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                 4


                 B&B INFoRmAkreom & IMAGE MAkm^gnMmp.NT
                             300 "Inom G=Stncon SOUL"Jmo
               Ulefoem M,&KLAC:lRC2, Mftw Iwo Z0772 a us^ 0 (201) Z4@i 10








                           D  E@ P A I' T @l E N 'I'  0 F  11 E A L T llp  EDUCATION

                                                A N 1)  IV 1, L F A R E


                                  I-lealt@i S--rxi.ccs aaicl Molital llealcl-i Administration

                                       @egional lledi.cal Programs SonTice









                                         ]\Tational Adi?-isor>T CoUnCil 01-1
                                                         4
                                            Rec,ional @led-Lcal Prociranis















                                            @liliutes of the @-lecting
                                               August 3-4, 1971









                                              Pa-rklm@,n Buildina
                                              Conference Room G/11







                                                                           01,

                                               I\Tltiojial ]@civisor), Coll],
                                                                                   CT       on               ')'Iedical Prograltis
                                                     @li@tes   of    ljl,,    TI.,
                                                                                                         'tilig
                                                                          AugLIS t         3-4
                                                                                              1972
                                'fl,  e   I\Tati-onal   Ajl,iso-r\;,   COU]ICil
                                                 c
                                for      its                                     oil Regional          dical        I)roryrb@
                                                                                                       'I'uesda)r   . I L,3
                                           -ercy) -e  Rooiii   C)-Il   of   to,  Parl-I.,Il@ll 1-@                 ,  @L'gust 3,  1971
                               ill     C031f                                     at      8:.30                                  Colikoiiod
                               Dr.  Harold
                                                                          Director                ildiaig,  I-Z@ch,-il-le
                               presided o-t;-(.r the Meeting.                                            -al  P"OUQnls  Service
                                                                                 I   Plegioaial    j\ledic
                               The   Colmcil @lenibei-s   resent ivere:@
                                                               p
                                    Dr.  Pla-Tad 1-@.  caimm,
                                    Dr.  @licliaei  I-,.  DeBakey                                                           ken
                                                                                             @Ir.  Sei%,all  o.
                                    Dr.     Bruce     TV.      Bierist                       Dr.  Alton ool-,sn-er
                                      Dr.              R.  IlLmt                             Dr  - Rtissell    B.     ll\otll
                                      Dr.  Antlloli), L.  Koi-,ia-ro,,:[@.               .   Dr.   George E.S,:]-Irei,,,
                                      Dr.  A-lexaiider    @l.    @'IcPliedra-Ti              Cars.  Florence R.  IV),Cl-off
                                      Dr.  'JO]Ila P.  @ferri.:Ll                            Dr.  Beiijaillin l@,T.  IV(Itl,,ins
                                      Dr.  Cl---
                                             ark    II.     @lillilcan                                        l,riedlaiader for
                            A listing of Rff)                                                  Dr.  @@'usser
                                                        staf-I members,  and others  attending is  appended.
                                  CALL TO ORDE-R A,\M OI)ENTING Pl@, IIRKS
                                  The    moetin,    i,,,as    called    to    Order    at     8:30    a.m. On August 3 by
                                 Dr.  Harol,@
                                                   Ilirgulies.
                                 '@-,ODUCTIO,@ OF ND
                                 S TA r, l@-                      Cg@l'CIL @T.-kiBBRS
                                                                                             CO,@i@fISSIO,\TE@D OFIICBPIS,        AM
                                Dr.        @,largulies        introduc
                                                                     ed the fol-lavi,,g
                                -vlho   i@ere   atte-ndi,iiL7    their,,    --               ,  ,e,,, raepbers  of tle Council
                                Dr.    join     p.                       -,-'-rst )neetin2:   Dr.  Anthony L.  Komaroff-
                                                                              @ll 0.
                                1-@'atkins.   Dr. I.,I@ir2ll-                                ilikeii
                               @Irs,  Audre)7 1,1. @la@s          lies     not-ed    that     ti         and Dr.  Beiii,-znir, TV.'
                                                                        4"-,  C -  R                                    the Council
                                                                   andA                      @O 1101@T mel'il-  ers  of  ,  '
                               present.                                             obc-rt OCT(len i%Tere                                 .1
                                                                                                               ulia-b I e to be


                                                                        -are,-rest
                                                                              . ricted unless  Cleared by the Office
                                                         or, H@'@,'-         @,rhe res
                                                          ssi,                          tr'ctiOn relates  to all ipaterial
                                                          ial.          I    --.meetings,       th@ supplemental Material
                                                                                    Iclucling tiie       agenda.

                                  respective
                                            institutions
                                                                                             a  coil-L-lict 0-
                          Occur.   This procedure.,@-.@                'I'  47   Of course   apply to                             ]flight
                          only even tjle al?l)licati"                                                           eii  bloc actions--
                                                                          -.-?nder      indivj "
                                                                                             dual         discuss-          -
                                                                                                                1011.







                                                                   2

                             Tlio follo,,%,illccl   co",Tj,,lj.ssioiaed Of:E-'Lccrs mid iiei@ l@RIS staff moi,,Ibers
                             there then introduced:


                                                                          r
                                                                       O.L'Vicors

                             Elvin    E. A(I,..i-,2is , i\,!. D.         @lirtiai A. G-ce--n-f-iclcl, @T.D.
                               -nes   I.            @I.D.
                             Jai                                         Komictli E. Joslyn, @.I.D.
                             Paul E.  Colia-rt,  i%I.D.                  Michael A. Nc-iNflian, @I.D.
                             Jeff-To), B.                                Duiie-I @,Tei@zer
                             Alan  KaT)lma,   @I.D.

                                                        ']\Ic,i@r 'Sta:E:f --@s

                             Charles   Barnes                            Cars. Glinter Johnson
                             ]ZicliaTd Clanton                           Cars . I\Tancy @IcC,ui-re
                             I,,b-s.   Shirley    Fai@y                  Roger I%,Illlor
                             John l@'arrell, @I.D.                       Spero @foutsatsos
                             IZobc,rt I-land),, PI-,.D.                  Jeffrey A. Passer
                             Calvin Jacl@son                             Rolai-icl Illilli&@-is



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

                      IV.    COiN'F@IP@cl-kTION OF FU=- I%-TET!i\'G D-,klT,S

                             The Council reaffirmed the following dates for future meetings:

                                                  No-i2-enibcr 9-10  1971
                                                  Feb-rua3.-y  8-9,   1972
                             Council then set     the following     subsequent meeting dates:

                                                  May 9-10, 1972
                                                  August    15-16,    1972
                       V.    CO,'\ISIDI@,ltkTIO-,\T OF      OF 'fTiF, @LAY 1.1-12, 1971, @F@E-TIf\'G
                             The Council considered @uid-approired the minutes of the @lay 11-12,
                             1971 moetinc, into the follu,%,iii- chances:

                             1.  South Carolina Pro4ect 1'r'43       "A Regional Program for the Iniorovcd
                                 'n-ierapeiitic               of I-lypertei-isi-on for South Carolina.''
                                                      0
                                 The record should sl,.oij that the -renal disease panel recoimended
                                 disapproval and that the Council concurred.
                             2.  The addition to the minutes of a resolution concerning funds
                                 placed in reserves i,riiich iNas ad,,)-nted i-i TY-CC.7-iti.ve. Session at the








                                                               3
                                Council            of- I-el)-i-uar),, 3, IP,71 i@i-tli a recpiest
                                                                                             t), Z 14-
                                                                                                 L, it be
                                transmitted  to  the  Sccret@l-,>,.  The  :Cull  text  Of-  the   resolution
                                and the copies of -@)ie @DI-)-ropri.ate transmittal n,@enioa-midLijn are
                                appended as Attacl-nii@-iit A.

                     ITI   RT,  IJ BY DI',,, @l-NlZr.'U!,TES

                           A.   Meeti.na       the Secretary
                                Ih-. @larg-Lili-os, scica7al  Council  riiembers,  Coordinators,  -,nd  others
                                ii-ite-restcci in Rc(-ioi@a.1 ',\.'Cd3".cal. Prograitis, met the      Secretary
                                on thy 24,th. Viie meeting has, the. effect c)-f ro-r-rectilll(-Tl  some
                                                                               -ting   scriTed   to   identify
                                prior misconceptions about P'.,-P.  The iiiec
                                all the st@enyths  -,,.,Iaicli  characterized  Regional  ',kledical  Procrans.
                                Du-riii,- the iiiegtiTig, st-ron(T support i@as elicited froni the
                                Secreta,@,-Is professional staff-, and the Secretary himself
                                indicated..that in  the  future  R@Hl  iqill  be  @i  key  element  in  devel-
                                opin(, mechanisms such as @L%10's tlirouul-i i.,,-Iiich  the  Department
                                full carry out near initiatives.

                          B.    Heai.-i3iR .i3-id rol)rj-ations
                                Both the  Senate  and  the  I-Jouse  liai7-e  reported  out  marked  increases
                                in funds for Fiscal Year 1972.  The House        I.ToUld  add  $'@O   million,
                                and  the  Senate  $70  million  to  the  aniou@,-it  requested.  In   addition
                                to  this,  $10  million  supplementary  appropriation   for   FY   1-971
                                increases the @,iiount held in reserve for FY 1972.  Tlae marked
                                increases  plus  the  la-rcTer  reserv.,,e  indicate  that  greater  amounts
                                may possibly be available for grants in 1-Y 1972.
                                Dui:iaia recent Senate appropri.atioa-i hearings, the     Chairman
                                     ssed  his  determination  that   budget   procedures   i@ould   not
                                expi7e
                                block expenditure of all rioi  -s appropriated.
                                In  response  to  questions  conceni-inc,  the  possible  use   of   Section
                                910, it iva,,; pointed out that Section  910  has  not  been  iiiTole),,iented
                                in  the  past  because  of  restricted  avail,-ibilitv  of  f-un@-.   Use   of
                                this authority i-@qi-glit ]fire been misunderstood as a signal that
                                additional  funds  i,:ere  available.   If   additional   funds   become
                                available, lioivei,-ei-, 1)@iTS i@ill consider  usina  the  Section  910
                                authority.  First  consideration  i@ould  'be  aiven   to   allocation   -of
                                additional funds  to  strono  RNUlls  that  1-iive  been  hurt  by  cuts  in
                                the past.
                         C.     Area Health Education Centers
                                The  Conares-s  is  considering  -hqo  proposals  relating  to   Area   Health
                                Bducatioia Centers.  The Administ-ration's Bill ivliicli has passed







                                                                   4

                                               i@oulcl place Area floaltli Education Centers in
                                  the lIoLiso
                                  The other i,,,oulcl I-)Ii,,:c, ,'J-]E@C's in ]@,IHIS.  Senate and flo,,ise
                                  Bills ai-o-.sti.11 in co,i:Ec-relice and it is still not cortaii-i
                                  i,ilietliey IkToa I-loal-Lli I:,di-icitioii Cei-,toTs fill (,-o to NII-I or P@,,U)S.
                                  'nie I-lo-Lisc, Bill i,@-Iiicli i-iiikos responsible,   rcciLiires   that    any
                                  Area Iloal-Lli E-diir--@ition Center I)c, doiclopecl  in  cooperation  i\Tj.tli
                                                '%Ic  1:      Z,
                                  a.Regioiial. i -di.,al 11-i-o@@Lm, so ill -:DI), e-1,031t, R'I'I) i,:ill Ila-,re
                                  extensive                      in        of this  @-iL  has de@,elo,.-)-d a
                                  irer, close             -,,elatio3-iship, i,,,itl-i the. 'Iliii-el-.u of
                                  @lanpo,,,:ei.-. I'he ti.,,o oa7(-c-@-nizatioii,-; lia-x.Tb been i-l-orl@incT l@-oll
                                  toaether,   have a cood uiidorstandino- of              needs to be done
                                  and i@ill be able     to coq@eTate effoctiarcl)r.
                                  Votera@'s Adiiiinistr,-.tio.,,-i his also exhibited     a high level of
                                  interest in Area 1-1--altli Education Centers.          The  IA   in'   cooper-
                                  ation i,,,itli l@%P and      has mounted a series       of   site   visits   to
                                  examine the potentialities for establishing             Arei lical-Oi Education
                                  Centers ijliicli i,,,Ould include an imrestn,,-iat @i.,Icl                on
                                  the part of the VA.   Ti-iese visits have been conducted in -Lreas
                                  1-iaviiia inadequate medical services, there good ivorl-,ing 3-clatioi-i-
                                  ships :-.-rc =already  established  i@ii.t)i  Recional  'j\ledical  Procr@i--,.
                                  The l@1% has made it quite clear that R%IP relationships ijould
                                  be very desirable, if not essential in all cases.

                                  Dr. llargulies asked          Friedlander to comment on the l@@'s
                                  interest in AI-fE-Cls.  'i%lr. r@-ricdlm-ider indicated that only those
                                  communities ivould be funded th-rouoli @@,k i@liere activities have, a
                                  direct relationship to improved quality of care.  ITA f-undiiau
                                  ivould provide initial support id-,icli aii Area Health Education
                                                        -pccted to pick up once legislation has passed
                                  Center i@ould be ex
                                  and funds have been appropriated.
                            D.    Equal                01@,)ortLuiity ProRress Report
                                  The Regional i',Iedical Progrmis      Service has developed a vc-'ry strong
                                  Equal E-iiil)lo),mient @1),  oi7tiz-iit),  program.  The  Service  has  an  EEO
                                  Council made up of r@, iPS employees ivliicli meets i@eekly.
                                  R@IPS has established definite coalF, and targets for er@iplovnient of
                                  minorities. ai-id reopen bNy, January 1972.   R@U"S expects similar EEO
                                  efforts to be uhdeT+-aken by granteesand affiliates.
                            B.    Report on Orientation Sessions - AuF-m
                                                                                 st 2, 1.971
                                  An orientation session for neiv Council members was held on
                                  August 2, 1971.           staff discussed the general purposes,
                                  organizational structure and history of I'xccyj.onal @ledical
                                  P-rogranz.   Ilie kinds of matters that come before the Council
                                  Here also                  'Die se.-,sio-i i-;as           I-)y       l@rcl,-off,










                          F.   ll\!')Is  Pro@-rcss RCI-)Oyt

                               Rec7ioTial    Medical     Proar=     throughout the  col,)iiti-)r  have   developed
                                  t,                   LI
                               an intense interest, in  Health  1,1,@iiiitcnuice  Or@,Yii-iizatioi)-s.  l@%-IP
                               has been             ti-l-o  specific  responsibilities  in  Tola'L--ioii   to
                                        'I'lic-!se a@e   to Set Up 7
                                                                     'Llidelill S for ri',  Ilitorill(T  tIlEl
                                                                              0                  LI
                               quality of care cnd (2) to describe for noaiitoi7i.ii,) or for      guide-
                               line purposes         is meant by "Health  iii-lintoii,,ij-ico,."  'Flies.0
                                             a-re an out(,ro,,,:th of increased             of   the   need
                               for a -more sati-sfac'o-n, method of d--te-i-iiiinii,.-
                                                                                              or not
                               quality of care boi-n,) provided mid paid for       i@itli   Federal   or
                               iioi-i-Fede-ral      is indeed .ideqLia-l@-c.

                               ]%Iai,iy  units  of  the  Federal   Government   have   been   dealing   with
                                                               4-
                               these and o-Lliw--issues -rel.aL,     to quality of care.   Ik,\fPS is
                                                                  t.>
                               COI'Ise-quea-itly i,.,orl\iiia ijith other  units,  NIJ.-I   and   Social
                                                     C,
                               Security to gain the benefit of       their c,@p---rioi-ice'.

                               In addition, R\!P is  settiiic,  -up  some  TncetincTs  with  coordinators
                               and  other  ii-idi:%7j-duals  who  are   concerned   with   measuring   and
                               monitoring   the    quality    of care.  I%le  will  also  be   callil-ig   on
                               members  of  the  CoiLicil  to contribute  their   thinking   and   special
                               skill.s in relation to quality of care issues.

                          G.   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   diseases   cancer,
                               stroke, )@idne), -ii-id 3-elated diseases. Recei-it  Coiicressioi-ial
                               interest in  Section  907  makes  it  laiol-ily  undesirable  not  to
                                                                  -reparation  of  the   required   list
                               proceed iijuiiediately with the p
                               and )@Nn' intend-, to  do  so.  The  list  will  not  attempt  to  be  all-
                               3.nclusive  or  to  include  all  institutions  ivhe-re  limited   services
                               are provided, but rather to list those institutions Israeli demonstrate
                               really  St  erior  and  advanced  performance.  Tiie  list   will   be
                                         IP
                               carefully  selective  and  will  be  desiaiied   around   criteril   which
                                                                         0
                               have been dorive-d 'Crom contracts to set up ouidelines for cancer.
                               heart  disease  and  stroke,  and  some  other   information   which   has
                                                      4
                               already been asseinl)"-.ed in the Kid,,aoy Disease Proo@ran to identify
                                                                                       t'
                               institutions which i..,@ould appropriately be included.

                                                                                         4
                               I'he list will be  coi-,,piled  on  the  basis  of  a  voluntary  response
                               to a survey of hospitals throughout the country.  The list would
                               identify  those  hos-r.-'!-tals  having  'characteristics  associated
                               with special  qualit@l-.  '11-iere  would  be  no  sense  of  accreditation
                               or -regulation, 310T would   a sense of   approval   or   disapproval   be
                               involved.  'nie   list will  constitute   a. selection derived from









                                                                        6

                                     Sec-reta-nr Is decision, prc-.,siu-r,,ibl.)- be               to physicians
                                     and to tire public i.ii                -uid  i@oulcl.   profile i nfo'nii,-Lt ion
                                     about  i.,-Iicre  certain  leiels  of  iTie-clical   care   are ivi i iib 1 e
                                     There has           --,came  qtcstion  in  the   past   is   to i..-lietlic-r 'cl@i--
                                      -reatioT                                                              h@-@     been
                                              i   of   suc-@   lists   is   a   feasible   endeavor,
                                     one of   the. reasons for failing to proceed                   raLicll),
                                     this acti-vit)@.

                                     General   discussion   follo,@.ied,   but   no   action   i,:as taken.

                      VII.               'P)Y @h@. BE.\@,,TY                       AJ.)-.If!NTSTP\,@k-@'Oiz,     SEP,@7ICES


                               @ii,. liall, -representing Dr. I%Tilson ivlio ivas unable to attend greeted
                               the  Council   and   -read   a   I)-reT)a-re-d   statement   coiiccrni.na   the   creation
                               of   a   better   'Health   care   system   tli-roucli   the   application   of   tocliiiolo-
                               gical develcr-r,,,o.@.it to the health field.   The discussion i@hicil foll.o-,..Tcd
                               indicated   that   the   Council   and   the   health   field    (Toneral-ly    have,    long
                               been  i,.vaTe  of  the  )ote-iil:i,-:Llities  of  cor;,outer  tec.1-iiiolo(,,@,  and  fallout
                               from the Aerospace p.-oc, mn in the provision of health care.   A
                               number of Cou-1--il -nien-ibei-s, hoiie-kroy, strongly indicated that sub-
                               ste2-iti@l   additional   funds   i,@?oulcl   be   needed   to   turn   the   interest   into
                               practical results.
                               @ll@. Hall also discussed. iargending changes in the organization of
                               the I-IS!I.H!% Administ-rator's Office and indicated the likelihood that
                               in  the  near  f-uc-i-re  a  number  of   pToc,-raiiis   fouler   be   grouped   under   four
                               Deputy   Acl--,anistrators   -rather   than   -reportiiia   directly   to    Dr.    I%Iilson.

                                                "TS
                     VIII.     SIIE-CIAL RFI)OT\

                               A.    P,-\IPS Reorganization

                                     Dr. Palil briefly outlined the current status of reorganization
                                     ivithin the ]Ze-ional 1,1@eclical Programs Service.
                                                      C,

                                     The   reorganization   is    currently    unde-nvay    and    it    will    probably
                                               C,
                                     be   early   Septe,,Tiber-before   all   branches   are   able    to    get    together
                                     and interact appropriately.
                                                             .t

                                     The reorganization -t@ill restructure the                   in iqhicl-i PV\LPS inter-
                                     acts iqith tjie individual Rec7ioiial '\Iedical Pro(Traiiis.   Four
                                     operational branches have been established on a geographical
                                     basis.   'niese,   to,-ether   with   th@    Grants    @.-Imagement    mid    Grants
                                     Re-kTieiv Branches coii.t3titute the i-iciv Division of Operations headed
                                     by @ir. Robert Chan)bliss.   Four Operations Branches have, been set
                                     up on a geographic basis.           Team     of     professional     and     supporting







                                                           7

                                               other di@@i.sioi-is -u-id offices, such as Plm-inil-ia
                                  F@@,alua-L-io-,i ,ind Pro:L'ossioaial -uid Tocluiical
                              been identified to sei-ie as joint appointees with 'clic Operations
                              Branches.


                         B.   Rf:-vici@ Criteri.a

                              Dr. Palil and I.,'r. Peterson discussed the net,,, l@i-PS      critcria
                              and rating system .

                              'D i e, revi-eij criteria and -rat-Li-ia syste,@i-i were developed by staff, and
                                                               0
                              ciTipl.o),cd for the first tL-Te by the      ReATi.ei,: Co,@ij-iiittce as its
                              July 1971 Eieetii@g.  'fi-ic criteria were derived fToiii t]-ie R.%U-)S
                                'LI                                                      -id a 1
                              "@,"ssioi-i Statc3-nei-it."  Each criterion i,,as i%Tei-liteti, ai
                                       5 scorii-i-- system ivas cimDlo)red for each.  re-\,-i@ivers
                              were asked to-ci3-cle the score for       r criterion about i@Iiicli they
                              were uncertain.  In - addition, the ratina sheets includ-d a place
                              for each revi.e7tver to indicate the basis for his c@,aluatioi-i.

                              'nie reA,ic@,Nrers appeared to feel cw,@lfort,-,ble with the o,,reral-1
                              process in which they had engaged.                of the Reliel@ Co-Tli-
                              mittee. felt 'chat the 17 criteria were comprehensive and that
                              the s-Lib-crite-ria. raised in the fonii of questions were, in fact,
                              useful in lielpinT  them  to  channel  their  thoughts.  Su,-ne.niodi-
                                               --o-rove-ire  ere suggested, hoi@.eirer.
                              fixations and   i3ii,     ]its I.,

                              As a result of this initial experience, plans  -  a-re  unde-n%Tay  to
                              rea,rran.c,c@-ai,.d clarify a i-iLLmber of the criteria -nicl to provide more
                              adequate iaif-o=.iation about certain items with a vieiv to increasing
                              the revieiic-rs confidence in their ratings.

                              In general the initial trial indicates that the criteria and
                              rating system are both i@orlcable and satisfactory.

                         C.   Comcil,'Rffviei%r Comittee and Staff Responsibilities       for Grants

                              Dr. @-la@,ulies-read to the CoLu-icil the material under    VIII, C. in
                              the Acyei-ida Book Dn-L-@tled "Re\,iei@ Responsibilities Under the
                                                   7
                              Trieru-iial        S-%stem.1'  It was moied by Dr. @lillikan and
                              seconded by Dr. I'@o'cli tli-at this stateni--nt be formally  adopted.
                              'I'lie motion i,,.as api-.)ro,,recl unanimously.  Ilie full text of the state-
                              ment is appended as Attacl-uiient B.

                         D.   Watts -lVillut@I)i-ool@

                              Dr. @,lar,,@ies introduced Dr. Alf--red @t. liavnes, Cliain-nai-i, Department
                              of ComLuiity  I,,Iedicile  and  Assistant  Dean  for  Conmnity  Health
                              Affairs, Charles R. Drew Postgraduate Medical Scl-iool, Los Angeles,








                                                                            8

                                      Di,. I-IgAiaes                                              Oil t)lc-,
                                      I)rool@ i?3.-o-ioct i,,,',iicli           'cllic coa-,,--orted effort  s of  t'IIC@
                                                          Kil-1(7) Jr.                I'..,).,;I)ital an-,I the     Clii3-les
                                      R.  Drei@  Post@T@Ldii-,it--  j\.Icdical  SC-l-iool  as  fell  C9.s   other   con,l-
                                                                Ilie-sc,                     lia-ve cori@!)j-iied ii-i a
                                      coliccrteli el-f-o-rt to est<-Lolisla a health se,2-vice center in -the
                                      IVatts   area   to   prc)v.,icle   qiial.iL)T   cqre   to   the   residents.    a'he
                                      project i---, oro-iiilzecl in such a                   that   serv-Lco   'co    tlie
                                      cai,;iiiTLmity is Teo-a-rdocl -is ea,-Liall),, --i,,d perhaps i-,.iore iri,,,oytaait,
                                      than educatioi-ial       aiid research activities.


                                E.    St@-I'L.Lis 01, R"@S ]Ze    'atio@

                                      @Ir.  Kenneth La-L-E-a   sirnarizecl the status of efforts to @vise RIP
                                      policies and f-,Ir--,g,,llatioi@

                                                                                                     d  \_ ID                el
                                      The         Gen--3-al- Co@i-,e.1's Office has -,icl-k7-ise  M,.S to          co     ct -.v
                                      rei@,rite tl-i- ProyraTn's Rc,,(,,Lilatioa@ to -reflect the most -r cent
                                      clia-i-iaos in the Statute v--, i@ell as nc-,7,%r operational procedures.
                                      The   General    Cc7,uisells    Office    is    developi.ii,7    in    initial    draft
                                      of such Pcoula.-Lions in cooperation i@rith PI.IPS.

                                      Considerable py--.,-"ess has also been i-.qade in developing a loose
                                                                                            -itees, affiliates and
                                                                             use of ayai
                                      leaf polic), m, -a-i         or tli
                                      @TS   staff.   Departi,,--ntal,   I-I&12-Lk   and   R'\IP   policies   lia--k@e    been
                                      assembled for ijiclii--,ioii, lig@@e-kTer, considerable editorial. i%Tork
                                      still -reniaii@ to be done.


                                            -Liter Assisted EKG -Analvsis
                                F.    Co@vr,

                                      Dr. John Farrell and Dr. i@,biineth Giiiible discussed a draft report
                                      Ol'i   the   subject    of    coi7ateT    assisted    EKG    analysis    that    wqs
                                      prepared at tl-ie.request of the Council.

                                      Technolocj.cally     fully     operational     EKG     analysis      -requiring      no
                                      further -reading            a pia),sa.ciai-i has not been achieved.   Development
                                      of a full), a-Lic,-.--.  --d syste,-ia of that level of sop7,iisticati.on is
                                      problematical.    '    CoIT,)uters    haire    been     accurately     -Md     reliably
                                      used for screening i-ioffal and abiioni-,il L-KG's i@itli less than 1
                                      percent error.

                                      'fhe cost of Automated E-J,Gls is estimated at $2 to $4 per cardio-
                                      grai-a exclusive of .1-te cost of rereading by a cardiologist and
                                      assun)inc, a r-unjiyri-r@i annual volume of input.

                                      Basic coiiclusions.2-f!@,zhccl from the study -were:                   (1)  that coTn-,outer
                                      assisted     EKG    ana-LYsls    an    effective     and     -reliable     screening
                                      teclinioii---,  (2) that clc-finit-L-kre                    Tp.,,iqt@ bE, dope 'hN, a


                                      c;:-  LL                         1!,@                                   c)l
                                      it   cannot    -replace him.






                                                                       9


                        IX.    li@T-"Ctyl'i@-li@

                                         the               SI-ssioii there    ivas a  discussion of the stit-lis
                               of efforts to consolidate three Olii-o                       In vi.ei@,  of  p-ro(,-rcss
                               that has been ii@icle it i-jas proposed to p--rjnit these l@ccyioiis to
                               ,-TPI)7. in                It i,,-a-,, also p-:opo-c;o@l tli@,lt Coiu-@cil -and  other
                               -tpl:)3.-  i-iate stiff        i,,,it)i  the  Interim  C-n2-,-nittee  and   the   Fiscal
                               A-ci-it.   It was moved I-,)- Dr.                 and seconded by Dr. ]@u..7@aroff
                               that the Coiil--ic-d.l. (,o on record as SUPPC)Ttillu this initial plan
                                                                     @-,]I')S I)c(@iii to Jerry ClireCtl_)7 I-
                               including   the   l@.co@,'so   that   R                                    ,i-th    Ohio
                                         -i  a   stafl   b   is.   The motion was adopted unanimously.
                                    s   oi             as


                               Otl-ior    items    discussed    during the Executi-kTe Sessi.pi-i included        (I.)
                               the status of the Alb,-:ny@@, Rochester and Central Xoii York P,,\P,               Is;
                               (2)  the  stitus.of  the  S@isqueli,-mna  Valley  P\i\E3;   and   (3)   tlio-,.   possible
                               separation of De@,jare froi-n the G3.-eater Delat%Tare Valley Pi,-Ul.
                               lio action was tal@eii on these matters.


                         X.    P\E.\TIBV OF PPPLIC.@TIO@,,S


                               A.   Hai-iai.i Re,-,i oa-.ial @.1-3di-cal P-roa-ram

                                    @ldtio.,i made by Dr. @,lilli-l@ma       Seconded by Dr. OcJ-isi-ier

                                    "Approval of the Hai,;aii application for o
                                                                              L             ne   year   failing    at
                                    $1,072,OOD   plus    an    additional    $30,000    with    the    strong    recom-
                                    inendation that none,, be utili--ccl for support of activities in
                                    tJie  Trust   -r-cyion   and   with   the   additional   -:idi7ice   as   specified
                                    on   page   1   of   the   Coiiunittee's   report.''    (Transcript,    page    20,
                                    line 20)

                                    The notion was unanimously approved.

                               B.   Northern ]\Ioiv Eii@olai-id Regional @'@edical

                                                                                                       -r
                                    Motion iiiad-   by  Dr. l@Lillil@an - Seconded by Dr. Scli enter


                                         -rove            -r
                                    AI)ID      the  r'eco..-c@iidations   of   the   IZeviei-i   Coimiittee,    including
                                    recordi-n-   the   six   items   of   their   critique,   iiitli   these   items   to
                                               0
                                    be kel-)t stroii@.v in mind then the triennial application is
                                    ultimately                   and with advice that through street" admin-
                                    istratiara leadership some of the real concepts of                           should
                                    be included in the ))-rogra-rn.         (Transcript, paue 26, line 3)

                                    The motion was un,-iii;        sl),    approved    after     further     discussion
                                                              @mou
                                    which  sua@lestocl  tli.-i-l-   t@-ic   Region   Ought   profitably   examine   goals
                                    and  objectives  do-\,c.!@oped  by  other  TC.%@IP's   and   develop   a   plan   for
                                    use of collectecl data.












                                   C.   Tc,,K,-is

                                         @loti.on          b), D'.. T'@,@;,erist     Seconded    by     ljr.     Fric-cllm-idc-r

                                         "Appro@T,il- for t@o )?,ea--i-s at a          f--Lindi.ii.(-      of         $1,590,000
                                         iliclujilig tire Cl---A'Cl@oli,,licl-ital                   (TTaiiEc-ril.)t,     paoc     29,
                                         line 25)

                                         'Jlie motion i.,,as                      aT  -r v
                                                                                    .,)p o , c,-I.

                                   D.                                         1'Prb(T-ruii

                                         @lot-ion   made   b),   Dr.    D--Bal@ey    -    Seconded    by    Dr.    Everist

                                         Con@,yreiico  ililt-li   the   Cor@-Eiiittee's   recol-@Tji,,oiidation   i.,,itla    the
                                         proviso tliit if 11-lic!' site visit slioul-d indicate a. need. for
                                         additional   -@.cls,  the request                    be    brought     back     before     the
                                         Council.,   .(Tyii-iscTi-pt, p.),<,Te 36,  line 5)

                                         The    riiotion    i@-as    ui-@,miroasl),     ipproved.  In subsequent discussion,
                                         it ivas a,@eed tJiat         there     i@oald     be      appropriate      -representc-itioii
                                         from staff and tlic.,        T@idrc.,y Disease Pinel on the site visit.

                                   E.    Bi-state Pcgiona.            @di.cal Pro,@r@,m

                                         @lotioii i,@i,-de b), Dr.    Oclis,.-ic-r   -   Seconded   by   Dr.    D.3Bal,,ey

                                         Concur  i,,,ith   i%,Iiat   the   R@-@Tic-,iv   Comiiittc-e   -reco,=u   ended,   that   there
                                         be an additional ),oar instead of the three years requested,
                                         and   that   this    be    in    the    aroix-it    of    @924,113    and    further    coii-
                                         currence i@ith the Co,--Tiittee's disal)p-rov,-d of the developmental
                                         component    and    the    other     -@,idiiig     relative     to     the     project.
                                        .(Transcript, pace 37,  Iii-ie 16)

                                         'Die    motion    i%,as    ui-iai-iimously     approved.

                                   F.    Geo-rgi-" P,,6(,ioi-ial        :-cal Prouam

                                         @ioti-on   made   by   Dr.   Canno-.q   -   Sect)iided   b),   Di-.   Nli.llil@an

                                         Approval   in   the   .-niol.-nt   of   $2.9   mi.'Ll.ion   for    each    of    the    first
                                         -h%lo years    and   $'L.9   r@,illio2-i   pl-Lis   the    requested    amoui-it    for
                                         project 30 for tJic third year,  the oxict amount to be deteiiv,Liiicd
                                         by  staff  oi-i  -LI-ic  I  .  -   -'   @   of   the   intent   of   Council.   In   addition,
                                         the Council conc-L--.- --Ln the -recomici-ida-Lioiis of the site visitors
                                         with respect to                                      spocificall)@ identified
                                         projects    with    the    exception    of     kidney     and     the     Stc-rhens     County
                                                                                    r     1 4


                                         'llie motion iNm.s     u-D-,-iii-,iously   approved.


                                                  ivas' not proseiit durii-L.@ consideration of this ai),r)li cati oi7i.










                                       G. AJ.ball)@

                                              @lotion iiia(Ic- by j',,Irs.  l@ycloi':f           Seconded by Tli-.

                                              "Al,.proval.  of-  -Cno  Rci-ici,,,  Ccj-r@,iiitce-ols   R-@coa-,,@-q@-lic-latio3-1   tll,-It   --Oii-s
                                              pi-oj                                       - oii- yeiT more  for  $900,000."
                                                    ect be                  for      oiil)7      I
                                              (Ta-m-isc-rii)t,      pace      57,      line 14.)

                                                             -i i@as   ui-i -mai-inous  1), afl)a7oved.
                                              The motioi


                                       li.    Central             Yo-rl.-                 @ieLii.cal       'P-rocram

                                              Motion     made     bv     @-IT.     Friedlai-ider     -      Seconded by Dr.  Cajuion

                                              Approval      for       6ne       year       funding,       contingent oii a staff-            folloii-
                                              up visi-t  six IPO,'.'CIIS  f-olloi,!iai(T         the  ai@,i.rd o-ic this  application to
                                                                                                           cil@
                                              eve..lu,@tte    the    pi.-ocloss    -L-liat's    been    iiia'-    in i-@ceti.no  the  conditions.
                                                                         0                                                      0
                                              (Tr@,iscTipt,      paoe      61,      line      l@D)

                                              Ilie motion              unaii-uiousl-y             approved.

                                       I.     Rochester    Pv@(,@io-iial    @.,,-odical    P     o.-,am

                                                 -Lion iuad- by Dr.  Mc Pliedr,@-i -  Seconded by Mr.  @lill-iken
                                              no

                                              Approval of -Ciie Rc-kTi.ei,7 Coiru7Ottec's  recor,-.-.iondation of $800,000
                                              and     deferral     of     any      action;uiitil      the      next      Council,ii,,cetii-ig      on
                                              the kidney project.                 (Transcript paoe  63,  line  24 and pace  68,
                                              line  15)

                                                                                -aously           approved.
                                              Ilie n@ption iNTas unani-i

                                       J.     @ien,.Pllis  I'@o,,cTional Medical Progr,-ti-a*

                                              Motion made by @Irs.  l@,yckoff  -  Seconded by @ir.  Milliken

                                              Ap,-,oToial of the P@ey',eiq Co,-mitte--  recommendation for  a funding
                                              level  $1,627,0'VO  for each of three years,  or a total of  $4,950,000
                                              plus     approval     of     su,,,,ge@ii-oiis     in     the,     blue     sheet     with      deletion
                                              of tl-ie                    to     "!--clical     l@soci,-:ition     @es      for      project      39.
                                              (Trai@cript,  ppce  71'),  line  7,  and page  87,  line  20)

                                              The motion Has un@,,,-.         imou-sly            approved.

                                       K.   @li  ij.(,an RegioncLI                        Program
                                                 ci

                                              Motion     made     by Ih-.    'Ic Ilhecl-ran         Seconded by Dr.  Komiroff


                                              li:Ul@, I llg -L U'.'L' Li@@,     Lji,      ..L Lli  al!CL SlXLii years        I-or     eacii     year,


                                @-Dr.  Czinnon             not                              consideration of this  qpplicLition.








                                                                   13



                                  @lotion made by Dr. Roth - Seconded by Dr. Cajuioji
                                  "Ap])rov.,).l o-r' f-iinAiii(T at the -rate proposed on pl"c, 5     of the
                                  -revised i]-) lica,tioai.1'    (TrLlisca7ipt, pace 140, lilic 6)

                                  'Die motion  i.,,as                 -i-,r.?-pi7oved subsequent to so.-Pc
                                  fLi-rclior discussion i,,iii.cli iiijicatcd that I)rocyress on this
                                  Project           Provide some cxarlples that could be used in
                                  @letiopolitpn D.C.

                                             'I'dOija6y'F6i:ii@dacibii.'

                                  '%,iotion r..ia@ie byDr. Camioia - Seconded 1)), Dr. Roth

                                  Disa-PPTOVal.   (Tr@-,tript, page 144, line 17)

                                  'nie motion i@as unanimously approved.

                             R.   California Recional. @1--dical Proarpja**

                                  Motion   made    by Dr. ]%Iillikpa-i - Seconded by D.-. Ko-.,naroff

                                  "Leiel  f-Lindi.-io for three years at $1-0,043,175 iiith exact amounts
                                  to  be  determined  c-ii  the   basis   of   negotiation   by   staff   duriii-
                                                                                                                Z>
                                  that  pericfd,   and   for   the   sm   to   include   the   kidney   project."
                                  (Ty,-uisca74-I)t, pacye 16, line 17)

                                  The motion i@as unanimously app-ro-ved.

                        X.  ADJgLJIZ%',%E,\'T

                             'Ihe meeti-na  i@as adj oun-iecl by Dr. Pal-il at -1: 20 pill.    on Au,@t         1971.
                                                                                                           4


                                                                     I hereby certify that, to the best of
                                                                    my kiio,,.,,ledc,,-, the foregoing minutes
                                                                                  0              t-I
                                                                    and attachments are accurate and
                                                                    complete.
                                                                    '/7 ','I
                                                                                  -ulles, @l
                                                                    Director
                                                                    Regional @l,edical Programs Service



                                                                           coi-isictur
                        *-Mrs.    W                                                  atioii oJ-' this application.
                                  Yckof-f- was not present du-ri-ni      consideration of'this application.



                                                                   ATTAC"','LT'?@T A
                                                                   Page








                     April 26, 1971                                    c 0 p y


                     resolution from the National Advisory Council on regional Medical
                      Prograris Service

                     Roger 0. E-eberg, M.D.
                     Assistant Secretary
                     for Health ind Scientific Affairs



                     Attached is a me,-no @7oui the National Advisory Council for Regional

                     Medical Pro-3:a-,iis which c-.xpi-osses -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.. I%Tilson, M.D.
                     Adminis tre tor


                     cc:  Herbert B. Pahl; Ph.D.
                          Harold Margulies M.D.




                                                                                                                                                                            2







                                 SU13JECT:            UN@'@Vj\l],A6@3-1l'Y  Ol,'            'J'IIOSF,  1'1'0"'l'  '@l                   1-@'i,ICII                 l@          I Aj,, I r)
                                                      J.'))'  Till,"                    )'071-',  l-')'SC'Al,  YJAl\'.    1971-      l@i\l)
                                                                                                                                              'O\
                                                      ]]AVE                1'1,,ACI-"D                                I'EQU@'@,STS





                                 I-I]iEl-@],@AS       Tiie                                         Pi.-ocriii,,s  Sc,.'ivi.cc,                  c-rc-,@3Lc@d  iii(i
                                                                             -poscs  of  (1)   iTi-,prc)-,,i.iic   foi-  all.  citi@cns  iccc,.ss   tc).
                                                      for  Llic  I)tii.
                                                      find       iLitil.i,7@it:i.c)ii       of       Llicir       local I)c@@tltli                s)Tstei,,is,        and        (2)
                                                      iiiipro,,,!.nct        Llie        quality        aii(3        cffccti@,(-@-,-icss        C)f"L-lic        lic@altli        services
                                                      pi.-ovicloci        x.?illiiii        rf@c,i.ons,        pirtictilarl3,        %.@iL]i        recard        to         cai-icer,
                                                      strol-,e  and.  disc            ases  of'  LI-ic  lic-,.irt  incl  ]@icliiey,   iii(I
                                                      'I-'lie                                                         Scrvi.c,-.o  during             tl)c    five        years         of
                                                      i.ts  c!>,j.,,itc@nce  liis  est@-blislic@et  N,i,3b].c,   local
                                                                                      t7i)e       i-iiajor       lic@,iltli       care       providers,        and        ii-,prc)@,ed
                                                      tl)c--                 -iiicl  qti@-il,iL)@  c)'L  tlir-,                                      no@.,7 c-,xi@;t-bctx..,ecii
                                                      tllE!";c      providers      anci      Llie      cotisttii,.c-rs       i..,Iio       coi-,ipris(-.       Llic-       several
                                                      i-egioiis ;   and

                                I,)I,EP,EAS           For  these  clisc.@ise  c@ite-o):ics  tl-ic  Ilc@c                                       J,,'c@dical              Pro-ra-iis
                                                      Sc,.rv5.cc        %.?Eis                           to     be     @-@     prii,,-,ary,  fui-icti.on@il.       irl.'l       of
                                                      t] IC! 1)cp@3rt II', C' LI t of II c@ a I tli , rLC],Licatioi, and                    1-7(,.Ifire  i..?Iic-i.-eby  tlie-
                                                      potential        benefits        i.@Iiicli         result         frori         tlic@  n@--ti.oii's          support          of
                                                      the  I)ioiiiediccil  rc.,sc@ircli  enterprise  at   the  @latioi-t@il  Iii&tS.Lutcs
                                                      of       lic.,il-tli       can        be        realized        froii        practical        @-I)plicat'ions        I.,,itlliii
                                                      coir@-nutiiLics;   therefore  bc-  it

                              IZESOLNIED:             Tliit  the  Netionbl  Advisory.Councl.1  for  'recional,  I-lecli.cil  Proc,rinis
                                                                                                                                                                                   C-1
                                                      iqislies        Lo        C-P).-c!ss        to        the        Adi-iiiiistr@tor,,        Ilealtli        Services        and
                                                                                                                                                            -it     S
                                                      I-Tc-ntal.  IlealLli  I-.(ii:iiiiistratio-,                     and  to  I:Iic,  Assist@ii                    ec3:etary
                                                      for       llcal.tli       @ind       Scic@iitific       Affairs        its        deep        concern        that        tlic!
                                                   .-,Linavaj.l,-I)il-ity  of  tiiose                                                   I..,I)i.cli          i.@orc@          appropriated
                                                      by  Llie  Coiii,,i-ess  for  fiscal  year  1971  and  Liiicli  E,,tib@,eqtici-itly  hz.-,,,c
                                                      been  placed  in  rc-sc-3-vc-  i,7ill  result  in  --c@riotis  ciii:tailii,,c!nt
                                                      the  rioinc.-nttim  of  tlic,.  ovEt,-i).l  pi:o-riin  ii-I  iiiceti.iic,  its  objectives
                                                      and,       tlic-re.'Loi.-e,       rcct-,lests       i:cco,,-iFI.cleratic)ii        of        this        iii,)Ltcr        in
                                                      tcyiiis         of         Llic         Adi-,ii.iiistritor's         e@:prc@,sed          n@itionil          priorities          for
                                                      iriii)rc)vl.iic,   tl-ic  lic@@ilti)  services  and  delivery  systc-iii  of  Llic  country;
                                                      and  be  it  fui.-t:lic@r

                             ]'\.I:@SC)LVI:"D:        I'li @i t as      near      syst(--riis       for       tlic-       delivery       of       licaltli       services       to
                                                      corr,;iiuni.t5.(-,.s  are  (Icvisc-d  iiicl  instituted,   the  C.oulicil  respectfully
                                                      submits  LI),IT  the                                  I-Ic!clicil  Progrii.'I.-,  Service                     i   the         vio.3t


                                                                             -i.iici.i)al      I)rogrei-,i  T,.,Iiicli                                   @ill     of    Llic
                                                      to  I)(-  Llic      1) I
                                                      provider!;          of  I)cialtli        care  witlij.ii  CC)nl,-.ii,,ii-ii.Li.c-s;            i II (I be     it           fLirLilcr





                                                                                                                                                                    3




                                      OL@IED                         slil)[)O).-t    Of
                                                                                                                            CC)LIlici@l
                                                                                                                                             3.,;Sllrc."C;
                                                                          '02-
                                                                                                                    SccreL@ll@Y         Lhit
                                                                                                                                                                   Cf. fol

                                                                                                                                      ?(,ell  Llic!   ]IC,.C,
                                                                                                              oil      COnLi@iijil,'71       b                oil
                                                               1) C'

                                                                                                                                                            0    c  I fo


                                                                                                                                                       -ii-
                                                                                                                  f f C) r t .3  11,                     icl  '!oil [:a
                                                                          " Ellcl   c 0       1) o ra t        c,                                        t     r            C'.
                                                                                                                       I-ileill .3s   @i I I
                                                                                                                           Cl                                   1115,tiLIlLes
                                                                                                   tl)('-  NatiO-Ill,  IiisLit@tiLcs  of
                                                                                                                                                                      in
                                                    orclea.-  Ll)aL  no                                L)c  ol.,crlool@czd  for  briiic@
                                                                                                                                                  ciii,   to  tile
                                                                             the  crcgte,,3t  POSsil)ICI  SI)eclcl  Lfiose  niccli-ciJ.'rescarcii
                                                   adx,aiicc@s  i.@!ii,cli  can  fori,@i  tile  I)asis  for  ii-,iprovii)@  3cccsc;  to  all(I
                                                   the  oN,cr@J.'l                        of  tile  liE!,Iltll  cpl:c-  a
                                                                                                                                 x,,iil.pble  to  tile  people
                                                   of  tl)(..Se  I-cg@o,-Is..
                                                  li-i  @,O  ClOilIC-1  Llic'  CoLilic5-l  aiii-io,,iices  Its  5.iltclit  to  estali).isli
                                                  1-1111)IC!Cljatcl@,  for  tile  T),Ciioilpl  1-ic-cl
                                                                                                                                            SC,
                                                                                                                                                            a  set
                                                  of  sliarpeiicd  p),-c,,
                                                                                           prioriti       -e@i  @s.  dcLeri,iiiicd. in  coi-,sLltition
                                                  1.7itil  li'cp]L-I)  @Ser%,icc@s  @,iicl  Centel -lic!@ilLfi.Aclriii-ti-stration,   Ltic
                                                                   InstiLL'tcs  or  llc-@@II.Ll) '.Iilcl otlier  Iciz@,clers  in  tile  fibid
                                                  of






                                                                                                            I-'!






                                                                                                                    C,
                                                                                                            A(Ivis         council
                                     once  cicli  tilrec,                    i   C,.   j             r      E!t,
                                                                                                                   @;clrv C.,;  to  rccoi@ni,,,,o
                                                 :L on .7,s  iii
                                                                                                                       to F;CL  a gellel.nl
                                     CO"Ilci-.I.'s                                                         ii  c-,@,    tj
                                     al)pi,o\,,Il  ,or  1-til  ]','fP  Lis  @-.:n
                                                                                            for  c
                                     In                  tc)'                                                     of,
                                     actions  oil                                                                               to  tl"(.!
                                                                                       A
                                     -cai,it                                             or
                                     Prior  to  revici-T l@y  tlic-.  Co-Lilicil
                                     r(@V4
                                                 (I l@y
                                                             1. F, i i c- d  IS  s t i f f  -a r-, t-. evisit  tc,,i,.t  ztiid  the  )@il'S
                                                 Conriit'cco.

                                     Excop@l-  as  specified bel.o;.!,  t-le                                                         cont:@,.iiu-
                                                                                                         ctivi":!.(-,F.,  for
                                                                            sLip,,,ort  't)r  nc!-,!   z                             c@coii(I  and
                                     tliird  (02  ind  O.'i)  yeqr  st,@,)I@ort %.:i,,Iio,it  fi.irt-I'lie-.-- C,,;,-,,icil  act--!on  insofar
                                     as  the  prol)o--ed  activitief@-  P,17C                             with                     policies.
                                                         :ill Lc,- pi-ovi-dcie@              @i               of  sucl)  nzlyirds.         SI)ecifl-
                                     The  Cot.tic@il i-
                                     call.y,   ti-le   Cc)tiic--"-l's    ac'tvi-ce                          X.2,ien:
                                          1.     Su7)plericfit;,,rv  ftii-,(is  are  rciqiiest:e(l  in                         to  the E.,,c,.nc-,ral-
                                                                                   for  t'l-tc, yc,.ir  ir,  quc-,stioi-I.
                                                 sup])or,:  r
                                          2.     A iie-@,7 or  increased J.'jeveloi)illc,@tzil  Cop-,poneiit  is  requested.
                                          3.     The  Council,  the ))ii.-c-.ct--or,  IZP-@PS,  or  tlic-. R(-,gion  r(@ciiiests
                                                 Council  revici-7.

                                                 The @il)plic,:nt-liis  failed  -'.Tl              Tr,,ItCrial  r-  ).ct  to -Iec-t  the
                                                  eatjireiic-,i)ts  of  t'ic,  Proi,,r@@m or  .,,T)plic@-@DI.c  I   S,  reCrUl,-,t@ioi-is
                                                 r  .                        I                                                       t,
                                                 or  fo@.,allv pro-,,ulp,,-itcci 1),-@licic-s  of  the  De))@irti.,ent,  IIS":'I"A
                                                 or ]@il'S.

                                     The               to I)c,                   to  the  Co,,ipci-1 ,Til.l  inc).Ilcl!2  the
                                     inforf:),-,tio.-i  coricc@i-,@iiii@  c--Etcli            revj.(@@,ed b-,,               for  contiiuntion
                                     support:
                                          1.     Tl)'C  .inc)tint                    recc-in,!)e)irled by      the  Council  for  r-undin[,,
                                                 and  the  za7.,o-,jnt
                                          2.     A list  of  activities  stipr)(irtc-@d  during  tire! iio@t  recent  f,,rint
                                                 year,  ideiitifv-fii-  those                      ],,iv(---  been  collected  I-.icl  tl!ose
                                                 %,.,inch leave ],(,c--ii  @-@upl)ortc-d  tlirou,,Ii  a devc-lop,,-,,,@iatLl  cor,-.poi-icnt.






                                                                                                                                      .1
                                                                                                          I




                                                                                                               TT,% C i
                                                                                                              A
                                                                                                              Pag-e 2




                                   3.    A                                                 'o
                                                                                                          Of tllc!


                                   4.    A  stir..lmqrN, of @),iy

                                                       cf ,;i7,,y



                                                                             .7il@l. I)c                 -,:C-. oil
                                         f r
                                         request    1)3,  Llia Couric-il.






                                     Iii),)roved    Ncitioi,-il n'dvisory Coul@@cil. @l.-I
                                     Au-ust 3,  1971




                                                                                                                                        AP PEN I) IX






                                                                                                      1,IST
                                              14ational  Adv4@or
                                                                        -y  CoL-,Ticil  o-i         I-,C"i.o"lal
                                                                                          3-4,        I-)71



                                      cou@.Ir-'Ill


                                      Dr.   Bl--nd           Cnrill,@Oll                                                     0.
                                      Dr.                                y                                Dr.    P, 1 t o. i
                                      Dr.   B-@ucc-,    W.     Evz--rist                                  Dr.                  B.      @c)th
                                      Dr.   @@i   IIiaiii        li-L;nt                                  Dr.    Ceor-!e.  E.      Scli--2 i rier
                                      L)r . t'@l'itht-.)iiy I,.                                           \Irs.  F'J.ol-eiice     l@'.  L."Ycl" off
                                      Dr.   A'Le)--aricicr '.i.  @IcPhc.-drai                             Dr.    Bzri            1.4.  1,@l.,'@kins
                                      Dr.   Jaiii      P.      '@Icrrill                                  Mr..   Edi..,a--.-d  Fried'Lander
                                      Dr.   Clark  H.  i@,'illikan                                        Dr.    li:,rol,-l

                                      P.1,VIPS   ST'lli@r


                                      Dr.   E).vin                                                        Mr.       Rocier       ',Geller
                                            Kenneth                                                       Miss
                                      v     -,Clcvc@l@qnd                                                                   @@'out-.atsos
                                      iMr.  Richard             CJ.anton                                  Miss      ',jary       @iiirphy
                                      Dr.   J@.i-nes  Clee-nan                                            Mr.               Nz,.@li
                                      Dr.   Paul  CoharL                                                  Miss              'N'els,)n
                                      ir.   Src-@Ticer          ColbLirn                                    r  .             N--Mzcr
                                      Dr.   Jeff  @--andal                                                Dr.    Mich,@--@l      \Icx@!Tiati
                                      Mrs.     Shirl-2y      1--airlev
                                                                                                          Dr.    Torbert          Pa(il
                                      Dr.   John  Farr,211                                                Mr.
                                                                                                                             Potersai-i
                                      l,ir. Gerald Cardell                                                                   Piitei-,
                                      Mr.   Terrence U-enz                                                    r. Mi'chael         Posto
                                            Sa-,iuel  U-iliner                                            Mr.    Lawrence         Pullcil
                                      Dr.   Keni-teth                                                     Miss     Leah      @z-_snick
                                                        Greenfield                                        @ir -  ',,!ortc)n    @ltobins
                                      Mrs.  Eve. I, tidal                                                 Mr.    I'%Icliard       Russell
                                      Dr.   Robert                                                        Mrs.      Jessie       Salazar
                                      Mrs.  Gloria 'Ticf@s                                                Mr.  Luther Says
                                      Dr.   Ed@@:,@rd  Iiiiipa!l                                          Miss     Tlieresa     Schcc-@i
                                      Mr.   Calv.@Lii                                                     Mrs    Patricia Schoe,-li
                                      Mr.   Josepli Jc-x,,Lll
                                      irs.     Glinter     J,),inso,.i                                            Judy          Silsbec
                                      Mr.  @liltoii Jo,---I--n                                            Mr.    @-lat-thcw    S-,-)ear
                                      Dr.   '.Kenneth
                                                                                                                 Sid:-lev       Stc!iri
                                                                                                                         I
                                      Dr.   Alriii                                                               J,-,rci-,ic     Stolov
                                      Dr.   Pliili;) I'llic,,er
                                                                                                          Mr.    14ill-,i-ii'     Torbert
                                      Mrs.    Lorraii-ic-     '\'yttle                                    Mr.    I,ec2  Va-i  14i-il@le
                                      Nliss Carol  Larsori
                                                                                                                 Lyman Van  N'ostrand
                                      Dr.  ilarian Le.@i,--Ii                                             Mrs    i\lar,,,Irct    Welst,
                                      Dr.     Harold      slar@,,ulies
                                      Dr. Gordon ;@-lacLeod                                               Mr.    Richard         l@hite
                                                                                                          Mr.    Roland          Williams




                                                                                                                        Pagc 2



                                           "IC          F                             S
                                 R%  I-IS                                      "f    1,

                                 l,ir  'tq i 1 1 i @l c  't@ e n, t i ico ii  IL                                                    V
                                 l,ir  ll%obert  Sha,,.i,  Re@,)iori  II                                                    l'c5?,ion VI
                                   r   C).ydL@   "-ouchf-.iaii,   itc,,ion   III              Mr.  D@-iii@-I  t,,ebster,               @IIII
                                                                 :Ile-lo-i    IV                              Cu)-ric-@,              IX


                                 OT 11



                                                                                              ',Ilr.  Dzivicl Lovenvirtli,  Cot-irultaiit
                                .I,jr.  tIc-@er Fo%,  O%Iil@                                  1-fiss Bctl,3'(-@ \101.)].CY,  lis%i,IA
                                 ,kli,.           lliltc,,i,  N!IFC                           @-ir.  Carl Ta),Io--,  O,'4B
                                 Cars.  FrEaicr--s  !',card








                                                         2
                                                                 National Advisory Co,,iricil oil
                                                                 Regi.oiiil iicdicil 1.1rograms
                     SCILIP,EINEI',, Georgc, E., @I.D. (74)
                     Director, Division of Nc@.pliroloay
                                                       0
                     Georgetown 11-iiiversity
                     School of
                     I,,Iashin@toii, D. C. . 20007

                     I,'ATKIl@S, l'Ic-nj,@,;nj.n W., D.P.M. (73)
                     li'/O Leiio@. A-,7cnue
                     New York, New York  10037

                     I,."YCKOFF, llrs. Florence r,. (72)
                     243 Corralitos Road
                     Watsonville, California  95076


                     EX OFFTCIO 1-@,,!,,BER


                     I,IUSSER, Marc J. , @f.D.
                     Chief Medical Officer
                     Veterans  Administratioi.-i
                     Washincton, D. C.     20@@20



                                               Vernon E. Wilson, M.D.
                                               Adminis tra tor
                                               Health Services and Mental
                                                Health Adm@inistration
                                               5600 Fishers Lane
                                               Rockville, Maryland  20852