time of discussion, the Council felt that the: application was too brief, that the methods to be followed were not spelled out adequately, amd that the budget was excessive in light of the justification given. This was, therefore, communicated to the \merican College of Surgeons, and a revision was submitted. The Division of Regional Medical Prograas, on the basis of discussion and favorable recowmendation by the Council, will pursue more detailed negotiations of the contract. Another proposal which had been discussed at the November Council meeting was a contract for a task force and regional diagnostic and treatment centers in the area of choriocarcinoma. The Council, in November, had given its general approval to this activity. However, in further discussion, realizing that one such Liboratory wae already being supported. . UY gy 24 POX eg La el Conor 2 > _— a Regional Medical Progranus : i a3e by the Cancer Cartzol Propr.za, the Uivision of Pesfonal Medical Programs held discussions with the National Center for Chronic Digease Control. An agreement was reached that this was en appropriate activity for the Cancer Control Program to carry out, and the Cincer Control Program agreed to extend its support beyond the initial laboratory already supported. Further, it was agreed that it would be more reasonable to have the National Cancer Inetitute provide eupport for all of the «linical trials activitier invelved in the choriocarcinoma program and to have the Cancer Control Program prowhde support for all of the Ieboratorites involved in thie prograan. The Division of Regional Medical Programs, therefore. will not be involved with supporting this activity, except in the area of continuing - education of physicians regarding the availability of these services ind the need to utilize these services for all patients where the poseibility of choriocarcinom: is indicated. Conference on Regianal Medical Propxams, Janusry 15-17, 1967 The Council discussed the Conference on Regional Medical Programs held in January in Waibington, D.C. and attended by 650 persons, ‘This Conference was held to obtain ideas for the Surgeon General's report to the President. and Congress on P.L. 89-239 from a representative group of knowledgeable persons from throughout the country. ‘The | . Conference also provided the opportunity for interchange of information | among organizations, institutions, ind individuals concerned with the __ regional medical programs. It is believed that the Conference was att excellent mechanism for achieving these purposes, It also served a useful coumunications function for other segments of the Public Health Service and other parts of the Government. oo. =a a ~ ee To Ee A progress report was made on the activities concerning the development of this Report. The ad hoc Advisory Coumittee, which is working on the - Report, has two more meetings scheduled before subaitting the final - Report. The Council members will be consulted prior to the completion o£ a final draft of the Report, after the ad hoc Advisory Comittee completes their recommendations. | fala ff Niet Robert Q. Mixstony MOD. ; cet DRMP Branch Chiefs EHandal:KYordy:J£h |