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              CALIFORNIA REGIONAL MEDICAL PR                                        R
                                                                           (A Non-ilrofit Corl)oration)

  I,,hn Tijpper, ti.[).                                                          PaL)l D. Ward
                                                                                 Executive Director
                                                   November 25, 1974

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  )Cfl C,, Ciark, &i.[-).
  @ecrt-tary-ire,isurer
               Mr. Matt Spear
               Division of RMP
               Parklawn Bldg., Room 15-87
               5600 Fishers Lane
               Rockville, MD   20852

               Dear Matt:

               Our project with Scripps Clinic and Research Foundation, "A
               Rlieumatology Clinic in the Imperial Valley", was terminated
               because of misapprehensions and irreconcilable differences between
               the project proposers and some members of the local  Imperial
               County Medical Society. Although approval or disapproval  by  the
               meciicai society was not a prerequisite for funding, the project
               directors from both Scripps and the University of California, San
               Diego, agreed that it would be counter-productive to proceed with
               the project in such a hostile atmosphere.

               All of the CRMP arthritis projects that were approved by  the
               National Technical Review Committee were funded at levels substan-
               tially below their original requests. Although each  project  has
               revised its workscope to reflect the approved funding level,  the
               net result has been a curtailment of our ability to effectively
               share information and coordinate our activities statewide.

               As you may recall, the Review Committee took no action on our
               request for a Regional Coordination Project.  In the past month we
               have formed and convened a Statewide Arthritis Council, and we  have
               held the first of a series of regular meetings with our project
               directors.  Both groups have expressed many areas of mutual
               interest including demographic data needs, quality of patient  care,
               health resources needs, and specific aspects of patient  evaluation.

               Although the advice letter from Herbert Pahl, Ph.D., dated June  29,
               1974, stated "no other RMP funds can be expended for arthritis
               activities", we feel compelled to provide staff assistance and
               support to the Council and to the project directors to assure
               maximum coordination and effectiveness in the CRMP Pilot Arthritis
               Program.  In order to sustain these regional coordination activi-
               ties, we are proposing that the $26,322 from project 154L  be
               assigned to CRMP to be used as a Regional Coordination budget  as
               detailed on the enclosed budget form.


                    Mr. Matt Spear               -2-                  November 25, 1974

                    If this meets with your approval, we will          ew Forms 15 and
                    16 to cover this activity.

                                                        Paul D. Ward
                                                        Executive Director

                    Enclosure

                    PDW/HJB/ram


                               CALIFORI'IIA REGIONAL  MED[CAL  PROGRAMS
                          7700 Edgewater Drive, Oakland, California 94621

                        Application   for   Operational    Project    or    Program    Award

                   California  Regional  Iledical  Program
  ,OtiTRACTOR

  IROJECT TITLE    Pilot Arthritis Program Regional Coordination        BUDGET S@iEET//

  REQUESTED  PROJECT   PERIOD  12/l/74        6/30/75

                                      B U D G E T R E  Q  U  E.S  T
    CODE
             Personnel
                  Salaries and.Wages   . . . . . .  .  . $    9,625
                  Feitige Benefits   . . . . .  .  .  .  .$     1,540
                        Personnel,       Total . . . . .  .  .  .  .  .  .  .  .$   11,165
             Equipment -'Built-in   (90% limitation)   . . .  .  .  .  .  .$     0
                          Movable  . . . . . . .  .  .  .  .  .  .  .  .  .  .$  0
             Consultant Costs    . . . . . . .  .  .  .  .  .  .  .  .  .  .  .$ 6
             Supplies   . . . . . . . . .  .  .  .  .  .  .  .  .  .  .  .  .  .$305
             -Travel   -    Domestic . . . . . . .  .  .  .  .  .  .  .  .  .  .  .$   10@250
             Rent   -    Space . . . . . . . .  .  .  .  .  .  .  .  .  .  .  .  .$- 560
                       Other . . . . . . . .  .  .  .  .  .  .  .  .  .  .  .  .$0
             Minor       Alterations and Renovations . . . .  .  .  .  .  .  .$  0
             Publication   Costs . . . . . . . . . . . . . . .  .  .  .  $      2,500
             Contractual Services    .  .  .  .  .  .  .  .  .  .  .  .  .
             Con-muni            s (telep@o@e,   Tailing  @eroy,) . . .  $       1,000
                    cation Cost-
             Computer and Data Processing     . . . . .  .  .  .  .  .  .  .$    0
             Other . . . . . . . . .  .  .  ...  .  .  .  .  .  .  .  .  .  .  .$547
                            - Stipends   . . . .  .  .  .  .  .  ...  .
             Trainee Costs                                          . .  $       0
                              Other  . . . . . .  .  .  .  .  .  .  .  .  .  .$

             TOTAL DIRECT COST SUPPORT          . . . .  .  .  .  .  .  .  .$    26,322

             INDIRECT COSTS (Estimated   Maximum)   . . .  .  .  .  .  .  .$     26,322
             TOTAL COST OF REQUEST  .. . ... . .  .  .  .  .  .  .  .  .  .  .$

                LESS ESTIMATED REVENTIP . . . .  .  .  .  .$

                TOTAL RMP SUPPORT REQUESTED     . .  .  .$

  -PECIAL CO',IIDITIONS:

  ,eplicable Indirect Cost Rates:

  lase:     S&W  TDC       $              %
  lase:  S&@      TDC-       $            %
  lase:  S&@      TDt-       $            %
  lase:  S&@      TDC-       $            %


                                     BUDGI,"T JUSTIFICATION

                               December 1, 1974 to June 30, 1975

           PERSONNEL:

              Pilot Arthritis Program Director is responsible
               for coordinating arthritis projects and state-
               wide council activities.                                         $  9,625

              Fringe                                                               1,540
                                                      TOTAL                      $11,165

           SUPPLIES

              Office Supplies                                                        300

           TRAVEL:

              CRMP Staff                                                          10.1250
                State Travel
                Interstate Travel

              State Council
                3 general meetings ($50/person) (17 members)
                6 task force meetings - $25 (10 members)

              Project Directors
                3 project directors group meetings - $50 (8 directors)
                I out-of-state meeting - $400 (8 directors)

           RENT SPACR.
                                                                                     560

           PUBLICATION COSTS:                                                      2,500

              An arthritis newsletter will be published four (4)
               times during the spring.

           COMMUNICATION COSTS:                                                    1,000

              Telephone, mailing, xerox

           OTHER:                                                                    547

              Special expenses for meetings

                                               TOTAL DIRECT COST SUPPORT         $26,322