Cn
December 6, 1974

Paul DB. Ward

Executive Director
California Regional Program
7700 Edgewater Drive
Oakland, Califorria 94621

Dear Mr. Ward:

Your letter of Nevember 25, requests approval to rebudget pilot arthritis
funds from the Scrippe Clinic and Research Foundation project (154L), te
overall C34? coordination of the remaining pilot arthritia activities.

We are avare of the circumstances which proscribed the inauguration of
this promising activity, and we share your regret with ite lose.

Your proposal to empley the $26,322 thus freed to provide Regional
arthritis program coordination and ataff assistance is appropriate,
and the requeat is approved. We will appreciate receipt of Forms 15,
and 16 documentation of this change at your earlist convenience.

With regard to the limitations placed on BMP funding of arthritis
activities (i.e., “no other BMP funds can be expended for arthritis
activities”), the prohibition was not intended to proseribe the normal
EMP program coordinative/evaluative activities which do net result in
program enlargement, per se. The ongoing SMP responsibility for these
funetions is recognised, and the earmark ceiling on pilet arthritis
activities is not censidered by us to be vidlated when arthritis is
subjected to the same management controle as are addreszed to other
RMP programs. We recognize the confusion surrounding this matter, and
we will issue a clarifying statement soon, prebably in the imminent
announcement of a conference of the pilot arthritis programs, te be
held in Kansas City, Missouri, on January 19-20, 1975.

Yours truly,

Matthew Spear
Public Health Advisor
Division of Regional Medical Programs

ee: Me. Gerdell
Hr, Teets
Mr. Ruseell