DE

PARTMENT OF HEALTH, EDUCATION

AND WELFARE

Health Services and Mental Health Administration

Regional Medical Programs Service

; National Advisory Council on
Regional Medical Programs

Minutes of the Meeting
August 3-4, 1971 -

Parklawn Building
Conference Room G/II

 

 
DEPARTMEAT OF 1 FEALTY, EDUCA
_ PUB

National Advisory

Minutes of the

The National Advis

for its twenty-

in Conference Room G-H of

Dr. Harold M,

presided over the meeting,
The Council Member:

Dr, Bland ¥,

ory Counc
fourth meeti

argulies, Direc

 

TION AND WELPARE
VICE

ry
X

LIC UEALTH Sur

Council on kegional Medical Programs
Twenty-fourth Meeting L/ 2/
August 3-4, 1971

il on Regional Medical Programs convened
ng at 8:50 a.m., Tuesday, August 3, 197]
he Parklayn Puilding, Rockville, Maryland,
tor, Regional Medical Programs Service

7 OF

t

S present were:.

Cannon . Mr. Sewall 0, Milliken
Dr. Michael FE, DeBakey. . Dr. Alton Ochsner
Dr. Bruce w, Everist Dr. Russell B. Roth
Dr. Willian R. Hunt Dr. George E.Schreiner

Dr. Antho
Dr. Alexander M, McPh
Dr. John P, Merrill

Dr. Clark H, Millikan

e

A listing of Rvp Staff members ,

I. CALL To ORDER AND OPEN

was called
fargulies,

The meeting

Dr. Harold }

II. INTRODUCTION oF NEW ‘co
STAFF
Dr. Margulies introduc

"who were attending the
Yr. Margulie
M. Mars an

*

Mrs, Audrey
present,

1/Proceedings of meet

of the Administr
submitted for di

ee

gs .

2/Tor the record. it ds ne

Tespective ins titutions ;

cccur. This pr

only when the a

ny L. Komarof

bo ell oO, Millik

ator, HEA". Th
SCuSSie |
and all other official docu

ocedure An
pplication

Mrs, Florence R
Dr. Benjamin w .
Mr. Edward Fr

Dr. Musser

- Wyckoff
Watkins
iedlander for

dran

and others attending is appended,
ING REMARKS

to order at 8:30 a.m. on August 3 by

UNCIL MEMBERS » COMMISSIONED OFFICERS, AND

ed the followin
im SFrst meetin

& hew members of the Council

8: Dr, Anthony L, Komarof€,
en, and Dr, Benjamin w,

S noted that tyo new members of the Council,

M3. C. Robert 0

d gden were unable to be

are restri
slates to al] material
‘~~ meetings, the Supplemental material,
ents. | <ncluding the agenda,

“sd that roth ape ohrant theoratarae From tho
‘D) in which & ¢
ret, of course, ;
-. under indiyj dua

ro
~

n,

 

 

 
2

The following new Commissioned Officers and new RMPS staff menbers
were then introduced:

‘"Comnuissioned Officers

 

Elvin EB, Adams, M.D. Martin A. Greenfield, M.D.
James I, Cleenan, M.D. Kenneth E, Joslyn, M.D.
Paul E. Cohart, M.D. Michael A. Newman, M.D.
Jeffrey B. Crandell, M.D. Daniel Nemzer

Alan Kaplan, M.D.

‘New Staff Members v -

r

Charles Barnes Mrs. Glinter Johnson

Richard Clanton . Mrs. Nancy McGuire . -
Mrs. Shirley Fairtey Roger Miller ,

John Farrell, M.D. Spero Moutsatsos

Robert Handy, Ph.D. _ Jeffrey A. Passer

Calvin Jackson Roland Williams

III. “ANNOUNCEMENTS -

Dr. Margulies made general announcements, and called attention to
the statement on "conflicts of interest'' in the information folder.

IV. CONFIRMATION OF FUTURE MEETING DATES

 

The Council reaffirmed the following dates for future meetings:

November 9-10, 1971
February 8-9, 1972

Council then set the following subsequent meeting dates:

May 9-10, 1972
August 15-16, 1972

V. CONSIDERATION OF MINUTES OF THE MAY 11-12, 197, MEETING

 

The Council considered and “approved the mimuites of the May 11-12,
1971 meeting with the following changes:

1. South Carolina Project #43, "A Regional Program for the Improved
Therapeutic Management of Hypertension for South Carolina."
The record should show that the renal disease panel recommended
disapproval and that the Council concurred.

2.. The addition to the minutes of a resolution concerning funds
placed in reserve which was adonted in Executive Session at the

 

 
3

Council Meeting of February 3, 1971 with a request that it be
transmitted to the Secretary. The full text of the resolution
and the copies of the appropriate transmittal memorandum are

appended as Attachment A.

VI. REPORT BY DR. MARGULIES

 

A.

Meeting with the Secretary

Dr. Margulies, several Council members, Coordinators, and others
interested in Regional Medical Programs, met with the Secretary
on May 24th. The meeting had the effect of correcting some
prior misconceptions about iP. The mecting served to identify
all the strengths which characterized Regional Medical Programs.
During the meeting, strong support was elicited from the
Secretary's professional staff, and the Secretary himself
indicated that in the future RMP will be a key element in devel-
Oping mechanisms such as HMO's through which the Department
will carry out new initiatives,

Hearing and Appropriations

Both the Senate and the House have reported out marked increases
in funds for Fiscal Year 1972. The House would add $30 million,
and the Senate $70 million to the amount requested. In addition
to this, $10 million supplementary appropriation for FY 1971
increases the amount held in reserve for FY 1972. The marked
increases plus the larger reserve indicate that greater amounts
may possibly be available for grants in FY 1972,

During recent Senate appropriation hearings, the Chairman
expressed his determination that budget procedures would not
block expenditure of all monies appropriated.

In response to questions concerning the possible use of Section
910, it was pointed out that Section 910 has not been implemented
in the past because of restricted availability of funds. Use of
this authority might have been misunderstood aS a Signal that
additional funds were available. If additional funds become
available, however, RMPS will consider using the Section 910
authority. First consideration would be given to allocation of
additional funds to strong RMP's that have been hurt by cuts in
the past.

Area Health Education Centers

 

The Congress is considering two proposals relating to Area Health
Education Centers. The Administration's Bill which has passed

 
4

the House would place Area Health Education Centers in NIH.
The other would place ANEC's in RMPS. The Senate and House
Bills are.still in conference and it is still not certain
whether Area Health Education Centers will go to NIH or RAPS.
The House Bill which makes NII] responsible, requires that any

. Area Health Education Center be developed in cooperation with

a Regional Medical Prosram, so in any event, RMP will have
extensive involvement. In view of this RMPS has developed a
very close working xelationship with the Bureau of Health
Manpower. The two organizations havé been working well
together, have a good understanding of what needs to be done,,
and will be able to cooperate effectively.

: v
Veteran's Administration has also exhibited a high level of
interest in Area Health Education Centers. The VA in cooper-
ation with RMP and NII has mounted a series of site visits to
examine the potentialities for establishing Area Health Education
Centers which would include an investment end involvement on
the part of the VA. These visits have been conducted in areas
having inadequate medical services, where good working relation-
ships are already established with Regional Medical Programs.
The VA has made it quite clear that RMP relationships would
be very desirable, if not essential in all cases.

Dr. Margulies asked Mr. Friedlander to comment on the VA's
interest in AHEC's. Mr. Friedlander indicated that only those
communities would be funded through VA where activities have a
direct relationship to improved quality of care. VA funding
would provide initial support which an Area Health Education
Center would be expected to pick up once legislation has passed
and funds have been appropriated.

Equal Employment Opportunity Progress Report

 

‘The Regional Medical Programs Service has developed a very strong

Equal Employment Opportunity program. The Service has an EEO
Council made up of RMPS employees which meets weekly.

RMPS has established definite goals and targets for employment of
minorities. and women by January 1972. RMPS expects similar EEO
efforts to be undertaken by grantees and affiliates.

Report on Orientation Sessions - August 2, 1971

 

An orientation session for new Council members was held on
August 2, 1971. The staff discussed the general purposes,
organizational structure and history of Regional Medical
Programs. The kinds of matters that come before the Council
were also discusse}. The session was attended by Mrs, Wrekoff,

fir. pudiiaci.

 

 
 

oan

IMO's - Progress Report

 

Regional Medical Programs throughout the country have developed
an intense interest in Health Maintenance Organizations. RvP

_has been assigned two specific responsibilities in relation to

HMO's. These are (1) to set up guidelines for monitoring the
quality of care and (2} to describe for monitoring or for guide-
line purposes what is meant by "health maintenance.'' These
assigmments are an outgrowth of increased avareness of the need
for a more satisfactory method of determining whether or not
quality of care being provided and paid for with Federal or ~~ .
non-Federal funds is indeed adequate. ‘

Many units of the Federal government have been dealing with .
these and othar issues relating to quality of care. RMPS is
consequently working with other HSMHA units, NIH and Social
Security to gain the benefit of their experience.

In addition, RMP is setting up some meetings with coordinators
and other individuals who are concerned with measuring and
monitoring the quality of care. We will also be calling on
members of the Council to contribute their thinking and special
skills in relation to quality of care issues.

Present Status of Section 907

 

Section 907 of the Act requires that the Secretary annually

publish a list of hospitals which possess the most advanced
scientific techniques for dealing with heart disease, cancer,

stroke, kidney and related diseases. Recent Congressional

interest in Section 907 makes it highly undesirable not to

proceed immediately with the preparation of the required list

and RMP intends to do so. The list will not attempt to be all-
inclusive or to include all institutions where limited services

are provided, but rather to list those institutions which demonstrate —

- really superior and advanced performance. The list will be

carefully selective and will be designed around criteria which
have been derived from contracts to set up guidelines for cancer,
heart disease and stroke, and some other information which has
already been assembled in the Kidney Disease Program to identify
institutions which would appropriately be included.

The list will be compiled on the basis of a voluntary response
to a survey of hospitals throughout the country. The list would
identify those hospitals having characteristics associated

with special quality. There would be no sense of accreditation
or regulation, nor would a sense of approval or disapproval be
involved. The list will constitute a selection derived from

 
 

VII.

VIIt.

SPECIAL REPORTS

6

Secretary's decision, presumably be available to physicians
and to the public in general and would provide information
about where certain levels of medical care are available.
There has been some question in the past as to whether the

. creation of such lists is a feasible endeavor, which has been
one of the reasons for failing to proceed more rapidly with

. this activity. .

General discussion followed, but no action was taken.

REMARKS BY MR. BENNY BOB HALL, DEPUTY ADUTNISTRATOR, HEALT H SERVICES
AND MENTAL HEALTH AD LINISTRATION

 

 

Mr. Hall, representing Dr. Wilson who was unable to attend greeted
the Council and read a prepared statement concerning the creation
of a better health care system through the application of technolo-

gical development to the health field. The discussion which followed

indicated that the Council and the health field generally have long
been aware of the potentialities of computer technology and fallout
from the Aerospace program in the provision of health care. A
mumber of Council members, however, strongly indicated that sub-
stantial additional funds would be needed to turn the interest into
practical results.

Mr. Hall also discussed impending changes in the organization of

the HSMHA Administrator's Office and indicated the likelihood that
in the near future a member of programs would be grouped under four
Deputy Administrators rather than reporting directly to Dr. Wilson.

A, RMPS Reorganization
Dr. Pahl briefly outlined the current status of reorganization
within the Regional Medical Programs Service.

The reorganization is currently underway and it will probably
be early September before all branches are able to get together
and interact appropriately.

The reorganization will restructure the way in which RMPS inter-
acts with the individual Regional Medical Programs. Four
operational branches have been established on a geographical
basis. These, together with the Grants Management and Grants
Review Branches constitute the new Division of Operations headed
by Mr. Robert Chambliss. Four Operations Branches have been set

up on a geographic basis. Teams of professional | and y Supporting
ete PE dee ee TT IPE LA Day eh FT ee, 3 Tepe

 
 

7

individuals in other divisions and offices, such as Planning
and Evaluation and Professional and Technical Development have
been identified to serve as joint appointees with the Operations
Branches.

- Review Criteria - a

Dr. Pahl and Mr. Peterson discussed the new RMPS review critcria
and rating system.

The review criteria and rating system were developed by staff,and
employed for the first time by the RMPS Review Committee as its
July 1971 meeting. The criteria were derived from the RMPS
“Mission Statement.'' Each criterion was weighted, and a 1
through 5 scoring system was employed for each. Reviewers

were asked to“tircle the score for any criterion about which they
were uncertain. In-addition, the rating sheets -included a place
for each reviewer to indicate the basis for his evaluation.

The reviewers appeared to feel comfortable with the overall
process in which they had engaged. Members of the Review Com-
mittee felt that the 17 criteria were comprehensive and that
the sub-criteria raised in the form of questions were, in fact,
useful in helping them to channel their thoughts. Some modi-
fications and improvements were suggested, however.

As a result of this initial experience, plans’ are underway to
rearrange and clarify a momber of the criteria and to provide more
adequate information about certain items with a view to increasing
the reviewers confidence in their ratings.

In general the initial trial indicates that the criteria and
rating system are both workable and satisfactory.

Council, Review Committee and Staff Responsibilities for Grants

 

Dr. Margulies-read to the Council the material under VIII, C. in
the Agenda Book entitled 'Review Responsibilities Under the
Triennial Review System.'' It was moved by Dr. Millikan and
seconded by Dr. Roth that this statement be formally adopted.
The motion was approved unanimously. The full text of the state-
ment is appended as Attachment B.

Watts-Willowbrook

Dr. Margulies introduced Dr. Alfred M, Haynes, Chairman, Department
of Community Medicine and Assistant Dean for Community Health

Affairs, Charles R. Drew Postgraduate Medical School, Los Angeles,
Cali fornia.

 
 

8

Dr. Haynes narracud a slide presentation on the Watts-Willow-
brook project which involves the concerted efforts of the
Martin Luther King, Jr. Memorial Hospital and the new Charles
R. Drew Postgr aduate Medical Scheol. as well as other com-
munity agencies. These organizations have combined in a
concerted effort to establish a health service center in the
Watts area to provide quality care to the residents. The
project is organized in such a manner that. service to the -
commmity is regarded as equally, and perhaps more important,
than educational and resear ch activit ties.

Status of. RMPS Regulat ions ‘

 

Mr. Kenneth Bawn summarized the status of efforts to revise RMP >
policies and Regulations.

The HEW General Counsel's Office has advised RMPS to complicte
rewrite the Program's Regulations to reflect the most coats
changes in the Statute as well as new operational procedures.
The General Counsel's Office is developing an initial draft
of. such Resulations in cooperation with RMPS.

Considerable pre vress has also been made in developing a loose
leaf policy mart::i for the use of grantees, affiliates and
RMPS staff. Departmental, HSMHA and RMP policies have been
assembled fur inclusion, however, considerable editorial work
still remains to be done.

Computer Assisted EKG Analysis. oo

 

Dr. John Farrell and Dr. Kenneth Gimble discussed a draft report
on the subject of computer assisted EKG analysis that was
prepared at the .request of the Council.

Technologically fully operational EKG analysis requiring no

’ further readins 4» a physician has not been achieved. Development

of a fully auo:..-d system of that level of sophistication is
problematical. ‘Computers have been accurately and reliably
used for screening normal and abnormal EKG's with less than 1
percent error. -

The cost of automated EKG's is estimated at $2 to $4 per cardio-

_ gram exclusive of the cost of rereading by a cardiologist and

assuming a minjwim annual volume of input.

Basic conclusions -27: ached from the study were: (1) that computer
assisted EKG analysis an effective and reliable screening
technique; (2) that definitive diacnosis must be done by a
CL ui Curuioicgist, ot icust an the prescil stute OL tue art,

it camot replace him.
 

IX.

EXECULTVE SESSION —— a _
During: the Executive Session there was a discussion of the status
of efforts to consolidate three Ohio RWP's. In view of progress
that has been made it was proposed to sermit these Regions to
apply in Februery. It was also proposed that Council and other
appropriate staff work with the Interim Committee and the Fiscal
Agent. It was moved by Dr. Millikan and seconded by Dr. komaroff
that the Cowicil go on record as supporting this initial plan
including the proviso that RMPS begin to work directly with Chio
RMP's on a staff basis. The motion was adopted unanimously.

Other items discussed during the Executive Session included (1)

the status of the Albany, Rochester and Central New York RMP's;

(2) the status:of the Susquehanna Valley RMP; and (3) the possible .
separation of Delaware from the Greater Delaware Valley RAP.

No action was taken on these matters.

REVIEW OF APPLICATIONS

 

‘A. Hawaii Regional Medical Program

 

Motion made by Dr. Millikan - Seconded by Dr. Ochsner

"Approval of the Hawaii application for one year funding at
$1,072,000 plus an additional $30,000 with the strong recom-
mendation. that money be utilized for support of activities in
the Trust. region and with the additional advice as specified
on page 1 of the Committee's report." (Transcript, page 20,
line 20) —

The motion was unanimously approved.

 

B. Northern New England Regional Medical Program
Motion made by Dr. Millikan - Seconded by Dr. Schreiner

Approve the recommendations of the Review Committee, including
recording the six items of their critique, with these items to
be kept strongly in mind when the triennial application is
ultimately reviewed, and with advice that through strong admin-
istrative leadership some of the real concepts of RMP should
be included in the program. (Transcript, page 26, line. 3)

The motion was unani smonsty approved after further discussion
which suggested. that the Region might profitably examine goals
and objectives devcloped by other RMP's and develop a plan for
use of collected data.

 
 

10

C. Texas Regional Méucal Program *

 

Motion made by D... Everist - Seconded by Mr. Friedlander

"Approval. for two years at a funding level of $1,590,000
including the developmental fimding.'' (Transcript, page 29,
line 25) |:

The motion was unanimously approved.

wate ‘ ‘
tee

D. Virginia Regiona...:.. 1. 1 Progran .

 

Motion made by Dr. DeBakey - Seconded by Dr. Everist

Concurrence with the Committee's recommendation with the
proviso that if the site visit should indicate a need for
additional funds, the request will be brought back before the
Council, (Transcript, pege 36, line 5)

The motion was unanimously approved. In subsequent discussion,
it was agreed that there would be appropriate representation
from staff and the Kidney Disease Panel on the site visit.

 

E. Bi-State Regiona. *+-udical Program
Motion made by Dr. Ochsner - Seconded by Dr. DeBakey

Concur with what the Review Committee recommended, that there
be an additional year instead of the three years requested,
and that this be in the amount of $924,115, and further con-
currence with the Comnittee's disapproval of the developmental
component and the other funding relative to the project.

(Transcript, page 37, line 16)

The motion was unanimously approved.

 

F, Georgia Regional *- “ical Program
Motion made by Dr. Cannon - Seconded by Dr. Millikan

Approval in the amount of $2.9 million for each of the first
two years and $1.9 million plus the requested amount for
project 39 for the third year, the exact amount to be determined
by staff on the E--/s of the intent of Council. In addition,
the Council conciz.-in the recommendations of the site visitors
with respect to tutti. Funding of specifically identified

- projects with the exception of kidney and the Stephens County

mrotoet 0 (Tranierictl meen £2 diese ty

The motion was un-nimously approved.

 

DY. Debakey Was not present during consideration of this application.
 

TT

H.

“A

li

Albany Regional Medical Program _

 

Motion made by Mrs. Wyckoff - Seconded by Mr. Friedlander
"Approval of the Review Committee's Recommendation that this
project be funded for only one year more for $900,000."
(Transcript, page 57, line 14)

The motion was unanimously approved.

Central New York Resional Medical Program

 

r

Motion made by Mr. Friedlander ~ Seconded by Dr. Cannon

Approval for one year funding, contingent on a staff follow-

up Visit six months following the award of this application to
evaluate the progress that's been made in meeting the conditions.
(Transcript, page 61, line 153)

The motion was unanimously approved.

%

Rochester Regional Medical Program

 

Motion made by Dr. Mc Phedran - Seconded by Mr. Milliken

Approval of the Review Committee's recommendation of $800,000
and deferral of any action, until the next Council,meeting on
the kidney project. (Transcript page 63, line 24 and page 68,
line 15) .

The motion was unanimously approved.

 

Memphis Regional Medical Program* _

Motion made by Mrs. Wyckoff - Seconded by Mr. Milliken

Approval of the Review Conmittee recommendation for a funding
level $1,627,000. for each of threc years, or a total of $4,950,000
plus approval of suygestions in the blue sheet with deletion

of the reference to Medical Association dues for project 39.
(Transcript, page 76, line 7, and page 87, line 20)

The motion was unanimously approved.

Michigan Regional Modical Program

 

Motion made by Dr. Mc Phedran - Seconded by Dr. Komaroff

' - . ~

LUuGy AUP ue ivaoeiy Liiui and $ixth years for each year,

 

*Dr. Cannon was not present during consideration of this application.

 

 
 

ty

M.

12

including the requested developmental component. (Transcript,
page 104, line 16 and page 105, line 8)

The motion was unanimously approved.
Wisconsin Regional ? Medi cal ‘Proeram

Motion nade by Dr. Roth : Seconded by Dr. Mc Phedr an.

Approval as recomended by the Review Committee. ' (Transcript,
page 106, line 15)

The motion was unanimously approved.

Maine Regional Medical Program

 

Motion made by Dr. Hunt - Seconded by Dr. Komaroff

“Accept the requested levels for the three years and bring

the Maine application before the Council again prior to funding
the 05 year for Council reconsideration." (Transcript, page 111,-
line 14)

The motion was unanimously approved.

. . Metropolitan D.C. Regional Medical Program

 

Motion made by Dr. Hunt - Seconded by Dr.. Ochsner

efer action on the application. Hold a site visit attended
by the Ad Hoc Renal Disease Panel, and also include attendance
by the Chief of Medicine, the Chief Surgeon and the Chief
Nephrologist of.each of the applicant institutions. (Transcript,
page 128, line 7)

The motion was Unansmous Ly approved. -

New Mexico Regional Medical Program

 

Motion made by Dr, Schreiner - Seconded by Mrs. Wyckoff

Approval for $850,000 for one year as recommended by the Review
Committee with an "additional $40,000. The additional funds

are not earmarked and may be used for kidney or for other
purposes at the discretion of the Region. (Transcript, page 134,
line 12, and page 159, line 1) .

The motte wre ue Ces tee oe aera

 
 

13

P. Tri-State Regional Medical Program

 

Motion made by Dr. Roth - Seconded by Dr. Cannon

"Approval of funding at the rate proposed on page 5 of the
revised application." " (Lranscript, page 140, line 6)

The motion was unanimously approved subsequent to some
Te further discussion which indicated that progress on this
project might provide some examples that could be used in
Metropolitan D.C.

Q. National Kidnéy Foundation. © “"910''*

 

Motion made by, Dr. Cannon - Seconded by Dr. Roth
Disapproval. (Transcript, page 144, line 17)
The motion was unanimously approved.

R. California Resional Medical Program**

 

Motion made by Dr. Millikan - Seconded by Dr. Komaroff

“Level funding for three years at $10,043,175 with exact amounts
to be determined on the basis of negotiation by staff during
that period, and for the sum to include the kidney project. "
(Transcript, page 16, line 17)

The motion was unanimously approved.
X. ADJOURNMENT

The meeting was adjourned by Dr. Pahl at-1:20 p.m. on August: A, 1971.

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

i | . | th rel Luss 4) whe,

Harold Margulies, M.
Director a ;
Regional Medical Programs Service

minis Wet ee sete Uesaih, Comsidcration of this application.
Mrs. Wyckoff was not. ‘present during consideration of this application.

4

 
 

ATTACEMENT A
Page

April 26, 1971 COPY

Resolution from the National Advisory Council on Regional Medical
Programs Service

Roger O. Egeberg, M.D. .
Assistant Secretary ro,
for Health and Scientific Affairs °° , :

Attached is a memo fsom the National Advisory Council for Regional

Medical Programs which expresses their deep concern. It was issued

without their having had a detailed chance to look at the report by

the group of consultants.

I would hope that we would have a chance to discuss this in the very

near future.

/s/
Vernon E., Wilson, M.D.
Administrator

ce: Herbert B. Pahl} Ph.D. OS -
Harold Margulies, M.D.
 

 

RESOLUTION

.

SUBJECT: URAVAILABI LITY OF THOSE PROGRAY MONIES WHICH WERE APPROPRIATED
BY THE CONGRESS FOR FISCAL YEAR 1971 AND WHICH SUBSEQUENTLY
NAVE BELN PLACED IN RESERVE - REQUESTS RECONSIDERATION, .

WHEREAS The Regional. Medical Programs Service was created and exists.

for the purposes of (1) improving for all citizens access to.
and utilization of their local health care systems, and (2)
improving the quality and effectiveness of the health services

provided within regions, particularly with regard to cancer,
stroke and diseases of the heart and kidney, and

ae

WHEREAS: ‘The Regional Nedical Programs Service during the five years of
its existence has esteblished viable, local organizational
networks among the major health care providers, and improved
the number and quality of the linkages which now exist: between
these providers and the consuiners who comprise the several
regions; and .

" WHEREAS : For these discase categories the Regional Medical Programs
—.. Service was established to be a primary, functional arin of
. the Department of Health, Education, and Welfare whereby the”
© potential benefits which result from the netion's support of
.. the biomedical research enterprise et the Mational Institutes
of Health can be realized from practical applications within
communities; therefore be it :
RESOLVED: That the National Advisory Council for Regional Medical Programs
wishes Lo express to the Administrator, Health Services and
Mental Health Administration, and to the Assistant Secretary
. . for Nealth and Scientific Affairs its deep concern that the
woo sunavailability of those program monies which were appropriated
. by the Congress for fiscal year 1971 and which subsequently have
; been placed in reserve will result in serious curtailment in |
pos - the momentum of the ovérall program in meeting its objectives
and, therefore, requests reconsideration of this matter in
. terms of the Administrator's expressed national priorities for
improving the health services and delivery system of the country;
and be it further 7
RESOLVED: That as new systems for the delivery of health services to
communities are devised and instituted, the Council respectfully
submits that the Regional Hedical Programs Service is the most

expediont fmetrrene § ta access tenes orb fe the ead

Pres of
. a to be the principal program which interrelates all of the
providers of health care within communj.ties; and be it further

 
 

. . - ATTACUMENT A
- Page 3
- . “ = ,
‘ .?
: _
. , . 7 ~ 2.

<

RESOLVED: That in Support of this request the Counes1 @ssures the
: a . Administrator and the Assistant Secretary that Specific effort
“Will be made immediately and on a continuing basis to reinforce
- ' the Jigison and collaborative efforts between the Regional
Nedical Progranis Service and other Health Service and Monta]
HeaJ}th Administration Programs as well es al] relevant Institutes
and program elements.of the National Institutes of Health in
order that no Opportunity be overlooked for bringing to the
regions with the éreatest possible speed those medical research
- advances which can form the basis for improving access to and i
"the overall] guality of the health cére available to the People
of these regions, . —

—~

In so doing the Council ennounces its intent to establish

immediately for the Regional Medica] Programs Service a set

of sharpened PYogréi priorities ag determined. in consultation
- - with Health Services and Mental Health Administration, the
National Institutes of Health ‘and other leaders in the field
of health, , ‘ ,

.

 

~ ae . ~ A.

.
.
Hey.

i
. . :

 
 

ATTACHMENT B
Pape 1

«

    
 

INDER n

Creme

epee tb,

 

Under the tricanial review syster, each Fegdonal hedical Program
normally will he reviewed by the Naticnal Advisory Council only
once each three vears. ‘ihe triemial review serves to recognize
the Region as an “accredited” organization and to set a general
Jevel of annual support fer the three year period. Thus, the
Council's favorable recommendation constitutes a time-limited
approval for an PIP as an organization having recapnized capabili-
ties, rather tan being approval for e specifie set of activities.
In addition to recommending the general level of support, Council

’

actions on individuel applications may inelude advice to the appli-

cant Regional Medical Progran, or specific conditions fer the prant.

Prior to review by the Council, each triennial application will be
reviewed by assigned KUPS staff, a site visit team and the NUPs
Review Committee,
. ~
Except as specified below, the Director, RAPS, will make continu-
ation avards, Including support for new activities, for second and
third (62 and 03) year support without further Council action insofar
as the proposed activities are consistent with relevant policies.
The Council will be provided with a summary of such awards. Specifi-
cally, the Council's advice will be scught when:

1. Supplenentary funds ere requested in addition te the general
vt 4

Support recomended for the year in qu uestion.
2. A new or increased Developmental Component is requested,

3. The Council, the Director, RMPS, or the Region requests
Council review.

4, The applicant.has failed ?n a material respect to meet the
requirements of the Program or applicable lavs, resulations
; _ or formally promulpat ted policies of the Department, HSSA
: or RMPS.

a

The summary to be provided to the Council will includ
information concerning each Regior revieved hy staf

support: , ~

ude the following
£,for continuation

1.0 The amount previously reccrmended by the Council for funding,
and the amount avarded. :

2. A list of activities supported during the most recent grant
year, identifying those which have been completed and those
which have been supported through a developmental component.

 

 
 

. ATTACHAUINT .B

- . " Page 2

~2-

2

A summary of the Kepion's response to any advice specificd by
the Council or limitetions upen or conditions of the sward.

A summary of any outstanding accomplishnents.
A summary of any outstancing problems.
roports from the Regional Advisory Group and

cr
(These wild be made availebie on
ouncil.)

Annual
from T > eteFF
request by the

 
 

Oe.

ew

Approved - National Advisory Council on Regional Medica

August 3, 1971

1-Programs
 

 

National Advisory Co

COUNCIL MEMBERS.

 

        

Dr. Bland W. Cann

Dr. Michazl B. DeBakey
Dr. Bruce W. Everist
Dr. William RB. Hunt

Dr. Anthony L. Komaroff

Dr. Alexander M. McPhedra

Dr. John P. Merrill
Dr. Clark H. Millikan

RMPS STAFF
Dr. Elvin Adams

Mr, Kenneth Baum

Mr. Cleveland Chembilss:
Mr. Richard Clanton
Dr. James Cleeman

Rre Paul Cohart

Myre Spencer Colburn
Dr. Je£& Crandall

Mrs. Shirley Fairley
Dy. John Farrell

Mr. Gerald Gardell
Mr. Terrence Genz

Mr. Samuel Gilmer

Dr. Kenneth Gimbel
Dre Martin Greenfield
Mrs. Eva Hendal

Dr. Robart Handy

Mrs. Gloria Hicks

Dr. Edward Hinnan

Mr. Calvin Jackson ~
Mr. Joseph Jewell ~~
Mrs. Glinter Johnson
Mr. Milton vee

Dr. Kenneth Jos si

Dr. Alan Kaplan

Dr. Philid Klieser
Mrs. Lorraine Kyttle
Miss Carol Larson

Dr. Marian Leach

Dr. Harold Margulies
Dr. Gordon MacLeod

nm

on Renional ied

APPENDIX
Page 1

ical Programs

Mr. Sewalt O. Milliken
Dr. Alton Ochsner

Dr. Russell B. Roth
Dr. Gearze E. Schreiner
Mrs. Florence R. Wyckoff

Dr. Benjahin rN. Watkins
Mre Edward Friedlander
Dr. Harold Marguliés

3
Mr. Spero Moutsatsos
Miss Mary Murphy
Mr. Frank Nash

Miss Elsa Nelson
Mr. Daniel Nemzer
Dr. Michesl Newman
Dr. Herbert Pahl
Mr. Roland Peterson
Mr. Eugene Piatek
Mr. Michael Posta
Mr. Lawrence Pullen
Miss Leah Resnick
Mr. Morton Robins
Mr. Richard Russell
Mrs. Jessie Salazar
Mr. Luther Says
Miss Theresa Schoen
Mrs Patricia Schoeni
Mr. Thomas Simonds
Mrs. Judy Silsbee
Mr. Matthew Spear
Mr. Sidney Stein
Mr. Jerane Stoloyv
Mr. Willian Torbert
Mr. Lee Van Winkle
Mr. Lyman Van Nostrand
Mrs Margaret Welsh
Mr. Richard White
Mr. Roland Williams

 

 
 

RMPS REGTOSAL OFFICE REPRESENTATIVES

a ae

 

Mr. Willian Mc Kenna, Region Lf
Mr. Robert Shaw, Rerzion IL

Mr. Clyde Couchman, Region IIT
Mx. Theoda Griffith, Region IV

OTHER

Dr. Marsaret Edwards, NCI
Mr. Peter Fox, OMB

Myre Howard Hilton, NHSC
Mrs. Frances Howard NLM

ES sya ey
APPLROIK

Page 2

Mr. Maurice Ryan, Reaion V
Mr. Dale Robertson, hegion VI

=

re Daniel Webster, Region VIITL
re Ronald Currie, Region IX

=

Mr. David Lovenvirth, Consultant
Miss Bettye Mobley, HSMHA.
Mr. Carl Taylor, OMB

£
 

NATIONAL ADVISORY

COUNCIL ON

REGIONAL MEDICAL PROGRAMS
October 20, 1971

BRENNAN, Michael J., M.D.
President, Michigan Cancer
Foundation

4811 John R Street

Detroit, Michigan

(72)

48201

CANNON, Bland W., M.D. (73)
910 Madison Avenue
Memphis, Tennessee 38103 _
CROSBY, Edwin L., M.D. (71)
Executive Fresident

American Hospital Association
Chicago, Illinois 60611

DeBAKEY, Michael E., M.D. (72)
President and Chief Executive
“Officer ~

Baylor College of. Medicine
Houston, Texas 77025

EVERIST, Bruce W., M.D.
Chief of Pediatrics
Green Clinic
Ruston, Louisiana

(71)

71270

HINES, Mr. Harold H., Jr.
Senior Vice President
Marsh & McLennan, Ine.
231 South LaSalle.
Chicago, Illinois

(74)

60604

HUNT, William R., M.D.
Commissioner oO
County of Allegheny
101 Courthouse
Pittsburgh, Pennsylvania

(71).
15219
KOMAROFF, Anthony L., M.D.

Beth Israel Hospital
Boston, Massachusetts

(72)

02215

» Atlanta, Georgia

MERRILL, John P., M.D. .(74)

NARS, Mrs. Audrey M. (71)
Marland
The Plains, Virginia 22171

McPHEDRAN, Alexander M., M.D. (73)

Emory University Clinic
1365 Clifton Road, N.E.
30322

Professor of Medicine
Harvard Medical School
Cambridge, Massachusetts 02115
MILLIKAN, Clark H., M.D.
Consultant in Neurology
Mayo Clinic

Rochester, Minnesota

(72)

55902

MILLIKEN, Mr. Sewall 0. (73)
Chief, Office of Comprehensive
Health Planning

Ohio Department of Health

450 Bast Town Street

Columbus, Ohio 43216

OCHSNER, Alton, M.D,
Ochsner Clinic

(73)

. 1514 Jefferson Highway

New Orleans, Louisiana 70121
OGDEN, Mr. C. Rébert (74)
President and General Counsel
North Coast Life Insurance Company
1120 Paulsen Building
Spokane, Washington 99201
ROTH, Russell B., M.D. (73)
240 West 41st Street

Erie, Pennsylvania 16508
National Advisory Council on
Regional Medical Programs

SCHREINER, George E., M.D. (74)
Director, Division of Nephrology
Georgetown University
‘School of Medicine
Washington, D. C. . 20007

WATKINS, Benjamin W., D.P.M. (73)
470 Lenox Avenue -
New York, New York 10037

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

ee

EX _OFFICTO MEMBER

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

CHATRMAN

Vernon E. Wilson, M.D.

Administrator

Health Services and Mental
Health Administration
5600 Fishers Lane
Rockville, Maryland 20852