deg Profile: i Grantee: : i i i Tri-State Regional Medical Program Medical Care and Education Foundation, Inc. Two Center Plaza Room 400 Boston, Massachusetts 02108 (Telephone: 617/742-7280) Program Coordinator: Leona Baumgartner, M.D. Originally Prepared By: Spencer Colburn Operations Officer Original Date: August 1969 i i Updated: vii bi i. IV. ve VI. Vil. me WEED fy Ill. ‘TABLE OF CONTENTS ~ Geography Demography Politics Historical Review Core Staff Organization Procedure for Proposals to Review Funded Operational Projects Appendix a SN .. . I. . GEOGRAPHY _ The Tri-State Region encompasses the states of Rhode Island, ' Massachusetts, and New Hampshire. There were initial attempts to _ organize New. England into one regional medical program. However, Vermont has: a State Legislature mandate to go its own way, Maine _ wanted to be autonomous, and Connecticut emphasized its interface with > “New York, For the states involved, there is a natural flow of patients ' to Boston where a high concentration of medical resources exist, ‘II. DEMOGRAPHY - ole. Population: | | 1965 statistics a Total -.3 states . = By -. Massachusetts co Sy Rhode Island New Hampshire - . a. Per cent Urban: © " Massachusetts _ " 83.6 New Hampshire. «58.3 oo _Rhode Island © : 86.4 ‘be Roughly 98% white Ce ‘Median age: (U.S. average 29.5) » Massachusetts . 32.1 New Hampshire 31.0 ‘Rhode Island 31.9 Land Area (sq. miles): New Hampshire Massachusetts ' Rhode Island Total - Health Statistics: (Mortality Rates) per 100,000 U.S. Diseases of the Heart 395 Malignant Neoplasms 151 Vascular Lesions, CNS 104 Facilities Statistics: a. Medical Schools: 940,000 350,000 920,000 9,304 8,257 1,214 18,775 Mass. 167 167 100 Boston Univ. Sch. of Medicine, Boston, Mass. Harvard Med. School, Boston Tufts Univ. Sch. of Medicine, Boston 670,000 — sq. miles sq. miles sq. miles sq. miles N. H. R. I » 433 460 185 188 123 90 Enrollment 291 510 431 Univ. of Mass. Sch. of Med., Amherst~Authorized in 1962 Worcester, Mass. Dartmouth Med. School, Hanover, N.H. (2 yr.basic med.sci.) 97 Brown Univ.Div. of Med. Sciences (developing), Providence, R. I. (2 yr. basic med. sciences) ge bb. Schools of Nursing: Number of Schools te ; Ye ee of Prof. Nurs. 1964 Enrollment - "Masgachusetts 60 7,189 _.. -+New Hampshire ~ S10 oo 733 ».*, A Rhode Island Bes 7 2022. coh : PE TT. ae egotah OT BAB Uh, Lt . lee mo : os a Be el Accredited Schools in Number of Schools I “Medical Technology: (all hospital based) 1964-1965 Enrollment at Massachusetts = 27 Oe AG ji New Hampshire 2 we 7. = 20 a Rhode Island . 5 ote BS od. Schools of Cytotechnology: Rhode Island — 2 e. Schools of X-Ray Technolegy: Massachusetts _ 50 |. , New Hampshire 8 (54 are college . Rhode Island 6 or university | affiliated) £. Schools of Physical Therapy: Mass. - 4 . (each college or Univ. a based) mae : a 8: Schools of Medical Record Technicians: Mass. - 1 | h. Hospitals: | There are 251 non-federal hospitals and 15 federal. Of the non- ‘| federal hospitals 63 are long term with 26,937 beds and 188 are yi H tt i. ii i short term with 49,465 beds. The fifteen federal hospitals have 7,391 beds and 1,723 of these are in four V.A. general hospitals. Personnel Statistics: * In New Hampshire there are 772 active M.D.'s (115/100,000), Massachusetts 8,127 (152/100,000) and Rhode Island 1,103 (120/100, 000). , In New Hampshire there are 2,691 active nurses (401/100,000), Massachusetts 21,025 (392/100,000) and Rhode Island 2,419 . (263/100,000). A “yrr. - POLETICS | New Hanipshire | Governor: i Walter R. Peterson, Jr. (R) 1969-1971 |! senators: Norris Cotton (R) 1954-1975; Appropriation, Commerce, Republican — i HI Policy, Small Business Thomas Mchityre (D) 1962-1973; Armed Services, Banking and Currency ee Representatives: | Louis Wyman (R) 1962-1970; House Administration, Public Works, - , Disposition of Exeuctive Papers, Organization of Congress Massachusetts | @overnor: pe] + Francis Sargent (R) 1967-1971 _ Senators: Edward M. Kennedy (D) 1962-1970; Judiciary, Labor and Public Welfare, Aging 4 \ Edward Brooke (R) 1966-1972; Aeroneutical and Space Sciences, Banking and Currency | Representatives: Silvir Conte (R) 1958-1970; Appropriation, Small Business . Edward Boland (D) .1954-1970; Appropriation Philip Philbin (D) 1942-1970; Armed Services Harold Donohue (D) 1946-1970; Judiciary F. Bradford Morse (R) 1960-1970; Foreign Affairs ia . William Bates (R) 1950-1970; Armed Services, Atomic Energy " Torhert Macdonald (D) a 1970; Government Operations, co Interstate and Foreign Commerce Thomas O'Neil @) 1952- 1970; Rules John McCormack (D) 1926-1970; Speaker of the House 87th, 88th, 89th. 90th, and the 91st Congress . Margaret Heckler (R) 1966- 1970; Government Operations, Veterans : Affairs James Burke (D) 1958-1970; Ways and Means ; : Hastings Keith (R) 1958-1970; Interstate and Foreign Commerce, * - . Merchant Marine aa Fisheries oom _ Rhode Island Governor: Frank Licht (D) 1969-1971 Senators: John Pastore (D) 1950- 1972; Appropriations, Commerce, Atomic — Energy (Chairman) Claiborne Pell (D) 1960-1972; Foreign Relations, Labor and Public Welfare, Rules and Administration, Library Representatives: Fernand St. Germain (D) 1960- 1970; Banking and Currency, Government Operations Vacancy - 2nd District —_ IV. HISTORICAL REVIEW Tri-State RMP Pre-Incorporation History 1964-1966 es October 1965-September 1966 - October 1965-September 1966 - In Rhode Island following the release of the DeBakey Commission Report the governor, acting on the request of his Commissioner of Health, established an Advisory Committee on Heart, Stroke and Cancer, Membership consisted of medical experts in the three disease categories and included a representative of the Brown University Medical Program. They functioned as voluntary citizen advisors to the state Health Department. In 1965 the Committee applied for and secured funds from HEW for a staff coordinator, but the salary proved too low for the Committee to be able to fill the position. After > PL 89-239 was passed the governor appointed additional members representing consumer groups and allied health professionals. The group continued intact until Tri-State was established, when it became officially the Rhode Island RMP Advisory Committee. In Massachusetts the Associate Dean for Administration at the Harvard Medical School heard about PL 89-239 just after its passage, and convened the deans of the other three medical schools (Boston University, Tufts, and the University of Massachusetts) together with the Commissioner of Health . and a representative of the Massachusetts Medical Society, to discuss the new program. After Tri-State RMP was officially established the governor appointed these participants individually, plus other representatives of the health community. In New Hampshire the public health doctor - in charge ofthe state's heart program attended a conference on heart disease where she heard about the passage of PL 89-239 and upon her return informed the executive of the State Heart Association. They approached the Dartmouth Medical School, whose Acting Dean then took the matter to the State Governor, who became immediately January~Marcli 1966 mY ie i March-September 1966 ‘8 interested. Later, after Tri-State was established, the governor appointed an advisory committee, which included consumer representatives and delegates named by medical and allied health organizations, "sand voluntary agencies. All New England Activities. Governor Volpe of Massachusetts, in conjunction with his Lieutenant Governor, Elliot Richardson, formerly Under-Secretary HEW, convened the six New England governors to consider a single RMP for the whole region. In Vermont the state legislature had already established a mandate to develop its own RMP; Maine elected to remain autonomous; and ~-€onnecticut emphasized its interface with New York. However, New Hampshire and Rhode Island both felt their natural flow of patients was to the medical resources of. --Massachusetts, so the governors of these three states agreed to a tri-state program, authorizing the creation of a single corporation. Pre-Incorporation Activities. Plans to incorporate were worked out jointly by the six medical schools in the Tri-State Region (Boston University, Brown, Dartmouth, Harvard, Tufts, and the University of Massachusetts) together with representatives of the three three state governors and three state medical societies. Interim meeting facilities, office space, and clerical assistance was provided by the Harvard Medical School, (then and until Tri-State became actually funded). Incorporation papers and By-Laws for the grantee organization, the Medical Care and Education Foundation, Inc. were filed with the New Hampshire Secretary of State on _ September 14, 1966. Tri-State RMP History ‘September 1966 - . Fixst Corporation meeting and elected to Foe oe the Board of Trustees six medical school representatives, three medical society representatives (one from each state), and three gubernatorial representatives (one from each state). ene _° Pirst Trustees meeting and Hencry C. Meadow, Associate Dean, Harvard Medical School was elected Acting President. RAG is established and committeés are set i up to draft a planning grant proposal and eh oo “ " .* £9 secure an Executive Director. ib ra October 1966 - . RAG is convened, has 63 members (21 from or m each state) and G. H. Whipple of the Massachusetts Heart Association is elected Chairman. March 1967 os The Medical Care and Education Foundation _ (MCEF) is incorporated in New Hampshire of | purpose of sponsoring the Tri-State Regional 4 Medical Program. M. V. Edds, Ph.D., Brown University, Division of Biology and Medical Science is elected President of Trustees. Trustees approve planning grant and aughorize three staff positions: Executive Director; | Director for Continuing Education, which was filled by Norman Stearns, M.D., part- | - oO time and funded by the Post-Graduate Institute (PMI) of the Massachusetts Medical Society; and Director for Data Collection, which was filled by Osler Peterson, M.D., part-time and funded by Harvard Medical ~ School. ; - June 1967 August 1967 2 September 1967 December 1967 ‘Norman $. Stearns, M.D. is appointed _ Acting Director. 10 - Trustees are requested by RAG to expand their membership by ten and with members nominated by RAG. Trustees concur. , Revised planning grant is reviewed. by Committee and Council. Major concerns: . ambitious budgeting for stage of development; lack of documentation of cummunity support; and inadequate representation of those “oe categorical institutions whose support is essential. Council approved $300,000 ($807,599 requested) contigent upon a site visit.. — Site Visit Visitors were encouraged by: evidence of more enthusiasm in the Region regarding RMP; the broadened representation on the Board of Trustees; and solution to past concerns are evolving. In a mail ballot to Council members, visitors recommended a high funding level ($400,000) based on findings during the site visit. Council approved. O01 Planning Award for $397,647 Program office staffing is started: A. F. Popoli is appointed Assistant Director for Administration (1/2 time); and T. R. Dawber, M.D., is appointed Coordinator for Brown University Medical School. Post-Graduate Medical Institute is contracted is assist in data collection, to develop a information center on continuing education opportunities both medical and non-medical, and to develop a regional network of medical libraries. “+ Spring 1968 ‘April 1968 oon May, 1968 July 1968 August 1968 September 1968 Me oll Staffing, continues as follows: . yebruary ~ J. M. tylor, M.D. became - Coordinator at Tufts University Medical ; School. March - H. Uhl, M.D. became Coordinator for Rhode Island and Brown University Medical School. . April - Leona Baumgartner, M. D., is appointed Executive Director; Norman Stearns, M.D. resumes position as Director for Continuing Education; D. Seibert, M.D. becomes Coordinator for Dartmouth Medical ‘School. ‘Planning supplement for $87,824 is approved. This award is to accomplish studies of legal and service systems affecting the practice of .----medicine in the states of this region, fund , ‘additional core staff position, and to acquire office space. University of Massachusetts is contracted to conduct study of medical manpower in the Tri-State area. A. Yarmolinsky, LLB, is appointed assistant tto Executive Director for legal affairs. R. Lium, M.D. is appointed Coordinator for Massachusetts. Second planning supplement is approved ($47,557). This award to provide greater attention to the needs and resources of the Region in areas outside the jamor institutions. First-.operational application is received, requesting support for three projects as follows:;- #1 - ‘Program of Continuing Education for Qualified Physical Therapist #2 - | Expansion and Consolidation of Coronary Care Training #3 - Establishment of a Comprehensive Inter- University Cardiovascular Program in , Department of Health and Hospitals of the City of Boston. October 1968 L ‘November 1968 December 1968 February 1969 - Director for Data Collection. 12. G. Williams is appointed Associate Director for Communications. B. J. Duffy, M.D., is appointed Assistant C. Farrisey, is appointed coordinator for Special Projects. Site Visit: (Drs. James, Shep, Fox, Mrs. Phillips, Mr. Russell, and Mr. Strachocki). Visitors were pleased with the progress of .. this region since Dr. Baumgartner has become the Executive Director. Also, the organization structure for decision-~ making appears effective. The visitors believe that acquisition of operational status will give further impetus to the regionalization process. K. W. Toll is appointed Communications and Conference Secretary. Norman Stearns, M.D., resigns to become Executive Director of the Post- ~Graduate Medical Institute. The following contracts are entered into: 1) With Executive Director, Rhode Island Health Planning Council as consultant for Cape Cod. 2) With Arthur D. Little, Inc., to conduct a@ study of Health Needs in the Northern Counties of New Hampshire and Vermont. 3) With New Hampshire Medical Society to study types and severity of illnesses in New Hampshire. First Operational Award ($308,667) Project #2 - Expansion and Consolidation of Coronary Care Training and Project #3 - Establishment of a Comprehensive Inter- Univeristy Cardiovascular Program. oN ‘+ “June 1969 “August (1969 | September 1969 November 1969 - NS 13 Project #4 - Boston University' s _, Comprehensive Regional Medical Program in : Cancer is funded. H. W. Keairnes, M.D. is ; appointed Coordinator ' for Evaluations. Council approves two projects - Project #5 a Teaching Program in Emphysema, and Project #6 Diet Counseling Service in Rhode Island. Due to the tight fiscal situation, additional funds were not awarded. : R. W. Murphy is appointed Coordinator for Eastern Massachusetts. Robert P. Lawton, is appointed Deputy © Director. _ Massachusetts Hospital Association is contracted to study joint purchasing for western Massachusetts hospitals and to study Home Health Care on North Shore of Massachusetts. COORDINATING HEADOUARTERS PROGRAM COORDINATOR STAFF CORE STAFF. __ Tri-State Regional Medical Program - Medical Care and Education Foundation, Inc. Two Center Plaza, Room 400 Boston, Massachusetts 02108 - (Tel.: 617/742-7280) ‘Leona Baumgartner, M.D. Chief Executive Officer DEPUTY DIRECTOR Robert P. Lawton “" ASSOCIATE DIRECTORS FOR ADMINISTRATION Alfred F. Popoli FOR DATA COLLECTION Osler Peterson, M.D. (50%) ASSISTANT DIRECTORS FOR DATA COLLECTION Benedict J. Duffy, Jr., M.D. John Pearson, M.D. FOR COMMUNICATIONS Greer Williams (50%) ASSISTANT TO EXECUTIVE DIRECTOR Adam Yarmolinsky (50%) STATE COORDINATORS MASSACHUSETTS Rolf Lium, M.D. NEW HAMPSHIRE Cornelia Walker, M.D. 15 Pleasant Street Concord, New Hampshire 03301 RHODE ISLAND Henry S. M. Uhl, M.D. Brown University Program of Medical Science Providence, Rhode Island 02912 “AREA COORDINATORS EASTERN MASSACHUSETTS _ Robert W. Murphy — WESTERN MASSACHUSETTS Open ° - UNIVERSITY COORDINATORS " BROWN UNIVERSITY PROGRAM OF MEDICAL SCIENCE _ Henry S.M. Uhl, M.D. _ BOSTON UNIVERSITY SCHOOL OF MEDICINE Thomas R. Dawber, M.D. - DARTMOUTH MEDICAL SCHOOL _ "Dean Seibert, M.D. ee a -. TUFTS UNIVERSITY SCHOOL OF MEDICINE ° oe , John M. Tyler, M.D. HARVARD MEDICAL SCHOOL Open UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL Open COORDINATORS FOR EVALUATIONS Harold W. Keairnes, M.D, ~~ SPECIAL PROJECTS COORDINATOR (Miss) Claire Farrisey COMMUNICATIONS AND CONFERENCE SECRETARY (Miss) Catherine Toll ~. FISCAL OFFICER Francis T. Lynch _ PROGRAM COORDINATORS , Open - 3 positions PROGRAM ANALYST Open COORDINATOR - PUBLIC HEALTH Open 16 RESEARCH ASSISTANT Elizabeth Ainslie Peter Simon Ruth Goodman - Karen Ross (P.T.) ADMINISTRATIVE ASSISTANT. Isabell McDermott FIELD WORKER Sean Kennedy Stephen Novak '. Elizabeth Steel _ Veronica Langelier Open - 2 positions GRANTS MANAGEMENT SPECIALIST Open , EXECUTIVE SECRETARY: Hazel Grant Grace Myshrall Babette Kronstadt SECRETARY Linda Don Frances Evans Laura Hoey Trudy Leik Sharon Whitaker Margaret Smith Open - 9 positions RECEPTIONIST Robin Grant CLERK-TYPIST Paula Ardizzoni BOOKKEEPER Open CARTOGRAPHER . Open MIMEOGRAPH OPERATOR Open FILE CLERKS Open - 2 positions a aes ae ’ S A OF ESSE LE | Cosas nia? ‘ . i at . “a 4 t " 4 ' * é 1 > Te er en Lb I fet, KE ty a rege ive d oe 1B wo a orl ers . : LO NS PO we ot ie wy . , P POvo yt CoN ihe i ee womens i . : ~~ aoe ‘ “ND 3D TErieies: j ; ne nt EE A ee ore Oy 4 dei eerie less ! ’ Ste N OE ee mi teas wpe . pool . Sg? . oak? Fe SAD OID ‘ . Ff: SIE LL LIT on 3 — nr, Ae ne nw eeneonnmermne riser Diaemy Som‘: i oe —— ee ft a { 3 a = 4 : 7 $ - met : PRES BEET ee rSi lee! 3 Loess LI OND, { i mena oe sy ae ref EME OME SSE semen nem, rate 8 mart ff sf) OLE ITF if LOS REO ALORS | Seen ewcenvon ined l 2 qitomer ert rnnt earn a sere eee oe < e ie PST i 73 rae fd wt PF a5 tS ; Rares nteonerner (0 be eanetenrn P—euset roe Sse oamnnal ~~ a 1 DLPZaTon Teer erieey sereemererran ates or LO REEL T, Seams a ow ane ome ae . —e woman en 7~ DE es fuses Geen tern narnregec i rege ‘ . . Vee: ST nie ee tered, L. i CAs, Saget Fen ec (oe rerenee —at fA $4 {io flue. ete 2E Corse f * are Sexe * ii ae RUA SE hs oe “- { Like EO fm MoATIONS| LEGGE PETE! ? a. GET ET, FG y ri 74 if at if “ . : toot te . a . i oa. eo , . . ~ : ft KEY: Bo 2 oe . e = i : my > Sedr> LIAS - Dir 2EOF RESPONSE ILE ON te = ee EOTTLd Lanes - Coo rareeerryve . NO PRLS IPUSTIY LE SUES Lapse BIOGRAPHICAL INFORMATION i. 1. “Leona Baumgartner, M. D. Gtrs. N. W. ‘Eias) a ‘Born Chicago, Illinois, 1902 De AGB; ; University of Kansas, 1923, ‘Bacteriology c. | M. A:, University of Kansas, 1925, Immunology de '\Ph.D., Yale University, 1932, Immunology , “Ge. iM. D., Yale University, 1934 ‘ff. “Positions held: i ‘1923- 28 Teaching in Colby ‘ (Kansas) Community ‘High School, | - Kansas City Junior College, University of Montana 1936-37 Acting Assistant Surgeon, U.S. Public Health Service 1937-53 New York City Department of Health: . ~~ + + 1937-38 Medical Instructor in Child and School Hygiene io. t. 1938-39 Director, Public Health Training ' ° 1939-40 District Health Officer 1941-48 Director, Bureau of Child Health. 1949-53 Assistant Commissioner, Maternal and Child Health Services (on leave 1949-50) - 1949-50 Associate Chief, U.S. Children's. Bureau (Consultant, 1950- 56) -1953-54 Executive Director, New York Foundation / 1954-62 . Commissioner, New York City Department of Health /'1962- -65 Assistant Administrator, Technical Cooperation and Research, i Agency for International Development, Department of State 11966- Visiting Professor of Social Medicine, Harvard Medical School 41968- Executive Director, The Medical Care and Education Foundation 2. Alfred F. Popolt a. Nporn Massachusetts, 1932 be WA. B., Boston University, 1955 : OM. S. "Columbia University, 1961 - Hospital Administrator a | Positions held: fe ‘igss- 59 Personnel Assistant, Meth. Hospital Brooklyn, New York “1960 _ Administrative Res., Mountainside Hospital Montclair, New Jersey 1961-63 Assistant in Administrative Medicine, to School of Public Health & Administrative Medicine | Columbia University 1963-64 Research Associate, Bureau of Hospital Administration, | Graduate School of Business Administration i University of Michigan 1964-66 Assistant Director, Maine Medical Center, , Portland, Maine : 1966-68 Research Associate and Administrator, Department of Preventive Medicine, Harvard Medical School 1968- Associate Director-Administrator ' Tri-State Regional Medical Program 28. Osler Luthéz Peterson,+M. D. - a. - ob. 7 @. ood. ; e. .. £. Born Minnésota, "1912, : A.B. Gustavus Adolphus College, 1934 MB. University of Minnesota, 1938 M.D.', University of Minnesota, 1939 4938-1940 1940-1943. 1943-1944 1944- 1956 1956-1967 1968- -M,P.H., Johns Hopkins University, 1947 - Positions held: Internship, University of Minnesota Hospitals Residency, Thorndike Memorial Laboratory, Boston City Hospital (Harvard) ' Rockefeller Foundation Virus Laboratory, . | Jt Rockefeller Institute Staff Member, The Rockefeller Foundation Assistant Director for Medical Education and Public Health, -The Rockefeller Foundation, New York Associate Director, Data Collection and Evaluation, Medical Care and Education Foundation, Inc. 4: Benedict James Duffy, Jr., M.D. aun om Born New York, 1920 A.B., Princeton University, 1941 M.D., University of Rochester, 1944 Positions held: 1944-45 1947-48 1948-50 1950-53 1954-59 1960-63 1963-64 1966 Interne, U.S. Naval Hospital, Brooklyn, N.Y. Medical Residency, Memorial Hospital, New York, N. Y. Clinical Investigation, Sloan-Kettering Institute, New York, N. Y. Assistant Professor of Radiation Biology and Medicine, University of Rochester Assistant Professor of Medicine, Georgetown University School of Medicine Professor and Chairman, Department of Preventive Medicine and Community Health, Seton Hall College of Medicine’ Director of Center for Population Research, Georgetown University Professor of Preventive Medicine, Tufts University School of Medicine 5. Richard John Christopher Pearson aowrwn -e .- Born Cheshire, 1931 B.A., University of Cambridge, 1951 B. Chir., University of Cambridge, 1954 M.B., M.A., University of Cambridge, 1955 M.P.H., Yale University, 1960 - a. b. Cc. e. 20 Rolf Lium, M.D. ‘Born North Dakota, 1907 B.A., Carlton College, 1928 M.D., Harvard, 1933 Positions held: "1940-1962 General Surgery 1962-1967 Medical Director of Admire | Bristol Hospital in Istanbul ‘1967-1968 Medical Director of Eastern Maine General Hospital, . Bangor, Maine. Cornelia Walker, M.D. Born 1907 A.B. Vassar College, 1927 M.D. Columbia University College of Physicians and Surgeons, 1934 . (Hendrik Van Loon Fellowship from Vassar, 1931-32) General practice, 1938-1949 Part-time Director of Heart Disease Control Program, new Hampshire Health Department, 1952- 1968 Henry S. M. Uhl, M.D. a. -b. c. d. Born Pennsylvania, 1921 A.B., Princeton University, 1943 M.D., Harvard, 1947 Positions held: (1952-1953 Instructor and Research Associate, Department of Medicine, Wayne State University College of Medicine 1952-1953. Assistant in Medicine, Visiting Staff, Detroit Receiving Hospital 1953-1958 Director of Medical Education, Worcester City Hospital, Worcester, Massachusetts ~ 1958-1960 Director of Medical Education and Research, and Associate Visiting Physician, The Springfield Hospital, Springfield, Massachusetts 1955-1960 Medical Director (part-time) in charge of administration 7 of courses, Postgraduate Medical Institute, Boston, Mass. 1960-1965 Assistant Professor of Postgraduate Medicine and - Instructor in Medicine, Albany Medical College of Union University 1960-1966 Assistant Director, Albany Regional Hospital Program 1965-1966 Associate Professor of Postgraduate Medicine, Albany Medical College of Union University | _-1966- Professor of. Medical Science and Associate Director of Medicine, Division of Biological and Medical Sciences, _ Brown University 1966- Associate Director of the Institute for Health Sciences, Brown University 2h “Thomas Royle Dawber, M. D. — - oe por eo a. Born 1913 _ be. A.B., Haverford College, Haverford, Pennsylvania, 1933 .¢. M.D., Harvard Medical School, Boston, Massachusetts, 1937 “dd. MPs ‘i, Harvard School of Public Health, Boston, 1958 e.- Positions held; . 1937-1966 Commissioned Officer, U. S.P.H.S. So i -£ 1944-1949 Chief of Medicine, U.S. Marine Hospital, Boston, Mass. 1950-1966 Chief, Heart Disease Epidemiology Study, NHI, NIH, oo) US. P. H.S., Framingham, Massachusetts Dean John Seibert, M.D. a. Born Connecticut, 1932 b. A.B., Brown University, 1954 c. M. D., Albany Medical College, 1958 da. Positions held ; ae. _ 1958-1959 Internship (Rotating), “Albany Hospital, ‘Albany, N. Ye 1959-1961 Residency, Albany Medical Center, Albany VA Hospital 1961-1963 Fellow in Hematology, Dartmouth Medical School, ; Mary Hitchcock Memorial Hospital 1963-1965 Senior Assistant Surgeon (Lt. Commander), USPHS, National Cancer Institute, National Institutes of Health 1965- Consultant in Hematology, Hitchcock Clinic, Mary Hitchcock Memorial Hospital 1965- Attending Physician, VA Hospital, White River Junction, , - Vermont John Mason Tyler, M.D. Born Minnesota, 1921 B.A., University of Minnesota, 1943 ‘M.D., Harvard, 1949 . Positions held: aoon 1949-1950 Internship, Boston City Hospital (Harvard Service) 1950-1951 Internship, Boston City Hospital (Harvard Service) 1951-1952 Assistant in Medicine, Boston City Hospital 1952-1953 Resident in Medicine, Boston City Hospital (Harvard Service) 1952-1953 Teaching Fellow in Medicine, Harvard University 1953-1955. Research Fellow in Medicine, Harvard University 1953-1959 Assistant in Medicine, Peter Bent Brigham Hospital 1953-1955 Research Fellow in Medicine, Boston Lying-In Hospital — -1953- Harvard University School of Medicine Fellowship 1953-1955 Fellowship, Heart Institute of the National Institutes of Health, Public Health Service 1955-1958 Assistant in Medicine, Harvard University School of Medicine 1955- - Senior Physician and Director of the Cardiopulmonary Laboratory, present Lemuel Shattuck Hospital i 1955- Research Associate, Harvard School of Public Health © ‘present cet db 1955 - Diplomate, American Board of Internal Medicine 1960-1966 Assistant Professor of Medicine, Tufts University A ~ <-> School of Medicine _1966- | _. | Associate Professor of Medicine, Tufts University School ; » Of Medicine Ls ‘present . ur oo ot iS | 1968- ‘Chief of Professional Services, Lemuel Shattuck Hospital 7 Present : -. a oo, "vr, ORGANIZATION Te a ia, 23 ‘Grantee: so a tthe Medical: Care and Education Foundation, Inc. Te ‘Room 400. ' Two Center Plaza Boston, Massachusetts 02108 bot Incorporators 1) There are six incorporators and they are appointed by the president of each university having a medical school in the region. i 2) Term is until removal by university president, or until resignation, or until removal at any meeting by two-thirds = vote of the total number of members of corporation. do ods 3) Meetings are annually and on call Trustees 1) The trusteeship has 22 members and by law the members are: the six incorporators; one representative of each State Governor ; and ten TRAG RieMIBEES- 2) Term is until resignation or until removed by the president of the institution representing. pe it 3) Meetings are quarterly. 4) Functions: Appoint members of the Regional Advisory Group, Professional Consultant Panel, and Executive Director, taking into consideration suggestions cuming from the Regional Advisory Group and State Committees; determine basic program and policy in cooperation with the Regional Advisory Group; approve all operational project proposals made to Washington. By law, none disapproved by the Regional Advisory Group can be forwarded; administer and evaluate projects which are eventually funded; are fiscally responsible agents. ry _ bit Tri-State Regional Advisory Group (TRAG) 1) There are 63 members and they are appointed by the Trustees who voted that TRAG shall consist of 21 members of each of the state advisory committee (Area Advisory Group). 2). Term is one-third of membership for 3 years, one-third for two ‘years, and one-third for one year. 3) 0 Society’ - 3; Hospitals - 5; Practicing Physicians - 9; AY 5) 6 Representation - is-as follows: Medical School - 2; Medical \ Nurses - 4; Allied Health - 2; Health Related - 1; Other ‘Health Education Schools - 3; Other Health Prof. Association - 33 Hospital Assoc. ~ 1; ‘Health & Related Planning Agencies - 5; Voluntary Health Agencies - 10; Official Health Agencies - 4; Consumer Representation - 11 t J The Chairman is Louis Leone, M.D. (R.I.) Director, Department - o£ Oncology, Rhode Island Genera? Hospital, Providence, Rhode Island i Meetings are quarterly Function: Advises Trustees and staff on overall objectives, basic development of the regional program, and its evaluation; sees all operational grant proposals and recommends approval or disapproval, using members of Professional Consultant Panel and staff as indicated; encourages cooperation among institutions, organizations, health personnel, and state and local health agencies; alerts itself to the needs of all areas in the region, seeing that each receives consideration; submits an annual . statement to the national office of Regional Medical Programs evaluating the effectiveness of the regional cooperative arrangements (regionalization) established in the Tri-State area. | Steering Committee 1) 2) 3) 4) 5) There are 12 members including TRAG Chairman and Vice Chairman (14 members in all) and they are appointed by a majority vote of those Regional Advisory Committee members present and voting at their annual meeting. 1 Term is for two years and until their successors: are elected. tie i There are four from each of the state Advisory Committees 1 fey Meetings are at least bi-monthly, and one meeting shall be held immediately following the annual meeting. a “| Function: Serve TRAG as its executive committee; shall review all project proposals and make recommendations on them to TRAG; shall perform such other duties as may be assigned; and shall report, to TRAG. , | - | : 25 State Advisory Committees - New Hampshire po 4) ‘There. are 21. members and they are appointed as follows: one — gubernatorial, one Medical Society, one public health, others as, representatives of health services or professional societies. 9) 3) 4) 5) 6) ~ Consumer Representation - 3 | Term has not yet been specified. Representation is as follows: Medical Society - 1; Hospital - 3; Practicing Physicians - 5; Nurses - 2; Allied Health - 1; Health Related - 1; Health and Related Planning Agencies - 2; Voluntary Health Agencies - 2; Official cea Agencies - 1; The Chairman is Donald C. Andresen, M.D., Assistant Clinical Prof. of Medicine, Dartmouth; also, President, New Hampshire — Heart Association Meetings are on call Function: Define State health needs and stipulate planning in each state and in local medical service areas; assist ‘in developing proposals for meeting these needs and express opinions on all proposals involving their own states before these proposals are submitted to Regional Advisory Group. The expression of these opinions is not an authoritative action but merely permits the State Committee to consider a. proposal before it is submitted to the Regional Advisory Group; express opinions on the appropriateness of all proposals through representation on the Regional Advisory Group. It is understood that members of the Regional Advisory Group vote:as individuals - and not merely as representatives of their states; suggest individuals for appointment by Trustees as professional consultants; work with other state planning groups; advise staff, Regional Advisory Group, and Trustees on special problems affecting each state and on interstate cooperation. Massachusetts 1) 2) There are 39 members and they are appointed in the same way as described under New Hampshire. Term is consistent with TRAG (2) . 4) $8) - 6) 4 3) 4) 5) 6) Term is consistent with TRAG (?) 26 Representation is as follows: Medical School - 4; Medical Society - 2; Hospital - 2; Practicing Physicians - 5; Nurses - 2; Other Health Education Schools - 2; Hospital Associations - 2; Health and Related Planning Agencies - 1; ‘Voluntary Agencies - 9; Official Health Agencies - 4; Other. Public Agencies - 1; Consumer Representation - 5 The Chairman is Lamar Soutter, M. D., Dean, School of Medicine, (University « of Massachusetts Meetings are monthly Function; Same as described under New Hampshire. Rhode Island 4y There are 21 members and they are appointed the same way described under New Hampshire. Representation is as follows: Medical Society - 1; Practicing Physicians - 2; Nurses - 1; Allied Health - 1; Other Health Education Schools - 1; Other Health Professional Associations - 3; Health and Related Planning Agencies - 2; Voluntary Health Agencies - 5; Other Public Agencies - 1; Consumer Representation - 4 The Chairman is Melvin D. Hoffman, M.D., President, Rhode Island Heart Association. Meetings are monthly Function; same as described under New Hampshire. Professional Consultant Panel. 1) 2) This panel has no formal arrangements for membership, term, or method of appointment. It is a resource pool of expertise in the region to be utilized as desired. Function: Advises staff, Trustee, Regional Advisory Group, and State Committees on specific problems, policies and priorities; evaluates or advises on choice of evaluators on specific planning or operational projects; suggests those from outside the area who will be useful to the Tri-State Program; identifies new scientific advances for RMP implementation; defines criteria for best possible care of patients with heart disease, cancer, or stroke, The focus of the evaluation by the scientific advisors will be on the scientific and professional merit of the proposed operations or policies. The members of the Regional Advisory - Loe : . ; . . . . / 27 , - , Group and the. Trustees make value judgements. Romer eee —-. pee . oe ca mom mee 8 ce mn ee - tot TT : . _—- i , “persons from the institutions applying for assistance will ‘obviously not advise on requests from that institution. — Efforts will also be made to have persons from other states . involved. nan Categorical and Other Committees ‘This Region has established the following ad hoc committees; Continuing .Education, Heart, Cancer, Multiphasic Screening, Screening for Cervical Cancer, and Renal Disease. MH - woe i it “ be PROCEDURE. FOR PROPOSALS 10_REVIEY Proposals may originate from any group or institution within a _ local medical service area, state, or regional groups (e.g., govern- mental or voluntary. agencies, universities, RMP units, or similar organizations). oe : ‘They! will follow this route: “1. Detailed instructions are in preparation, but in any case applicant first should discuss proposal with’the appropriate state coordinator, who is a member of the RMP staff. All ' proposals whould be formally submitted to: ae Executive Director a -Tri-State Regional Medical Program _...Iwo Center Plaza -*; Boston, Massachusetts 02108 2.' After reviewing and further processing, the staff forwards : the proposal to an appropriate consultant panel for evaluation of scientific and professional nerit a contribution to patient care. - ‘3. Staff sends all proposals which have been reviewed by the appropriate State Committees, together with the comments of the consultant panel, to Regional Advisory Group. 4. The Regional Advisory Group will approve or disapprove of the ‘proposal and attach its comments for consideration and decision by the Trustees, FUNDED OPERATIONAL PROJECTS 29 ‘Project me - EXPANSION AND. CONSOLIDATION OF CORONARY CARE TRAINING _.. FOR THE NORTHERN PORTION OF THE TRI- STATE REGION TO PROVIDE STATE-WIDE SERVICE © _ Objectives: To expand the Coronary Care ‘Training Unit at the Mary Hitchcock Hospital, Hanover, New Hampshire, to help meet “the unmet need for the training of personnel, to provide aa “. Project #3 - _. Objectives: leadership and guidance to other local programs and to explore new methods of training at the community level. ESTABLISHMENT OF A COMPREHENSIVE INTER-UNIVERSITY CARDIOVASCULAR PROGRAM IN THE DEPARTMENT OF HEALTH AND -. HOSPITALS IN THE CITY OF BOSTON To establish a clinical~cardiovascular program to provide comprehensive in- and out-patient care for indigent patients ‘with heart disease in the primary service area, to make this Project #4 - . Objectives: ‘level of care available to patients referred by physicians throughout the Region, and to insure continuity of medical care and follow-up in Boston City Hospital. COMPREHENSIVE REGIONAL MEDICAL PROGRAM IN CANCER Proposed by Boston University Medieal Center, project envisions two goals in its operational approach: (1) Resources of the Boston University Medical College and seven hospitals will be utilized to create a teaching,. training and patient care atmosphere; : (2) Provision of a geographically distinct and identifiable cancer: unit at the University Hospital.