76
EXHIBIT VI
Regional Medical Program
Rehew Committee
Mark Berke
Director
Mount Zion Hospital and
Medical Center
San Francisco, California
Kevin P. Bunnell, Ph. D.
Associate Director
Western Interstate Commission for
Higher Education
Boulder, Colorado
Sidney B. Cohen '
Management Consultant
Silver Spring, Maryland
Edwin L. Crosby, M.D.
Director
American Hospital Association
Chicago, Illinois
George James, M.D. (Chairman)
Dean
Mount Sinai School of Medicine
New York, New York
Howard W. Kenney, M.D.
Medical Director
]ohn A. Andrew Memorial Hospital
Tuskegee Institute
Tuskegee, Alabama
Edward J. Kowalewski, M.D.
Chairman
Committee of Environmental Medicine
Academy of General Practice
Akron, Pennsylvania
' Deceased, April 1967.
George E. Miller, M.D.
Director
Center for Medical Education
College of Medicine
University of Illinois
Chicago, Illinois
Anne Pascasio, Ph. D.
Associate Research Professor
Nursing School
University of Pittsburgh
Pittsburgh, Pennsylvania
Samuel H. Proger, M.D.
Professor and Chairman
Department of Medicine
Tufts University
School of Medicine
President
Bingham Associates Fund
Boston, Massachusetts
David E. Rogers, M.D.
Professor and Chairman
Department of Medicine
School of Medicine
Vanderbilt University
Nashville, Tennessee
Carl Henry William Ruhe, M.D.
Assistant Secretary
Council on Medical Education
American Medical Association
        . .
Chicago, Zlltnofs
Robert J. Slater, M.D.
Executive Director
The Association for the Aid of
Crippled Children
New York, New York
John D. Thompson
Director, Program in Hospital
Administration
Professor of Public Health
School of Public Health
Yale University
New Haven, Connecticut
Kerr L. White, M.D.
Director
Division of Medical Care and
Hospitals
School of Hygiene and Public Health
Johns Hopkins University
Baltimore, Maryland

77
EXHIl3IT VII
Consultants to the
Division of Regional
Uedical Programs
Stephen Abrahamson, M.D.
Director
Ofice of Research in Medical Education
University of Southern California
Los Angeles, California
Roy Acheson, M.D.
Epidemiologist
School of Medicine
Yale University
New Haven, Connecticut
Alexander Anderson, M.D.
Director
Training Programs for Center of Medical
Education
College of Medicine
University of Illinois
Chicago, Illinois
William Anlyan, M.D.
Dean
Medical Center
Duke University
Durham, North Carolina
Norman T. J. Bailey, Ph. D.
Professor
Biomathematics Departsment
Cornell University Medical School and
Sloan-Kettering Institute for Cancer
Research
New York, New York
A. B. Baker, M.D.
Professor and Director
Division of Neurology
University of Minnesota
Minneapolis, Minnesota
    26S-640 O-67-G
Norman Beckman, Ph. D.
Director
Ofice of Intergovernmental Relations
and Urban Program Coordination
Department of Housing and Urban De-
velopment
Washington, D.C.
A. E. Bennett, M.D.
Department of Clinical Epidemiology and
Social Medicine
St. Thomas' Hospital Medical School
London, S.E. 1, England
Robert Berg, M.D.
Professor and Chairtman
Department of Preventive Medicine and
Community Health
University of Rochester
Rochester, New York
Donald Bergstrom
Assistant to State Health Commissioner
Vermont Department of Health
Burlington, Vermont
Mark Berke
Director
Mount Zion Hospital and Medical Center
San Francisco, California
Leonidas H. Berry, M.D.
Professor
Cook County Graduate School of Medi-
cine
Senior Attending Physician
Michael Reese Hospital
Chicago, Illinois
Mark S. Blumberg, Ph.D.
Special Assistant to the Vice President for
Business and Finance
University of California
Berkeley, California
Nemat 0. Borhani, M.D.
Head, Heart Disease Control Program
Bureau of Chronic Diseases
California Department of Public Health
Berkeley, California
Paul Brading
Director of Research in Medical
Education
Albany Medical College
Albany, New York
Kevin P. Bunnell, Ph. D.
Associate Director
Western Znterstate Commission for
Higher Education
Boulder, Colorado
Mary I. Bunting, Ph. D.
President
Radcliffe College
Cambridge, Massachusetts
Ray E. Brown, L. I-I. D.
Director
Graduate Program in Hospital
Administration
Duke University Medical Center
Durham, North Carolina
Hugh Butt, M.D.
Professor of Medicine
Mayo Clinic
Rochester, Minnesota
Donald J. Caseley, M.D.
Associate Dean and Medical Director
College of Medicine
Universities of Illinois
Chicago, Illinois
Hilmon Castle, M.D.
Associate Dean
College of Medicine
University of Utah
Salt Lake City, Utah
Leonard Chiazze, Jr. M.D.
Assistant Professor of Community
and International Medicine
Georgetown University
Washington, D.C.
Sidney B. Cohen
Management Consultant
Silver Spring, Maryland
John D. Colby
Chief
Research Training Branch
Division of Research
and Training Dissemination
Ofice of Education
Washington, D.C.
Warren H. Cole, M.D.
Emeritus Professor and Head
Department of Surgery
University of Chicago
Chicago, Illinois
Murray M. Copeland, M.D.
Associate Director
M. D. Anderson Medical Hospito
Tumor Institute
Texas Medical Center
Houston, Texas
Edwin L. Crosby, M.D.
Director
American Hospital Association
Chicago, Illinois
Gordon R. Curnming
Administrator
Sacramento County Hospital
Sacramento, California
Anthony Curreri, M.D.
Professor of Surgery
Director
Division of Clinical Oncology
Cancer Research Hospital
University of Wisconsin
Madison, Wisconsin
4 and

78
Frederick Cypherr, Ph. D.
Assistant Dean
School of Education
Ohio State University
Columbus, Ohio
Michael E. DeBakey, M.D.
Professor and Chairman
Department of Surgery
Baylor University
Houston, Texas
Edward W. Dempsey, Ph. D.
Chairman
Department of Anatomy
College of Physicians and Surgeons
Columbia University
New York, New York
McCormack Detmer
Assistant Director
Division of Longterm Care
American Hospital Association
Chicago, Illinois
E. Grey Dimond, M.D.
Director
Scripps Clinic and Research
Foundation
La Jolla, California
Robert Dyar, M.D.
Chief of Research
California Department of Public Health
Berkeley, California
Paul M. Ellwood, Jr., M.D.
Executive Director
American Rehabilitation Foundation
Minneapolis, Minnesota
Bruce W. Everist, Jr., M.D.
Chief of Pediatrics
Green Clinic
Ruston, Louisiana
Sidney Farber, M.D.
Director of Research
Children's Cancer Research Center
Boston, Massachusetts
Charles D. Flagle, M.D.
Professor
Public Health Administration
School of Hygiene and Public Health
Johns Hopkins University
Baltimore, Maryland
John G. Freymann, M.D.
Medical Director
Boston Lying-in Hospital
Boston, Massachusetts
Herbert P. Galliher, Jr., Ph. D.
Professor
Department of Industrial Engineering
University of Michigan
Ann Arbor, Michigan
Kermit Gordon
Vice President
The Brookings Institution
Washington, D.C.
Jack Haldeman, M.D.
Executive Director
Hospital Planning and Review Council
for Southern New York
New York, New York
John Hammock, Ph. D.
Professor
Department of Educational Psychology
University of Georgia
Athens, Georgia
A. McGehee Harvey, M.D.
Chairman
Department of Medicine
School of Medicine
Johns Hopkins University
Baltimore, Maryland
James E. Heald, Ph. D.
Director
School for Advanced Studies in Educa-
tion
Michigan State University
East Lansing, Michigan
John B. Hickam, M.D.
Professor and Chairman
Department of Medicine
Indiana University Medical Center
Indianapolis, Indiana
Charles J. Hitch, Ph.D.
Vice President for Administration
University of California
Berkeley, California
Howard F. Hjelm
Acting Director
Elementary and Secondary Research
Bureau of Research
O&e of Education
Washington, D.C.
John R. Hogness, M.D.
Dean
School of Medicine
University of Washington
Seattle, Washington
James T. Howell, M.D.
Executive Director
Henry Ford Hospital
Detroit, Michigan
J. Willis Hurst, M.D.
Professor and Chairman
Department of Medicine
School of Medicine
Emory University
Atlanta, Georgia
Ralph Ingersoll, M.D.
Director of Research in Medical Educa-
tion
School of Medicine
Ohio State University
Columbus, Ohio
George James, M.D.
Dean
Mount Sinai School of Medicine
New York, New York
Hilliard Jason, M.D.
Chairman
Department of Medical Education,
Research, and Development
College of Human Medicine
Michigan State University
East Lansing, Michigan
Boisfeuillet Jones
Director
Emily and Ernest Woodruff Foundatioi
Atlanta, Georgia
Richard D. Judge, M.D.
Assistant Professor,
Department of Internal Medicine
University of Michigan
Ann Arbor, Michigan
Howard W. Kenney, M.D.
Medical Director
John A. Andrew Memorial Hospital
Tuskegee Institute
Tuskegee, Alabama
Charles V. Kidd, Ph. D.
Executive Secretary
Federal Council for Science and
Technology
Ofice of Science and Technology
Washington, D.C.
Charles E. Kossman, M.D.
Professor
Department of Medicine
New York University Medical Center
New York, New York
Edward J, Kowalewski, M.D.
Chairman
Board of Directors
Academy of General Practice
Akron, Pennsylvania

79
Peter Lee, M.D.
Assistant Professor
Department of Pharmacology
          . .
School of Me&cane
University of Southern California
Los Angeles, California
Jack Lein, M.D.
Assistant Dean and Director for
Continuing Education
School of Medicine
University of Washington
Seattle, Washington
E. James Lieberman, M.D.
Director
Audiovisual Facility
Communicable Disease Center
Public Health Service
Atlanta, Georgia
Abraham Lilienfeld, M.D.
Professor and Chairman
Department of Chronic Diseases
School of Hygiene and Public Health
Johns Hopkins University
Baltimore, Maryland
Robert Lindee
Assistant Dean for Administration
Medical School
Stanford University
Palo Alto, California
Samuel Martin, M.D.
Pl0vOSt
College of Medicine
University of Florida
Ganesville, Florida
Manson Meads, M.D.
Dean
Bowman Gray School of Medicine
Wake Forest College
Winston Salem, North Carolina
Richard L. Meiling, M.D.
Dean
College of Medicine
Ohio State University
Columbus, Ohio
C. Arden Miller, M.D.
Vice Chancellor for Health Sciences
University of North Carolina
Chapel Hill, North Carolina
George E. Miller, M.D.
Director
Center for Medical Education
College of Medicine
University of Illinois
Chicago, Illinois
Clark H. Millikan, M.D.
Consultant in Neurology
Mayo Clinic
Rochester, Minnesota
George E. Moore, M.D.
Director
Roswell Park Memorial Institute
Buffalo, New York
William D. Nelligan
Executive Director
American Institute of Cardiology
Bethesda, Maryland
Charles E. Odegaard, Ph. D.
President
University of Washington
Seattle, Washington
Stanley W. Olson, M.D.
Program Coordinator
Tennessee Mid-South Regional
Medical Program
Nashville, Tennessee
John Parks, M.D.
Dean
School of Medicine
George Washington University
Washington, D.C.
Anne Pascasio, Ph. D.
Associate Research Professor
Nursing School
University of Pittsburgh
Pittsburgh, Pennsylvania
Joye Patterson, Ph. D.
Publications Director
Medical Center
University of Missouri
Columbia, Missouri
William J. Peeples, M.D.
Commissioner
State Department of Health
Baltimore, Maryland
Edmund D. Pellegrino, M.D.
Director
Medical Center
State University of New York
Stony Brook, New York
Alfred M. Popma, M.D.
Chief of Radiology
St. Luke's Hospital and School of Nursing
Boise, Idaho
Samuel Proger, M.D.
President
Bingham Associates Fund
Boston, Massachusetts
Fred M. Remley
Chief Engineer
Television Center
University of Michigan
Ann Arbor, Michigan
David E. Rogers, M.D.
Professor and Chairman
Department of Medicine
School of Medicine
Vanderbilt University
Nashville, Tennessee
John Rosenbach, Ph. D.
Director
State University of New York at Albany
Albany, New York
Carl Henry William Ruhe, M.D.
Assistant Secretary
Council on Medical Education
American Medical Association
Chicago, Illinois
Paul Sanazaro, M.D.
Director
Division of Education
Association of American Medical Colleges
Evanston, Illinois.
Raymond Seltser, M.D.
Professor of Medicine
School of Hygiene and Public Health
Johns Hopkins University
Baltimore, Maryland
Mack I. Shanholtz, M.D.
State Health Commissioner
State Department of Health
Richmond, Virginia
Cecil G. Sheps, M.D.
General Director
Beth Israel Medical Center
New York, New York
Arthur A. Siebens, M.D.
Director
Rehabilitation Center
University of Wisconsin Hospital
Madison, Wisconsin
Robert W. Sigmond
Executive Director
Hospital Planning Council of Allegheny
County
Pittsburgh, Pennsylvania

80
Robert J. Slater, M.D.
Executive Director
The Association for the Aid of Crippled
Children
New York, New York
`Vergil N. Slee, M.D.
Director
Committee on Professional Hospital AC-
tivities
First National Building
Ann Arbor, Michigan
Clark D. Sleeth, M.D.
Dean
School of Medicine
West Virginia University
Morgantown, West Virginia
John M. Stacy
Director
Medical Center
University of Virginia
Charlottsville, Virginia
Robert E. Stake, Ph. D.
Assistant Director
Center for Instruction, Research, and
Curriculum Evaluation
College of Education
University of Illinois
Urbana, Illinois
Jacinto Steinhardt, Ph. D.
Scientific Advisory CO the President and
Professor of Chemistry
Georgetown University
Washington, D.C.
Patrick B. Storey, M.D.
Professor of Community Medicine
Hahnemann Medical College
Philadelphia, Pennsylvania
Emmanuel Suter, M.D.
Dean
College of Medicine
University of Florida
Gainesville, Florida
Adrian Terlouw
Educational Consultant
Sales Service Division
Eastman Kodak Company
Rochester, New York
John D. Thompson
Professor of Public Health
Director
Program in Hospital Administration
School of Public Health
Yale University
New Haven, Connecticut
Cornelius H. Traeger, M.D.
New York, New York
Ray E. Trussell, M.D.
Director
School of Public Health and Administra-
tive Medicine
Columbia University
New York, New York
A. Earl Walker, M.D.
Professor of Neurological Surgery
Johns Hopkins University
Baltimore, Maryland
James V. Warren, M.D.
Chairman
Department of Medicine
College of Medicine
Ohio State University
Columbus, Ohio
Max H. Weil, M.D.
Associate Professor of Medicine
School of Medicine
University of Southern California
Los Angeles, California
Burton Weisbrod, Ph. D.
Associate Professor
Department of Economics
University of Wisconsin
Madison, Wisconsin
Benjamin B. Wells, M.D.
Assistant Chief Medical Director for Re-
search and Education in Medicine
Department of Medicine and Surgery
Veterans Administration
Washington, D.C.
Kelly West, M.D.
Chairman
Department of Continuing Education
University of Oklahoma Medical Center
Oklahoma City, Oklahoma
Robert E. Westlake, M.D.
Syracuse, New York
Storm Whaley
Vice President
Health Sciences
University of Arkansas Medical Center
Little Rock, Arkansas
Kerr L. White, M.D.
Director
Division of Medical Care and Hospitals
School of Hygiene and Public Health
Johns Hopkins University
Baltimore, Maryland
Kimball Wiles, Ph. D.
Dean
School of Education
University of Florida
Gainesville, Florida
Loren Williams, M.D.
Director
Research in Medical Education
Medical College of Georgia
Augusta, Georgia
George A. Wolf, M.D.
Provost and Dean
School of Medicine
University of Kansas
Kansas City, Kansas
Richard M. Wolf, Ph. D.
Assistant Professor of Education
School of Education
University of Southern California
Los Angeles, California
Alonzo S. Yerby, M.D.
Head
Department of Health Services
Administration
School of Public Health
Harvard University
Cambridge, Massachusetts
Paul N. Ylvisaker, Ph. D.
Director
Public Affairs Program
Ford Foundation
New York, New York
Lawrence E. Young, M.D.
Chairman
Department of Medicine
School of Medicine
University of Rochester
Rochester, New York

81
ALABAMA.
Alabama.
ALBANY, N.Y.
Northeastern New York,
and portions of
Southern Vermont
and Western
Massachusetts.
ARIZONA.          Arizona.
ARKANSAS.
Arkansas.
BI-STATE.
Eastern Missouri
and Southern Illinois
centered around
St. Louis.
Benjamin B. Wells, M.D.
University of Alabama Medical
Center
1919 Seventh Avenue, South
Birmingham, Alabama 32533
Frank M. Woolsey, Jr., M.D.
Associate Dean
Albany Medical College of
Union University
47 New Scotland Avenue
Albany, New York 12208
Merlin K. DuVal, M.D.
Acting Dean
University of Arizona
College of Medicine
Tucson, Arizona 85721
Winston K. Shorey, M.D.
Dean, University of Arkansas
School of Medicine
4301 West Markham Street
Little Rock, Arkansas 72201
William H. Danforth, M.D.
Vice Chancellor for Medical
Aairs
Washington University
660 South Euclid Avenue
St. Louis, Missouri 63110
Iicgional Designation
-
CALIFORNIA.
CENTRAL NEW
YORK.
COLORADO-
WYOMING.
CONNECTICUT.
Preliminary Planning
      1z 1 qion
California.
Syracuse, New York,
and 15 surrounding
counties.
Colorado and Wyoming.
Connecticut.
=
--
--
--
--
--
-
Program Coordinator
-
Paul D. Ward
Executive Director
California Committee on Re-
gional Medical Programs
Room 302
655 Sutter Street
San Francisco, California 94102
Richard H. Lyons, M.D.
Professor and Chairman
Department of Medicine
State University of New York
Upstate Medical Center
766 Irving Avenue
Syracuse, New York 13210
C. Wesley Eisele, M.D.
Associate Dean for Postgraduate
Medical Education
University of Colorado
Medical Center
4200 East Ninth Avenue
Denver, Colorado 80220
Henry T. Clark, Jr., M.D.
Program Coordinator
Connecticut Regional Medical
Program
272 George Street
New Haven Connecticut 06510

82
Regional Designation
FLORIDA.
GEORGIA.
GREATER
DELAWARE VALLEY.
HAWAII.
ILLINOIS.
Preliminary Planning
   Region
Florida.
Georgia.
Eastern Pennsylvania
and portions of
Delaware and
New Jersey.
Hawaii.
Illinois.
Program Coordinator
Samuel P. Martin, M.D.
Provost J. Hillii Miller
Medical Center
University of Florida
Gainesville, Florida 32601
J. W. Chambers, M.D.
Medical Association of Georgia
938 Peachtree Street N.E.
Atlanta, Georgia 30309
William C. Spring, Jr., M.D.
Greater Delaware Valley
Regional Medical Program
301 City Line Avenue
Bala-Cynwyd,
Pennsylvania 19004
Windsor C. Cutting, M.D.
School of Medicine
University of Hawaii
2538 The Mall
Honolulu, Hawaii 96822
Leon 0. Jacobson, M.D.
Dean, University of Chicago
School of Medicine
Chairman, Coordinating Com-
mittee of Medical Schools and
Teaching Hospitals of Illinois
950 East 59th Street
Chicago, Illinois 60637
Regional Designation
INDIANA.
INTERMOUNTAIN.
IOWA.
KANSAS.
F
--
--
-
Preliminary Planning
   Region
Indiana.
Utah and portions of
Colorado, Idaho,
Montana, Nevada, and
Wyoming.
Iowa.
Kansas.
--
-_
-_
--
--
-
Program Coordinator
George T. Lukemeyer, M.D.
Associate Dean
Indiana University School of
Medicine
Indiana University Medical
Center
1100 West Michigan Street
Indianapolis, Indiana 46207
C. Hilmon Castle, M.D.
Associate Dean and Chairman
Department of Postgraduate
Education
University of Utah
Salt Lake City, Utah 84112
Willard Krehl, M.D., Ph. D.
Director, Clinical Research
Center
Department of Internal
Medicine
University Hospital
University of Iowa
Iowa City, Iowa 52240
Charles E. Lewis, M.D.
Chairman, Department
of Preventive Medicine
University of Kansas Medical
Center
Kansas City, Kansas 66103

83
Regional Designation
_--~
LOUISIANA.
MAINE.
MARYLAND.       Maryland.
MEMPHIS.
METROPOLITAN
WASHINGTON, D.C.
-
--
--
--
--
-
Preliminary Planning
    Region
--        ---
Louisiana.
Maine.
Western Tennessee,
Northern Mississippi,
and portions of
Arkansas, Kentucky,
and Missouri.
District of Columbia and
2 contiguous counties in
Maryland, 2 in Virginia
and 2 independent cities
in Virginia.
Program Coordinator       Regional Designation
----
-
Joseph A. Sabatier, M.D.
Louisiana Regional Medical
Program
Clairborne Towers Roof
119 South Clairborne Avenue
New Orleans, Louisiana 70112
MICHIGAN.
Manu Chatterjee, M.D.
Merrymeeting Medical Group
Brunswick, Maine
MISSISSIPPI.       Mississippi.
Thomas B. Turner, M.D.
Dean, The John Hopkins
University
School of Medicine
725 Wolfe Street
Baltimore, Maryland 2 1205
MISSOURI.         Missouri.
James W. Culbextson, M.D.
Professor and Cardiologist
Department of Internal Medicine
University of Tennessee
College of Medicine
Memphis, Tennessee 38103
MOUNTAIN STATES.
Thomas W. Mattingly, M.D.
Program Coordinator
District of Columbia Medical
Society
2007 Eye Street N.W.
Washington, D.C. 20006
NEBRASKA-SOUTH
DAKOTA.
--
--
-
Preliminary Planning
    Region
--
Michigan.
Idaho, Montana,Nevada,
and Wyoming.
Nebraska and South
Dakota.
Program Coordinator
D. Eugene Sibery
Executive Director
Greater Detroit Arca Hospital
Council
966 Penobscot Building
Detroit, Michigan 48226
Guy D. Campbell, M.D.
University of Mississippi Medical
Center
2500 North State Street
Jackson, Mississippi 39216
Vernon E. Wilson, M.D.
Dean, School of Medicine
University of Missouri
Columbia, Missouri 65201
Kevin P. Bunnell, Ed. D.
Associate Director
Western Interstate Commission
for Higher Education
University East Campus
30th Street
Boulder, Colorado 80302
Harold Morgan, M.D.
Nebraska State Medical Associa-
tion
1408 Sharp Building
Lincoln, Nebraska 68508

84
Regional Designation
NEW JERSEY.
NEW MEXICO.
NEW YORK METRO-
POLITAN AREA.
NORTH CAROLINA.
NORTH DAKOTA.
Preliminary Planning
   Region
New Jersey.
New Mexico.
New York City, and
Nassau, Suffolk, and
Westchester Counties.
North Carolina.
North Dakota.
Program Coordinator
Alvin A. Florln, M.D., M.P.H.
New Jersey State Department of
Health
Health-Agriculture Building
P.O. Box 1540, John-Fitch
Plaza
Trenton, New Jersey 08625
Reginald H. Fits, M.D.
Dean, University of New Mexico
School of Medicine
Albuquerque, New Mexico 87106
Vincent de Paul Larkin, M.D.
New York Academy of Medicine
2 East 103d Street
New York, New York 10829
Marc J. Musser, M.D.
Executive Diictor
North Carolina Regional Medi-
cal Program
Teer House
4019 North Roxboro Road
Durham, North Carolina 27794
Theodore H. Harwood, M.D.
Dean, School of Medicine
University of North Dakota
Grand Forks, North Dakota
58202 .
Regional Designation
NORTHERN
NEW ENGLAND.
NORTHLANDS.
OHIO STATE.
OHIO VALLEY.
OKLAHOMA.
Preliminary Planning
   Region
Vermont and three
counties in
Northeastern
New York.
Minnesota.
Central and Southern
two-thirds of Ohio (61
counties, excluding
Metropolitan Cincin-
nati area).
Greater part of Kentucky
and contiguous parts of
Ohio, Indiana, and
West Virginia.
.-.
Oklahoma.
Program Coordinator
John E. Wennberg, M.D.
University of Vermont
College of Medicine
Burlington, Vermont 05481
J. Minott Stickney, M.D.
Minnesota State Medical Associ-
ation
200 First Street, Southwest
Rochester, Minnesota 55981
Richard L. Meiling, M.D.
Dean, Ohio State University
College of Medicine
410 West 10th Avenue
Columbus, Ohio 43216
William H. McBeath, M.D.
Diictor, Ohio Valley
Regional Medical Program
1718 Alexandria Drive
Lexington, Kentucky 40504
--
Kelly M. West, M.D.
University of Oklahoma
Medical Center
808 N.E. 13th Street
Oklahoma City, Oklahoma
73104

85
Iicgional Designation
OREGON.
ROCHESTER, NEW
YORK.
SOUTH CAROLINA.
Preliminary Planning
   Region
Oregon.
Rochester, New York and
11 surrounding
counties.
SouthCarolina.
Program <:oordinator
M. Roberts Grover, M.D.
Director, Continuing Medical
Education
University of Oregon
School of Medicine
3181 S.W. Sam Jackson Park
Road
Portland, Oregon 97201
Ralph C. Parker, Jr., M.D.
Clinical Associate Professor of
Medicine
University of Rochester School
of Medicine and Dentistry
Rochester, New York 14620
Charles P. Summerall, III, M.D.
Associate in Medicine (Cardiol-
%Y)
Department of Medicine
Medical College Hospital
55 Doughty Street
Charleston, South Carolina
29403
Regional Designation
SUSQUEHANNA
VALLEY.
TENNESSEE MID-
SOUTH.
TEXAS.
TRI-STATE.
I'rcliminary Planning
   Region
Block of 24 counties
centered around Harris-
burg and Hershey.
Eastern and Central
Tenncsme and contigu-
ous parts of Southern
Kentucky and North-
ern Alabama.
Texas.
Massachusetts, New
Hampshire and
Rhode Island.
Program Coordinator
Richard B. McKenzie
Executive Assistant
Council on Scientific Advance-
ment
Pennsylvania Medical Society
Taylor Bypass and Erford Road
Lemoyne, Pennsylvania 17043
Stanley W. Olson, M.D.
Professor of Medicine
Vanderbilt University
Baker Building
1 IO 2 1st Avenue, South
Nashville, Tennessee 37203
Charles A. LcMaisixe, M.D.
Vice-Chancellor for Health
ACIS
University of Texas
Main Building
Austin, Texas 78712
Norman Stearns, M.D.
Medical Care and Educational
Foundation
22 The Fcnway
Boston, Massachusetts 02115

a6
Regional Designation
VIRGINIA.
WASHINGTON-
ALASKA.
WEST VIRGINIA.
=-=
--
--
--
_-
1
-
Primary Planning
  Region
--
Virginia.
Alaska and Washington.
West Virginia.
Program Coordinator
Kinloch Nelson, M.D.
Dean, Medical College of
Virginia
200 East Broad Street
Richmond, Virginia 232 19
Donal R. Sparkman, M.D.
Associate Professor of Medicine
University of Washington
School of Medicine
Seattle, Washington 98105
Charles L. Wilbar, M.D.
West Virginia University
Medical Center
Morgantown, West Virginia
26506
Regional Designation
WESTERN NEW
YORK.
WESTERN PENNSYL-
VANIA.
WISCONSIN.
Primary Planning
  Region
Buffalo, New York and i
surrounding counties.
Pittsburgh, Pennsylvania
and 28 surrounding
counties.
Wisconsin.
Program Coordinator
Douglas M. Surgenor, M.D.
Dean, School of Medicine
State University of New York at
Buffalo
101 Capen Hall
Buffalo, New York 14214
Francis S. Cheever, M.D.
Dean, School of Medicine
University of Pittsburgh
Flannery Building
3530 Forbers Avenue
Pittsburgh, Pennsylvania 152 13
John S. Hirschboeck, M.D.
Wisconsin Regional Medical
Program, Inc.
Room 1103
110 East Wisconsin Avenue
Milwaukee, Wisconsin 53202

87
EXHIBIT IX
Review and Approval of
Operational Grants
This exhibit outlines review and ap-
proval procedures for use in review-
ing grants for the establishment and
operation of Regional Medical Pro-
grams authorized by Section 904(a)
of Title IX of the Public Health
Service Act.
Background
These procedures were developed
after extensive consideration of: (1)
the philosophy and purposes of Title
IX; (2) the initial experience in re-
viewing the planning grant applica-
tions awarded under Section 903 ;
(3) consideration of the first opera-
tional grant proposals, including site
visits to the regions involving mem-
bers of the National Advisory Council
on Regional Medical Programs and
the Regional Medical Programs Re-
view Committee; (4) preliminary
discussion of the issues involved in
the review of operational applica-
tions by the National Advisory Coun-
cil on Regional Medical Programs at
its November 1966 meeting; and (5)
extensive discussion with both the
Review Committee and the National
Advisory Council concerning the ef-
fectiveness of these procedures dur-
ing the actual review of the first op-
erational applications. As a result of
these considerations, the resulting re-
view and approval process is to the
greatest possible extent keyed to the
anticipated nature of operational
grant requests and to the policy issues
inherent in the Regional Medical
Programs concept.
Characteristics of
Operational Grants
In designing this review process, at-
tention has been given to the follow-
ing characteristics of applications for
Regional Medical Program grants :
( 1) complexity of the proposals with
many discrete but interrelated activi-
ties involving different medical fields;
(2) the diversity of grant proposals
resulting from encouragement of
initiative and determination at the
regional level within the broad
parameters provided in the Law,
Regulations, and Guidelines: (3) the
many different attributes of the over-
all operational proposals which need
to be evaluated during the review
process, including not only the merit
of highly technical medical activities
in the fields of heart disease, cancer,
stroke, and related diseases but also
the effect of the proposal on improved
organization and delivery of health
services and the degree of effective
cooperation and commitment of the
major medical resources: (4) the re-
lationships of the proposals to the
responsibilities of many other com-
ponents of the Public Health Service
and other Federal programs; (5) the
characteristics of these initial pro-
posals as the first steps in the more
complete development of the Re-
gional Medical Program, guided by a
continuing planning process.
Objectives of
Review Process
The objectives sought in the develop-
ment of this review process are based
on a careful assessment of the goals
of the Regional Medical Programs
and how the achievement of those
goals can be most effectively furthered
by the process used in making deci-
sions on the award of grant funds.
Consideration of these basic policy
issues Ied to delineation of the follow-
ing objectives of the review process:
0 The operational grant applica-
tion must be viewed as a totality
rather than as a collection of discrete
and separate projects.
iJ The decision-making process for
the review and approval of opera-
tional grants must be developed in
a way that stimulates and preserves
the essential goal setting, priority
determination, decision making and
evaluation at the regional level.
0 During the review process the
staff of the Division of Regional
Medical Programs and the review
groups must be concerned with the
probability of effective implementa-
tion of the proposed atcivities in ad-
dition to the inherent technical merit
of the specific proposals.
O The review process must provide
the opportunity for the reviewers to
assure a basic level of quality and
feasibility of the individual activities
that will make an investment of grant
funds worthwhile.
0 The review process must have
sufficient flexibility to cope with the
variety of operational proposals sub-
mitted, allowing for the tailoring of
the review to the needs of the par-
ticular proposal.
17 The review process should en-
able the staff and reviewers to view a
Regional Medical Program as a con-
tinuing activity, rather than a dis-
crete project with time limits. There-
fore, the review process should have
continuity during the grant activity
and should provide the opportunity
to judge the development of Regional
Medical Programs on the basis of
results and evaluation of progress, in
addition to the evaluation of the prob-
able effectiveness of initial proposals.

88
Criteria
The basic criteria for the review of
Regional Medical Program grant re-
quests are set forth in the Regulations
as follows:
"Upon recommendation of the Na-
tional Advisory Council on Regional
Medical Programs, and within the
limits of available funds, the Surgeon
General shall award a grant to those
applicants whose approved programs
will in his judgment best promote the
purposes of Title IX. In awarding
grants, the Surgeon General shall take
into consideration, among other re-
levant factors the following:
"(a) Generally, the extent to which
the proposed program will carry out,
through regional cooperation, the
purposes of Title IX, within a geo-
graphic area.
"(b) The capacity of the institutions
or agencies within the program, in-
dividually and collectively, for re-
search, training, and demonstration
activities with respect to Title IX.
"(c) The extent to which the appli-
cant or the participants in the pro-
gram plan to coordinate or have co-
ordinated the Regional Medical Pro-
gram with other activities supported
pursuant to the authority contained
in the Public Health Service Act and
other Acts of Congress including
those relating to planning and use
of facilities, personnel, equipment,
and training of manpower.
"(d) The population to be served by
the Regional Medical Program and
relationships to adjacent or other Re-
gional Medical Programs.
"(e) The extent to which all the
health resources of the region have
been taken into consideration in the
planing and/or establishment of the
Program.
"(f) The extent to which the par-
ticipating institutions will utilize
existing resources and will continue
to seek additional nonfederal re-
sources for carrying out the objectives
of the Regional Medical Program.
"(g) The geographic distribution of
grants throughout the Nation."
In utilizing these criteria in the
review process, it was determined,that
the sequence of consideration of the
various attributes of the proposal
would be important if the objectives
of the review process listed above
were to be achieved. The review proc-
ess, therefore, must focus on three
general characteristics of the total
proposal which separately and yet
collectively determine its nature as a
comprehensive and potentially ef-
fective Regional Medical Program :
0 The first focus must be on those
elements of the proposal which iden-
tify it as truly representing the con-
cept of a regional medical program.
The review groups have determined
that it is not fruitful to consider spe-
cific aspects of the proposal unless
this first essential determination con-
cerning the core of the program is
positive. In making this determina-
tion, considerations include such
questions as: "Is there a unifying con-
ceptual strategy which will be the
basis for initial priorities of action,
evaluation, and future decision mak-
ing?'  "Is there an administrative
and coordinating mechanism involv-
ing the health resources of the regions
which can make effective decisions,
relate those decisions to regional
needs, and stimulate the essential CO-
operative effort among the major
health interests?" "Will the key lead-
ership of the overall Regional Medi-
cal Program provide the necessary
guidance and coordination for the de-
velopment of the program?" "What
is the relationship of the planning al-
ready undertaken and the ongoing
planning process to the initial opera-
tional proposal!"
.a After having made a positive de-
termination about this core activity,
the next step widens the focus to in-
clude both the nature and the ef-
fectiveness of the proposed coopera-
tive arrangements. In evaluating the
effectiveness of these arrangements,
attention is given to the degree of in-
volvement and commitment of the
major health resources, the role of
the Regional Advisory Group, and
the effectiveness of the proposed ac-
tivities in strengthening cooperation.
Only after the determination has
been made that the proposal reflects
a regional medical program concept
and that it will stimulate and
strengthen cooperative efforts will a
mom detailed evaluation of the spe-
cific operational activities be made.
[7 If both of the two previous eval-
uations are favorable, the operation-
al activities can then be reviewed,
individually and collectively. Each
activity is judged for its own intrin-
sic merit, for its contribution to the
cooperative arrangements, and for
the degree to which it includes the
core concept of the Regional Medical
Programs. It should also fit as an in-
tegral part of the total operational
activities, and contribute to the over-
all objectives of the Regional Medi-
cal Programs.
Review Procedures
Below is a chart which describes
the various steps in the review process

which will be applied to initial oper-
ational grant proposals from each
region. The first four operational
grant proposals were subject to the
various steps of this process. Those
steps were not carried out in precisely
the order and sequence provided
in this chart since the first four ap-
plications were used as a test situa-
tion for the development of this op-
erational procedure. It is also likely
that further experience will lead to
appropriate modification of these
procedures. The following comments
may help to explain this review proc-
ess, which has been agreed to by the
Regional Medical Programs Review
Committee and the National Advis-
ory Council on Regional Medical
Programs. The complexity of these
grant requests and the steps in the
review process which seems appro-
priate for their review will require as
much as 6 months for the completion
of the total review process in most
cases.
0 Initial Consideration by Review
Committee-The first steps of the re-
view process involve preparation for
the site visit which will be conducted
for each operational grant applica-
tion. The first consideration of the
application by the Review Commit-
tee will be for the purposes of pro-
viding information and comments
for the guidance of the site visit team,
utilizing staff analyses of the plan-
ning grant experience, considerations
of gross technical validity, policy is-
sues raised by the particular applica-
tion, and initial input on relation-
ships to other Federal programs.
0 Site Visit-I n i t i a 1 experience
has indicated that a site visit by mem-
bers of the Review Committee and
the National Advisory Council is es-
sential for the assessment of the over-
all concept and strategy used by the
Regional Medical Program in de-
veloping the operational proposal and
for assigning priorities to specific proj-
ects included in the proposal. It also
provides the opportunity to assess the
probable effectiveness of cooperative
arrangements and degree of commit-
ment of the many elements which
will be essential to the success of a
Regional Medical Program. As the
discussion above points out, favor-
able conclusions on these aspects of
the Regional Medical Program must
be reached before it is justifiable to
begin the major investment of the
time of the Division staff, technical
reviewers in other parts of the Pub-
lic Health Service, technical consul-
tants, and the Division of Regional
Medical Program review groups,
which is required for the assessment
of the various components of the ap-
plication. The site visit is not a sub-
stitute for the investment of this effort
but provides the opportunity to evalu-
ate the cooperative framework of the
Regional Medical Program and the
overall probability of the success of
the proposed program.
0 Intensive Analysis and Technical
Reviews-If the site visit report jus-
tifies the investment of additional ef-
fort in the review of the application,
the Division staff proceeds with an
intensive analysis of the specifics of
the application. This analysis pro-
vides the framework for obtaining
specific comments from other com-
ponents of the Public Health Service
and other Federal health agencies
with related programs, detailed com-
ments from the various components
of the Division of Regional Medical
Programs staff, technical site visits on
specific projects within the overall
application when considered neces-
sary, and for the assimilation of ad-
ditional information from the appli-
cant as a result of the site visit. The
technical review of specific projects
should not only evaluate the intrinsic
merit of the project but should help
to identify specific problems on any
project which might prevent that
project from making a meaningful
contribution to the objectives of the
Regional Medical Program. Techni-
cal reviews also consider the justifica-
tion for the particular project budget
as presented. This aspect of the re-
view process presents the opportunity
to consider possible overlaps and
duplications with other Public Health
Service programs which can be a
factor in determining how much sup-
port should be provided for the par-
ticular activity from the Regional
Medical Program grant. The oppor-
tunity to raise these questions is not
limited to Division of Regional Medi-
cal Programs staff initiative since
copies of all applications are distrib-
uted to the interested National In-
stitutes of Health, to all Bureaus of
the Public Health Service, and to the
National Library of Medicine at the
time of receipt. Representatives from
all these organizations are invited to
meetings of the Review Committee.
0 Second Review by Review Com-
mittee and Recommendation for AC-
tion-The Review Committee con-
siders all of the information available
concerning the application. In addi-
tion to the application itself and the
site visit report, a summary of all
available information is presented to
the Committee in a staff presenta-

Flow Chart
Operational Grant Review and Approval Process
Initial Staff Information re:
a. Planning grant experience
b. Gross technical validity
c. Policy issues
d. Relationship to other Federal programs
Review Committee Guidance               o
(Prepared 2d day by site team)
Guidance for Site Visit Team
Judgments re:
      )  1. Concept of Regional
Medical Programs
2. Cooperative Arrangements
3. Relationship of projects,
one to another and to the
total
4. Approximate magnitude of
support warranted
5. Quality of projects where

91
applicant
from outside Division of Regional
Medical Programs, where indicated,
including comments from other com-
ponents of the Public Health Service; may
have necessitated technical site visit on
specific project(s)
3. Further Staff information
4. Discussion by site visitor(s) of additional
information obtained subsequent to site visit
In addition to application and
site visit report:
1, Additional information from
In addition to above:
1. Review Committee recom-
mendations
2. Further StafI information
per Committee instructions
Provided to Applicant:
1. Recommendation and comments of
Council; if overall approval
proceed to 2
2. Recommend overall budget ceiling
for grant
3. Summation of all comments derived from the
review process about particular activities
contained in application
Staff review of
revised proposal
Actions :
1. Recommendations
a. Approval
b. Approval with conditions
c. Deferral
d. Return for revision
e. Disapproval
2. Instructions to Staff
3. Recommendation of an overall
grant amount based on discussion
of specifics of the application
Actions :
1. Recommendations
a. Approval
b. Approval with conditions
c. Deferral
d. Return for revision
e. Disapproval
2. Instructions to Staff
3. Recommendation of an overall
grant amount
Applicant action:
Submission of revised proposal
within recommended overall budget
ceiling utilizing the comments and
criticism resulting from the
review process
Action :
a. Award of Grant or
b. Further negotiation
with applicant

92
tion. The Review Committee then
makes its recommendation concern-
ing the application. Because of the
complex nature of the applications,
the Review Committee can divide its
recommendation into several parts re-
lating to different parts of the appli-
cation. If there is an overall favor-
able recommendation on the readi-
ness of the Regional Medical Program
to begin the operational program, the
Review Committee recommends an
overall grant amount based on a dis-
cussion of the specifics of the applica-
tion. This amount takes into consid-
eration problems raised by technical
reviewers, overlap with other pro-
grams, feasibility of the proposals,
and other relevant considerations
raised during the review process.
While the overall amount recom-
mended is based on discussion of the
specific components of the total ap-
plication, the recommendation does
not in most cases include specific ap-
proval or disapproval of individual
projects except when a project is
judged to be infeasible, to be outside
the scope of Regional Medical Pro-
grams, to be an undesirable duplica-
tion of ongoing efforts, or to lack es-
sential technical soundness.
0 Review by National Advisory
Council on Regional Medical Pro-
grams-The  National  Advisory
Council considers the Review Com-
mittee recommendations. It has avail-
able to it the full array of material
presented to the Review Committee
and a staff summary of that material.
Further information obtained by the
staff on the instructions of the Re-
view Committee may also be pre-
sented. The National Advisory Coun-
cil makes the required legal recom-
mendation concerning approval of
the application, including recommen-
dations on the amount of the grant.
The Council may delegate to the staff
the authority to negotiate the final
grant amount within set limits. A
recommendation of approva1 applies
to all projects except when indicated
by the Council, even though the grant
amount recommended may be less
than the amount requested because
of the judgments applied during the
review of the application or because
of overall limitations of funds.
0 Meeting with Representatives of
the Applicant-Following the Na-
tional Advisory Council meeting, the
staff of the Division meets with rep-
resentatives of the applicant and
presents to them the recommendation
and comments of the Council. If the
recommendation is favorable and the
Division intends to award a grant, the
staff also presents the recommended
overall budget ceiling for the grant
along with a summation of all the
comments derived from the review
process concerning particular activi-
ties contained within the application,
including criticisms of specific proj-
ects and comments about the budget
Ievels proposed for specific projects.
The staff also indicates if any proj-
ects included in the application are
not to be included in a grant award
because of Council recommendation
or Division decision based on nega-
tive factors as discussed above.
0 Submission of Revised Propos-
al--On the basis of this meeting,
the applicant submits a revised pro-
posal within the recommended over-
all budget ceiling, utilizing in the re-
vision the comments and criticisms
and technical advice resulting from
the review process. This step of the
process requires the applicant to
reconsider their priorities within the
recommended budget level and to
assume the basic responsibility for
making the final decisions as to
which activities will be included in
the operational program. Unless a
project has been specifically excluded
from the approval action, the appli-
cant may choose to undertake an
activity even if doubts about the
activity were raised during the re-
view process. The applicant includes
such an activity with the under-
standing that the progress of the
activity will be followed with special
interest by the review groups and will
be judged in the future on the basis
of results.
O Final Award Decision-Follow-
ing staff review of the revised pro-
posal, the final decision on the award
is made by the Division Director.
Additional negotiations with the ap-
plicant may also take place.
June 1967

93
EXHIBIT X
Principal Staff of the Division
of Regional Medical Programs,
June 30, 1967
The Ofice of the Director provides pro-
gram leadership and direction.
Robert Q. Marston, M.D.
Director
Karl D. Yordy
Assistant Director for Program Policy
William D. Mayer, M.D.
Associate Director for Continuing
Education
Charles Hilsenroth
Executive Oficer
Maurice E. Odoroff
Assistant to Director for Systems
and Statistics
Edward M. Friedlander
Assistant to Director for Communications
and Public Information
The Continuing Education and Training
Branch provides assistance for the quality
development of such activities in Regional
Medical Programs.
William Mayer, M.D.
Chief
Cecilia Conrath
Assistant to Chief
Frank L. Husted, Ph. D.
tread, Evaluation Research Group
The Develofiment and Assistance Branch
serves as the focus for two-way communi-
cation between the Division and the in-
dividual Regional Medical Programs.
Margaret H. Sloan, M.D.
Chief
Ian Mitchell, M.D.
Associate for Regional Development
The Grants Management Branch inter-
prets grants management policies and re-
views budget requests and expenditure
reports.
James Beattie
Chief
The Grants Review Branch handles the
professional and scientific review of appli-
cations and progress reports.
Martha Phillips
Acting Chief
The Planning and Evaluation Branch ap-
praises and reports on overall program
goals, progress and trends and provided
staff work for the Surgeon General's Re-
port to the President and the Congress.
Stephen J. Ackerman
Chief
Daniel I. Zwick
Assistant Chief
Roland L. Peterson
Head, Planning Section
Rhoda Abrams
Acting Head, Evaluation Section
268-649 O--&i'---7

94
EXHIBIT XI
Complcmcntary Relationships
Between the Comprehensive
Health Planning and
Puljlic Health Service
Amcndmcnts of 1966 and
the Heart Disease, Cancer,
and Stroke Amendments
of 1965
A Fact Sheet from the Office of the
Surgeon General, Public Health
Service, March, 1967
Public Law 89-749, the Comprehen-
sive Health Planning and Public
Health Services Amendments of 1966,
establishes mechanisms for compre-
hensive areawide and State-wide
health planning, training of planners,
and evaluation and development ef-
forts to improve the planning art.
Public Law 89-239, the Heart Dis-
ease, Cancer, and Stroke Amend-
ments of 1965, authorized grants to
assist in the planning, establishment,
and operation of regional medical
programs to facilitate the wider avail-
ability of the latest advances in cart
of patients afflicted with heart disease,
cancer, stroke, and related diseases.
Public Law 89-239 has been in op-
eration for about a year. Public Law
89-749 is yet to be implemented.
The purposes of P.L. 89-749, de-
scribed in Section 2 (b) are : to estab-
lish "comprehensive planning for
health services, health manpower,
and health facilities" essential "at
every  level of government"; to
strengthen "the leadership and ca-
pacities of State health agencies"; and
to broaden and make more flexible
Federal "support of health services
provided people in their communi-
ties."
P.L. 89-749 asserts that these objec-
tives will be attained through "an
effective partnership, involving close
intergovernmental collaboration, of-
ficial and voluntary efforts, and par-
ticipation of individuals and organi-
zations. . . ." The Act establishes a
new mechanism to relate varied
planning and health programs to
each other and to other efforts in
achievement of a total health pur-
pose.
The law has five major sections:
O Formula grants to the States for
comprehensive health planning at the
State level through a designated
State agency;
0 Grants for comprehensive health
planning at the areawide level;
0 Grants for training health plan-
ners;
0 Formula grants to States for pub-
lic health services;
0 Project grants for health services
development
The purpose of P.L. 89-239, as set
forth in Section 900(b) of the Pub-
lic Health Service Act, is "To afford
to the medical profession and the
medical institutions of the Nation,
through . . . cooperative arrange-
ments, the opportunity of making
available to their patients the latest
advances in the diagnosis and treat-
ment of (heart disease, cancer, stroke,
and related) diseases. . . ."
The process for achieving this pur-
pose is to establish regional coopera-
tive arrangements among science,
education, and service resources for
health care . . ." for research and
training (including continuing educa-
tion) and for related demonstrations
of patient care in the fields of heart
disease, cancer, stroke, and related
diseases. . . ." (Section (a) )
This law focuses on the cooperative
involvement of university medical
centers, hospitals, practicing physi-
cians, other health professions, and
voluntary and officia1 health agencies
in seeking ways to build effective link-
ages between the dcvelopmcnt of new
knowledge and its application to the
problems of patients. The law pro-
vides flexible mechanisms which em-
phasize the exercise of initiative and
responsibility at the regional level in
identifying problems and opportuni-
ties in seeking these objectives and in
developing specific action steps to
overcome the problems and exploit
the opportunities.
The Public Health Service sees P.L.
89-239 and P.L. 89-749 as serving
the common goal of improved health
care for the American people along
with other Public Health Service and
non-Public Health Service grant pro-
grams such as community mental
health centers, migrant health pro-
grams, air pollution control, programs
for the training of health manpower,
the neighborhood health centers un-
der the Office of Economic Oppor-
tunity, the medical programs of the
Children's Bureau, and State and
local health programs. In the States
and communities, P.L. 89-749 will
provide a vehicle for effective inter-
action among these programs, recog-
nizing as it does that the diversity of
the various States and areas of the
Nation is considerable, and that the
specific relationships between and
among programs will have to be
worked out at these levels rather than
through a specific Federal mandate.
The planning resources created at the
State and local level under Public
Law 89-749 are expected to afford
valuable assistance in the achieve-

95
ment of the objectives of Public Law
89-239, other programs of the Public
Health Service, and other health en-
deavors in each of the States. Public
Law 89-749 provides, however no
authority for these planning resources
to impose their conclusions or recom-
mendations on any other programs,
Federal or non-Federal, except for
activities carried out under Section
(d) and parts of Section (e) of the
Law which must be in accordance
with the comprehensive State health
plan developed by the State compre-
hensive health planning agency. The
Public Health Service intends to
stimulate effective interaction among
these programs, recognizing that the
diversity of the various States and
areas of the Nation is considerable.
Both P.L. 89-239 and P.L. 89-749
provide flexible instruments for es-
tablishing productive relationships
between these and other programs.
The maintenance of this flexibility in
the administration of the grant pro-
grams will permit each State and rc-
gion to design and develop a relation-
ship that is appropriate for its par-
ticular circumstances. Both programs
call for a close private-public part-
nership. Both programs must place
dependence on imaginative, reason-
able local approaches to cooperation
and coordination. Both programs
recognize that they can only achieve
their full potential by the close and
complete involvement of other com-
ponents of the health endeavor. A
vital partnership must be developed
between the Federal government, the
universities, local and State govern-
ment, the voluntary health interests
and individuals and organizations dc-
signed to develop creative action for
health.
The Congress recognized the rela-
tionship of comprehensive health
planning to other planning activities.
The Report of the Senate Committee
on Labor and Public Welfare
(No. 1655, September 29, 1966)
stated :
"The comprehensive planning of the
State health planning agency with the
advice of the council would comple-
ment and build on such specialized
planning as that of the regional medi-
cal program and the Hill-Burton
program, but would not replace
them. . . ."
"The State health planning agency
provides the mechanism through
which individual specialized plan-
ning efforts can be coordinated and
related to each other. The agency will
also serve as the focal point within
the State for relating comprehensive
health plans to planning in areas out-
side the field of health, such as urban
redevelopment, public housing, and
so forth."
Characteristics of These
Two Important Acts
The complementary relationship of
the programs established by P.L. 89-
239 and P.L. 89-749 to foster dc-
vclopment of a "Partnership for
Health" is illustrated by the follow-
ing outline of some of their major
elements.
Scope
P.L. 89-239: The Regional Medical
Program. To identify regional needs
and resources relating to heart dis-
ease,  cancer, stroke, and related
diseases and to develop a regional
medical program which utilizes re-
gional cooperative arrangements to
apply and strengthen resources to
meet the needs in making more
widely available the latest advances
in diagnosis and treatment of these
diseases.
P.L. 89-749 : The Comprehensive
Health Planning Program. To estab-
lish a planning process to achieve
comprehensive health planning on
a Statewide basis which identifies
health problems within the State, sets
health objectives directed toward im-
proving the availability of health
services, identifies existing resources
and resource needs, relates the activi-
ties of other planning and health
programs to the meeting of these
health objectives, and provides as-
sistance to State and local officials,
private voluntary health organiza-
tions and institutions, and other pro-
grams supported by PHS grant funds
in achieving the more effective al-
location of resources in accomplishing
the objectives.
Participants
P.L. 89-239: University medical
centers, hospitals, practicing physi-
cians, other health professions, vol-
untary and public health agencies,
and members of the public, A re-
gional advisory group representing
these interests and playing an active
role in the development of the re-
gional program must approve any
application for operational activities
of the regional medical program.
P.L. 89-749 : State agency designated
by the Governor does the planning.
State advisory council advises on the
planning process. Membership must
include more than half consumer
representation. Membership will also
include voluntary groups, practition-
ers, public agencies, general planning
agencies, and universities.

96
The Process
P.L. 89-239 :
O Establish cooperative arrange-
ments among science, education, and
service resources.
O Assess needs and resources.
0 Develop pilot and demonstration
projects, emphasizing flow of knowl-
edge in uplifting the cooperative
capabilities for diagnosis and care of
patients.
0 Relate research, training, and
service activities.
O Develop effective continuing edu-
cation programs in relation to other
operational activities.
0 Develop mechanisms for evalu-
ating effectiveness of efforts in the
provision of improved services to
patients with heart disease, cancer,
stroke and related diseases.
P.L. 89-749:
0 Establish State and areawide
health goals.
0 Define total health needs of all
people and communities within area
served for meeting health goals.
/J Inventory and identify relation-
ships among varied local, State, na-
tional, governmental and voluntary
programs;  regional medical pro-
grams, mental health, health facili-
ties, manpower, medicare - so that
these programs can be assisted in mak-
ing more effective impact with their
resources.
0 Provide  information,  analyses,
and recommendations which can
serve as the basis for the Governor,
other health programs and communi-
ties to make more effective allocations
of resources in meeting health goals.
JJ Provide a focus for interrelating
health planning with planning for
education, welfare and community
development.
O Strengthen planning, evaluation,
and service capacities of all partici-
pants in the health endeavor.
0 Provide support for the initiation,
integration, and development of pilot
projects for better delivery of health
services; develop plans for targeting
flexible formula and project grants
at problems and gaps identified by the
planning process.
Specific Planning Relationships
Q There are a variety of ongoing
health planning and community
health organization activities. Many
are supported in part by the Public
Health Service, such as Regional
Medical Programs (P.L. 89-239))
community mental health centers,
areawide health facility planning,
and the Hill-Burton programs. These
activities are stimulating the creation
of new relationships between health
resources and functions as well as as-
sisting in the creation of additional
resources in the stimulation of more
effective performance of functions
for the purpose of achieving more ef-
fective attainment of identified health
goals. Each of these programs re-
quires participation not only by a
broad range of health professionals
but also by representatives of the con-
sumers of health services. Each of
these programs is dependent upon
the interaction of the full range of
relevant health interests, including
those in the public sector and the
private voluntary sector in achieving
the particular progam goals.
Comprehensive  health planning
(P.L. 89-749) is designed to provide
assistance in the development of more
effective relationships among such
health programs and to provide a
better basis for relating these pro-
grams to the accomplishment of over-
all health objectives at the State and
local level. Based on similar prin-
ciples of broad participation, it calls
for the stimulation of all parties to
contribute to the goal of insuring the
availability of comprehensive health
services to all who need them.
0 Both regional medical programs
and comprehensive health planning
are intended to strengthen creative
Federalism-more productive mech-
afiisms for partnership and cooper-
ation between the national, State
and local levels of government, the
public and voluntary private health
activities,  and the academic and
health services environments. P.L.
89-749 will create planning resources
at the State and local level. The in-
formation, analyses, and plans de-
veloped by these planning resources
can provide invaluable assistance to
State and local authorities, to volun-
tary health organizations and insti-
tutions, and to the other health pro-
grams involved in planning and de-
veloping the organization of health
activities   which   are  supported
throuih other Public Health Service
grant funds. This planning resource
created under Section 314(a) will
thus contribute to the more effective
accomplishment of health objectives
and the setting of priorities in achiev-
ing those objectives through the ac-
tivities supported under the other sec-
tions of this Law. In addition, the
resource will contribute to the deter-
mination of priorities foi action not
only by those with public responsi-
bility and accountability for health
services but also by the many other
health organizations, institutions, and

97
personnel which bear the direct re-
sponsibility for the delivery of health
services for most of the population.
P.L. 89-749 recognizes that the ac-
complishment of improvements in the
quality and coverage in health serv-
ices, both personal and environ-
mental, depends upon the voluntary
participation and energies of both
the private and public sectors of the
health endeavor.
.o The planning, operational pro-
grams, and organizational frame-
works being created under the
Regional Medical Programs, commu-
nity mental health centers, and area-
wide health facility planning groups,
including the advisory groups estab-
lished for other programs such as the
Regional Medical Programs, should
serve as sources of strength and
valuable assistance for the areawide
and State-wide health planning coun-
cils created under P.L. 89-749 and
for the planning resources created
under this Law.
0 The broad range of health inter-
ests represented in Regional Medical
Program planning efforts, along with
other appropriate health interests,
will be essential participants and con-
tributors to the State health planning
council and to the activities of the
health planning agency. When the
activities of that agency address
themselves to the problems of extend-
ing high-quality personal health
services which fully benefit from the
developments in new medical knowl-
edge, the cooperative involvement of
these health interests in both the Re-
gional Medical Program planning
and development and in the planning
and evaluation activities under P.L.
89-749 will make an essential con-
tribution to productive relationship
between these activities.
O The comprehensive health plan-
ning activities will use data available
from many sources including that
generated or analyzed by the Region-
al Medical Programs, particularly
on health status of populations ef-
fected, health resources, and health
problems and needs. The compre-
hensive health planning activities
can also benefit from the experience
obtained under the Regional Medi-
cal Programs which have represented
an exploratory effort of considerable
importance in developing an en-
vironment for concerted planning by
many elements of the health en-
deavor and in the implementation,
development and evaluation of new
systems for the facilitation of the de-
livery of the benefits of medical ad-
vance in specific disease areas through
more effective means of communica-
tion, education, training, organiza-
tion, and delivery of health services.
Many of the planning and imple-
mentation activities under the Re-
gional Medical Programs will have
implications and applications to a
broader range of health problems
than heart disease, cancer, stroke,
and related diseases. The mechanisms
created by the Regional Medical Pro-
gram can be useful in achieving the
broad goals of comprehensive health
stated under P.L. 89-749.
Training Health Planners
Section 314(c) of P.L. 89-749 au-
thorizes grants to public or nonprofit
organizations for "training, studies,
and demonstrations," in order to ad-
vance the state of health planning art
and increase the supply of competent
health planners.
For the first years, emphasis will be
placed on increasing health planning
manpower. (Until  now,  Public
Health Service effort has been lim-
ited to ad hoc short courses or in-
service training.) This new activity
will help meet a critical shortage
faced by regional medical programs,
medical centers, operating health
agencies, as well as comprehensive
health planning agencies about to de
launched.
Operating Grants
Section 314(d) of P.L. 89-749 au-
thorizes formula grants to State
health and mental health authorities
for comprehensive public health
service. The Act brings together a
group of previously compartmented
or categorical Public Health Service
grants. Grant awards will depend on
a plan submitted by the health
agency which reflects the way in
which the State intends to use the
funds as part of an effort to provide
adequate Public Health Services.
This plan, in turn, must be in accord
with the State's comprehensive health
planning.
Section 314(e), authorizing project
grants for "health services develop-
ment," broadens and consolidates a
series of Public Health Service proj-
ect grants, making possible Federal
support for new and innovative proj-
ects, locally determined, to meet
health needs of limited geographic
scope or specialized regional or na-
tional significance; stimulating and
initially supporting new programs of
health services,  and undertaking
studies, demonstrations, or training
designed to develop new or improved
methods of providing health services.
The first two of these categories of
health service development grant

98
must conform to objectives, priorities,
and plans of comprehensive State
health planning.
With the exception of the statutory
requirement that the programs sup-
ported by these grants must conform
to comprehensive State health plan-
ning, P.L. 89-749 formula and proj-
ect grants bear the same reIation to
the comprehensive health planning
process as do, far example, the opera-
tional grants under regional medical
programs, air pollution control, or
community mental health center
staffing.
The operational grants under P.L.
89-239 will support an interrelated
program of activities which utilize
regional cooperative arrangements
to accomplish the objectives of that
law in the fields of heart disease, can-
cer, stroke, and related diseases. The
cooperative arrangements and the
specific program elements are viewed
by many regions as providing useful
models for application to a wide
spectrum of health problems which
can be implemented through other
means and which will have close
relevance to the achievement of many
of the activities supported under
P.L. 89-749 and other health pro-
grams. Conversely, the regional med-
ical programs can benefit from the
planning and operational activities of
other health programs including
those supported under P.L. 89-749.
Other programs supported by Public
Health Service funds such as mental
health, migrant health, and air pollu-
tion can have the same type of pro-
ductive interrelationship with the
comprehensive health planning pro-
grams.
The Public Health Service has a re-
sponsibility to prevent waste of scarce
resources through useless duplication.
To assure the most effective inter-
relationship among these and other
Public Health Service grant pro-
grams, the Public Health Service is
currently developing informational,
and review systems to promote effec-
tive coordination between all of its
varied grant programs.
EXHIBIT XII
Public I,n\v 89- 239
89th Confycss, S. 596
Octohcr 6, 1965
An Act
Heart Dl,sease,
Cancer, and
Stroke Amend-
ments of 1965.
To amend the Public Health Service Act to
assist in combating heart disease, cancer,
stroke, and related diseases.
nc it enacted by the Senate and Ilouse of
Repreaentativm iof the United States of
America in Congrees a88Cmbkd, That this
Act may be cited as the "Heart Disease,
Cancer, and Stroke Amendments of 1965".
SEC. 2. The Publlc IIealth Service Act (42
U.S.C., ch. GA) is amende.d by addlns at the
end thereof the following: new title :
"TITLE IX-EDUCATION, RESEARCH,
TRAINING, AND DEMONSTRATIONS IN
THE  FIELDS OF HEART DISEASE,
CANCER,   STROKE,   AND   RELATED
DISEASES
"SEC. 900. The purposes of this tltie are
"(a) Through grants, to rncourafie and
assist In the establishment of regional CD-
operatfve  arranaements  among  medical
schools, research institutions, and hospitals
for research and training (including con-
tinning edoration) and for related demon-
strations of patient care in tire firids of
heart disease, cancer, stroke, and related
diseases :
"(I~) To afford to the medical professIon
and the medical institutions of the Nation,
through such cooperative arrangements, the
opportunity of making availubie to their pa-
tients the latest advances in the diagnosis
and treatment of these diseases; and
"(c) Ry these means. to improve Se"-
eraliy the health manpower and facilities
avail"ble to the NatIon, and to accomplish
these ends without interfering with the pat-
terns, or the "lethods of fimmcin~:. of pa-
tient care or ~uofesslonnl iwactice, or with
the administratlon of hospitals, and in cw
operntion with practicing ~)hysicians, medi.
cal center officials, hospital administrators,
and rcpres~ntativrs from appropriate volun-
tary health agencies.
"Authorization of Afuwopriationa
"SEC. 901. (a) There are authorized to
be appropriated $50.000,000 for the fiscal
year ending June 30, 19GG. $90,000,000 for
the IlscaI year ending June 30, 1967, and
$200.000.000, for the fiscal year endlug Jonr~
30, 1068, for grants to assist public or non-
pro5t private universities, medical schools.
research institutions, and other public or
nonprofIt private institutions and agencies
In I)l"nnin& in conducting feasibility studies,
and in operating pliot projects for the estab-
lishment of regional mrciical programs of
research, training, and demorlstration actir-
ities for carrying orlt the purposes of this
title. Sums appropriated under this sectlo"
for any fiscal year shall remain avallahIe for
making such wants untli the end of the i%ral
yenr fallowing the fisral J-ear for which the
appropriation is made.
"(b) A unnt under this titlr shall be for
part or ail of the cost of the planning or
other actirities with respect to mhich the
agpllcatio" Is made, except thnt nn.r such
want with respect to construction of, or
provision of built-in (ax determined III nc-
cordanw with rwwlatlons) rqrriimwnt for.
any facility "lay not wrcwl 90 prr wntum of
the cost of such constructinrl or rqlliptlw"t.
"(r) Funds a~~i~roi~rir~twl purslmrlt to tllis
title shnll not he availahlr to ibay the c,ost
of hospitnl, medical, or other cart of iuatiwts
rsccpt to the rxtent it ix. as drtrrmlnr~d in
accordnnw  with rrgaiations. Jnridr"t to
thaw rrscnrch, tminin~, or dfwlollstration
nctiritiw which arc rncompassed hy the
J,nrposrs of this title. No patient shall h
furnished hospital. ~nrdicni, or othw carp
;tt any fnrility incidrnt to rwwwil. trninl"6z.
or demonstration activities carried ant tvitJ1
funds appropriated pnrsrmnt to this titip.
"nless he h"s heen referwd to such faciiit?
by a practicing ~hy~lcia".

"Deflnitione
"SEC. 902. For the purposes of this title-
"(a) The term `regional medical program'
means a cooperative arrangement among a
group of public or nonprofit private institu-
tions or agencies engaged in research, train-
ing, diagnosls, and treatment relating to
heart disease, cancer, or stroke, and, at the
option of the applicant, related disease or
diseases; but only if such group-
"(1) is situated within a geographic
area, composed of any part or parts of
any one or more States, which the Surgeon
General determines, in accordnnce with
regulations, to be appropriate for carry-
ing out the purposes of this title ;
"(2) consists of one or more medical
centers, one or more clinical research cen-
ters, and one or more hospitals; and
"(3) has in effect cooperative arrange-
ments among its component units which
the Surgeon General flnds will be adequate
for effectively carrying out the purposes of
this title.
"(b) The term `medical center' means a
medical school or other medical institution
involved in postgraduate medical training
and one or more hospitals afiliated there-
with for teaching, research, and demon-
stration purposes.
"(c) The term `clinical research center'
means an institution (or part of an lnstitu-
tlon) the primary function 6f which is re-
search, training of specialists, and demon-
stratlons and which, in connection therewith,
provides specfalieed, high-quality diagnostic
and treatment services for inpatients and
outpatients.
"(d) The term `holspltal' means a bospi-
tal as defined in section 625(c) or other
health facility in which local capability for
diagnosis and treatment is supported and
augmented by the program established un-
der this title.
"(e) The term `nonprofit' w applied to
any institution or agency means an instltu-
tion or agency which is owned and operated
by one or more nonproflt corporations or as-
sociations no part of the net earnings of
which inures, or may lawfully inure, to the
bene6t of any private shareholder or
lndivldual.
"(f) iThe term `construction' includes
alteration, major repair (to the extent per-
mitted by regulations), remodeling and
renovation of existing buildings (including
initial equipment thereof), and replacement
of obsolete, built-in (as determined in ac-
cordance with regulations) equipment of
existing buildings.
"&-ante for PZannZng
"SEC. 903. (a) The Surgeon General, upon
the recommendation of the National Ad-
visory Council on Regional Medical Pro-
grams established by sectton 905 (hereafter
in this title referred to as the `Council'), is
authorized to make grants to public or non-
proflt private universities. medical schools,
research institutions, and other public or
nonprofit private agencles and institutions
to assist them in planning the development
of regional medical programs.
"(b) Grants under this section may be
made only upon application therefor ap-
proved by the Surgeon General. Any such
application may be approved only if It con-
tains or is supported by-
  "(1) reasonable assurances that Fed-
eral funds pald pursuant to any such grant
will be usbd only for the purposes for
which paid and in accordance with the
applicable provisions of this title and the
regulations thereunder ;
"(2) reasonable assurances that the
applicant will provide for such fiscal con-
trol and fund accounting procedures as are
required by the Surgeon General to assure
proper disbursement of and accounting for
such Federal funds ;
"(3) reasonable assurances that the ap-
plicant will make such reports, in such
form and containing such information as
the Surgeon General may from time to
time reasonably require, and mill keep
such records and aflord such access tbere-
to as the Surgeon General may flnd neces-
sary to assure the correctness and verltlca-
tion of such repor
"(4) a   L s ; and
      satfsfa tory showing that the
applicant has designated an advisory
group, to advise the applicant (and the
institutions and agencies participating in
the resulting regional medical program)
in formulatfng and carrying out the plan
for the establishment and operation of
such regional medical program, which
advisory group includes practicing physi-
cians, medical center o!licials, hospital ad-
ministrators, representatives from appro-
priate medical societies, voluntary health
agencies,  and representatives of other
organizations, institutions, and agencies
concerned with activities of the kind to be
carried on under the program and mem-
hers of the public famlllar with the need
for the services provided under the
program.
"Grant8 for E8tabZishnU39kt and Operation of
Regional Medical Program8
"SEC. 904. (a) The Surgeon General, upon
the recommendation of the Council, is au-
thorized to make grants to public or non-
profit private universities, medical schools,
research institutions, and other public or
nonprofit private agencies and instltutlons to
assist in estahllshment and operation of
regional medical programs, including cou-
structlon and equlmpment of facilities in con-
nection therewith.
"(b) Grants under this section may be
made only upon application therefor ap-
proved by the Surgeon Geneml. Any such
application may be approved only if it is rec-
ommended by the advisory group described
in section 903(b) (4) and contains or is sup-
ported by reasonable assurances tbat-
  "(1) Federal funds paid pursuant to
any such grant (A) will be used only for
the purposes for which paid and in ac-
cordance with the applicable provisions of
this title and the regulations thereunder,
and (B) will not supplant funds that are
otherwise avallahle for establishment or
operation of the regional medical program
with respect to which the grant is made;
  "(2) the applicant ~111 provide for such
flseal control and fund accounting proce-
dures as are required by the Surgeon
General to assure proper disbursement of
and accounting for such Federal funds ;
Records.
"(3) the applicant will make such re-
ports, in such form and containing such
information as the Surgeon General may
from: time to time reasonably require, and
~111 keep such records and alTord such
access thereto as the Surgeon General
may find necessary to assure the cor-
rectness and veri5catlon of such reports;
and
"(4) any laborer or mechanic employed
by any contractor or subcontractor in the
performance of work on any construction
aided by payments pursuant to any grant
under this section will be paid wages at
rates not less than those prevalllng on
slmllar construction in the locality as
determined by the Secretary of Labor in
accordance with the Davis-Bacon Act, as
amended (40 U.S.C. 276a-276a-5) ; and
the Secretary of Labor shall have, with
respect to the labor standards speclfled in
this paragraph, the authority and func-
tions set forth in Reorganlcatfon Plan
Numbered 14 of 1950 (15 F.R. 3176; 6
U.S.C. 133515) and section 2 of the Act
of June 13, 1934. as amended (40 U.S,.C.
27&z).
"National Advieory Council ott Regional
Medical Program8
Appointment of
members.
"SEC. 905. (a) The Surgeon General, with
the approval of the Secretary, may appoint,
without regard to the civil service laws. a
National Advisory Council on Regional Medl-
cal Programs. The Council shall consist of
the Surgeon General, who shall be the chalr-
man, and twelve members, not otherwise in
the regular full-time employ of the UnIted
States, who are leaders in the flelds of the
fundamental sciences. the medical sciences,
or public oRairs. At least two of the ap-
pointed members shall be practicing pbysl-
clans, one shall be outstanding in the study,
diagnosis, or treatment of heart disease. one
shall he outstanding in the study, dlagnosls,
or treatment of cancer, and one shall be out-
standing in the study, diagnosis, or treat-
ment of stroke.
Term of of3ce.
"(b) Each appointed member of the Cnun-
~11 shall bold oflice for a term of four years,
except that any member appolnted to fill a
vacancy prior to the expiration of the term

100
for which his predecessor was appointed
shall be appointed for the remainder of such
term, and except that the terms of of&e
of the members flrst taking oRIce shall expire,
as designated by the Surgeon General at the
tlme of appointment, four at the end of the
Brst Fear, four at the end of the second year,
and four at the end of the thlrd year after
the date of appointment. An appointed mem-
ber shall not be ellglble to serve continuously
for more than two terms.
Compensation.
l`(c) Appointed members of the Council,
while attending meeting8 or conferences
thereof or otherwise serving on business of
the Council, shall be entitled to receive com-
pensation at rates ilxed by the Secretary,
but not exceeding $100 per day, including
traveltime, and while 80 serving away from
their homes or regular places of business they
may be allowed travel expenses, including
per diem in lieu of subsistence, as authorized
by section 5 of the Admlnlstrative Expenses
Act of 1946 (5 U.S.C. 73h-2) for per-
sons in the Government service employed
intermittently.
Applications for
grants, recom-
mendations.
"(d) The Council shall advise and assist
the Surgeon General in the preparation of
regulations for, and as to policy matters
arising with respect to, the administration
of this title. The Council shall consider all
applications for grants under this title and
shall make recommendations to the Surgeon
General with respect to approval of appllca-
tlons for and the amounts of grants under
this title.
"Regulations
"SEC. 900. The Surgeon General, after
consultation with the Council, sball *re-
scribe general regulations coverng the terms
and conditions for approving applications for
grants under this title and the coordination
of programs assisted under this titIe with
programs for training, research, and demon-
strations relating to the same disease8
assisted or authorized under other titles of
this Act or other Acts of Congress.
`~Infornation on BpecZaZ Treatment and
Training Centers
"SEC. 907. The Surgeon General shall es-
tablish, and maintain on a current basis, n
list or lists of facllltle8 in the United States
equipped and staffed to provide the most ad-
vanced methods and techniques in the dlag-
nosls and treatment of heart disease, cancer,
or stroke, together with such related lnfor-
mation, including the availablllty of ad-
vanced specialty training in such facllitles,
as he deems useful, and shall make such list
or lists and related information readily
available to licensed prnctitloners and other
persons requiring such information. To the
end of mnking such list or lists and other
information most useful, the Surgeon Gen-
eral shall from time to time consult with in-
terested national professional orgnnizations.
Report to President and Congress
"SEC. 908. On `or before June 30, 1967,
the Surgeon General after consultation wit11
the Council, shall submit to the Secretary
for transmission to the President and then
to the Congress, a report of the activities
under this title together with (1) a state-
ment of the relationship between Federal
Ananclng and llnancing from other sources
of the activities undertaken pursuant to tbis
title, (2) an appraisal of the actlritles as-
sisted under this title in the light of their
effectiveness in carrying out the purposes of
this title, and (3) recommendatlon8 with
respect to extension or modification of this
title in the light thereof.
"Recorda and Aadit
"SEC. 909. (a) Each recipient of a grant
under this title shall keep such records as the
Surgeon General may prescribe, including
records wblch fully di8closc the amount and
disposition by such recipient of the proceeds
of such grant, the total cost of the project or
undertaking in connection with which such
grant is made or used, and the amount of
that portion of the cost of the project or
undertaking supplied by other sources, and
such records as will facilitate an effective
audit.
"(b) The Secretary of Health, Education,
and Welfare and the Comptroller General of
the Unlted States, or any of their duly au-
thorized representatives, shall have access
for the purpose of audit and exnmination to
any books, documents, papers, and record8
of the recipient of any grant under this title
which are pertinent to any such grant."
SEC. 3. (a) Section 1 of the Public Health
Service Act is amended to read as followS :
"SECTION 1. TitIes I to IX, inclusive, of
this Act may be cited as the `Public Health
Service Act'."
(b) The Act of July 1, 1944 (58 Stat.
082), as amended, is further amended by ru-
numbering title IX (as in effect prior to the
enactment of this Act) as title X, and by
renumbering sections 901 through 914 (as
in effect prior to the enactment of this Act),
and references thereto, as sections 1001
through 1014, respectlreIy.
APPROVED OCTOBER G, 1905, 10 :15
a1.
Leglslaticc Uistory:
House Report Ko. 963 accompanying H.R.
3140 (Comm. on Interstate and Foreign
Commerce).
Senate Report No. 3GR (Comm. on Lnbor and
Public Welfare).
Congressional Record, Vol. 111 (19G5) :
June 25: Considered in Senate.
June 28 : Consldered and passed Senate.
Sept. 23: H.R. 3140 considered in IIouse.
Sept. 24: Considered and passed House,
amended, in lieu of H.R. 3140.
Sept. 29:  Senate concurred in Housr
amendments.
EXHIBIT XIII
Kcgulations
Regional Medical
Programs
March 18, 1967
SUBPART E-GRANTS FOR
REGIONAL MEDICAL PROGRAMS
(Added l/18/67,5.%? FR 571.)
AUTHORITY: The provisions of this Sub-
part D issued under sec. 215, 58 Stat. 690.
sec. 906, 79 Stat. 930; 42 U.S.C. 216, 2991,
Interpret or apply sets. 900, 901, 902, 903,
904, 905, 909, 79 Stat. 926, 927, 928, 929,
930, 42 U.S.C. 299, 299a. 299b. 299c, 299d.
299e, 2991.
0 54.401 APPLICABILITY.
The prorlsions of this subpart apply to
grants for planning, establishment, and
operation of regional medical programs a8
authorized by Title IX of the Public Healtll
Service Act, as amended by Public Law
89-239.
0 54.402 DEFINITIONS.
(a) All terms not defined herein shall
have the meaning given them in the Act.
(b) "Act" means the Public HeaItb Serr-
ice Act, as amended.
(c) "Title Ix"  menn8 TitIe IX of tllr
Public IIealth Service Act as amcndcd.
(d) "Related diseases" mean8 those tlls
eases wblcb can reasonably be consldercd to
bear a direct relatlonshlp to heart disease,
cancer, or stroke.
(e) "Title IX diseases" means heart dis-
ease, cancer, stroke, and related diseases.
(f) "Program" means the regional medl-
cal program as detlned in section 902(a) of
the Act.
(g) "Practicing pbysiclan" means any
physician licensed to practice medicine In

101
accordance with applicable State lnws and
currently en6n6ed in the diagnosis or treat-
ment of patients.
(11) "Major repair" includes restorati011
of an existing buildln6 to a sound state.
(I) "Built-in equipment" iS eq"ipn1ent
adlxed to tlie fnclllty nnd customarily in-
cluded in the construction contmct.
(j) "Advisory group" means the group
designated pursuant to section 003(b) (4)
of the Act.
(k) "Geograpl1lc urea" mcnns nny area
that tl1e S"r6con General deter1nlnes forn1s
an economic and socially related re6ion,
taking  into considerntion sue11 factors us
present and future populntion trends and
patterns of 6rowth; location and extent of
trnnsportntlon nnd communication fncilities
and systems; presence and distribution of
educntional, medicnl nnd health facilities
and pro6rams, and other activities wl1iclr in
the opinion of the Surgeon General are ap-
propriate for carrying out the purposes of
Title IX.
0 54.403 ELIGIBILITY.
In order to be eli6ible for n 6rant, the
applicant shall :
(a) Meet the requirements of section 903
or 904 of the Act;
(b) Be locnted in a State ;
(c) Be situated within a geographic area
appropriate under the provisions of this suh-
part for carrying out the purposes of tlie Act.
O 54.404 APPLICATION.
(a) Forma. An nppllcntion for n 6rant
shall be submitted on such forms and in sucli
manner ns  the Surgeon General may
prescribe.
(b) Ezecutlon. The application sl1nll be
executed by nn individual authorized to act
for the npplicnnt nnd to assume on behalf
of the applicant all of the obligations speci-
fied in the terms and conditions of the grant
including those contnlned in tl1ese reguln-
tions.
(c) Description of program. In addition
to nny other pertinent information tlint tlm
Sur6eon General mny require, tl1e npplieant
shall submit a description of tl1e pro6rnm
in sufficient detail to clearly identify thr
nnturc, need, purpose, plan. nnd mrthods of
the program. the nature nnd fuuctions of
the pnrtlclpnting institutions, tlm 6co6ruphlc
nrea to be served, the cooperntive arrange-
ments in effect, or intended to be made ef-
fective, within the group, the justification
supported by n budget or other data, for the
amount of the funds requested, and Onnnciul
or other data demonstrnting tlmt grunt funds
will not supplnnt funds otherwise nrnilable
for estnbllshment or operntion of tl1e rcgionnl
medical pro6rnm.
(d) Advisor2/ group; eatabliskment; CL.&
dencc. An application for a grant under seo-
tion 003 of the Act slmll contni11 or be sup-
ported by documentary evidence of the es-
tahlishxnent of an advisory 6ro"p to provide
ndvice in formulatin und carrying out tlie
establishment ond operation of a program.
(e) AdtAnoty group; naernberskip; descrip-
tion. Tl1e npplicntion or s"pportin6 material
shall describe the selection and membership
of the designated advisory group, showin
tlie extent of inclusion in such 6ro"p of
proCtiCin6 plrysicians , members of other
health professions. medical center oillcinls.
liospitnl administrators, representatives from
appropriate  medical societies,  voluntary
a6encies. representatives of other or6anisa-
tions, institutions nnd a6encles concerned
with activities of the kind to be carried on
under the program, nnd members of the pub-
lic fnmiliar with the need for the services
provided under the program.
(f) Constructiols; purposes, plnus, and
specifications; 11arraticc dcseription. Wit11
respect to an npplication for funds to be
used in wl1olc or pnrt for constructkm as dc-
Aned in Title IX. the npplicnnt slmll furnish
in sufficient detnil plnns nnd sprcificntions
IS well as n narrative description, to indicntc~
the need, nature, und lmrpose Of tile pro-
posed construction.
(6) Advisory group; ?`eCOlMneldItiO~l. A11
spplication for a grant under section 904 of
the Act shall contain or he supported hy n
copy of the written rrcomn1cndntiou of the
ndrisory 6roup.
O 54.405 TERMS, CONDITIONS,
AND ASSURANCES.
111 nddition to uny other terms. conditions,
and nssurances required by law or iniposed
by the Surgeon General, rncll 6rnnt shnll bc
subject to the following terms, conditions,
nnd  ussurances to be furnislled by tl1e
6runtec. The Surficon Gencrsl may nt nny
time approve rsccptions where lie finds tlmt
such exceptions are not inconsistent with the
Act and the purposes of the program.
(a) Use of funds. The 6rantee will "SC
gr0llt funds solely for the purposes for wl1icl1
the 6rnnt was made, as set forth in tile alp-
proved npplication nnd nwnrd stntement. In
the event any part of the amount paid a
6rnntee is found by the S"r6eon Genernl to
llave been cspcnded for purposes or by uny
metl1ods contrary to tlie Act, the re6ulntlons
of this subpart, or contrary to any condition
to tile award, then sucl1 srantee. upon bein
notified of such flndln6, nnd in nddition to
any otlier requirement, shall pny an equal
umount to the United States. Chnnges in
grant purposes may be made only in nccord-
ante wit11 procedures established by tlm
Sur6eon General.
(b) Obligation of funds. No funds may be
chnr6ed ngninst tlle 6rant for services per-
formed or mnterlal or equipment delivered,
pursuant to a contract or agreement entered
into by the applicant prior to the effective
date of the pmnt.
(c) rnventionn or di8COVWi.98. Any 6rant
award hereunder in whole or in part for re-
searcl1 is subject to the regvlntions of the
Department of Health, Education, and Wel-
fare as set forth in Parts 0 nnd 8 of Title 46,
ns nmended. Such repulatlons shall npply to
nny program nctlvity for which 6rant funds
nre in fact used whether within the scope
of the progrnm as approved or otl1erwise.
Appropriate measures shnll be tnken by the
6rnntec nnd by the SurEeon Genernl tc* nss11re
tlmt no contracts, assignments, or other nr-
rangements inconsistent with the 6rnnt obli-
6ntion are continued or entered into and
tlrnt nll personnel involved in the supported
activity are aware of and comply with such
obligation. Laboratory notes, related tech-
nlcal data, and information pertainin to in-
ventions or discoveries made throu6ll nctivi-
ties supported by 6rnnt funds shall he
maintained for such periods, and filed wit11
or otlmrwise made available to the Sur6eon
General or those lie may desbgnte nt sue11
times nnd in such manner as he may deter-
mine necessary to carry out such Department
W6UhtiOIlS.
((1) Reports. The 6ra11tee sl1nll maintain
nnd file wit11 the Surgeon General such prO6-
ress, fiscal, nnd otlier reports, inClUdin6
reports of meetings of the advisory 6roup
convened before and nftrr nwnrd of a grant
under section 904 of the Act, as the Surpeon
Genernl may prescribe.
(e) Records retention. All construction,
financial, and other records relating to the
USC of 6rant funds sl1all he retained until
the Srnntee lms received written notice that
the records hare been audited unless n dlffer-
ent period is permitted or required in writln6
by the S"r6eon General.
(f) Responsible   oflicial.  The   OiIlCiQl
designated in tl1c npplicntion ns responsible
for the coordination of the pro6mm sl1nll
continue to be responsible for the duration
of the period for which 6rnnt funds nrc made
nvalloble. The grantee shnll notify tl1e Sur-
6eOn General immedintely if such otllclnl be-
comes unnvailnhle to dischnr6e this respon-
sibility. The Surgeon Qeneral may terminnte
the grant whenever such otllcinl shall become
thus unavailable unless the grantee replaces
such oi3clnl wit11 another ofllclal found by
tlie Surgeon General to be qunlified.
0 54.400 AWARD.
Upon recomniendation of the National Ad-
visory Council on Re6ional Medical Pro-
Brams, nnd within the limits of nvnilable
funds, the Surgeon General shall nwnrd a
grant to those npplicants whose approved
proprams will in his judgment best promote
the purposes of Tile IX. In awnrdinp grnnts,
the Sur6eon General shall take into con-
siderntlon, nmon6 other relevant factors the
follo\vin6 :
(a) Generally, the extent to which tl1e
proposed pro6rnm will carry out, throu6li
regional cooperation, the purposes of Title
IX, within a geo6raphlc area.
(b) The capacity of the institutions or
nsencies within the program, individually
nnd collectively, for research, training, nnd
demonstmtion nctivities wit11 respect to Title
IX.
(c) The extent to whicl1 the applicant or
tl1e participants in the program plan to
coordinate or 11ave coordinated the re6ional
medicnl program with other activities sup-
ported pursuant to tl1e autllority contained
in the Public Health Service Act nnd other
.icts of Conpress inClUdin6 those relntlng
to planning nnd use of facilltles, personnel.
nnd equipment, and training Of manpower.
(d) The population to be served by the
regional medical pro6ram and relationships

102
to adjacent or  other regional medical
programs.
(e) The extent to which ail the health
resources of the region have been taken into
consideration in the piannln6 and/or estab-
lishment of the proGram.
(f) The extent 6 which the partlclpatln6
Institutions will utiilze exIstIn resources
and will continue to seek additional non-
federal resources for carryln6 out the objec-
tlves of the reglonai medical proSram.
(6) The 6eo6raphic diatributlon of grants
throu6hout the Nation.
0 54.407 TERMINATION.
(a) Terminatton bu the Burgeon General.
Any grant award may be revoked or termi-
nated by the Surgeon Generni In whole or
In part at any time whenever he finds that
in his judgment the srantee has falied in a
material respect to comply wlth requirements
of Title IX and the re6uiations of this sub-
part. The Brantee shall be promptly notliled
of such finding in writin and 6Iven the
reasons therefor.
(b) Termtnation bg the grantee. A
srantee may at any time terminate or cancel
Its conduct of an approved project by notify-
in6 the Surgeon General In wrItin settin
forth the reasons for such termination.
(c) Accounting.  Upon any termlnatlon,
the grantee shall account for all expenditures
and obligations char6ed to grant funds:
Provided, That to the extent the termination
is due in the judament of the Sur6eon Gen-
eral to no fault of the Grantee, credit shall
be allowed for the amount required to settle
at costs demonstrated by evidence satisfac-
tory to the Surseon General to be mlnlmum
settlement costs, any noncancellable obiiga-
tions incurred prior to receipt of notice of
termlnatlon.
O 54.408 NONDISCRIMINATION.
section 601 of Tftie VI of the CM1 Riehts
e- --
Act of 1964, 42 U.S.C. 2000d, provfdes that
no person in the United States shall, on the
6round of race, color, or natlonal origin, be
excluded from participation in, be denied the
benefits of, or be subjected to discrimlnatfon
under any program or activity receiving Fed-
eral financlai asslstance. Re~uiatlonx Impie-
mentin the statute have been issued as Part
80 of the Tltie 45, Code of Federal Reguin-
tlons. The re6lonni medical programs pro-
vide Federal flnancfai assistance subject to
the Civil RI6hts Act and the reguiatlons.
Each grant is subject to the condition that
the srantee shall comair with the reauire-
m-ents of Executive drier 11246, 30-F.R.
12319, and the appilcable rules, re6ulatious,
nnd procedures prescribed pursuant thereto.
O 54.409 EXPENDITURES
BY GRANTEE.
(a) Allocation of costs. The grantee
shall allocate expenditures a,s between di-
rect and indirect costs in accordance wvlth
peneraily accepted and establlshed account-
in6 practices or as otherwlse prescribed by
the Sur6eon General.
(b) Direct co8t8  fn general. Funds
pranted for direct costs may be expended by
the Brantee for personal services, rental of
space, materials, and supplies, and other
ltems of necessary cost as are required to
carry out the purposes of the grant. The
Surgeon General may issue rules, instruc-
tions, interpretations, or iimltatlons sup-
piementlng the re6uiations of this subpart
and prescribint the extent to which parti-
cular types of expenditures may be Charged
to grant funds.
(c) Direct CO8t8; personal scrcicee. The
costs of personal services are payable from
arant funds substantinliy in proportion to
the tlme or effort the individual devotes to
carryIn out the purpose of the grant. In
such proportion, such costs may include all
direct costs incident to such services, such
as salary durin6 vacations and retirement
and workmen's compensation Char6es, in ac-
cordance with the policies and accountin
practices conslstentiy applied by the 6rantee
to all Its activities.
(d) Direct COSt8; care of patients. The
cost of hospital, medlcai or other care of
patients is payable from 6rant funds only to
the extent that such care is incident to the
research, training. or demonstration activi-
ties supported by a grant hereunder. Such
care shall be incident to such activities only
If reasonably associated with and required
for the effective conduct of such activities,
and no such care shall be char6ed to such
funds unless the referral of the patient in
documented with respect to the name of the
practicIn6 physician making the referral,
the name of the patient, the date of referral.
and any other relevant information which
may be prescribed by the Surgeon General.
Grant funds shall not be charged with the
cost of-
(1) Care for intercurrent conditions (es-
cept of an emergency nature where the inter-
current condltlon results from the care for
which the patient was admitted for treat-
ment) that unduly interrupt, postpone, or
terminate the conduct of such activities.
(2) Inpatient care if other care which
would equally effectlreiy further the pur-
poses of the grant. could be provided at a
smaller cost.
(3) Bed and board for inpatients in excess
of the cost of semiprivate accommodutlons
unless required for the effective conduct of
such activities. For the purpose of this
para6raph,  "semiprivate accommodations"
means two-bed,  three-bed,  and four-bed
accommodations.
IJ 54.410 PAY1fENTS.
The Surgeon General shall, from time to
time, make payments to a 6rantee of ali or
a portion of any srant award, either in ad-
vance or by way of reimbursement for es-
penses to be incurred or incurred to the
extent he determines such payments neces-
sary to carry out the purposes of the 6mnt.
0 54.411 DIFFERENT USE OR
TRANSFDR : GOOD CAUSE
FOR OTHER USE.
(a) Compliance by granteee. If, at any
time, the Suraeon General determines that
the eii6ibility requirements for a program
nre no lon6er met, or that any facility or
equipment the construction or procurement
of which was charged to grant funds is, dur-
in6 its USefUi life, no lon6er bein used for
the purposes for which it was constructed
or procured either by the 6rantee or any
transferee, the Government shall have the
rl6ht to recover its proportionate share of
the value of the facility or equipment from
either the Frantee or the transferee or any
institution that is using the facility or
equipment. The Government's proportionate
shnre shall be the amount benrin6 the same
ratio to the then value of the facility or
equipment, as determined by the Surgeon
Generni. as the amount the Federal parlici-
patlon bore to the cost of constructlon or
procurement.
(b) Dinerent ase or transfer; notiffcation.
The grantee shall promptly notify the Sur-
6eon General in writIn if at any time during
Its useful life the facility or equipment for
construction or procurement of which 6rant
funds were char6ed is no ion6er to be used
for the purposes for which it was constructed
or procured  or is sold or otherwise
transferred.
Cc) Forgioenese.  The Surgeon General
mny for 6ood cause release the grantee or
other owner from the requirement of con-
`tinued eligibility or from the obli6ation of
continued use of the fncility or equipment
for the grant purposes. In determining
whether Good cnuse exists, the Surgeon Gen-
eral shall take into consideration, among
other factors, the extent to which-
(1) The facility or equipment will be de-
voted to research. training, demonstrations,
or other activities related to Title IS
diseases.
(2) The circumstances callin for n.
chan6e in the use of the facility were not
known, or with reasonable diilgence could
not have been known to the applicant, at the
time of the application, and are &cum-
stances reasonably beyond the control of thr
nppiicant or other owner.
(3) There are reasonable nssurnnccs that
other facilities not previously utliizeti for
Title IX purposes will he so utilized nnd nrgb
substantially the equivalent in rrnture nntl
extent for such purposes.
0 54.412 PUBLICATIONS.
Grantees may publish materials relating
to their reglonai medical program without
prior review provided that such publications
carry a foOtnOte SCknOwledging nSSiStancr
from the Public Health Service, and indi-
catin that findings and conclusions do not
represent the views of the Service.
IJ 54.413 COPYRIGHTS.
Where the 6rant-supported activity result?
in copyrl6htabie material, the nuthor Is frr
to copyright. but the Public Health Servh
reserves a royalty-free, nonexclusive. irrer,
cnbie license for use of such mntrrini.
0 54.414 INTEREST.
Interest or other income earned on pny-
menta under this subpart shall be paid to
the United States as such interest is received
by the prantee.

103
EXHJlm' XIV
Sclectcd Bibliography
I. Selected Historical Documents
and National Reports
Citizens Commission on Graduate Medi-
cal Education, The Graduate Education
of Physicians. Chicago, Illinois. Council
on Medical Education, American Medical
Association, 1966.
Coggeshall, Lowell T., Planning for Medi-
cal Progress Through Education. Evan-
ston, Illinois. Association of American
Medical Colleges, 1965.
Commission on Hospital Care, Hospital
Care in the United States. New York.
Commonwealth Fund, 1947.
Committee on the Costs of Medical Care,
Medical Care For the American People:
The Final Report (28). University of
Chicago Press, 1932.
ices. The Right Honorable Lord Dawson
Consultative Council on Medical and
Allied Services, Interim Report on Future
of Thames, Chairman. London, England,
Provisions on Medical and Allied Seru-
His Majesty's Stationery Office, 1920.
Council on Medical Education and Hos-
pitals, Money and Medical Schools.
Chicago, Illinois. American Medical As-
`fiation, Undated.
iyer, Bernard V., Study Director, Life-
: me Learning for Physicians: Principles,
Practices, Proposals. Joint Study in Con-
tinuing Medical Education, Journal of
Medical Education, Vol. 37, No. 6, Part
2. June, 1962.
Flcxner, Abraham, Medical Education in
the United States and Canada. A Report
to the Carnegie Foundation for the Ad-
vancement of Teaching. New York, 1910.
Kidd, C. V., American Universities and
Federal Research. Cambridge, Massa-
chusetts. Belknap Press of Harvard Uni-
versity Press, 1959.
Mountin, Joseph W., Pennell, Elliot H.,
and Hoge, Vane M., Health Service
Areas-Requirements for General Hospi-
tal and Health Centers. Public Health
Service Bulletin, No. 292. U.S. Govern-
ment Printing Office, Washington, D.C.,
1945.
Mountin, Joseph W. and Greve, Clifford
H., Public Health Areas and Hospital
Facilities. Public Health Service Bulletin
No. 42, U.S. Government Printing Office,
Washington, D.C., 1950.
National Commission on Community
Health Services, Health Is a Community
Aflair. Cambridge, Massachusetts, Har-
vard University Press, 1966.
fice, Washington, D.C., 1952.
President's Commission on the Health of
the Nation, Building America's Health :
A Report. U.S. Government Printing Of-
President's Commission on Heart Disease,
Cancer and Stroke, Report to the Presi-
dent: A National Program to Conquer
Heart Disease, Cancer and Stroke. Vol. 1.
U.S. Government Printing Office, Wash-
ington, D.C., December, 1964.
President's Commission on Heart Disease,
Cancer and Stroke, Report to the Presi-
dent: A National Program to Conquer
Heart Disease, Cancer and Stroke. Vol. 2.
U.S. Government Printing Office, Wash-
ington, D.C., February, 1965.
Price, D. K., Government and Science:
Their Dynamic Relation in American
Democracy. New York, New York Uni:
versity Press, 1954.
Price, D. K., The Scientific Estate. Cam-
bridge, Massachusetts. Belknap Press of
Harvard University Press, 1965.
Sheps, C. G., Wolf, G. A., Jr., and Jacob-
son, C., editors, Medical Education and
Medical Care-Interactions and Pros-
pects. Report to the Eighth Teaching In-
stitute, Association of American Medical
Colleges, Evanston, Illinois, 1961.
Somers, Herman M., and Somers, Anne
R., Doctors, Patients and Health Insur-
ance. Washington, D.C., The Brookings
Institution, 1961.
U.S. Congress, Senate Committee on
Appropriations, Federal Support of Medi-
cal Research. Report of the Committee of
Consultants on Medical Research to the
Subcommittee on the Departments of
Labor and Health, Education, and Wel-
fare; 86th Congress, 2nd Session. U.S.
Government Printing Office, Washington,
D.C., 1960.
-
II. Publications on
Regional Medical Programs
Battey, Louis, L., "Georgia Regional
Medical Program," Journal of the Medi-
cal Association of Georgia, Vol. 56, No.
4, p. 141-142. April, 1967.
Burgess, Alex M., Jr., Colton, Theodore,
Peterson, Osler L., "Categorical Programs
for Heart Disease, Cancer, and Stroke,"
The New England Journal of Medicine,
Vol. 273, No. 10. September 2, 1965.
Callahan, Barbara, "Those Regional
Medical Programs: Where the Action
Will Be," Hospital Progress, Vol. 47, p.
57-64. December, 1966.
Callahan, Barbara, "Regional Medical
Programs taking Giant Steps," Hospital
Progress, Vol. 48, No.,,~, p. 78-83. March,
1967.
Castle, C. Hilmon, "Regional Medical
Programs,"  Rocky Mountain Medical
Journal. January, 1967.
Clark, Henry T., Jr., "Shaping the Hos-
pital for its Future Role," Hospitals, Vol.
40, p. 49-53. February 1, 1966.
U.S. Department of Health, Educatim
and Welfare, The Advancement of Medi-
cal Research and Education. (Bayne-
Jones Report). U.S. Government Printing
Office, Washington, D.C., 1958.
U.S. Department of Health, Education,
and Welfare, Surgeon General's Consul-
tant Group on Medical Education, Phy-
sicians for a Growing America (Bane
Report). Public Health Service Publica-
tion No. 109. U.S. Government Printing
Office, Washington, D.C., 1959.
Clark, Henry T., Jr., "The Challenge of
the Regional Medical Programs Legisla-
tion," The Journal of Medical Education,
Vol. 41. April, 1966.
Clark, Henry T., Jr., "Regional Medical
Programs,"  Hospital Practice. March,
1967.
"Conference on Regional Medical Pro-
grams Examines Plans for Heart Disease,
Cancer and Stroke," The Modern Hos-
pital, Vol. 108, No. 2, p. 79-80. February,
1967.

104
"Continuing Medical Education-Does it
Matter?"  (Editorial), Journal of the
American Medical Association, Vol. 197,
No. 6, p. 505-506. August 8, 1966.
Dempsey, Edward W., "The Case for
Regional Medical Complexes," Medical
Opinion and Review. October, 1965.
Dodge, Harold T., "Regional Medical
Program for Heart, Cancer and Stroke,"
The Iournal of the Medical Association
of the State of Alabama, Vol. 36, No. 7.
January, 1967.
Ebbert, Arthur, Jr., "A Look at Public
Law 89-239: The Heart Disease, Cancer,
and Stroke Program," Connecticut Med-
icine, Vol. 30, No. 9, p. 8-16. June 21,
1965.
"Evolution or Revolution in American
Medicine," Modern Medicine, p. 8-16.
June 21, 1965.
"Get Together If You Want a Regional
Grant," The Modern Hospital, Vol. 107,
No. 2. August, 1966.
Guidelines for Regional Medical Pro-
grams, Division of Regional Medical Pro-
grams, National Institutes of Health, U.S.
Department of Health, Education and
Welfare. July 1, 1966.
Hill, Lister, "A Program to Combat Heart
Disease, Cancer and Stroke," The En-
quirer, Boonville, Indiana. November,
1965.
Hogness, John R., "The Northwest Hos-
pital," Bulletin of the New York Aca-
demy of Medicine, Vol. 43, No. 6, p. 495-
503. June, 1967.
Hudson, Charles L., "(P.L. 89-239) Re-
marks on Regional Medical Programs,"
Journal of the Medical Association of
Georgia, Vol. 56, No. 4, p. 154-155.
April, 1967.
Huston, Phillips,  "Do We Need Those
Regional Complexes?" Medical Econom-
ics. June 28, 1965.
"Innovative Plans for the Georgia Re-
gional Medical Programs," Journal of the
Medical Association of Georgia, Vol. 56,
No. 4, p. 149-151. April, 1967.
James, George, "Implications of the Heart
Disease, Cancer and Stroke Programs, an
Interpretation,"  Medical Opinion and
Review. October, 1966.
James, George, "Summation," Bulletin of
the New York Academy of Medicine, Vol.
43, No. 6, p. 522-524. June, 1967.
Jones, Frank W., "The Medical Society
and the Regional Medical Program in
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