Zo Da, Ben Z, Reporting from: the other side of the looking glass, Kenneth Baum, Associate Director for Transitional Management, RMP Services, and self-styled bureaucrat, reminded mem. bers of the National Association for Health Resources De- velopment of the almost unbelievable obstacles encounter. ed and overcome by the regional medica! Programs during their ten-year life: “We functioned under three U.S. Presidents. “We operated during the emergence of the “Great Society,” the civil rights movement and the termination of the Johnson Administration. The Vietnam War, Watergate, the rise of fonsumerism, the energy crisis and inflation all affected us. “We served under six Secretaries and five Assistant Sec- vetaries of DHEW, seven Regional Medical Program Service directors and we were part of three different agencies (NIH, HSMHS, HRA), five separate bureau level divisions and had zwo different modes of operation.” , ° The almost unbelievable sequence of “stop and go” orders would have long since destroyed less dedicated operations, he indicated in a talk before the NAHRD at St. Petersburg Beach in September, and proceeded with the following chronology: Octuber 27, 1972 — Congress passed the last continuing resolution before phaseout. danuary 29, 1973 — President Nixon’s budget called for a veduction in RMP funding from $150 million to $55.8 million to continue RMP’s only until June 30, 1973, under the belief that they had little effect on the nation’s health care delivery #ysiem. February 1, 1973 — RMP’s notified by telegram of the phaseout. February 6,.1973 — All RMP’s advised to terminate hy June 30, 1973. February 22, 1973 — RMP’s notified to submit final phase out plans. April 4, 1973 — Phaseout awards issued with the under- standing that there would be no funds beyond September 30, 1973. - . May 31 to June 5, 1973 — Congress passed legislation for RMP extension. The House voted $159 million for RMP’s 372-1 and the Senate 94-0, dune 18, 1973 — President Nixon signed the bill. June 26, 1973 — The House voted $81.9 million for RMP’s for the remainder of Fiscal Year ‘73. June 27, 1973 — The restrictions of the April 4 telegram removed. ° duly 1, 1973 — The President signed the continuing resolu- jon for $81.9 million. July 5, 1973 — RMP’s notified by telegram that they had nability through September 30, 1973, August 2, 1973 — DHEW notified RMP'’s to spend $46 nillion instead of $81.9 million. August 28, 1973 — First quarter funds of $17.1 million nd $2 million for pediatric pulmonary programs allocated nd RMP viability moved up to December 31, 1973. September 7, 1973 — Fy '74 spending ceilings determined. September 20, 1973 — RMP’s extended an additional six tonths to June 30, 1974. September 21, 1973 — NARMP suit filed. November 12, 1973 — RMP’s submitted applications. December 28, 1973 — Awards made. December, 1973 — Congrese confirmed the $81.9 million Herne ht Ll Lhe Josee has 12 re —h “He, ek, BAUM UNREELS TAPi; ON RMP PHASEOUT in the continuing resolution and earmarked $4.5 million for arthritis proyram. February 7, 1974 — Court order issued to DHEW and OMB to release RMP Funds. . February 22, 1974 — $89.6 million of unimpounded FY "73 funds released. March 6-7, 1974 — RMP’s were notified of released funds and given instructions for applications, June 13, 1974 — Applications received from 53 RMP's for $127 million. $84 million was awarded and 25 per cent of the funds were reserved for the August cycle at which time 47 RMP's recvived $27.3 million. October 20, 1974 — The last $5 million of the appropriation awarded. January 4, 1975 — President Ford signed PL 93-641. March, 1975 — Congress passed a continuing resolution with $75 million for RMP’s during transition. June 27, 1975 — Awards issued to carry RMP’s through June 30, 1976. , March 15, 1976 — NARMP agreed tu request a 90-day uni- form phaseout period from July 1 to September 30, 1976. April 30, 1976 — BHPRI) Issued uniform phascout guide lines. June 1, 1976 — Congress appropriated $10 million to con- . tinue exemplary RMP projects. September, 1976 — RMP's submitted final information to BHPRI). Along with these frustrations, Baum reminded members of NAHRD that many institutional changes occurred during the life of the regional medica] programs and several health issues came into national focus relating to smoking, alco- hol, cholesterol, abortion, swine flu, the right to die, mal- practice insurance, auto safety and medicaid abuses. Baum also recalled in this historical Perspective that RMPs had been looked upon as provider-dominated although Federal health programs may not he dominated by providers, consumers or any other organized interest group. He urged that health professionals recognize a continuing need to interact with Congress and the Executive Branch in an organized manner to assist them regarding issues of con- cern. Baum said many RMP programs which began with RMP moved to other places and now have nu RMP identity. He said that while the RMP identity may have been played down, RMPs generated programs that have improved the health care delivery system and are saving lives. He closed his talk by complimenting .RMPs on their resiliency, paying tribute to: © dedicated staffs and volunteers who believed in RMP goals and objectives °’a program with posiiive purposes rather than one of control * the ability to operate, based on local decision-making and priority-setting without bureaucratic rules * the capacity to evaluate our programs and relate their successes ourselves when the federal government was unable to do so. When Kenneth Baum concluded his talk to the NAHRD, members gave him a standing ovation and Charles White, Conference Chairman, ‘announced that official recognition would be accorded him. @ k