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DEPARTMENT OF HEALTH, EDUCATION
: A ND WE L PA R EB
Health Services and Mental Health Administration
Division of Regional Medical Programs

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; Nationai Advisory Council on
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Regional Medical Programs

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Minutes of the Meeting
| July 28-29, 1970

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-Parklawn Building a
Conference Room G/H ~

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DEPARTMENT OF HEALTH, MDUCATION AND WELFARE
. [ F PUBLIC TAAL SERVICE

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National Advisory Council on Regional Medical Programs
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Minutes of the Twentieth Meeting YY 2

The National Advisory Counc! on Regional Medical Programs convened
for its twentieth meeting at 8:30 a.m., Tuesday, July 28, 1970 in
Conference Room G/H of the Parklawn Building, Rockville, Maryland.
Dr. Harold Margulies , Acting Director, Regional Medical Programs
Service presided over the meeting.

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| July 28-29, 1970

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The Council members present were: .
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Dr. Bland W. Cannon : ‘Dr. Edmund D. Pellgrino ,
Dr. Edwin L. Crosby (7/28 only ) Dr. Alfred M. Popma

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

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

Dr. William R. Hunt 4 Mrs. Florence R. Wyckoff
Dr. Alexander M. |MePheciran .

A listing of RMP staff members , and others attending is appended.
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CALL TO ORDER AND OPENING REMARKS
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The meeting was called to order at 8:30 a.m. on July 28 by
Dr. Harold Margulies. .

 

ANNOUNCEMENTS |
The Council members were, welcomed to the new Conference facilities in
the Parklawn Building and the general arrangements for the conduct of

the meeting in these facilities was explained. Dr. Marpulies announced
his: plans for an executive session with the Council at the close of the

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first day of the meet ing.

 

Proceedings of meetings are restricted unless cleared by the Office of

the Administrator, HSMHA, The restriction relates to all material submitted
for discussion at the meetings, the supplemental material, and all other
official documents, including the agenda. -

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For the record, it is noted that inembers absent themselves from the
meeting when the Councilsis discussing applications: (a) from their
respective institutiions, 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.

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INTRODUCTION OF Nis MEMBERS

 

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

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

at the next meeting. /

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

 

 

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

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

either in the Regions c or in the headquarters | office.

In recognition of the very formidable probleme facing Regional Medical
Programs Service, Wilson expressed regret that he was not able

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

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

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

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Alithoursh his plans will include a reneral outline of the "mission"

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

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

the Council for developing the policies and detailed program directions

that would lead to even more efficient and effective cooperative arrangements

between the private sector, which they represent , and the Federal effort.
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Dr. Wilson told the Council of the resignation of Mr. Irving Lewis
as, Deputy Administrator of HSMHA, and about Mr. Lewis' appointment

as Professor in the Department of Community Medicine at Albert

Einstein College of Medicine in New York. Mr. Lewis addressed the
Council briefly, stating again his faith in the Regional, Medical
Programs as; representing "the only concept of true regionalization

of health services that can be expected to work" in the United States.
Mr. Lewis expressed his thanks to the Council for the many pleasant
working relationships he had had with them. Mrs. Florence Wyckoff
responded fcr the Council, expressing their appreciation for his
assistance to them, especially in helping them to understand the
principles of Federal financing of health care and in the area of health
economics generally. 5

CONFIRMATION OF FUTURE MEETING DATES

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

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

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

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

A REPORT FROM THE DIRECTOR - Dr. Harold Margulies
A. Progress of HR 17570 and $3355

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

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

B. Appropriations for Fiscal Year 1971

Status of the Appropriation Bill was reviewed and the Council was

reminded of the various circumstances which impinge on the total amount

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

 

 

 
 

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activities at DHEW, HSMHA, and RMPS levels; the possibility of
administrative "earmarking" of some funds for RMP participation in
comprehensive regional kidney disease programs; all in addition to a
total amount slightly in excess of $77 million required to meet
minimal continuation requirements of ongoing regional activities.

C. Funding Strategy

Dr. Margulies made a brief introduction of a new management information
system being inplemented by RMPS.

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

more stringently guidelines to this kind of rebudgeting and to

recapture some of thége balances for reallocation among the Regional
Medical Programs in response to evidence of successful regionalization
and program development.

D. The FAST Recommendations

In a brief. review of the recommendations of the Federal Assistance
Streamlining Task Force and his plan for responding to them, Dr. |
Margulies emphasized the "liaison" role of the DHEW Regional Offices

in the development of HSMHA programs generally, and in helping to

relate Regional Medical Programs to both publicly and privately—funded
programs in the area served; but with the retention of the principal
management responsibility in the Regional Medical Programs Service ,

at the national level. He also mentioned especially the Service's
coneern, antedating the Task Force study, for better delineation of

the multiplicity of activities now covered by the core budget in
Regional Medical Program grants. . ,
Dr. Margulies explained the intent of RMPS in placing a Program
Representative in each of the ten DIIW Remional Offices and described
what he sees as the service role of these individuals.

PROGRESS NOTES FROM STAFF -
A. Contracts under Section 907 — Dr. Margaret Sloan

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

heart disease, cancer, and stroke...."

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

 

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

- The Joint Conmittee for Stroke Facilities, supported

by a contract with the American Neurological Association, ~
has chosen to withhold publication of its report until it
is entirely completed.

The report of the Special Advisory Conmittee on Cancer
Care Facilities of the Cancer Commission of the American
College of Surgeons, which was supported under a contract
now completed, has been reviewed by the Regional Medical
Programs Service and was received by the National Acvisory
Council at the April 1970 meeting. Negotiations between the
American College of Surgeons and the RMPS, preparatory to
corpletion and RMP approval of this report, are now underway.
(This was discussed in more detail with Council during the
Executive Session).

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

Authorized under Section 910 of Title IX of the Public Health Service

Act, this program of project grants will be implemented for the first

time early in FY 1971. The Council was reminded of its original role

in the development of the basic guidelines and operating policies for

these grants. They were assured that these are reflected in the final
edition of the program documents which are now in clearance.

The Council expressed its persistent concern about the potential effect
of the funding of these grants on the total funds available for Section
904 grants (operational support. to Regions). Dr. Margulies said that he
expected to be able to present to the Council at its next meeting, a2
plan for allocation of grant funds that would take into consideration an
appropriate distribution of the available dollars between these two major
grant activities,

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

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

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

the certification of Model Cities officials in this regard. Although

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

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

 

 

 
 

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- serve urban popula’silons néed not plan them exclusively for Model Cities

areas and need not seek any endorsement or concurrence beyond their own
review ard approval mechanism.

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D. Sentor Clinical (Traineeships - Mrs. Martha Phillips

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Mrs. Phillips recalled to the Council che circumstances leading to the
Departmental decision to place respons:.bility for the Senior Clinical
Traineeship prcgram in Regional Medical Programs Service. She also
reported to the Council on the: selection of the first group of Traineeships |
to be awarded under RMPS sponsorship. This selection process was carried
out by panels of nontFeder'al experts in the cancer field and was chaired’
by Dr. Michael Brennan, to whom the Council delegated authority for
the selection of individual trainees to the total extent of $300,000 of

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FY 1970 funds. Thirty trainees were selected from among 80 applicants,
and represent the disciplines of medicine, gynecology, pathology,
pediatrics, radiology, arid surgery. The training will be done in major
medical centers throughout the United States.
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E. Guidelines for Instructional Technology - Miss Cecilia Conrath
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A second edition of these puidelines was before the Council for their

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

to prepare these guidelines, expressed his belief that they are now
ready for publication and implementation, with certain rewriting. This

is being done by RMPS staff, incorporatirg Dr. Pellegrino's suggestions.

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F. Evaluation Activities - Mr. Roland Peterson = ,
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In reporting to the Council, Mr. Peterson mentioned the final summation
and distribution of the Regional Progress Summaries which resulted from
the questionnaire developed and tabulated by his staff; on the Regional
Medical Program Evaluation] Conference to be held at the University of
Chicago Conference Center in September; and on his plans for evaluation
activities in FY 71 Which will be chargeable to the "evaluation earmark."
This earmark was explained to the Couneil by both Mr. Peterson and

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

portions of the total withheld for HSMHA and DHEW evaluative activities.

The entire matter of evaluation sparked considerable discussion in the

Council. It was the consensus that in order for these funds to be

effectively utilized,!a much broader concept of evaluation must be developed.

There was a good deallof discussion of the contract with Arthur D. Little, Inc.

and expression of considerable doubt as to the real value of any findings

being reported. Several off the Council members have had individual experience
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with the conduct of the contract activities and feel that thesehave not
always been handled in the! best interests of the Program. There was
unanimous agreement with the suggestion, made by Dr. Roth and Dr. Cannon,
that interim reports jon the progress of such undertakings, either this
current one or any future such contracts, be required and that they be
Council for review and discussion. The Council

made available to the
requested a more defiritive report from

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contract, particularly as

was originally let.

Arthur D. Little, Ine.

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‘They also asked to

as

it relates to

the staff on the results of the
the purposes for which the contract
see the final report from the

poon as it is received by RMPS.

In summarizing the discussion, Dr. Pellegrino suggested that all | eT

evaluation activities s
of Regional Medical Proprams as they are

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houlld, in the long run, serve to test the viability
developing; and if they are

found not to be viable to determine why they are not.

 

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KIDNEY DISEASE ACTIVITIES IN REGIONAL MEDICAL PROGRAMS

Dr. Margulies reviewed for the Council the circumstances leading to

the addition, in both the House and Senate vers ions of the continuation
lepislation, of kidney disease as one of the specific disease categorical

targets of Regional Medical Programs.

He asked for guidance of the

Council in the development. of a responsive and effective policy for
Regional Medical Programs participation in comprehensive regional kidney

disease programs throughout the Nation.

He is aware that the final

definition of such a policy, especially as it would apply to the immediate
future, will not be possible until after Congressional action, on Doth
the continuation legislation and the appropriations, is complete.

In order to provide some, background for their deliberation, Dr. Margulies
explained that he had asked the staff to prepare some basic information

and to draft some suggested, policy guidelines.
agenda materials presented to the Council.

These were part of the
He then introduced

Dr. George Schreiner, Chief, Nephrology Section, Department of Medicine,

Georgetown University and Dr. Richard RB.

Freeman, Department of Medicine

(Nephrology), University of Rochester School of Medicine, whom he had
invited to the feet ine to provide expert reference to the Counci1 in

their deliberations.

Dr. Schreiner made a |detallied presentation of the ' “state of the art"

of the management of | chronic kidney disease.

He included resume of the

techniques and methodologies of screening, diagnosis and therapy; and
the shortcomings as well as successes in prevention, treatment, and

rehabilitation. (

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Nephrology is, Dr. Schreiner said, a new area of specialization. As
such it has the disadvantage of a severe shortage of trained specialists;
but has the advantage of having few established traditions, and is in
che enviable. position of being able to profit from the mistakes made
in establishing resources

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for open heart sursery,

high voltage radiotherapy, etc.

 

 
 

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Organization for the > delivery of servies to patients with kidney disease,
Dr. Schreiner believes, lends itself so ideally to regionalization that
the: development of lsuch a program can and will serve as a framework for
regionalization of service in other more traditionally established
disciplines. .
Again, as in nearly. all their past discussions of kidney disease, the
Council expressed concern about the apparent lack of emphasis on
prevention as part of an! overall kidney disease program. Dr. Schreiner
and Dr. Freeman helieve that the only hope for real prevention will
come via prenatal care and “penetic engineering" and although work -
in these areas is progressing, it will not have any significant impact —
for fifty to sixty | years, They also believe that the more traditional
approaches to prevention | generally will not be seen to be effective for
at least 20 years. | | .
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Both Dr. Schreiner and Be. Freeman spoke to the issue of the cost ‘of
developing regionalized kidney disease services; and the way in which
the ,enormous number's often used in this regard have been misleading and
discouraging to institutions and communities. Both agreed that the
$15 million inent-ionied ini the pending lepislation could make a
significant difference in thé extension of services of existing kidney
disease centers or Kin the establishment of some smaller number of
entirely new ones. | Dr. Margulies reminded the Council that the
$15 million to which the' Bill makes reference, is recommended as a maximum
assignnent of Regional Medical Program grant funds to kidney disease
efforts, and in no Way earmarks or limits any dollars exclusively for
this purpose; nor does it. provide, or even recemmend the provision,
of funds over and above the grant funds to be otherwise available. for
purposes of Regional Medical Programs .
Dr. Everist raised the question of the mechanics of incorporating
kidney-disease programs into the 55 Repjlonal Medical Programs if, the
principle of local autonomy and decision-making is to be maintained.
It is his belief that unless and until Regions with appropriate
existing facilities can be "seduced" into affording high regional
priority to kidney disease control, it will be necessary to use the
Section 910 authority, so that national direct ives may be used to
develop "sensible programs in sensible places.'

Accepting, the apparently’ inevitable lag time before the results of
a planned program of prevention can be felt, Dr. Fellegrino asked for
the advice of Dr. Schreiner and Dr. Freeman. on what immediate impact
Regional Medical Programs. could reasonably have, considering the -
provisions of the proposed legislation and within the amount of funds
that are likely to be avallable within the next two or three years.
Responding first, Dr. Schreiner recommends the strengthening of
existing facilities, particularly those which have committed themselves
to outreach beyond the confines of the medical center within which

they exist; and further. identifying those among, this group that iend them-

 

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selves to further interLinkage to provide a mttaplying rather than
simply an additive effect. Dr. Freeman recommends the support of the
completion and extension to full services of a small number of
centers which can be developed on the basis of existing, although
perhaps not entirely complete, resources; the use of RMP funds for
support of planning, particularly in regard to increased effective
utilization of expensive resources ; and the training of personnel,
principally physicians, who can serve to train others (other physicians

and paramedical personne}.

The Council strongly endinsed Dr. MePhedran's point regarding the
importance of thoughtful: integration of a kidney disease program into
an existing Regional Medical Program; particularly in planning,
sub-regionalization, continuing education, and ter protess+onat
communication activities,

In a subsequent diceusstdn on the second day, the Council members
reflected on the recommendations of Dr. Freeman and Dr. Schréiner
as well as on the goals, objectives, and the basic operational concepts
which guide Regional Medical Programs at the present time. Since

these proscribe against the use of funds forthe direct provision of
patient services, and the total amount of funds likely to be available

.will proscribe against making major contributions toward the establishment

of facilities, the Counei1 agreed that the major focus of RMP involvement
will be (a) the encouragement of better and more effective cooperative
arrangements among carefully selected institutions and resources which
together might forma "decentralized center" and (b) in the strengthening
of existing institutional resources competent and willing to develop
outreach, both in the demonstration of service and the training of
personel. Both of| the above require national as well as regional
planning. : |

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

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

in, and available to, each of the 55 Regional Medical Programs. This

‘should include (a) preserit ly self-contained centers, (b) institutions

which have the capability of becoming an integral part of such a center,

and (c) institutions and resources which might participate in an inter—
regional arrangement, Por | ‘the provision of kidney disease services. An
assessment of the "Size and shape" of the kidney disease problem in each

of the Regions would provide the other essential piece of basic information.
Dr. Margulies agreed to provide these data based on the existing geographic
pattern of the 55 Regional Medical Program.

REVIEW OF APPLICATIONS

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A, Issues Identified

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1. In the matter of RMP: I support of short— term training projects, the

Council considered the history provided them by staff, and a number of

 

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specific projects ine luded in the applications under review at this
meeting. They be: eve that under most circumstances it is not necessary
or appropriate for Regional Medical Programs grant funds to be used to
cover the full costs of both the presentation of short-term training
projects and of stipends ; and expenses of the participants.
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The majority of projects | ‘in this category provide opportunities for up—-
geading and development of new skills in special techniques or procedures
and are directed to individuals presently employed in health care
institutions. Under the circumstances these institutions should, and
in most cases do, make regular provis ion for this kind of training for
their staffs. f
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The Council therefore recommended the following changes in policy
guidelines regarding payrients to participants in continuing education
and training projects (as, defined in the Guidelines Addendum, February
1970, page 13) nicl are supported by Resional Medical Program. grant
funds.
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Regional vets Program grant funds may not be used for the
payment of stipends, either directly or on the "maintenance of
income principle," to participants in short-term continuing
education and training projects. ‘This does not include training
for new careers = new types of health personnel.

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Other allowable costs of participant's support may be

. calculated accord iris to. _the existing, uuidelines. Regional Medical
Program grant Punnds may “be requested and awarded for per diem and
travel to the extent of 50% of the tdtal amount so derived. ‘The
awarded funds may then be paid to the enrolled trainees as considered
appropriate by the project personnel, depending on the participants'
ability to provide these costs for themselves and/or the willingness
of their employers to provide them. No single individual may
receive per diem jor travel allowance at a rate higher than that

prescribed by the present Guidelines

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

2. The Council considered) the present Guidelines regarding Regional
Medical Program funding of. projects of long-term post-doctoral training,
at_the senior resident and! post-resident levels, particularly in the -
elinical sub-specialties of importance In patient management in the
diseases tarreted by ‘Regional Medical Programs. As has been pointed out
by both the Review Committee and the Council, requests for support for
training of this kind are appearing more and more frequently in Regional
Medical Program applications; because of the increasingly critical
Shoprare ot individugls trained In these fietus, but also because cf’ the
drastic reduction in NIH funding which has Previously been available for
this purpose.

 

 

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

to strengthen the essential involvement of these centers of clinical

excellence into the | framework of cooperative arrangements which form the_
basis of the Region'of which they are a part. It is recognised, however,
that the allocation of an amount of funds large enough to make a significant
impact, if provided, from ithe present MiP appropriation, would create a
serious and inappropriate. imbalance in the RMP efforts to meet more their
varied and comprehensive poals. The Council, therefore, requested the.
RMPS staff to forward to both HSMIA and DHEW its unanimous recommendation .
that arrangements be made, to provide Federal assistance to clinical departments
in major teaching centers to offset the identifiable education costs (as
distinct from the costs: identified with provision of patient services) of
the maintenance of their clinical residency and post-residency training -
proprams; that this mechanism be provided through the framework of Regional
Medical Programs; and that funding, over and above the current grant funds
appropriated to Regional Medical Programs, be sought for this purpose.

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Accordingly, the Colneil yreconmends that until such funds are added to
the annual appropriation, the Regional Medical Program Guidelines for
operational grants under Section 904 of Title IX of the PHS Act be
changed to exclude the payment of stipends and other participant costs
‘for long-term training at the post-doctoral level.

3. The Council is keenly aware of the potentially crippling effect on
Regional Medical Programs of continous investment in projects which were
initially approved for demonstration of, or trainine in, new techniques

of patient care, but provide what becomes an essential service tc patients.
They continue to believe, however, that it would be unwise and indeed
inpossible to develop a firm policy arbitrarily including or excluding
projects of this kind, and instead urge the RMPS staff to work closely
with Regions, as they develop projects, to be certain that other. sources
of support for maintenance of the service involved be well in hand before
such a project is initiated; and also to encourage Regions to carefully
investigate every possibility of capturing the fees paid for the service

“involved, for reinvestment in the project.

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B. Special Actions
NORTHEASTERN OHIO REGIONAL MEDICAL PROGRAM
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In response to a special) appeal for reconsideration of previous action

on Project #7 (A Comprehensive Out-patient Stroke Rehabilitation

Demonstration), the Council considered the additional information submitted
and recommended that the! project be approved as requested. |

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“support of this Center.

of ‘the project as amended.

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NORTHLANDS REGIONAL MEDICAL PROGRAM -

The National Advisory Counes 1 considered a request for the initiation
of interim support to the Diabetes Detection and Education Center in
Minneapolis with the understanding that (a) these funds will be made
available from the Region! s unexpended balances and (b) that this
approval does not in any sense indicate commitment to approve the
forthcoming application for RMP participation in the long-range basic

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VIRGINIA REGIONAL MEDICAL PROGRAM

 

In regard to Project #h (Stroke ina Small Rural Community) the ‘Council
concurred in the staff! s| recommendation for a waiver of the restrictions
imposed as a condition of the criginal approval of this project,

subject to the satisfaction of RMPS that the purposes of the project are
being adequately achieved.

WESTERN NEW YORK REGIONAL MEDICAL PROGRAM

 

In regard to Project #10! (Western New York Tumor Registry) the Council
concurred with the Review Committee's recommendation for continuation
hs {

| V/

i;
Cc. Reconmendations for Act lon =

 

The Council recorded their recommendations in the format “which was

adopted in the previous Fs review cycle (Appendix I).

PY

ALBANY REGIONAL eek PROGRAM

 

RM 00004 7/70.1 - Gperat tonal Supplemental - Approval with specific
conditions. |
Project #TACR) - Approval IT with the conditions Specified by
F the Review Committee.
Project #7B(R) - Approval I with the conditions specified by
the Review Conmittee.
Project #18 ~ Non-approvall II — Revision Required.

01 - $36,930 /
P|
L |

I

 

 

02 - $36,930 03 - $0

All amounts are > direct costs only and unless otherwise specified refer

:

to a 12-month periea-
The designation O1j 0c, etc. relates to the first, second, etc., budget
periods of the subject application, not necessarily the budget periods
that will seta (Pe supplemented.

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“iM -

CALTHOINTA RGTONAL, MiEDTCAL “PROGRAM (CONT)

'

Project #56 - spprowha: IT | a
. Project #60 - Approval T in the reduced amount
Project #61 — Non-approval I
I b>
ol - $107,307 7 02 - $117,248 03 - $121,393
Hi ! . a .

Jt
mo CENTRAL NEW YORK REGIONAL MEDICAL PROGRAM
| 1

ri
t

 

RM 00050 7/70.1 - Gperational Supplement — Conditional approval.

 

Project #15 - Approval I at a reduced level with the conditions ° oe
specified by the Review Conmittee. §

01 - $40, 000 | 02 ~ $50,000 03 - $53,000
ae |
|
COLORADO/WYOMING REGIONAL MEDICAL PROGRAM
4h
RM OOOO 7/70.1 - QperatLonal Supplement - Return for Revision.

 

. Project. #13R ~ Non-abproval II. Return for revision with the
prantpieation requested by the Review Committee.
i |

FLORIDA REGIONAL MEDICAL, PROGRAM

: ,

RM 00024 7/70.1 - Return for revision. '

 

Project #36 — slon-approval IT with recommendations for revision
as suggested by the Review Committee.

: | : - . | y
GEORGIA REGIONAL MEDICAL PROGRAM

 

RM 00046 7/70.1 - Conditional approval.
Projects #31 al 432 -~ Approval in the reduced amount of $100,000
| to be used for the initiation of both projects
| 's as seen fit by the Georgia RMP.
Project #33 - Non-approval I.

ee

01 - $100, 000 ! 02 -— $100,000 03 - $0
I -
| . 4
GREATER DELAWARE VALLEY REGIONAL MEDICAL PROGRAM

 

 

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

 

Project #19 - Non-approval T

ee

,
 

| -15-

HAWATT REGIONAL rEDICAL, PROGR

»

 

RM 00001 7/70.1 ~ pera sona Supplemert - Approval

|

Project #21 ~ Approve I.
Project #22 - iApproval I

7 | ,
01 - $202,743 02 - $99,168 03 — - $108, 252

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RM 00061 _7/70.1 ae with specific conditions. _ -
Profect #9 - Non-approval II with the recommendations for revision
suggested by the Review Committee.
Project #10 - Approval I
. Project #11 - Approval T with the conditions specified by the Review
Commi ttee.
Project #12 - Approyal I
Project #13 - Approy val I with the conditions specified by the Review
Committee ; with second and third year funding contingent
upon progress in the first year to be assessed by the
Gounei1 on the basis of a progress report, continuation
application, and the report of the technical site visit
tO beiheld sometime toward the end of the first year.
| t

O1 - $587,412 02 - $661,237 03 - $341,883

I

i

INDIANA REGIONAL MEDICAL PROGRAM —
 T

RM £00"3 7/70.1 ~ pesrationa Supplement - Non-approval

Project #19 - Non-approvall IT inappropriateness for RMP funding based
on the Council's decision to defer approval of projects
propos ing the clinical application of genetic counselling,
pending further scientific validation of the clinical

ses ne this technique.

Project #20 - Non-approval IT with the recommendations for revision
supgested by the Review Conmittee.

|
ae EE OCS REBTONAL MUDICAL PROGRAM

RM 00015 1/10. l- Operational Supplement — Return for Revision

 

 

-

 

 

Project #2% = Hon-approval IT with the recemmendations for revision
suggested by the Review Conmittee.

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_ KANSAS REGIONAL MEDICAL [PROGRAM

ory

 

RM 00002 7/70.1 -~ Sperat tonal Supplement -— Return for Revision

Project #39 - Non-approval II with the recommendations for revision
suggested by the Review Gommittee.
Py
LOUISIANA REGIONAL MEDICAL PROGRA
r :
RM 00033 7/70.1 - Approval with specific conditions.
a ; [
s Project # 8 ~ Non-approval II witn the recommendations for revision
supyested by the Review Conmittee.
Project #9 - Approval I in a reduced amount and with the conditions
Specified by the Review Committee.

 

Project #10 - Approval I
Project #11 - Approval II
Project #12 - Non-approval II with the recommendations for revision
supgested by the Review Committee.
’ Project #13 - ipproval Ir

O1 = $147, 532 02 = $77,242 03 = $79,342
ro : : |

\
MARYLAND REGIONAL epee PROGRAM
RM OOO44 7/70.1 are 1/10. 2 - Operational Supplements - _ Approval with
specific conditions. '

I

Projects #25 and #2 of - Approval I with both projects to be combined
k
|

 

 

 

| at a reduced amount and with the conditions
| specified by the Review Committee.

[

Project #27 - Approval T
’ Project Hoe ~ Non-approva | IT with the recommendations for revision
sugpested by the Review Committee. ,
Project #29 - Non-approva | I .
Project #30 — Non-approval I

01 - $94, 915 - 02 - $144,475 03 - $145,975

i

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MEMPHIS REGIONAL MEDICAL PROGRAM

| i
RM 00051 7/70.1 - Qperat ional Supplement - Disapproval. ‘Inappropriate for
RMP funding. | f=
| \ .
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Project #27 - Non-approval T. ‘The Council was in apreement with the
Review Committee in recommending nmon-approval for the

Peripheral Vascular Clinic Project. They wish, however,

 

 

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MEMPHTS REGIONAL meprcab, PROGRAM (CONT) .
[ i :
to be certain that the project personnel and the

Memphis: RMP understand that the recommendation in
no way reflects a dl: apreement with the inherit
service: value of the Clinic nor suggests lack of
confidence in the stuff and Institution. The action
does not preclude resubmission.of a request for RMP

finding} for the continuing education aspects of this

project! at such time as these are more thoroughly

planned: and ready to be implemented.

I

Project #28 - eprepprerst I

{
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%

METROPOLITAN WASHINGTON, D. C, REGIONAL MEDICAL PROGRAM *
[

RM 00031 7/70.1 - operational Supplement - - Approval with specific conditions.

Project #36 - Non-approval I
Project #37 - Approval I at the reduced level and with the

conditions specified by the Review Committee.

ol - $38,477 . : 02 - $40,618 03 ~ $44,928
I .

 

|
MICHIGAN REGIONAL MEDICAL, PROGRAM
RM 00053 7/70.1 - Operational Supplement, - Approval with specific conditions.

os

Project #16R - Approval I

Project #27 - Approval I with the conditions specified by the Review
Committee. In concurring with all of the recommendations
of the Review Committee, the Council urged the RMPS
staff to work closely in the development of this project
with the hope that it will come closer to a demonstration
of comprehensive care, as promised by its title, than
it would presently appear to be.

Project #28 - Non-approval | ‘IT with the recommendations for revision

suggested | by the Review Committee.

4

 

| | .
Ol - $550,970 | 02 - $454,574 03 ~ $477,459
! ; : _

i

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MISSISSIPPI REGIONAL MEDICAL PROGRAM

|
RM 00057 7/70.1 - Operational Supplement - Approval with specific conditions.
Project #2R - Approval in the reduced amount for 18-months with the
conditions specified by the Review Committee and with
the understanding that this will represent the termination
of RMP Lfund ing: of this activity.

i =

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po

MISSISSIPPI REGIONAL MURTCAL PROGRAM (CONT)
|
" Project #13 - Approval t

Project #14 ~ Non-approval II with the recommendation that the Ression
be requested to revonsider their program in the light
of the National guidelines for RMP Pa in
¢omprehensive kidney disease programs. Council further
recommended that the Region be afforded direct help by
the statf of RMPS in making their decision in this.
regard and in planning a revision if such is to be proposed.
| i

ol - 213,120 ! 02 — $125,946 3 _ $39,455 °° -

MISSOURL REGIONAL Mt mprcnL. PROGRAM

 

RM 00009 7/70.1 and 1/10. 2 - Operational Supplement - Approval with specific
conditions. i

I '
i

Project #60 - Non-ap roval II 7 So
Project #o1 - Non-approval TI. Although the Council agreed with the
Review Committee that these two projects, as presented,
are unacceptable for Regional Medical Programs support,
they recalled the recommendations of the recent indepth
site visit to MoRMP and suggested that with staff help
m both RMPS and MoRMP these "outreach" projects
could ‘be developed into important components of the Program.
Project #62 - Approval I in a reduced amouht and with the conditions
specified by the Review Committee. —
Project #63 - Non-approval II - The Council recommends that this
project be integrated into the Region's overall continuing
educat,ion effort Ln the preparation of the Region's
fmiversary Review application. A

|

ol - $330,243 > — $36,984 03 - $39,165
i .

. '
MOUNTAIN STATES REGIONAL MEDICAL PROGRAM -

I.
i

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RM_00032 7/70.1 ~ Operational Supplement - Approval

 

|
Project #12 - Approval t
Project #13 - Approval I

01 - $184,976 02 ~ $191,117 03 - $197,804

|

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NEW MEXICO REGIONAL MADTCAL PROGRAM

 

 

RM 00034 7/70.1 - operational Supplement - Approval with specific conditions.

I

Project #13 - Non-approval Tr

t

_
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' | -19-

7 NEW MEXTCO REGIONAL | MEDICAL eons (cont)

 

‘Project #14 - Agprovall I in the reduced amount ard with the
conditions specified by the Review Conmittee.
Project #15 - Approval I with the conditions specified by the
Review Committee.
' .
t
ol - $92,100 7 02 - $99,900 03 ~ $101,765
| i

NEW YORK HmRIROPOLE AN REGIONAL MEDICAL, PROGRAM

 

» RM 00058 7/70.1 and 7/70. » - Operational Supplements ~ Approval with
specific me
Project #16 ~ Non-approval II with the recommendations for revision
suggested by the Review Conmittee and with the advice
that the Region deter further planning for RMP
participation in kidney disease services in the New
York Metropolitan area until they receive the National

policy paidelines wl which are in preparation.

 

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

Project #18 ~ Non-approval I

Project #19 - A provall I .
OL ~ $476,175 - 02 = $494,965 ° 03 - $350,000
i:
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NORTH CAROLINA REGIONAL MEDICAL PROGRAM —

f
RM 00006 7/70.1 - operational supplement — Approval with specific conditions.

f
“Project #3R - Approval I
Project #26 - Ng Action Taken. Site visit required.

roles

Ol - $89, 908 : 2 = $62,550 03 - $42,306

{
7

NORTH DAKOPA REGTONAL MEDICAL PROGRAM

 

 

 

RM 00060 7/70.1 ~ Operational Supplement - Approval with specific conditions.

Project #5 - hpproval T

Project #0 - Approval) T. “Although Council was in general agreement
with the: Review Conmittee concerning the shortcomings of
this project, it was thelr opinion, based on first-hand
knowledge of the [Institution and personnei involved in
the project and on their experience in site visiting this

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NORTH DAKOTA REGIONAL MEDICAL PROGRAM (CONT)
I i
Region, that the approval of this project is
essential for further development of the North
Dakota Regional Medical Programs. In recommending
approval, Council strongly urged RMPS staff to work
with the: Region and with personnel involved in this
‘project to correct some of the deficiencies and get it
ony Fo a; good start.
;

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

| 1
to the Council.
/ |

Project #8 - Nor-approval I
Project #9 - Apyroval |

OL - $115,383

02 - $79,772 03 = $79,549

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ah

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NORTHWEST OHIO REGTONAL MEDICAL PROGRAM
— :
RM 00063 7/70.1 and 7/70.2 - Operational Supplements - Approval with
specific conditions. " 4

ta

Project #01-S ~| Non-approval T

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

 

F
}

-

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

|
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- se = > NORTHWEST: OHIO poisTONAL MEDICAL — (CONT)
t
‘ ‘The value of an assessment visit as recommended by
the visitors was questioned since it would probably
do no more than re-identify the problem. Council
suggested that perhaps direct and frequent assistance
from RMP staff and consultants would be more helpful
than further investigations of the situation.
Ol - $145 ,830 : 02 ~ $70,525. 03 - $21, 250
: i
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. OHIO STATIV REGIONAL MEDICAL PROGRAM / :
a |
RM 00022 7/70.1 and 7/70.2 — Operational Renewal and Supplement - Approval
with specific conditions.
r “|
Project #1R - Approval I at the reduced level ani with the conditions
specified by the Review Conmittee
Project ABR - Approval T in the reduced amount and with the conditions
specified by the Review Committee.
; Project #22 - Approval I (this project was considered by the Council in
C ° . ~ vps previous review cycle and action was deferred at that
tine).
Project #24 ~ Non-approval Il with the recommendations for revision
suggested by the Review Committee.

 

Ol - $714,075 “02 - $778,731, 03 - $847,944
: : ;
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OHIO VALLEY REGIONAL MEDICAL PROGRAM
: i .

RM 0004S 7/70.1 ~ operat ional Supplement — Approval with specific conditions.

I

approval I in the reduced amount recommended by the

expert) technical reviewer.

Approval T. To be funded only if not furred by other

Federal resources.

Project #1! - Approval IT

Project #15 Approval I

Project #lb - Non-approval TI with the recommendations for revision

as suggested by the Review Committee.
Project #17 - Non-approval IT with the recommendat ions for revision
Sugpested by the Review Committee. -
Project #18 - Non-approval I

ng |

01 =. $273,546

 

 

Project #12

Project #13

02 - $296,215 03 - $327,657

N

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OREGON REGIONAL MEDTCAL PROGRAM
FO

RM 00012 7/70.1 ~ Operational Supplement. -- Approval

Project #12R ~ Approval I

Project #16 — Approval I

 

 

,

01 - $59,375 02 ~ $28,829 03 - $14,843_
| , :
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PUFRTO RICO REGIONAL MEDICAL PROGRAM / fa
Pos :

 

 

I
RM 00065 7/70.1 ~ Operational Supplement — Approval with specific conditions.
I. 1 :

Project #9 - Approval T inthe reduced amount and with the conditions
specified by the Review Committee.
Project #11 - Approval I with the conditions specified by the
Heview Committee.
OL = $320,936 | 02 + $227,436 03 - $233,636

SOUTH CAROLINA REGIONAL’ MEDICAL PROGRAM

 

|
RM_ 00035 7/70.1 - Operational Supplement. - Non-approval.
; |
Project #35 - Non-approval II with the recommendations for revision
suggested by the Review Committee.
Project #36 - No action taken. Site visit is indicated.
Project #37 - Non-approval L
, |
SUSQUCHANNA VALLEY) REGIONAL MEDICAL PROGRAM

fe ~

RM 00059 7/70.1 - bperational Supplement. - Approval with specific conditions.
[ t :

Project #20 - Non-approval I . .
Project #21 — Approval I in the reduced amount to reflect the newly

adopted policy on training project participants.

Project #22 - Non-approval 1

Project #23 - Non-approval I

Project #24 - Non-approval II with the recommendations for revision

suggested by the Review Committee. _

Project #25 - Non-approval II. The Council was in general agreement
with the Review Conmittee regarding the specifics of the
project, but believe that further development of this
project; along with #24 is in the best interest of the
the Region and has requested that the RMPS staff offer
assistance to the Repion in this repard.

Project #26 - Approval I

 

i i
Ol - $92,131 7 02 - $78,915 03 ~ $83,294

 

 
 

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TEXAS REGIONAL, MEDICAL PROGRAI

 

r RM‘ 00007 7/70.1 - Operational Supplement - Approval with specific conditions.
| r
Project #8R - Approval I contingent upon the satisfaction of a
technical site visit team regarding four specific
r ints | Set forth by the Review Committee.

Project #14R - Approval I with conditions specified by the Review Conmittee.

Project #L5R - Approval I

Project #15 - Non-approval I

Project #49 - Non-approval I
: [: i

|
O1 - $460,640 ~, 2 = $296,595 03 -— $240, 386
. ; a

MUDICAL PROGRAM

TRI-STATE REGIONAL

RM 00062 7/70.1 - Operational Supplement; - Approval

 

 

' Project #9 - Approval IT in a reduced amount and with the conditions
specified by the Review Committee.

I

ts

02 -

. ol - $105,300 |
‘ I :

- : |
VIRGINIA REGIONAL merry PROGRAM

RM OOO49 7/70.1 — operational Supplement —- Approval with specific conditions.
|
Project #10 - . Approval I with the conditions specified by the
Review. Conmittee. In discussing this project the
Council wished to stress the importance of the, condition
for approval. of this project and urges great care on the
part of the staff in adjusting the second and third
year amounts of RMP support by utilizing patient revenues

to offset costs of the project.

$85 ,600 03 - $63,000

 

s

 

 

Ol - $268, 52 02 - $480,479* 03 - $533,504%

® To be negotiated downward
|
WESTERN NEW YORK Eee TONAL MEDICAL PROGRAM . -
PT , : ;
RM 00013 7/70.1 —Operar ional Supplement - Approval with specific conditions.

 

 

Project #15 - Approval I in the reduced Arneuint and with the conditions
specified.

Project #16 - Approval T in the reduced amounts nnd with the conditions

specified by the Review Conmittee. Council expressed its

willingness to allow the Region to increase the funding

I :

 

 
 

 

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WESTERN NEW YORK REGIONAL MEDICAL PROGRAM (CONT)
‘of this project to a maximum of $100,000, providing

such a level of funding would be required to maintain
this valuable regional resource.

Project #17 - Non-approval I
O1 - $350,000 =~ 02 — $350,000 03 - $350,000

WESTERN PENNSYLVANIA REGIONAL MEDICAL PROGRAM
RM 000/11 7/70.1 - Operational Supplement - Approval

Project #9 - Approval I
01 - $43,911 02 — $44,820 03 - $46,995

WISCONSIN REGIONAL, MEDICAL PROGRAM

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

 

Project #13A (R) — Approval II

Project #18A — Approval I 5

Project #18B - Non-approval I. -

Project #181 — Non-approval I

Project #18K — Non-approval I

Project #19 - Non-approval I. Council based this recommendation on
the findings of a collateral review of the project.»
‘by the staff of Maternal and Child Health Service, HSMHA,
which was requested at the suggestion of the Review Committee.

Project #20 - Approval I

Project #21 ~ Non-approval I

Project #22 — Approval I

Project #23 - Approval I in the reduced amount and with the conditions -
specified by the Review Conmittee.

O01 - $292,815 02 — $167,807 03 — $172,395
 

 

_ —_ ~ 25 -
XI. ADJOURNMENT
The meeting was adjourned at 11:30 a.m. on July 29, 1970
:
: ~

: i: ' I hereby certify that, ‘to the best of
\ my knowledge, the foregoing minutes
! i are accurate and complete.

(3 so | a 4

No! i . : . a
i f ‘| a)
; rhe A L
| — lan ot! LA mv lus
; i. figrold Margulies, Me)
} Acting Director °
Regional Medical Programs Service
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7 - 26 -
paid fa OE RECO UMETDARLGLo

- f ; I Ve .
. : i.
" Fron the Panels to the Review | Committee

0

On Projedts Only) 7

 

\
Technically scund and capably directed
Feasible under speci fied | conditions
Unapprovable on techrii cal geounds
t 1 -
; | 7
From the Review Committee to the National Advisory Council
i .

~ (On Projects)

Approval To - Additional “Lunes reeours nided
Approval TI - No addi tional. funds recomended
i

Non-approval To - Thapprdmdate for Dale funding;
Non-approval TT - Revi sion required
No action taken - i ed addit Jounal dnformedbion

‘ Nocd site visit
Necd Council deeisjon

 

(On Entire Applications) |
:
|

, Approval
KO Approval with specific cord tlions

Deferral | : ; .

Return Por Revision! A

Disapproval - Tnapproprate for DHMP funding
oe 5

! t 4

Na :
Bor nT the Nat: Jonat Advisony Council to tie » Ahninistrator,

“(On Patire A plications)

Approva L
Approval. with specific conditious

(As poconmended by, the Rov iew Contaittee or other 225)
Deferral

:
Returi for Revisr sion _
Disapproval — Inappropriate for Dip Punling
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3 7 = :
 NATTOUAL ADVISORY COUNC ON
REGIONAL MMOTCAL Thochaeis

 

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BRENNAN, Michael J., M.D. (72)
President, Michigan Cancer Foundation

4811 John R Street’
Detroit, Michigan | 48201

 

Professor of Medicine
Wayne State University |
f
CANNON, Bland W., M.D. (73)
910 Madison Avenue ;, -
Memphis, Tennessee |) 3810
| P
Division of Neurosur: ery,
University of Tennessee College
of Medicine

:
'

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CROSBY, Edwin L., M.D. (71)

Executive Vice President. and Director

American Hospital Association.
Chicago, Illinois 60611,

|
DeBAKEY , Michael E.l, M.D, (72)
President: and Chief| Executive Officer
Baylor College of “ediciné ~
Houston, Texas 77025
Professor and Chairman
Department of Surgery
College of email
EVERIST, Bruce W., M.D. '(71)
Chief of Pediatrics | ,
Green Clinic
Ruston, Louisiana

 

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721270 |
E

HUNT, William R., M.D. (71)
Board of Commissioners s
County of Allegheny |

101 Courthouse |
Pittsburgh, Pennsylvania

SB meee ee ee

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

OGDEN, }

CHAT RIAN ;

 

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

Mayo Clinic

Rochester, Minnesota 55902

*%. C. Robert (70)
President and General Counsel
North Coast Life Insurance Company
Spokane, Washington 99201

PELLEGRINO, Edmund D., M.D. (70)
Vice President for the Health
Sciences and Director of the Center
State University of New York

_ Stony Brook, New York 11790

- POPMA, Alfred M., M.D. (70)
“Regional Director

Mountain States RMP
525 West Jefferson Street
Boise, Idaho 83702

ROTH, Russell B., M.D. (73)
240 West Hist Street
Erie, Fennsylvania 16508

 

Vice Speaker of the House
of Delegates , AMA

- SHANHOLTZ, Mack I., M.D. (70)

State Health Commissioner
State Department of Health
Richmond, Virginia 23219

TREEN, Mr. Curtis (71)

Director, Pension and Insurance Dept.
United Rubber, Cork, Linoleum,
and Plastic Workers of America

‘Akron, Ohio 44308

WYCKOFF, Mrs. Florence R. (72)

. 243 Corralitos Road

Watsonville, California 95076

Dr. Vernon ff. Wilson

i Mental Health Administration
( 5600 Fishers Lane

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| Administrator, Uealth Serviees and
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Rockville, vapyland 20852

ANIA

 

 

 
 

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ATTENDANCE AT a NATIONAL ADVIouRY COUNCIL

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7 July 28-29, 1970
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RMPS STAFF ATTENDING

 

Miss Rhoda Abrams Dr. Marion E. Leach
Mr. H. Earle Belue - Mr. Gregory Lewis
Dr. Edward T. Blomquist Mr. Ray Maddox
Mr. J. Edgar Caswell ce Miss Elsa Nelson
Dr. Donald R. Chadwick Mr. Roland Peterson
Mr. Cleveland R. 'Chambliss Mrs. Martha L. Phillips ;
Mr. Clyde Couchman _ Miss Leah Resnick
Dr. Sam Fox, III) ' *Mr. Donald Riedesel
X Mr. Edward Friedlander Mrs. Jessie Salazar .
Mr. Sam 0. filmer = Mrs. Sarah Silsbee
Mr. Charles Hilsenroth) Dr. Margaret Sloan
Miss Dona Houseal. - ee Mr. James Smith

Mr, Frank Ichniowski
Dr. Anthony Komaroff Mr. Lee Teets
Mrs. Lorraine Kyttle _Mr. Francis Van Hee, Jr.
Mr. John M. Korn, Jr. | Mr. Lee Van Winkle

: | , Mr. Frank Zizlavsky

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x .
OTHERS ATTENDING | p= +

f .

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Mr. Dan Spain

i,

Dr. Maurice Bender , Os:

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

Dr. John Cashman, CHS, "HSMHA s
Mr. James Dunlop.’ A.D. ‘Little, Inc.

Miss Sylvia Kesinger, CHS, HSMIA

Dr. Richard Levinson, Veterans Administration
Mr. Wendall Maddrey , "NCHSRED, HSMHA

Mrs. Sylvia Paymer, NCT, NIH

Mr. Norman Tucker, BHPEME, NTH

De. T. OM. Valea | NIAMD, NIH

Dr. William Zukel, NHELT, NIH

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