in I  #it, 11
                             I


                    Profile:   Maine Regional Medical Program

                    Grantee:   Medical Care Development, Inc.
                               295 Water Street
                               Augusta, Maine  04330
                               (Telephone:  207/622-7566)

                    Pro@ram Coordinator:   I-lanu Chatterjee, M.D.

                    Ori@inally Pre2ared By:  Spencer Colburn
                                               Operations Officer

                    Original Date:  August,   1969

                    Updated:


                                        TABLE OF CONTENTS

                11.  Georgraphy

                III.  Demography

                IV.   Politics

                  V.  Historical Review

                VIE.  Core Staff

                VII.  Organization

              -VIII.  Decision-Making Process

                IX.   Funded Operational Projects


                             MAINE REGIONAL IIEDICAL PROGRAM

         II.  Geography

                   The Maine Regional Medical Program is coterminous with the State.

                   Many of the same geographic characteristics and resource problems

          of Maine apply to northern New Hampshire and Vermont and consideration for

          redefinition of boundaries has been considered,, however, due to extremely

          poor transportation connections between these areas, no redefinition is

          anticipated.  Because Maine problems are so different from Massachusetts,,

          no redefinition 'is being considered in this direction either.


          111. DEMOGRAPHY

                1) Population: The estimated 1965 population is 993,000.

                    a)  51%,urban
                    b) Roughly 99*/. white
                    C)  Median age:  31.6 (U.S. average 29.5)

                2)  Land Area:  31,012 square miles

                3)  Health statistics:

                    a)  Mortality rate for heart disease--463/100,000 (high)
                    b)  Rate for cancer--182/100,000 (high)
                    c)  Rate for CNS vascular lesions--126/100,000 (high)

                4)  Facilities statistics:

                    a)  ]No medical schools

                    b)  Seven Schools of Nursing, one is university-based and one
                        is based at a junior college.

                    c)  Three Schools of Medical Technology

                    d)  No Schools of Cytotechnology

                    e)  Eight Schools of Xray Technology

                    f)  There are 58 hospitals, five are federal and 53 are non-federal.
                        Of the non-federal hospitals, 45 are short term with 3,508 beds
                        and eight are long term with 4,802 beds.  The five federal hospitals
                        have a total of 1,189 beds.

                5)  Personnel statistics:

                    a)  There are 1,078 IlDs (110/100,000) and 221 DOs (22.5/100,000) in
                        Maine.

                    b)  There are 3,856 active nurses (393/100,000) in Maine.


             IV.                          POLITICS

          Governor:

              Kenneth 'Curtis (D) until 1972

          Senators:

              Margaret Chase Smith (R); Aeronautical and Space Science,  Appropriations,
                                         Armed Services

              Edmund S. Muskie (D) 1959-1970; Banking and Currency,  Government Operations,
                                               Public Works, Special Committee on Aging

          RepreseiMtives:

              Peter N. Kyros (D) 1966-1970;Di-strict o'f-'Columbia, Interstate and Foreign
                                            Commerce.
              William D. Hathaway (D) 1964-1970; Education and Labor, Merchant Marine and
                                                  Fisheries


            V. HISTORICAL REVIEW
                 Fall 1965   Spring 1966             Interest is generated regarding Regional
                                                     Medical Programs and the possibility of
                                                     Maine being part of a New England UT
                                                     is considered.

                                                     Maine, however, chooses to remain autonomous
                                                     and the search for  an  appropriated  grantee
                                                     organization is started.  Bingham Associates
                                                     Fund becomes actively interested and assist
                                                     in pre-planning.

                                                     The Maine Medical Association and the Maine
                                                     Medical Center are considered  as  a  grantee
                                                     possibility but it is soon evident that this
                                                     will not be acceptable to all,, especially
                                                     the osteopathic segment.  Consequenfly,
                                                     Medical Care Development, Inc. is formed.
                                                     This corporation has no  pre-existing  hea  t
                                                     complex affiliation and is acceptable component
                                                     of the medical care system.
                 September, 1966                     Dr. Merle S. Bacastow,  Director  of  Medical
                                                     Education, Maine Medical Center, and
                                                     Mr. George T. Nilson, M.P.H., Field
                                                     Director of the Bingham Associates Fund
                                                     came to DRMP to discuss a draft application
                                                     from the Stata of Maine.
                 December, 1966                      First Planning Request - Establishes the
                                                     State of Maine as the Region.

                                                     Medical Care. Development, Inc. c/o
                                                     Department of Health  and  Welfare,  Augusta,
                                                     Maine, was designated as the applicant
                                                     organization.
                                                     Bingham Associates Fund, Boston, Massachusetts,
                                                     was designated as the fiscal agent.

                                                     George T. Nilson, M.P.H. was identified
                                                     as the active-planning coordinator on 100%
                                                     loan to Medical Care Development, Inc. from

                                                     Bingham Associated Fund.

                                                     Applicant propose to appoint hospital
                                                     coordinators to serve as liaison between
                                                     the community hospitals medical staffs
                                                     and the RNP.


            May, @967                                 01 planning Axqar
            May to Mid Summer 1967                         rogram's professional staff is
                                                      The p
                                                      assembled and Dr. Manu Chatterjee is
                                                      appointed full-time program-coordinator.
             Fall 1967    Spring 1968                 Periodic meetings with the health and
                                                      educational agencies of this Region continue
                                                      and become established procedure.

                                                      Twenty-eight hospital coordinators are
                                                      appointed and in 28 other hospitals someone
                                                      functioning in anoth@r capacity (Chief of
                                                      Staff, etc.) are acting coordinators.  These
                                                      56 hospitals represent 98% of the regions
                                                      hospitals b6ds.

                                                      Three,meetings are held with the hospital
                                                      coordinators.

                                                      Two feasibility studies are initiated.  one
                                                      studies the  linking  of  hospitals  with  referral
                                                      centers by Data Phone, visual display by
                                                      scope monitoring, and a private "hot-line"
                                                      for voice communication.  The other studies,
                                                      the  continuing  education  of  private  physicians
                                                      .in a community hospital in conjunction with
                                                      monthly staff meetings.

                                                      RAG membership is completely divorced of     the
                                                      grantee organization to completely eliminate
                                                      any overlap of membership or'legal problems
                                                      that may arise.

                  February, 1968                      First operational request received.  'This
                                                      application  request  support  for  four  projects.

                                                      Project #1 - visiting Guest Resident
                                                      Project #2 - Yennebec Valley Regional
                                                                   --Health Agency
                                                      Project #3 - Physician Seminar
                                                      Project #4 - Smoking Control

                                                      On June 14, 1968, Projects  #I,  #2,  and  #4  were
                                                      funded and the Region became operational.

                 April, 1968                          02 Planning Award $204,709 DC includes
                                                      @61,713 carryover from 01.

              ------May, -1968                     ---$15,000 grant from Maine Heart Association
                                                      to implement coronary care data-phone
                                                      feasibility study.

                 June, 1968                           Site visit (Dr. Willian, T@uite, Professor
                                                      Thompson, Dr. Stephenson, Mr. Strachocki.,
                                                      I-Irs..McDonaid, Miss Morrill)


                                                   Project #2 - Kennebec Valley Regional Health
                                                   Agency   Mr. Burt Sheeham appointed Executive
                                                   Director effective Septembe 25, 1968.

                                                   Project #4 - Smoking Control - Program is
                                                   staffed and public relation efforts are started.

                                                   Core staff is expanded and Mr. John LaCasse is
                                                   appointed Associate  Coordinator  for  Applied
                                                   Technology.

                  March, 1969                      01 Operational Supplement Award $45,414

                                                   Project #5 - Coronary Care  Program and
                                                   Project #6 - Physicians Continuing Education
                                                   Program are funded.  These projects were
                                                   approved by the November 1968 Council.

                  April, 1969                      01 Operational Supplement  Award  $501,437  DC
                                                   Includes continued funding for core activities
                                                   support only.

                                                   This application is also included request for
                                                   funding of Project #8 - Directors of Medical
                                                   Education; and #9  -  Regional  Library.  Both
                                                   of these Projects were approved but unfunded.

                  June,  1969                      Niles Perkins, M. D.  is  appointed  Assistant
                                                   @rogram Coordinator for Project Design.

                  July,  1969                      All awards'are placed under one accounting
                                                   mechanism. This allowed  for  the  funding  of
                                                   Projects #8 and #9 for one  year  through  the
                                                   use of carryover funds.

                                                   Philip G. Good is appointed Associate Coordinato
                                                   for Continuing Professional Education.

                  June,  1968                      02 Planning Award Supplement $153,460 DC
                                                   This award was for additional core staff,
                                                   consultants, office  equipment,  and  expenses
                                                   of several feasibility studies.

                  July,  1968                      RMP assumed fiscal responsibility for its
                                                   own program and operational projects.

                                                   John Davy ' M.D., is appointed Associate
                                                   Coordinator for Maine Cities.

                  Summer-Fall 1968                 Project #1 - Visiting Guest Resident-Progress
                                                   slowly due to change of hous staff in July
                                                   and recruitment difficulties.


                August, 1969.                 August Council considered four projects:
                                              #11 - Department of Community Medicine
                                              Maine.Medical Center; #12 - Coronary Arteriography
                                              and Myocardial Resvascularization; #13   - Care,
                                                      rovascular Disease; and #14 - Regional
                                              of Cereb
                                              Cancer 'Program.
                                              Council recommended approval of #14,   return for re-
                                              vision of #11 and disapproval of #12   and #13 as
                                              both of these projects were service oriented and
                                              high in equipment cost.


                                          CORE STAFF
           VI.

           Coordinating Headquarters

              14aine's Regional Medical Program
              295 Water Street
              Augusta, Maine  04330
              (Tel. 207/622-7566)

           Program Coordinator:  Manu Chatterjee, M.D.

           Staff:
              Assistant Program Coordinator for'Project De@n
                  Niles Perkins, M.D.

              Associate Coordinator   Continuin& Professional Education
                  *Philip Good, M.D.

              .Associate Coordinator  Maine Cities
                  John Davy, M.D.

              Associate Coordinator   Ap
                                        _Rlied T
                  John LaCasse

              Director Administrative Services
                  Justin Cowger

              Director Grant Program Policy
                  (Mrs.) Janet Jones

              Director Community Relations
                  Jefferson Ackon

              Director Nursin&
                  Cora Pike, R.N.

              Research Assistant
                  Patricia Wallace

              Secre'tary/Boo'kkeej2er
                  Joan Towle

              Secretaries
                  Virginia Roderick          Sandra Canto
                  Linda-Frantz               Judith Barnard
                  Judith Carleton

           *Dr. Good's time is spent 10% in core staff activities and 90% as project
           director for  roject lk6  Pliysicians' Contiiiuinc, Education Pro,-ram.
                        p


                                    L.,c-dical Care  Devel.oi:)iiient,  Inc.
                                                                                                     "4A' IN I:"  S...

                                                                                            R E G I 0 i\'A T,, MEDICAL'   OGRA'Lli
                                                                                                                PR

                                          BOARD OF DIRECTORS
                                                                   I
                                                                                            Rf:,GIONAL-..

                                                                                                               hairman.
                                                                                                      UA
                                                                                             @ORY             c
                                                                                              ors

                                        PROGRAM COORDINATOR
                                      Manu  Cha-tterjee,  M.D

                                                                    7,or,project  Design
                                                                                                                      Till:'TS. UINIV..
                                                                                                COL    SUFTAN',     S'.
                                                                                                                         N.

          ASSOC'CA'@ct-,'               ASSOCIATE     ASSO
                                                                          A.@SO                        I[EART DISEASI@..'
         COORDINATOR          COORDIL\IATOR          COORD               COORD
                                                     Maine
                             Abt)].ied
                         D.  John L@qasse
                                                     John E
                                                                                                       CANCER

                                                                                                            c       0
                                                                                                       Ilad-l' y  PIrr  t; M.

                                                                                                       STROK@E-.
                                                                                                       CharlE!s  Kunl@l'c-'. D.

                                        DIRECTOR     DIRECTOR            D.'ERECTOIC                   R@,'IfAB.Tf,ITATION
                               C drdniun            Grant Program        NLIrSing                      John I,orent-7,, M. D4..
                                                  =0 r:
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         Just'.  Cowge          efferson  Ackor-,   Janet'Jones.'       Cora  Pike,  )R..N..           -R]:'SEARCII&

                                                                                                             NG@


                 BIOGRAPHICAL   SKETCHES

                 1)  Manu Chattergee,  M.D.

                     a)   Born Massachusetts, 1920
                     b)   A.'B., Olivet College, 1942
                     c)   M-S., Western Reserve, 1946 (Clinical Psychology)
                     d)"  M:D.,   Western Reserve, 1951
                     e)@  Positions  held:

                          1952-53   -    Residency internal Medicine, Mary Imogene Bassett
                          1953-54   -    Fellowship - Cardiopulmonary Disease, Mary Imogene
                                         Bassett
                          1954-55   -    Fellowship - Department of Medicine, Cardiology,
                                         University of California Hospital, San Francisco
                          1955-67   -    Merrymeeting Medical Group    Internal Medicine, Cardi-
                                         ology

                 2)  Niles  L.  Perkins, M.D.

                     a)   Born Maine, 1919
                     b)   B.A., Bowdoin College, 1946
                     c)   M.D., Tufts, 1950
                     d)   M.P.H., Harvard, 1966
                     e)   Positions held:

                          1950-53   -    General Practice, Bingham, Maine
                          1953-55   -    Medical Director, Bath Iron Works
                          1960-62   -    Residency in Medicine and Cardiology, Maine
                                         Medical Center
                          1962-65   -    Private Practice, Internal Medicine and Cardiology,
                                         Portland, Maine
                          1969-69   -    Director, Bureau of Medical Care, Maine Department
                                         of Health and Welfare

                 3)  Philip C. Good, M.D.

                     a)   Born Massachusetts, 1909
                     b)   A.B., Bowdoin College, 1936
                     C)   M.D., Harvard, 1940
                     d)   Positions  held:

                          1946 -  1969   Private practice - Pediatrics, Portland, Maine
                          1958 -  1968   Chief of Pediatrics, Maine Medical Center-


                ORCANIZATION
          v

                Gran

                Medical Care Development, Inc.
                1)   There are 51 members and they are appointed by agency represented
                     or elected by Board of Directors.

                2)   Term is indefinite until replaced by recommending agency  or
                     resignation.  Automatically suspended if two consecutive annual
                     meetings ate missed without due cause.
                3)   Representation is as follows:  Maine Medical Association    8;
                     Maine Osteopathic Association - 4; Maine Hospital Association - 4;
                     Maine Heart Association   3; Maine Cancer Society - 3; Governor - 3;
                     Maine Dental Association   1; Maine Nurses Association - 1;
                     Associated Hospital Service of Maine - 1; A commercial Life and
                     Health insurance Company - 1; 'Nursing Home Association - 1; Health
                     Faci-lities Planning Council - 1; Maine Tuberculosis and'Health
                     Association -1; Bingham Associates Funds - 1; Elected at Large
                     by above - 18; to include representatives for health organizations,
                     hospital boards of trustees, educators, governmental agencies,
                   'allied health professions, and the general public.

                4)   Chairman

                5)   Meetings are held at least annually (April)

                6)   Functions:  To conduct studies within or without the State of Maine
                     designed to investigate and evaluate any of the characteristics,
                     qualities, or circumstances that may be considered to determine,
                     influence, or otherwise affect the quality, quantity distribution,
                     or resources, or facilities commonly included in or related to those
                     services referred to as "medical care.

                Board of Directors

                1)   There are 19 members (4 officers, 15 members and 2 vacant); they are
                     appointed at the annual meeting of the Corporation.

                2)   Term is t-or 3 years.

                3)   Representation is as follows:  Medical Society - 5; Hospital
                     Association - 1;  University - 2; Other Health Professional
                     Society   1; Affiliated Hospital - 1; Cancer Society - 1; other
                     Hospital   1; Heart Association - 2; Other Voluntary Health Agency
                     Official Public Health Agency    1; Health Insurance Industry


                      airman is Roswell Bates, D.O.,, President
                4)  Ch
                5)   14eetings.are at least quarterly
                6)  Functions:  The Board of Directors is the major policy forming
                     body of the R14P.  it has determined personnel policies and has
                   .been instrumental in defining a policy manual for the entire
                     Organization to include financial and accounting methods  and  the
                     development of affiliation agreements with participating  institutions.

                Re&ional Advisory Group
                1)   There are 33 members (3 vacant); they are appointed by Board
               ---   of Directors.

                2)   Term is for 3 years.
                3)   Representation is as follows: Medical School  -  1;  Other  Health
                     Education Schools - 1; Other University - 2; Hospital Associations    1;
                     Other Health Professional Societies - 1; Health Practitioner
                     Affiliated Hospital - 3; Other Hospitals - 10; Other Health Related.
                     Planning Agencies - 3; Heart Association - 1; Other Voluntary ftealth
                     Agencies - 1; Public Agencies (non-health)  -2;  Health  Insurance
                     Industries - 1; Public or Consumer Representation  -  2
                4)   Chairman is 11. Douglas Collins, M.D.-(Internist)
                5)   Meetings are held six times per year plus  any  special meetings
                     called.
                6)   Functions:  1) Participate in the planning-program of Maine's RNP,
                     by offering guidance and suggestions to those  who  are directly
                     responsible for the planning; 2) Review  the  immediate and long term
                     plans for the region for relevance to the objectives of the RMP;
                     3) Recommend approval or disapproval of request which  are  to  be
                     submitted to DRNP for program development and support as part of
                     the DRNP; 4) Prepare an annual statement giving the evaluation
                     of effectiveness of the regional cooperative arrangements established
                     under the RNP.

                 Catep.orical and Other Committees.
                 1)  Hospital Coordinators:  Three committees have been established, made
                     up of hospital coordinators who are chosen by the  staff  of  each
                     individual hospital and whose primary purpose is to define the areas
                     of interest, set priorities for the local institution, and be the
                     liaison between that local institution and  the  Regional  Medical
                     Program. The three committees are made up  of:  the  coor  inators
                     in the northeastern section of the state from the smaller hospitals;
                     the.coordinators in the southwestern section of the state from the
                     smaller hospitals; so called referral center hospital coordinators
                     representing the larger hospitals of the state.


                                     ttees have been instrumental in all  the  p  ann
                     These three cowni                                              iLng
                     programs of this Regional Medical Program.  They  have participated in the
                     development of the operational grants.  Surveys  taken from their  '
                     local institutions have determined the content  of  operational grants,
                     and they have approved, in principle, the finished products.   Their
                     individual Assessments of their areas point the  direction  for
                     feasibility studies. They themselves  are  data-gathering  arms in
                     terms@of assessment of regional  resources.  Their  involvement in
                     this Regional Medical Program has probably been one of the most
                     important single inputs, and these three committees  represent  the
                     basis of physician involvement.
                2)-  Cancer Advisory Committee:  This is a group.which is selected from
                     the Cancer Coordinating Committee of this region established by the
             @---@@-@--American College of Surgeons. This Advisory Committee serves  the
                     function of defining areas of involvement for  Regional  Medical
                     Program activities.  Their first order of priority was an educational
                     program in cancer management and a cervical cancer program.
                3)   Director of Medical Education:  This is a committee made up of the
                     -five full time Directors of Medical Education of this region.  Their
                     chief function has been to define areas needs in continuing medical
                     education. They were instrumental  in  developing  two  operational
                     rant requests; one was the  continuing  education  program  for
                     9
                     physicians and the second, a Director of Medical Education program
                     for the entire state to include a third-faculty concept.  They have
                     been of assistance in defining a library program  for  the  region.
                4)   Physician Manpower Committee:  This committee is made up of advisors
                     to premedical students in the four major Maine college, the Commissioner
                     of Education for the region, and two medical schools.  The purpose
                     of this committee is to design programs for attracting more'liaine
                     undergraduates into medical schools, as this region  rates fiftieth
                     in the nation in this respect.
                5)   Radiologists' Committee: This is a committee  made  up  of  all the radiolo-
                     gists in the region involved in  supra  voltage  therapy.  They are
                     concerning themselves with determining a "grand design" for supra
                     voltage therapy units for this region-t--o include necessary personnel,
                     Patient referral patterns, and cost effectiveness.  They are still
                     --having difficulty resolving some issues. They  have  reviewed  an
                     oncology -proposal for the establishment of a  super  center  in  an
                     unsuper area.  This proposal was not approved.
                 6)  Mercy Hospital-Regional Medical Program Committee:  This committee
                     is made up of four physicians and the  Executive  Director  of  the
                     hospital.  They are at the present time defining'what the needs of
                     this 250-bed acute care Catholic hospital are and how they may relate
                     to this region and Maine's Regional  Medical  Program.

                                                                       '7


                 7)   Joint Committee  of  Allied  Health  Organizations:  This  is  a  committee
                      made up 'of 15 representatives  of  the  allied  health fields.    They
                      have concerned  themselves  with  the  alleged  nursing shortage   problems
                      of the region and the  need  for  definition  of  types of   educational
                      programs  for.the  entire  allied  health  field.  They have been
                      instrumental  in  assisting  Maine's  Regional  Medical Program in
                      devising a  questionnaire  which  has  been  circulated to  all  hospitals
                      in:the region.  Personal  site  visits  for  definition  of  the  above-
                      mentioned factors have been made.

                 8)   Maine  Medical  Center-r@-Task  Forces  in  Heart,  Cancer  &  Stroke:   This
                      is a large  committee  made  up  of  subcommittees  representing  heart
                      disease, cancer, and stroke,  whose  areas  of  emphasis  have  been  to
                      establish the relationship  of  this  largest  medical  complex  in  the
                      region to the needs of the  rest  of  the  state.  After  a  couple  of
                      years of work,  they  have  been  instrumental  in  several  operational
                      projects which  have  been  presented  for  review.  They  have  concerned
                      themselves with a regional approach to these categorical areas
                      and defining areas where health care from the standpoint of
                      sophisticated, diagnostic, and treatment facilities are lacking
                      for the entire region.

                 Local Advisory Groups

                 1)   Upper Kennebec  Valley,  a  voluntary  health  organization:  This  is  an
                      organization which has been developed under the impetus of this
                      Regional Medical Program  for  defining  the  total  health  care  needs  and
                      activating programs in  a  subregion  of  this  state  including  80,000
                      people and 4,000 square  miles.  It  has  representation  from  a  city  of
                      moderate size  to  include  a  large,  disadvantaged  rural  area.  This
                      committee is made up  of  representatives  of  all  the  hospitals,  health
                      organizations and  consumers.  During  the  past  two  months,  it  has
                      structured its organizational makeup to conform with 314b requirements.
                      As this organization  also  exists  outside  any  health  power  structure,
                      it has made major inroads into establishing lines of communication
                      between physicians  in  small  communities  and  the  larger  communities.
                      It has developed a regional facility  such  as  a  blood  bank  for  the
                      entire ten-hospital region and has a Director of Medical Education
                      for the region as well.  It  is  pioneering  a  systems  approach  to  the
                      health care system.  It is originating a multiphasic screening project
                      for the CAP population of  65  years  of  age  and  over.

                 2) .-The Ban
                             .gor ReEional'Health Advisory Gro        This  is  an  organization
                      made up of the three hospitals in  a  subregion  of  Maine  which  is  a
                      referral Area and which  has  the  responsibility  for  the  health  care  of
                      a large region.  There are two allopathic and one osteopathic hospitals.
                      They have developed a  program  for  a  combined  Director  of  Medical
                      Education, a  program  in  emergency  medical  care,  and  training  programs


                    ,with a mix of the osteopathic and allopathic physicians of the areas.
                    They are currently exploring new methods for establishing medical care
                    for small hospitals in rural areas to include Data-Phones, interactive
                    television, etc.
                3)  indiaii.Health Committee of the Maine Medical Association:  This
                    @ommittee was appointed, in part, by the Maine  Medical  Association
                    and,by Maine's Regional Medical Program.  Maine's Indian population
                    is'a State responsibility, not Federal,'and represents one of the
                    -most impoverished pockets of this region. This committee  has  been
                    involved in defining what the actual medical needs are  and  methods
                    of entry into the health care system. - @;- This'--e-'ffort is. still in the
                    planning stage with recommendations for implementation to be '
                    formulated soon. These meetings are chaired and  organized  by  this
                    Regional Medical Program.

                Subregions (Map on following page delineates areas)
                Six subregions have been delineated.  In two of these areas voluntary
           -------health-organizations have been established for planning for the subregion-
                as well as the future development of operational projects.  One of these
                subregions is presently the recipient of an RNP grant in area-wide health
                care. This particular region is to serve as a prototype  for  the  other
                five., and it is.hoped to model similar type organizations in the  other
                subregions.

                The purpose of these subregions is to facilitate  planning,  operations,
                and local participate and liaison.

                The areas were determined with regard to hospital planning  and  medical
                trade areas.


        MK@-NE REGIONAL MEDICAL PROGRAM
              Six Subregions

                                                               OSTOOK
                                                            ARO
                                                             COUNTY

                                                             BANGOR
                                                           0

                               WISTON          u

                        PORT

                                                              .U MEDICAL TRADE  CENTER


                                  EXHIBIT
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                      P"O,-I' @T

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            IX.  FUNDED OPERATIONAL PROJECTS

                 #1 -- VISITING  GUEST RESIDENT PROJECT
                       .Objectives:    To continue and expand a program initiated by    the
                                           am Associates Fund which sent senior residents
                                       Bingh
                                       or fellows at Tufts--New England Medical Center to small
                                       community hospitals.  This establishes a line-of
                                       communication between the University Hospital Center and
                                       the relatively isolated practitioners.  The recruitment
                                   -----base--for residents has been expanded beyond th
                                                                                        e Boston
                                       area.  During the first year  sixteen residents or
                                       fellows spent a combined 17  weeks  in  eight  community
                                       hospitals. It is  anticipated  that  during  the  second
                                       year, 10 hospitals will each receive 4 resident visits
                                       making a total of 40 weeks of Guest Residency Progr     amming.

                 #2     KENNEBEC VALLEY REGIONAL HEALTH AGENCY PROGRAM
                        Objectives:    This project would  allow  Maine  s  Regional  Medical  Program
                                       to cooperate with the Regional Health Age   ncy to Maine's
                                       Upper Kennebec Valley in developing a regional approach
                                       to health care and health planning for residents in an
                                       isolated area.

                        SMOKING CONTROL
                        Objectives:    This project is desioned to improve the health status-
                                                            C)
                                       of Maine people  through  an  educational  and  action  program
                                       directed against "cigarette disease."  Basic work has
                                       already been done by the Maine Interagency Council on
                                       Smoking and the Health Council of Maine.  This project
                                       would involve Maine's Regional Medical Program in these
                                       activities and provide a coordinator and other staff
                                  ------assistance, office equipment and supplies, and other
                                       administrative costs.

                  #5    CORONARY CARE PROGRAM
                        Objectives:  This is a comprehensive program designed to bring the
                                       latest advances in diagnosis and treatment to patients
                                       with acute  coronary  disease  by  establishing  coronary  care
                                       units in 20 community hospitals over a five-year period.
                                       These hospitals will  be  linked  by  remote  monitoring
                                       methods to referral areas where expert consultation services
                                       are available on  a  24-hour  basis.  Included  in  this
                                       program are:  (1) planning consultation service;
                                       (2) training programs for nurses; (3) training programs
                                       for physicians; (4) visiting physician program;
                                       (5) paramedical consultation service; (6) operational
                                       aids  data collection  and evaluation; (7) hospital cardio-
                                       pulmonary resuscitation programs; (8) possible mobile
                                       coronary care units (future) and, (9) remote monitoring
                                           om-,nunicatioi-is media.
                                       by  c


                #6    PHYSICIANS' CONTINUING  EDUCATION PROGRMI

                      Objectives:   This project will establish teaching programs in 20
                                    community hospitals and five groups of small community
                                    hospitals.  Four programs will be presented annually to
                                    the staffs of these hospitals.

                #8    DIRECTOR OF MEDICAL EDUCATION PROGRAM

                      Objectives:   Proposes a "third faculty" of Directors of Medical
                                    Education to alleviate the need for continuing education
                                    of health professionals in rural and semi-rutal areas.

                      REGIONAL LIBRARY

                      objectives:   Expand the existing facilities of the Maine Medical
                                    Center Medical Library so that it can more adequately
                                    function as a regional medical library.